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Charge Type Price  
Service Code CPT 31623
Hospital Charge Code 900803501
Hospital Revenue Code 361
Min. Negotiated Rate $1,129.92
Max. Negotiated Rate $4,001.80
Rate for Payer: Cash Price $2,118.60
Rate for Payer: EPIC Health Plan Commercial $1,883.20
Rate for Payer: Galaxy Health WC $4,001.80
Rate for Payer: Global Benefits Group Commercial $2,824.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,140.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,793.75
Rate for Payer: LLUH Dept of Risk Management WC $1,129.92
Rate for Payer: Multiplan Commercial $3,766.40
Rate for Payer: Networks By Design Commercial $3,060.20
Rate for Payer: Prime Health Services Commercial $4,001.80
Service Code CPT 31525
Hospital Charge Code 900803512
Hospital Revenue Code 450
Min. Negotiated Rate $2,455.44
Max. Negotiated Rate $8,696.35
Rate for Payer: Cash Price $4,603.95
Rate for Payer: EPIC Health Plan Commercial $4,092.40
Rate for Payer: Galaxy Health WC $8,696.35
Rate for Payer: Global Benefits Group Commercial $6,138.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,824.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3,898.01
Rate for Payer: LLUH Dept of Risk Management WC $2,455.44
Rate for Payer: Multiplan Commercial $8,184.80
Rate for Payer: Networks By Design Commercial $6,650.15
Rate for Payer: Prime Health Services Commercial $8,696.35
Service Code CPT 31525
Hospital Charge Code 900803512
Hospital Revenue Code 410
Min. Negotiated Rate $2,455.44
Max. Negotiated Rate $8,696.35
Rate for Payer: Cash Price $4,603.95
Rate for Payer: EPIC Health Plan Commercial $4,092.40
Rate for Payer: Galaxy Health WC $8,696.35
Rate for Payer: Global Benefits Group Commercial $6,138.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,824.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3,898.01
Rate for Payer: LLUH Dept of Risk Management WC $2,455.44
Rate for Payer: Multiplan Commercial $8,184.80
Rate for Payer: Networks By Design Commercial $6,650.15
Rate for Payer: Prime Health Services Commercial $8,696.35
Service Code CPT 31525
Hospital Charge Code 900803512
Hospital Revenue Code 410
Min. Negotiated Rate $293.00
Max. Negotiated Rate $8,696.35
Rate for Payer: Aetna of CA HMO/PPO $7,385.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3,180.93
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,332.68
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,120.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,984.00
Rate for Payer: BCBS Transplant Transplant $6,138.60
Rate for Payer: Blue Shield of California Commercial $407.00
Rate for Payer: Blue Shield of California EPN $293.00
Rate for Payer: Cash Price $4,603.95
Rate for Payer: Cash Price $4,603.95
Rate for Payer: Cash Price $4,603.95
Rate for Payer: Cigna of CA HMO $6,547.84
Rate for Payer: Cigna of CA PPO $7,570.94
Rate for Payer: Dignity Health Commercial/Exchange $3,180.93
Rate for Payer: Dignity Health Media $2,120.62
Rate for Payer: Dignity Health Medi-Cal $2,332.68
Rate for Payer: EPIC Health Plan Commercial $2,862.84
Rate for Payer: EPIC Health Plan Medicare/Senior $2,120.62
Rate for Payer: EPIC Health Plan Transplant $2,120.62
Rate for Payer: Galaxy Health WC $8,696.35
Rate for Payer: Global Benefits Group Commercial $6,138.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $7,673.25
Rate for Payer: Heritage Provider Network Commercial $3,477.82
Rate for Payer: Heritage Provider Network Transplant $3,477.82
Rate for Payer: IEHP Medi-Cal $3,435.40
Rate for Payer: IEHP Medi-Cal Transplant $3,435.40
Rate for Payer: IEHP Medicare Advantage $2,120.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,824.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $320.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $2,120.62
Rate for Payer: LLUH Dept of Risk Management WC $2,455.44
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,671.98
Rate for Payer: Molina Healthcare of CA Medicare $2,841.63
Rate for Payer: Multiplan Commercial $8,184.80
Rate for Payer: Networks By Design Commercial $6,650.15
Rate for Payer: Prime Health Services Commercial $8,696.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $6,138.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $6,138.60
Rate for Payer: TriValley Medical Group Commercial/Senior $6,138.60
Rate for Payer: United Healthcare All Other Commercial $509.00
Rate for Payer: United Healthcare All Other HMO $478.00
Rate for Payer: United Healthcare HMO Rider $428.00
Rate for Payer: United Healthcare Select/Navigate/Core $391.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $3,180.93
Rate for Payer: Vantage Medical Group Medi-Cal $2,332.68
Rate for Payer: Vantage Medical Group Senior $2,120.62
Service Code CPT 31525
Hospital Charge Code 900803512
Hospital Revenue Code 450
Min. Negotiated Rate $320.44
Max. Negotiated Rate $8,696.35
Rate for Payer: Aetna of CA HMO/PPO $7,385.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3,180.93
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,332.68
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,120.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,984.00
Rate for Payer: BCBS Transplant Transplant $6,138.60
Rate for Payer: Cash Price $4,603.95
Rate for Payer: Cash Price $4,603.95
Rate for Payer: Cash Price $4,603.95
Rate for Payer: Cigna of CA PPO $7,570.94
Rate for Payer: Dignity Health Commercial/Exchange $3,180.93
Rate for Payer: Dignity Health Media $2,120.62
Rate for Payer: Dignity Health Medi-Cal $2,332.68
Rate for Payer: EPIC Health Plan Commercial $2,862.84
Rate for Payer: EPIC Health Plan Medicare/Senior $2,120.62
Rate for Payer: EPIC Health Plan Transplant $2,120.62
Rate for Payer: Galaxy Health WC $8,696.35
Rate for Payer: Global Benefits Group Commercial $6,138.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $7,673.25
Rate for Payer: Heritage Provider Network Commercial $3,477.82
Rate for Payer: Heritage Provider Network Transplant $3,477.82
Rate for Payer: IEHP Medi-Cal $936.00
Rate for Payer: IEHP Medi-Cal Transplant $936.00
Rate for Payer: IEHP Medicare Advantage $2,120.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,824.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $320.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $2,120.62
Rate for Payer: LLUH Dept of Risk Management WC $2,455.44
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,671.98
Rate for Payer: Molina Healthcare of CA Medicare $2,841.63
Rate for Payer: Multiplan Commercial $8,184.80
Rate for Payer: Networks By Design Commercial $6,650.15
Rate for Payer: Prime Health Services Commercial $8,696.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $6,138.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $6,138.60
Rate for Payer: United Healthcare All Other Commercial $5,115.50
Rate for Payer: United Healthcare All Other HMO $5,115.50
Rate for Payer: United Healthcare HMO Rider $5,115.50
Rate for Payer: United Healthcare Select/Navigate/Core $5,115.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $3,180.93
Rate for Payer: Vantage Medical Group Medi-Cal $2,332.68
Rate for Payer: Vantage Medical Group Senior $2,120.62
Service Code CPT 31526
Hospital Charge Code 900501508
Hospital Revenue Code 361
Min. Negotiated Rate $262.43
Max. Negotiated Rate $8,626.65
Rate for Payer: Aetna of CA HMO/PPO $7,385.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3,180.93
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,332.68
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,120.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $5,938.00
Rate for Payer: BCBS Transplant Transplant $6,089.40
Rate for Payer: Blue Shield of California Commercial $3,612.31
Rate for Payer: Blue Shield of California EPN $2,351.09
Rate for Payer: Cash Price $4,567.05
Rate for Payer: Cash Price $4,567.05
Rate for Payer: Cigna of CA PPO $7,510.26
Rate for Payer: Dignity Health Commercial/Exchange $3,180.93
Rate for Payer: Dignity Health Media $2,120.62
Rate for Payer: Dignity Health Medi-Cal $2,332.68
Rate for Payer: EPIC Health Plan Commercial $2,862.84
Rate for Payer: EPIC Health Plan Medicare/Senior $2,120.62
Rate for Payer: EPIC Health Plan Transplant $2,120.62
Rate for Payer: Galaxy Health WC $8,626.65
Rate for Payer: Global Benefits Group Commercial $6,089.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $7,611.75
Rate for Payer: Heritage Provider Network Commercial $3,477.82
Rate for Payer: Heritage Provider Network Transplant $3,477.82
Rate for Payer: IEHP Medi-Cal $3,435.40
Rate for Payer: IEHP Medi-Cal Transplant $3,435.40
Rate for Payer: IEHP Medicare Advantage $2,120.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,769.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $262.43
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $2,120.62
Rate for Payer: LLUH Dept of Risk Management WC $2,435.76
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,671.98
Rate for Payer: Molina Healthcare of CA Medicare $2,841.63
Rate for Payer: Multiplan Commercial $8,119.20
Rate for Payer: Networks By Design Commercial $6,596.85
Rate for Payer: Prime Health Services Commercial $8,626.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $6,089.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $6,089.40
Rate for Payer: United Healthcare All Other Commercial $5,893.00
Rate for Payer: United Healthcare All Other HMO $7,027.00
Rate for Payer: United Healthcare HMO Rider $4,217.00
Rate for Payer: United Healthcare Select/Navigate/Core $3,918.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $3,180.93
Rate for Payer: Vantage Medical Group Medi-Cal $2,332.68
Rate for Payer: Vantage Medical Group Senior $2,120.62
Service Code CPT 31526
Hospital Charge Code 900501508
Hospital Revenue Code 450
Min. Negotiated Rate $2,435.76
Max. Negotiated Rate $8,626.65
Rate for Payer: Cash Price $4,567.05
Rate for Payer: EPIC Health Plan Commercial $4,059.60
Rate for Payer: Galaxy Health WC $8,626.65
Rate for Payer: Global Benefits Group Commercial $6,089.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,769.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3,866.77
Rate for Payer: LLUH Dept of Risk Management WC $2,435.76
Rate for Payer: Multiplan Commercial $8,119.20
Rate for Payer: Networks By Design Commercial $6,596.85
Rate for Payer: Prime Health Services Commercial $8,626.65
Service Code CPT 31526
Hospital Charge Code 900501508
Hospital Revenue Code 361
Min. Negotiated Rate $2,435.76
Max. Negotiated Rate $8,626.65
Rate for Payer: Cash Price $4,567.05
Rate for Payer: EPIC Health Plan Commercial $4,059.60
Rate for Payer: Galaxy Health WC $8,626.65
Rate for Payer: Global Benefits Group Commercial $6,089.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,769.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3,866.77
Rate for Payer: LLUH Dept of Risk Management WC $2,435.76
Rate for Payer: Multiplan Commercial $8,119.20
Rate for Payer: Networks By Design Commercial $6,596.85
Rate for Payer: Prime Health Services Commercial $8,626.65
Service Code CPT 31526
Hospital Charge Code 900501508
Hospital Revenue Code 450
Min. Negotiated Rate $262.43
Max. Negotiated Rate $8,626.65
Rate for Payer: Aetna of CA HMO/PPO $7,385.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3,180.93
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,332.68
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,120.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $5,938.00
Rate for Payer: BCBS Transplant Transplant $6,089.40
Rate for Payer: Cash Price $4,567.05
Rate for Payer: Cash Price $4,567.05
Rate for Payer: Cash Price $4,567.05
Rate for Payer: Cigna of CA PPO $7,510.26
Rate for Payer: Dignity Health Commercial/Exchange $3,180.93
Rate for Payer: Dignity Health Media $2,120.62
Rate for Payer: Dignity Health Medi-Cal $2,332.68
Rate for Payer: EPIC Health Plan Commercial $2,862.84
Rate for Payer: EPIC Health Plan Medicare/Senior $2,120.62
Rate for Payer: EPIC Health Plan Transplant $2,120.62
Rate for Payer: Galaxy Health WC $8,626.65
Rate for Payer: Global Benefits Group Commercial $6,089.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $7,611.75
Rate for Payer: Heritage Provider Network Commercial $3,477.82
Rate for Payer: Heritage Provider Network Transplant $3,477.82
Rate for Payer: IEHP Medi-Cal $936.00
Rate for Payer: IEHP Medi-Cal Transplant $936.00
Rate for Payer: IEHP Medicare Advantage $2,120.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,769.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal $262.43
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $2,120.62
Rate for Payer: LLUH Dept of Risk Management WC $2,435.76
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,671.98
Rate for Payer: Molina Healthcare of CA Medicare $2,841.63
Rate for Payer: Multiplan Commercial $8,119.20
Rate for Payer: Networks By Design Commercial $6,596.85
Rate for Payer: Prime Health Services Commercial $8,626.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $6,089.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $6,089.40
Rate for Payer: United Healthcare All Other Commercial $5,074.50
Rate for Payer: United Healthcare All Other HMO $5,074.50
Rate for Payer: United Healthcare HMO Rider $5,074.50
Rate for Payer: United Healthcare Select/Navigate/Core $5,074.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $3,180.93
Rate for Payer: Vantage Medical Group Medi-Cal $2,332.68
Rate for Payer: Vantage Medical Group Senior $2,120.62
Service Code CPT 36909
Hospital Charge Code 909036909
Hospital Revenue Code 361
Min. Negotiated Rate $2,046.48
Max. Negotiated Rate $7,247.95
Rate for Payer: Cash Price $3,837.15
Rate for Payer: EPIC Health Plan Commercial $3,410.80
Rate for Payer: Galaxy Health WC $7,247.95
Rate for Payer: Global Benefits Group Commercial $5,116.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $5,687.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3,248.79
Rate for Payer: LLUH Dept of Risk Management WC $2,046.48
Rate for Payer: Multiplan Commercial $6,821.60
Rate for Payer: Networks By Design Commercial $5,542.55
Rate for Payer: Prime Health Services Commercial $7,247.95
Service Code CPT 36909
Hospital Charge Code 909036909
Hospital Revenue Code 361
Min. Negotiated Rate $951.00
Max. Negotiated Rate $7,247.95
Rate for Payer: Aetna of CA HMO/PPO $3,429.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $7,247.95
Rate for Payer: AlphaCare Medical Group Medi-Cal $4,689.85
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $4,689.85
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $5,938.00
Rate for Payer: BCBS Transplant Transplant $5,116.20
Rate for Payer: Blue Shield of California Commercial $5,104.87
Rate for Payer: Blue Shield of California EPN $3,322.54
Rate for Payer: Cash Price $3,837.15
Rate for Payer: Cash Price $3,837.15
Rate for Payer: Cigna of CA PPO $6,309.98
Rate for Payer: Dignity Health Commercial/Exchange $7,247.95
Rate for Payer: Dignity Health Media $7,247.95
Rate for Payer: Dignity Health Medi-Cal $7,247.95
Rate for Payer: EPIC Health Plan Commercial $3,410.80
Rate for Payer: EPIC Health Plan Transplant $3,410.80
Rate for Payer: Galaxy Health WC $7,247.95
Rate for Payer: Global Benefits Group Commercial $5,116.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $6,395.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $5,687.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $3,431.46
Rate for Payer: LLUH Dept of Risk Management WC $2,046.48
Rate for Payer: Multiplan Commercial $6,821.60
Rate for Payer: Networks By Design Commercial $5,542.55
Rate for Payer: Prime Health Services Commercial $7,247.95
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $5,116.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $5,116.20
Rate for Payer: United Healthcare All Other Commercial $1,834.00
Rate for Payer: United Healthcare All Other HMO $1,517.00
Rate for Payer: United Healthcare HMO Rider $1,041.00
Rate for Payer: United Healthcare Select/Navigate/Core $951.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $7,247.95
Rate for Payer: Vantage Medical Group Medi-Cal $7,247.95
Rate for Payer: Vantage Medical Group Senior $7,247.95
Service Code CPT 96375
Hospital Charge Code 946100112
Hospital Revenue Code 361
Min. Negotiated Rate $40.45
Max. Negotiated Rate $6,668.88
Rate for Payer: Aetna of CA HMO/PPO $154.48
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $89.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $65.28
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $59.35
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $914.00
Rate for Payer: BCBS Transplant Transplant $316.20
Rate for Payer: Blue Shield of California Commercial $6,668.88
Rate for Payer: Blue Shield of California EPN $4,340.48
Rate for Payer: Cash Price $237.15
Rate for Payer: Cash Price $237.15
Rate for Payer: Cash Price $237.15
Rate for Payer: Cigna of CA PPO $389.98
Rate for Payer: Dignity Health Commercial/Exchange $89.02
Rate for Payer: Dignity Health Media $59.35
Rate for Payer: Dignity Health Medi-Cal $65.28
Rate for Payer: EPIC Health Plan Commercial $80.12
Rate for Payer: EPIC Health Plan Medicare/Senior $59.35
Rate for Payer: EPIC Health Plan Transplant $59.35
Rate for Payer: Galaxy Health WC $447.95
Rate for Payer: Global Benefits Group Commercial $316.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $395.25
Rate for Payer: Heritage Provider Network Commercial $97.33
Rate for Payer: Heritage Provider Network Transplant $97.33
Rate for Payer: IEHP Medi-Cal $96.15
Rate for Payer: IEHP Medi-Cal Transplant $96.15
Rate for Payer: IEHP Medicare Advantage $59.35
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $351.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $40.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $59.35
Rate for Payer: LLUH Dept of Risk Management WC $126.48
Rate for Payer: Molina Healthcare of CA Medi-Cal $74.78
Rate for Payer: Molina Healthcare of CA Medicare $79.53
Rate for Payer: Multiplan Commercial $421.60
Rate for Payer: Networks By Design Commercial $342.55
Rate for Payer: Prime Health Services Commercial $447.95
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $316.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $316.20
Rate for Payer: United Healthcare All Other Commercial $263.50
Rate for Payer: United Healthcare All Other HMO $263.50
Rate for Payer: United Healthcare HMO Rider $263.50
Rate for Payer: United Healthcare Select/Navigate/Core $263.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $89.02
Rate for Payer: Vantage Medical Group Medi-Cal $65.28
Rate for Payer: Vantage Medical Group Senior $59.35
Service Code CPT 96375
Hospital Charge Code 946100112
Hospital Revenue Code 361
Min. Negotiated Rate $126.48
Max. Negotiated Rate $447.95
Rate for Payer: Cash Price $237.15
Rate for Payer: EPIC Health Plan Commercial $210.80
Rate for Payer: Galaxy Health WC $447.95
Rate for Payer: Global Benefits Group Commercial $316.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $351.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $200.79
Rate for Payer: LLUH Dept of Risk Management WC $126.48
Rate for Payer: Multiplan Commercial $421.60
Rate for Payer: Networks By Design Commercial $342.55
Rate for Payer: Prime Health Services Commercial $447.95
Service Code CPT 90945
Hospital Charge Code 944000100
Hospital Revenue Code 804
Min. Negotiated Rate $255.36
Max. Negotiated Rate $904.40
Rate for Payer: Cash Price $478.80
Rate for Payer: EPIC Health Plan Commercial $425.60
Rate for Payer: Galaxy Health WC $904.40
Rate for Payer: Global Benefits Group Commercial $638.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $709.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal $405.38
Rate for Payer: LLUH Dept of Risk Management WC $255.36
Rate for Payer: Multiplan Commercial $851.20
Rate for Payer: Networks By Design Commercial $691.60
Rate for Payer: Prime Health Services Commercial $904.40
Service Code CPT 90945
Hospital Charge Code 944000100
Hospital Revenue Code 804
Min. Negotiated Rate $137.10
Max. Negotiated Rate $907.56
Rate for Payer: Aetna of CA HMO/PPO $539.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $830.08
Rate for Payer: AlphaCare Medical Group Medi-Cal $608.73
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $553.39
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $633.93
Rate for Payer: BCBS Transplant Transplant $638.40
Rate for Payer: Blue Shield of California Commercial $784.17
Rate for Payer: Blue Shield of California EPN $621.38
Rate for Payer: Cash Price $478.80
Rate for Payer: Cash Price $478.80
Rate for Payer: Cigna of CA HMO $680.96
Rate for Payer: Cigna of CA PPO $787.36
Rate for Payer: Dignity Health Commercial/Exchange $830.08
Rate for Payer: Dignity Health Media $553.39
Rate for Payer: Dignity Health Medi-Cal $608.73
Rate for Payer: EPIC Health Plan Commercial $747.08
Rate for Payer: EPIC Health Plan Medicare/Senior $553.39
Rate for Payer: EPIC Health Plan Transplant $553.39
Rate for Payer: Galaxy Health WC $904.40
Rate for Payer: Global Benefits Group Commercial $638.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $798.00
Rate for Payer: Heritage Provider Network Commercial $907.56
Rate for Payer: Heritage Provider Network Transplant $907.56
Rate for Payer: IEHP Medi-Cal $896.49
Rate for Payer: IEHP Medi-Cal Transplant $896.49
Rate for Payer: IEHP Medicare Advantage $553.39
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $709.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal $137.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $553.39
Rate for Payer: LLUH Dept of Risk Management WC $255.36
Rate for Payer: Molina Healthcare of CA Medi-Cal $697.27
Rate for Payer: Molina Healthcare of CA Medicare $741.54
Rate for Payer: Multiplan Commercial $851.20
Rate for Payer: Networks By Design Commercial $691.60
Rate for Payer: Prime Health Services Commercial $904.40
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $638.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $638.40
Rate for Payer: TriValley Medical Group Commercial/Senior $638.40
Rate for Payer: United Healthcare All Other Commercial $532.00
Rate for Payer: United Healthcare All Other HMO $532.00
Rate for Payer: United Healthcare HMO Rider $532.00
Rate for Payer: United Healthcare Select/Navigate/Core $532.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $830.08
Rate for Payer: Vantage Medical Group Medi-Cal $608.73
Rate for Payer: Vantage Medical Group Senior $553.39
Service Code CPT 90947
Hospital Charge Code 988190947
Hospital Revenue Code 804
Min. Negotiated Rate $80.40
Max. Negotiated Rate $284.75
Rate for Payer: Cash Price $150.75
Rate for Payer: EPIC Health Plan Commercial $134.00
Rate for Payer: Galaxy Health WC $284.75
Rate for Payer: Global Benefits Group Commercial $201.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $223.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal $127.64
Rate for Payer: LLUH Dept of Risk Management WC $80.40
Rate for Payer: Multiplan Commercial $268.00
Rate for Payer: Networks By Design Commercial $217.75
Rate for Payer: Prime Health Services Commercial $284.75
Service Code CPT 90947
Hospital Charge Code 988190947
Hospital Revenue Code 804
Min. Negotiated Rate $80.40
Max. Negotiated Rate $810.77
Rate for Payer: Aetna of CA HMO/PPO $810.77
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $284.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $184.25
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $184.25
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $199.59
Rate for Payer: BCBS Transplant Transplant $201.00
Rate for Payer: Blue Shield of California Commercial $246.90
Rate for Payer: Blue Shield of California EPN $195.64
Rate for Payer: Cash Price $150.75
Rate for Payer: Cash Price $150.75
Rate for Payer: Cigna of CA HMO $214.40
Rate for Payer: Cigna of CA PPO $247.90
Rate for Payer: Dignity Health Commercial/Exchange $284.75
Rate for Payer: Dignity Health Media $284.75
Rate for Payer: Dignity Health Medi-Cal $284.75
Rate for Payer: EPIC Health Plan Commercial $134.00
Rate for Payer: EPIC Health Plan Transplant $134.00
Rate for Payer: Galaxy Health WC $284.75
Rate for Payer: Global Benefits Group Commercial $201.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $251.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $223.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal $205.66
Rate for Payer: LLUH Dept of Risk Management WC $80.40
Rate for Payer: Multiplan Commercial $268.00
Rate for Payer: Networks By Design Commercial $217.75
Rate for Payer: Prime Health Services Commercial $284.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $201.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $201.00
Rate for Payer: TriValley Medical Group Commercial/Senior $201.00
Rate for Payer: United Healthcare All Other Commercial $167.50
Rate for Payer: United Healthcare All Other HMO $167.50
Rate for Payer: United Healthcare HMO Rider $167.50
Rate for Payer: United Healthcare Select/Navigate/Core $167.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $284.75
Rate for Payer: Vantage Medical Group Medi-Cal $284.75
Rate for Payer: Vantage Medical Group Senior $284.75
Hospital Charge Code 906601319
Hospital Revenue Code 402
Min. Negotiated Rate $176.16
Max. Negotiated Rate $623.90
Rate for Payer: Aetna of CA HMO/PPO $481.43
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $623.90
Rate for Payer: AlphaCare Medical Group Medi-Cal $403.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $403.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $437.32
Rate for Payer: BCBS Transplant Transplant $440.40
Rate for Payer: Blue Shield of California Commercial $433.79
Rate for Payer: Blue Shield of California EPN $344.25
Rate for Payer: Cash Price $330.30
Rate for Payer: Cigna of CA HMO $469.76
Rate for Payer: Cigna of CA PPO $543.16
Rate for Payer: Dignity Health Commercial/Exchange $623.90
Rate for Payer: Dignity Health Media $623.90
Rate for Payer: Dignity Health Medi-Cal $623.90
Rate for Payer: EPIC Health Plan Commercial $293.60
Rate for Payer: EPIC Health Plan Transplant $293.60
Rate for Payer: Galaxy Health WC $623.90
Rate for Payer: Global Benefits Group Commercial $440.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $550.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $489.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal $279.65
Rate for Payer: LLUH Dept of Risk Management WC $176.16
Rate for Payer: Multiplan Commercial $587.20
Rate for Payer: Networks By Design Commercial $477.10
Rate for Payer: Prime Health Services Commercial $623.90
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $440.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $440.40
Rate for Payer: TriValley Medical Group Commercial/Senior $440.40
Rate for Payer: United Healthcare All Other Commercial $367.00
Rate for Payer: United Healthcare All Other HMO $367.00
Rate for Payer: United Healthcare HMO Rider $367.00
Rate for Payer: United Healthcare Select/Navigate/Core $367.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $623.90
Rate for Payer: Vantage Medical Group Medi-Cal $623.90
Rate for Payer: Vantage Medical Group Senior $623.90
Hospital Charge Code 906601319
Hospital Revenue Code 402
Min. Negotiated Rate $176.16
Max. Negotiated Rate $623.90
Rate for Payer: Cash Price $330.30
Rate for Payer: EPIC Health Plan Commercial $293.60
Rate for Payer: Galaxy Health WC $623.90
Rate for Payer: Global Benefits Group Commercial $440.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $489.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal $279.65
Rate for Payer: LLUH Dept of Risk Management WC $176.16
Rate for Payer: Multiplan Commercial $587.20
Rate for Payer: Networks By Design Commercial $477.10
Rate for Payer: Prime Health Services Commercial $623.90
Service Code CPT 57170
Hospital Charge Code 910400024
Hospital Revenue Code 510
Min. Negotiated Rate $72.20
Max. Negotiated Rate $413.10
Rate for Payer: Aetna of CA HMO/PPO $293.24
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $373.46
Rate for Payer: AlphaCare Medical Group Medi-Cal $273.87
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $248.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $289.56
Rate for Payer: BCBS Transplant Transplant $291.60
Rate for Payer: Blue Shield of California Commercial $358.18
Rate for Payer: Blue Shield of California EPN $283.82
Rate for Payer: Cash Price $218.70
Rate for Payer: Cash Price $218.70
Rate for Payer: Cigna of CA HMO $311.04
Rate for Payer: Cigna of CA PPO $359.64
Rate for Payer: Dignity Health Commercial/Exchange $373.46
Rate for Payer: Dignity Health Media $248.97
Rate for Payer: Dignity Health Medi-Cal $273.87
Rate for Payer: EPIC Health Plan Commercial $336.11
Rate for Payer: EPIC Health Plan Medicare/Senior $248.97
Rate for Payer: EPIC Health Plan Transplant $248.97
Rate for Payer: Galaxy Health WC $413.10
Rate for Payer: Global Benefits Group Commercial $291.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $364.50
Rate for Payer: Heritage Provider Network Commercial $408.31
Rate for Payer: Heritage Provider Network Transplant $408.31
Rate for Payer: IEHP Medi-Cal $403.33
Rate for Payer: IEHP Medi-Cal Transplant $403.33
Rate for Payer: IEHP Medicare Advantage $248.97
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $324.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal $72.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $248.97
Rate for Payer: LLUH Dept of Risk Management WC $116.64
Rate for Payer: Molina Healthcare of CA Medi-Cal $313.70
Rate for Payer: Molina Healthcare of CA Medicare $333.62
Rate for Payer: Multiplan Commercial $388.80
Rate for Payer: Networks By Design Commercial $315.90
Rate for Payer: Prime Health Services Commercial $413.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $291.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $291.60
Rate for Payer: TriValley Medical Group Commercial/Senior $291.60
Rate for Payer: United Healthcare All Other Commercial $243.00
Rate for Payer: United Healthcare All Other HMO $243.00
Rate for Payer: United Healthcare HMO Rider $243.00
Rate for Payer: United Healthcare Select/Navigate/Core $243.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $373.46
Rate for Payer: Vantage Medical Group Medi-Cal $273.87
Rate for Payer: Vantage Medical Group Senior $248.97
Service Code CPT 57170
Hospital Charge Code 910400024
Hospital Revenue Code 510
Min. Negotiated Rate $116.64
Max. Negotiated Rate $413.10
Rate for Payer: Cash Price $218.70
Rate for Payer: EPIC Health Plan Commercial $194.40
Rate for Payer: Galaxy Health WC $413.10
Rate for Payer: Global Benefits Group Commercial $291.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $324.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal $185.17
Rate for Payer: LLUH Dept of Risk Management WC $116.64
Rate for Payer: Multiplan Commercial $388.80
Rate for Payer: Networks By Design Commercial $315.90
Rate for Payer: Prime Health Services Commercial $413.10
Hospital Charge Code 908600157
Hospital Revenue Code 510
Min. Negotiated Rate $57.36
Max. Negotiated Rate $203.15
Rate for Payer: Aetna of CA HMO/PPO $156.76
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $203.15
Rate for Payer: AlphaCare Medical Group Medi-Cal $131.45
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $131.45
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $142.40
Rate for Payer: BCBS Transplant Transplant $143.40
Rate for Payer: Blue Shield of California Commercial $176.14
Rate for Payer: Blue Shield of California EPN $139.58
Rate for Payer: Cash Price $107.55
Rate for Payer: Cigna of CA HMO $152.96
Rate for Payer: Cigna of CA PPO $176.86
Rate for Payer: Dignity Health Commercial/Exchange $203.15
Rate for Payer: Dignity Health Media $203.15
Rate for Payer: Dignity Health Medi-Cal $203.15
Rate for Payer: EPIC Health Plan Commercial $95.60
Rate for Payer: EPIC Health Plan Transplant $95.60
Rate for Payer: Galaxy Health WC $203.15
Rate for Payer: Global Benefits Group Commercial $143.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $179.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $159.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal $91.06
Rate for Payer: LLUH Dept of Risk Management WC $57.36
Rate for Payer: Multiplan Commercial $191.20
Rate for Payer: Networks By Design Commercial $155.35
Rate for Payer: Prime Health Services Commercial $203.15
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $143.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $143.40
Rate for Payer: TriValley Medical Group Commercial/Senior $143.40
Rate for Payer: United Healthcare All Other Commercial $119.50
Rate for Payer: United Healthcare All Other HMO $119.50
Rate for Payer: United Healthcare HMO Rider $119.50
Rate for Payer: United Healthcare Select/Navigate/Core $119.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $203.15
Rate for Payer: Vantage Medical Group Medi-Cal $203.15
Rate for Payer: Vantage Medical Group Senior $203.15
Hospital Charge Code 908600157
Hospital Revenue Code 510
Min. Negotiated Rate $57.36
Max. Negotiated Rate $203.15
Rate for Payer: Cash Price $107.55
Rate for Payer: EPIC Health Plan Commercial $95.60
Rate for Payer: Galaxy Health WC $203.15
Rate for Payer: Global Benefits Group Commercial $143.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $159.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal $91.06
Rate for Payer: LLUH Dept of Risk Management WC $57.36
Rate for Payer: Multiplan Commercial $191.20
Rate for Payer: Networks By Design Commercial $155.35
Rate for Payer: Prime Health Services Commercial $203.15
Hospital Charge Code 908603050
Hospital Revenue Code 510
Min. Negotiated Rate $12.00
Max. Negotiated Rate $42.50
Rate for Payer: Aetna of CA HMO/PPO $32.80
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $42.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $27.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $27.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $29.79
Rate for Payer: BCBS Transplant Transplant $30.00
Rate for Payer: Blue Shield of California Commercial $36.85
Rate for Payer: Blue Shield of California EPN $29.20
Rate for Payer: Cash Price $22.50
Rate for Payer: Cigna of CA HMO $32.00
Rate for Payer: Cigna of CA PPO $37.00
Rate for Payer: Dignity Health Commercial/Exchange $42.50
Rate for Payer: Dignity Health Media $42.50
Rate for Payer: Dignity Health Medi-Cal $42.50
Rate for Payer: EPIC Health Plan Commercial $20.00
Rate for Payer: EPIC Health Plan Transplant $20.00
Rate for Payer: Galaxy Health WC $42.50
Rate for Payer: Global Benefits Group Commercial $30.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $37.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $33.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal $19.05
Rate for Payer: LLUH Dept of Risk Management WC $12.00
Rate for Payer: Multiplan Commercial $40.00
Rate for Payer: Networks By Design Commercial $32.50
Rate for Payer: Prime Health Services Commercial $42.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $30.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $30.00
Rate for Payer: TriValley Medical Group Commercial/Senior $30.00
Rate for Payer: United Healthcare All Other Commercial $25.00
Rate for Payer: United Healthcare All Other HMO $25.00
Rate for Payer: United Healthcare HMO Rider $25.00
Rate for Payer: United Healthcare Select/Navigate/Core $25.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $42.50
Rate for Payer: Vantage Medical Group Medi-Cal $42.50
Rate for Payer: Vantage Medical Group Senior $42.50
Hospital Charge Code 908603050
Hospital Revenue Code 510
Min. Negotiated Rate $12.00
Max. Negotiated Rate $42.50
Rate for Payer: Cash Price $22.50
Rate for Payer: EPIC Health Plan Commercial $20.00
Rate for Payer: Galaxy Health WC $42.50
Rate for Payer: Global Benefits Group Commercial $30.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $33.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal $19.05
Rate for Payer: LLUH Dept of Risk Management WC $12.00
Rate for Payer: Multiplan Commercial $40.00
Rate for Payer: Networks By Design Commercial $32.50
Rate for Payer: Prime Health Services Commercial $42.50