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Service Code NDC 72241-024-05
Hospital Charge Code 1710871
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.10
Rate for Payer: Aetna of CA HMO/PPO $0.08
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.07
Rate for Payer: BCBS Transplant Transplant $0.07
Rate for Payer: Blue Shield of California Commercial $0.09
Rate for Payer: Blue Shield of California EPN $0.07
Rate for Payer: Cash Price $0.05
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: Dignity Health Commercial/Exchange $0.10
Rate for Payer: Dignity Health Media $0.10
Rate for Payer: Dignity Health Medi-Cal $0.10
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: EPIC Health Plan Transplant $0.05
Rate for Payer: Galaxy Health WC $0.10
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.09
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.10
Rate for Payer: Networks By Design Commercial $0.08
Rate for Payer: Prime Health Services Commercial $0.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.07
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.07
Rate for Payer: TriValley Medical Group Commercial/Senior $0.07
Rate for Payer: United Healthcare All Other Commercial $0.06
Rate for Payer: United Healthcare All Other HMO $0.06
Rate for Payer: United Healthcare HMO Rider $0.06
Rate for Payer: United Healthcare Select/Navigate/Core $0.06
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.10
Rate for Payer: Vantage Medical Group Medi-Cal $0.10
Rate for Payer: Vantage Medical Group Senior $0.10
Service Code NDC 60687-447-11
Hospital Charge Code 1710871
Hospital Revenue Code 259
Min. Negotiated Rate $0.58
Max. Negotiated Rate $2.07
Rate for Payer: Blue Shield of California Commercial $1.73
Rate for Payer: Blue Shield of California EPN $1.24
Rate for Payer: Cash Price $1.09
Rate for Payer: Cigna of CA HMO $1.70
Rate for Payer: Cigna of CA PPO $1.70
Rate for Payer: EPIC Health Plan Commercial $0.97
Rate for Payer: Galaxy Health WC $2.07
Rate for Payer: Global Benefits Group Commercial $1.46
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.93
Rate for Payer: LLUH Dept of Risk Management WC $0.58
Rate for Payer: Multiplan Commercial $1.94
Rate for Payer: Networks By Design Commercial $1.58
Rate for Payer: Prime Health Services Commercial $2.07
Service Code NDC 51079-215-20
Hospital Charge Code 1710871
Hospital Revenue Code 259
Min. Negotiated Rate $1.45
Max. Negotiated Rate $5.13
Rate for Payer: Blue Shield of California Commercial $4.30
Rate for Payer: Blue Shield of California EPN $3.09
Rate for Payer: Cash Price $2.72
Rate for Payer: Cigna of CA HMO $4.23
Rate for Payer: Cigna of CA PPO $4.23
Rate for Payer: EPIC Health Plan Commercial $2.42
Rate for Payer: Galaxy Health WC $5.13
Rate for Payer: Global Benefits Group Commercial $3.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $4.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.30
Rate for Payer: LLUH Dept of Risk Management WC $1.45
Rate for Payer: Multiplan Commercial $4.83
Rate for Payer: Networks By Design Commercial $3.93
Rate for Payer: Prime Health Services Commercial $5.13
Service Code NDC 62332-142-31
Hospital Charge Code 1710871
Hospital Revenue Code 259
Min. Negotiated Rate $0.17
Max. Negotiated Rate $0.61
Rate for Payer: Aetna of CA HMO/PPO $0.47
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.61
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.40
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.43
Rate for Payer: BCBS Transplant Transplant $0.43
Rate for Payer: Blue Shield of California Commercial $0.53
Rate for Payer: Blue Shield of California EPN $0.42
Rate for Payer: Cash Price $0.32
Rate for Payer: Cigna of CA HMO $0.50
Rate for Payer: Cigna of CA PPO $0.50
Rate for Payer: Dignity Health Commercial/Exchange $0.61
Rate for Payer: Dignity Health Media $0.61
Rate for Payer: Dignity Health Medi-Cal $0.61
Rate for Payer: EPIC Health Plan Commercial $0.29
Rate for Payer: EPIC Health Plan Transplant $0.29
Rate for Payer: Galaxy Health WC $0.61
Rate for Payer: Global Benefits Group Commercial $0.43
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.17
Rate for Payer: Multiplan Commercial $0.58
Rate for Payer: Networks By Design Commercial $0.47
Rate for Payer: Prime Health Services Commercial $0.61
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.43
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.43
Rate for Payer: TriValley Medical Group Commercial/Senior $0.43
Rate for Payer: United Healthcare All Other Commercial $0.36
Rate for Payer: United Healthcare All Other HMO $0.36
Rate for Payer: United Healthcare HMO Rider $0.36
Rate for Payer: United Healthcare Select/Navigate/Core $0.36
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.61
Rate for Payer: Vantage Medical Group Medi-Cal $0.61
Rate for Payer: Vantage Medical Group Senior $0.61
Service Code APR-DRG 3834
Min. Negotiated Rate $19,390.22
Max. Negotiated Rate $25,277.12
Rate for Payer: IEHP Medi-Cal $19,390.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal $25,277.12
Service Code APR-DRG 3833
Min. Negotiated Rate $10,614.08
Max. Negotiated Rate $13,836.54
Rate for Payer: IEHP Medi-Cal $10,614.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $13,836.54
Service Code APR-DRG 3831
Min. Negotiated Rate $5,205.01
Max. Negotiated Rate $6,785.26
Rate for Payer: IEHP Medi-Cal $5,205.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $6,785.26
Service Code APR-DRG 3832
Min. Negotiated Rate $7,134.10
Max. Negotiated Rate $9,300.02
Rate for Payer: IEHP Medi-Cal $7,134.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal $9,300.02
Service Code CPT J9119
Hospital Charge Code NDG222941
Hospital Revenue Code 636
Min. Negotiated Rate $403.28
Max. Negotiated Rate $1,428.27
Rate for Payer: Blue Shield of California Commercial $1,196.39
Rate for Payer: Blue Shield of California EPN $860.32
Rate for Payer: Cash Price $756.14
Rate for Payer: Cigna of CA HMO $1,176.22
Rate for Payer: Cigna of CA PPO $1,176.22
Rate for Payer: EPIC Health Plan Commercial $672.13
Rate for Payer: EPIC Health Plan Transplant $672.13
Rate for Payer: Galaxy Health WC $1,428.27
Rate for Payer: Global Benefits Group Commercial $1,008.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,120.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal $640.20
Rate for Payer: LLUH Dept of Risk Management WC $403.28
Rate for Payer: Multiplan Commercial $1,344.26
Rate for Payer: Networks By Design Commercial $840.16
Rate for Payer: Prime Health Services Commercial $1,428.27
Service Code CPT J9119
Hospital Charge Code NDG222941
Hospital Revenue Code 636
Min. Negotiated Rate $27.46
Max. Negotiated Rate $1,428.27
Rate for Payer: Aetna of CA HMO/PPO $54.09
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $34.33
Rate for Payer: AlphaCare Medical Group Medi-Cal $30.21
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $30.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $56.25
Rate for Payer: BCBS Transplant Transplant $1,008.19
Rate for Payer: Blue Shield of California Commercial $1,238.40
Rate for Payer: Blue Shield of California EPN $981.31
Rate for Payer: Cash Price $756.14
Rate for Payer: Cash Price $756.14
Rate for Payer: Cigna of CA HMO $1,176.22
Rate for Payer: Cigna of CA PPO $1,176.22
Rate for Payer: Dignity Health Commercial/Exchange $34.33
Rate for Payer: Dignity Health Media $30.21
Rate for Payer: Dignity Health Medi-Cal $30.21
Rate for Payer: EPIC Health Plan Commercial $37.07
Rate for Payer: EPIC Health Plan Medicare/Senior $27.46
Rate for Payer: EPIC Health Plan Transplant $27.46
Rate for Payer: Galaxy Health WC $1,428.27
Rate for Payer: Global Benefits Group Commercial $1,008.19
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,260.24
Rate for Payer: Heritage Provider Network Commercial $45.04
Rate for Payer: Heritage Provider Network Transplant $45.04
Rate for Payer: IEHP Medi-Cal $44.49
Rate for Payer: IEHP Medi-Cal Transplant $44.49
Rate for Payer: IEHP Medicare Advantage $27.46
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,120.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal $60.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $27.46
Rate for Payer: LLUH Dept of Risk Management WC $403.28
Rate for Payer: Molina Healthcare of CA Medi-Cal $34.60
Rate for Payer: Molina Healthcare of CA Medicare $36.80
Rate for Payer: Multiplan Commercial $1,344.26
Rate for Payer: Networks By Design Commercial $840.16
Rate for Payer: Prime Health Services Commercial $1,428.27
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1,008.19
Rate for Payer: TriValley Medical Group Commercial/Senior $1,008.19
Rate for Payer: United Healthcare All Other Commercial $840.16
Rate for Payer: United Healthcare All Other HMO $840.16
Rate for Payer: United Healthcare HMO Rider $840.16
Rate for Payer: United Healthcare Select/Navigate/Core $840.16
Rate for Payer: Vantage Medical Group Commercial/Exchange $34.33
Rate for Payer: Vantage Medical Group Medi-Cal $30.21
Rate for Payer: Vantage Medical Group Senior $30.21
Service Code NDC 0093-4175-73
Hospital Charge Code 1715596
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.20
Rate for Payer: Blue Shield of California Commercial $0.16
Rate for Payer: Blue Shield of California EPN $0.12
Rate for Payer: Cash Price $0.10
Rate for Payer: Cigna of CA HMO $0.16
Rate for Payer: Cigna of CA PPO $0.16
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.09
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.15
Rate for Payer: Prime Health Services Commercial $0.20
Service Code NDC 68180-440-01
Hospital Charge Code 1715596
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.20
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Aetna of CA HMO/PPO $0.15
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.13
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.14
Rate for Payer: BCBS Transplant Transplant $0.14
Rate for Payer: Blue Shield of California Commercial $0.17
Rate for Payer: Blue Shield of California EPN $0.13
Rate for Payer: Cash Price $0.10
Rate for Payer: Cigna of CA HMO $0.16
Rate for Payer: Cigna of CA PPO $0.16
Rate for Payer: Dignity Health Commercial/Exchange $0.20
Rate for Payer: Dignity Health Media $0.20
Rate for Payer: Dignity Health Medi-Cal $0.20
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: EPIC Health Plan Transplant $0.09
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.09
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.15
Rate for Payer: Prime Health Services Commercial $0.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.14
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.14
Rate for Payer: TriValley Medical Group Commercial/Senior $0.14
Rate for Payer: United Healthcare All Other Commercial $0.12
Rate for Payer: United Healthcare All Other HMO $0.12
Rate for Payer: United Healthcare HMO Rider $0.12
Rate for Payer: United Healthcare Select/Navigate/Core $0.12
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.20
Rate for Payer: Vantage Medical Group Medi-Cal $0.20
Rate for Payer: Vantage Medical Group Senior $0.20
Service Code NDC 67877-544-68
Hospital Charge Code NDG9501B
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.09
Rate for Payer: Blue Shield of California Commercial $0.07
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.05
Rate for Payer: Cigna of CA HMO $0.07
Rate for Payer: Cigna of CA PPO $0.07
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Galaxy Health WC $0.09
Rate for Payer: Global Benefits Group Commercial $0.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.08
Rate for Payer: Networks By Design Commercial $0.07
Rate for Payer: Prime Health Services Commercial $0.09
Service Code NDC 68180-440-01
Hospital Charge Code 1715596
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.20
Rate for Payer: Blue Shield of California Commercial $0.16
Rate for Payer: Blue Shield of California EPN $0.12
Rate for Payer: Cash Price $0.10
Rate for Payer: Cigna of CA HMO $0.16
Rate for Payer: Cigna of CA PPO $0.16
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.09
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.15
Rate for Payer: Prime Health Services Commercial $0.20
Service Code NDC 0093-4175-73
Hospital Charge Code 1715596
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.20
Rate for Payer: Aetna of CA HMO/PPO $0.15
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.13
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.14
Rate for Payer: BCBS Transplant Transplant $0.14
Rate for Payer: Blue Shield of California Commercial $0.17
Rate for Payer: Blue Shield of California EPN $0.13
Rate for Payer: Cash Price $0.10
Rate for Payer: Cigna of CA HMO $0.16
Rate for Payer: Cigna of CA PPO $0.16
Rate for Payer: Dignity Health Commercial/Exchange $0.20
Rate for Payer: Dignity Health Media $0.20
Rate for Payer: Dignity Health Medi-Cal $0.20
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: EPIC Health Plan Transplant $0.09
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.09
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.15
Rate for Payer: Prime Health Services Commercial $0.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.14
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.14
Rate for Payer: TriValley Medical Group Commercial/Senior $0.14
Rate for Payer: United Healthcare All Other Commercial $0.12
Rate for Payer: United Healthcare All Other HMO $0.12
Rate for Payer: United Healthcare HMO Rider $0.12
Rate for Payer: United Healthcare Select/Navigate/Core $0.12
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.20
Rate for Payer: Vantage Medical Group Medi-Cal $0.20
Rate for Payer: Vantage Medical Group Senior $0.20
Service Code NDC 67877-544-68
Hospital Charge Code NDG9501B
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.09
Rate for Payer: Aetna of CA HMO/PPO $0.07
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.06
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.06
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.06
Rate for Payer: BCBS Transplant Transplant $0.06
Rate for Payer: Blue Shield of California Commercial $0.07
Rate for Payer: Blue Shield of California EPN $0.06
Rate for Payer: Cash Price $0.05
Rate for Payer: Cigna of CA HMO $0.07
Rate for Payer: Cigna of CA PPO $0.07
Rate for Payer: Dignity Health Commercial/Exchange $0.09
Rate for Payer: Dignity Health Media $0.09
Rate for Payer: Dignity Health Medi-Cal $0.09
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: EPIC Health Plan Transplant $0.04
Rate for Payer: Galaxy Health WC $0.09
Rate for Payer: Global Benefits Group Commercial $0.06
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.08
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.08
Rate for Payer: Networks By Design Commercial $0.07
Rate for Payer: Prime Health Services Commercial $0.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.06
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.06
Rate for Payer: TriValley Medical Group Commercial/Senior $0.06
Rate for Payer: United Healthcare All Other Commercial $0.05
Rate for Payer: United Healthcare All Other HMO $0.05
Rate for Payer: United Healthcare HMO Rider $0.05
Rate for Payer: United Healthcare Select/Navigate/Core $0.05
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.09
Rate for Payer: Vantage Medical Group Medi-Cal $0.09
Rate for Payer: Vantage Medical Group Senior $0.09
Service Code NDC 0093-4177-74
Hospital Charge Code NDG9502
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.21
Rate for Payer: Aetna of CA HMO/PPO $0.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.14
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.14
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.15
Rate for Payer: BCBS Transplant Transplant $0.15
Rate for Payer: Blue Shield of California Commercial $0.18
Rate for Payer: Blue Shield of California EPN $0.15
Rate for Payer: Cash Price $0.11
Rate for Payer: Cigna of CA HMO $0.18
Rate for Payer: Cigna of CA PPO $0.18
Rate for Payer: Dignity Health Commercial/Exchange $0.21
Rate for Payer: Dignity Health Media $0.21
Rate for Payer: Dignity Health Medi-Cal $0.21
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: EPIC Health Plan Transplant $0.10
Rate for Payer: Galaxy Health WC $0.21
Rate for Payer: Global Benefits Group Commercial $0.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.20
Rate for Payer: Networks By Design Commercial $0.16
Rate for Payer: Prime Health Services Commercial $0.21
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.15
Rate for Payer: TriValley Medical Group Commercial/Senior $0.15
Rate for Payer: United Healthcare All Other Commercial $0.13
Rate for Payer: United Healthcare All Other HMO $0.13
Rate for Payer: United Healthcare HMO Rider $0.13
Rate for Payer: United Healthcare Select/Navigate/Core $0.13
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.21
Rate for Payer: Vantage Medical Group Medi-Cal $0.21
Rate for Payer: Vantage Medical Group Senior $0.21
Service Code NDC 0093-4177-74
Hospital Charge Code NDG9502
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.21
Rate for Payer: Blue Shield of California Commercial $0.18
Rate for Payer: Blue Shield of California EPN $0.13
Rate for Payer: Cash Price $0.11
Rate for Payer: Cigna of CA HMO $0.18
Rate for Payer: Cigna of CA PPO $0.18
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: Galaxy Health WC $0.21
Rate for Payer: Global Benefits Group Commercial $0.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.10
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.20
Rate for Payer: Networks By Design Commercial $0.16
Rate for Payer: Prime Health Services Commercial $0.21
Service Code NDC 0093-4177-73
Hospital Charge Code 1715604
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Aetna of CA HMO/PPO $0.18
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.24
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.17
Rate for Payer: BCBS Transplant Transplant $0.17
Rate for Payer: Blue Shield of California Commercial $0.21
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: Dignity Health Commercial/Exchange $0.24
Rate for Payer: Dignity Health Media $0.24
Rate for Payer: Dignity Health Medi-Cal $0.24
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: EPIC Health Plan Transplant $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.17
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.17
Rate for Payer: TriValley Medical Group Commercial/Senior $0.17
Rate for Payer: United Healthcare All Other Commercial $0.14
Rate for Payer: United Healthcare All Other HMO $0.14
Rate for Payer: United Healthcare HMO Rider $0.14
Rate for Payer: United Healthcare Select/Navigate/Core $0.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.24
Rate for Payer: Vantage Medical Group Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 67877-545-88
Hospital Charge Code 1715604
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.14
Rate for Payer: Aetna of CA HMO/PPO $0.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.10
Rate for Payer: BCBS Transplant Transplant $0.10
Rate for Payer: Blue Shield of California Commercial $0.12
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.07
Rate for Payer: Cigna of CA HMO $0.11
Rate for Payer: Cigna of CA PPO $0.11
Rate for Payer: Dignity Health Commercial/Exchange $0.14
Rate for Payer: Dignity Health Media $0.14
Rate for Payer: Dignity Health Medi-Cal $0.14
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: EPIC Health Plan Transplant $0.06
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.06
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.10
Rate for Payer: Prime Health Services Commercial $0.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.10
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.10
Rate for Payer: TriValley Medical Group Commercial/Senior $0.10
Rate for Payer: United Healthcare All Other Commercial $0.08
Rate for Payer: United Healthcare All Other HMO $0.08
Rate for Payer: United Healthcare HMO Rider $0.08
Rate for Payer: United Healthcare Select/Navigate/Core $0.08
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.14
Rate for Payer: Vantage Medical Group Medi-Cal $0.14
Rate for Payer: Vantage Medical Group Senior $0.14
Service Code NDC 67877-545-68
Hospital Charge Code NDG9502
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.14
Rate for Payer: Blue Shield of California Commercial $0.11
Rate for Payer: Blue Shield of California EPN $0.08
Rate for Payer: Cash Price $0.07
Rate for Payer: Cigna of CA HMO $0.11
Rate for Payer: Cigna of CA PPO $0.11
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.06
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.10
Rate for Payer: Prime Health Services Commercial $0.14
Service Code NDC 0093-4177-73
Hospital Charge Code 1715604
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Blue Shield of California Commercial $0.20
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Service Code NDC 67877-545-68
Hospital Charge Code NDG9502
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.14
Rate for Payer: Aetna of CA HMO/PPO $0.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.10
Rate for Payer: BCBS Transplant Transplant $0.10
Rate for Payer: Blue Shield of California Commercial $0.12
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.07
Rate for Payer: Cigna of CA HMO $0.11
Rate for Payer: Cigna of CA PPO $0.11
Rate for Payer: Dignity Health Commercial/Exchange $0.14
Rate for Payer: Dignity Health Media $0.14
Rate for Payer: Dignity Health Medi-Cal $0.14
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: EPIC Health Plan Transplant $0.06
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.06
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.10
Rate for Payer: Prime Health Services Commercial $0.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.10
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.10
Rate for Payer: TriValley Medical Group Commercial/Senior $0.10
Rate for Payer: United Healthcare All Other Commercial $0.08
Rate for Payer: United Healthcare All Other HMO $0.08
Rate for Payer: United Healthcare HMO Rider $0.08
Rate for Payer: United Healthcare Select/Navigate/Core $0.08
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.14
Rate for Payer: Vantage Medical Group Medi-Cal $0.14
Rate for Payer: Vantage Medical Group Senior $0.14
Service Code NDC 67877-545-88
Hospital Charge Code 1715604
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.14
Rate for Payer: Blue Shield of California Commercial $0.11
Rate for Payer: Blue Shield of California EPN $0.08
Rate for Payer: Cash Price $0.07
Rate for Payer: Cigna of CA HMO $0.11
Rate for Payer: Cigna of CA PPO $0.11
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.06
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.10
Rate for Payer: Prime Health Services Commercial $0.14
Service Code NDC 50268-151-11
Hospital Charge Code 1710149
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.41
Rate for Payer: Aetna of CA HMO/PPO $0.31
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.41
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.26
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.29
Rate for Payer: BCBS Transplant Transplant $0.29
Rate for Payer: Blue Shield of California Commercial $0.35
Rate for Payer: Blue Shield of California EPN $0.28
Rate for Payer: Cash Price $0.22
Rate for Payer: Cigna of CA HMO $0.34
Rate for Payer: Cigna of CA PPO $0.34
Rate for Payer: Dignity Health Commercial/Exchange $0.41
Rate for Payer: Dignity Health Media $0.41
Rate for Payer: Dignity Health Medi-Cal $0.41
Rate for Payer: EPIC Health Plan Commercial $0.19
Rate for Payer: EPIC Health Plan Transplant $0.19
Rate for Payer: Galaxy Health WC $0.41
Rate for Payer: Global Benefits Group Commercial $0.29
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.36
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.18
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.38
Rate for Payer: Networks By Design Commercial $0.31
Rate for Payer: Prime Health Services Commercial $0.41
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.29
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.29
Rate for Payer: TriValley Medical Group Commercial/Senior $0.29
Rate for Payer: United Healthcare All Other Commercial $0.24
Rate for Payer: United Healthcare All Other HMO $0.24
Rate for Payer: United Healthcare HMO Rider $0.24
Rate for Payer: United Healthcare Select/Navigate/Core $0.24
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.41
Rate for Payer: Vantage Medical Group Medi-Cal $0.41
Rate for Payer: Vantage Medical Group Senior $0.41