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Charge Type Price  
Hospital Charge Code 905200004
Hospital Revenue Code 220
Min. Negotiated Rate $334.00
Max. Negotiated Rate $5,238.00
Rate for Payer: Blue Shield of California Commercial $5,238.00
Rate for Payer: Blue Shield of California EPN $3,750.00
Rate for Payer: Cash Price $2,526.75
Rate for Payer: Cash Price $2,526.75
Rate for Payer: Cash Price $2,526.75
Rate for Payer: EPIC Health Plan Commercial $2,246.00
Rate for Payer: Galaxy Health WC $4,772.75
Rate for Payer: Global Benefits Group Commercial $3,369.00
Rate for Payer: Heritage Provider Network Commercial $334.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,745.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2,139.32
Rate for Payer: LLUH Dept of Risk Management WC $1,347.60
Rate for Payer: Multiplan Commercial $4,492.00
Rate for Payer: Networks By Design Commercial $3,649.75
Rate for Payer: Prime Health Services Commercial $4,772.75
Hospital Charge Code 905200005
Hospital Revenue Code 220
Min. Negotiated Rate $334.00
Max. Negotiated Rate $5,238.00
Rate for Payer: Blue Shield of California Commercial $5,238.00
Rate for Payer: Blue Shield of California EPN $3,750.00
Rate for Payer: Cash Price $963.90
Rate for Payer: Cash Price $963.90
Rate for Payer: Cash Price $963.90
Rate for Payer: EPIC Health Plan Commercial $856.80
Rate for Payer: Galaxy Health WC $1,820.70
Rate for Payer: Global Benefits Group Commercial $1,285.20
Rate for Payer: Heritage Provider Network Commercial $334.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,428.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal $816.10
Rate for Payer: LLUH Dept of Risk Management WC $514.08
Rate for Payer: Multiplan Commercial $1,713.60
Rate for Payer: Networks By Design Commercial $1,392.30
Rate for Payer: Prime Health Services Commercial $1,820.70
Hospital Charge Code 905200001
Hospital Revenue Code 220
Min. Negotiated Rate $334.00
Max. Negotiated Rate $5,238.00
Rate for Payer: Blue Shield of California Commercial $5,238.00
Rate for Payer: Blue Shield of California EPN $3,750.00
Rate for Payer: Cash Price $1,903.50
Rate for Payer: Cash Price $1,903.50
Rate for Payer: Cash Price $1,903.50
Rate for Payer: EPIC Health Plan Commercial $1,692.00
Rate for Payer: Galaxy Health WC $3,595.50
Rate for Payer: Global Benefits Group Commercial $2,538.00
Rate for Payer: Heritage Provider Network Commercial $334.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,821.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,611.63
Rate for Payer: LLUH Dept of Risk Management WC $1,015.20
Rate for Payer: Multiplan Commercial $3,384.00
Rate for Payer: Networks By Design Commercial $2,749.50
Rate for Payer: Prime Health Services Commercial $3,595.50
Service Code CPT 81507
Hospital Charge Code 910401507
Hospital Revenue Code 310
Min. Negotiated Rate $127.68
Max. Negotiated Rate $452.20
Rate for Payer: Cash Price $239.40
Rate for Payer: EPIC Health Plan Commercial $212.80
Rate for Payer: Galaxy Health WC $452.20
Rate for Payer: Global Benefits Group Commercial $319.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $354.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal $202.69
Rate for Payer: LLUH Dept of Risk Management WC $127.68
Rate for Payer: Multiplan Commercial $425.60
Rate for Payer: Networks By Design Commercial $345.80
Rate for Payer: Prime Health Services Commercial $452.20
Service Code CPT 81507
Hospital Charge Code 910401507
Hospital Revenue Code 310
Min. Negotiated Rate $127.68
Max. Negotiated Rate $4,014.90
Rate for Payer: Aetna of CA HMO/PPO $4,014.90
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1,192.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $874.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $795.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,566.11
Rate for Payer: BCBS Transplant Transplant $319.20
Rate for Payer: Blue Shield of California Commercial $343.67
Rate for Payer: Blue Shield of California EPN $272.38
Rate for Payer: Cash Price $239.40
Rate for Payer: Cash Price $239.40
Rate for Payer: Cigna of CA HMO $340.48
Rate for Payer: Cigna of CA PPO $393.68
Rate for Payer: Dignity Health Commercial/Exchange $1,192.50
Rate for Payer: Dignity Health Media $795.00
Rate for Payer: Dignity Health Medi-Cal $874.50
Rate for Payer: EPIC Health Plan Commercial $1,073.25
Rate for Payer: EPIC Health Plan Medicare/Senior $795.00
Rate for Payer: EPIC Health Plan Transplant $795.00
Rate for Payer: Galaxy Health WC $452.20
Rate for Payer: Global Benefits Group Commercial $319.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $399.00
Rate for Payer: Heritage Provider Network Commercial $1,303.80
Rate for Payer: Heritage Provider Network Transplant $1,303.80
Rate for Payer: IEHP Medi-Cal $1,287.90
Rate for Payer: IEHP Medi-Cal Transplant $1,287.90
Rate for Payer: IEHP Medicare Advantage $795.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $354.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,208.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $795.00
Rate for Payer: LLUH Dept of Risk Management WC $127.68
Rate for Payer: Molina Healthcare of CA Medi-Cal $1,001.70
Rate for Payer: Molina Healthcare of CA Medicare $1,065.30
Rate for Payer: Multiplan Commercial $425.60
Rate for Payer: Networks By Design Commercial $345.80
Rate for Payer: Prime Health Services Commercial $452.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $319.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $319.20
Rate for Payer: TriValley Medical Group Commercial/Senior $319.20
Rate for Payer: United Healthcare All Other Commercial $643.95
Rate for Payer: United Healthcare All Other HMO $643.95
Rate for Payer: United Healthcare HMO Rider $643.95
Rate for Payer: United Healthcare Select/Navigate/Core $643.95
Rate for Payer: Vantage Medical Group Commercial/Exchange $1,192.50
Rate for Payer: Vantage Medical Group Medi-Cal $874.50
Rate for Payer: Vantage Medical Group Senior $795.00
Service Code CPT 94799
Hospital Charge Code 900800400
Hospital Revenue Code 460
Min. Negotiated Rate $195.17
Max. Negotiated Rate $3,719.60
Rate for Payer: Aetna of CA HMO/PPO $2,870.22
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $292.76
Rate for Payer: AlphaCare Medical Group Medi-Cal $214.69
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $195.17
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,607.22
Rate for Payer: BCBS Transplant Transplant $2,625.60
Rate for Payer: Blue Shield of California Commercial $2,586.22
Rate for Payer: Blue Shield of California EPN $2,052.34
Rate for Payer: Cash Price $1,969.20
Rate for Payer: Cash Price $1,969.20
Rate for Payer: Cash Price $1,969.20
Rate for Payer: Cigna of CA HMO $2,800.64
Rate for Payer: Cigna of CA PPO $3,238.24
Rate for Payer: Dignity Health Commercial/Exchange $292.76
Rate for Payer: Dignity Health Media $195.17
Rate for Payer: Dignity Health Medi-Cal $214.69
Rate for Payer: EPIC Health Plan Commercial $263.48
Rate for Payer: EPIC Health Plan Medicare/Senior $195.17
Rate for Payer: EPIC Health Plan Transplant $195.17
Rate for Payer: Galaxy Health WC $3,719.60
Rate for Payer: Global Benefits Group Commercial $2,625.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3,282.00
Rate for Payer: Heritage Provider Network Commercial $320.08
Rate for Payer: Heritage Provider Network Transplant $320.08
Rate for Payer: IEHP Medi-Cal $316.18
Rate for Payer: IEHP Medi-Cal Transplant $316.18
Rate for Payer: IEHP Medicare Advantage $195.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,918.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $195.17
Rate for Payer: LLUH Dept of Risk Management WC $1,050.24
Rate for Payer: Molina Healthcare of CA Medi-Cal $245.91
Rate for Payer: Molina Healthcare of CA Medicare $261.53
Rate for Payer: Multiplan Commercial $3,500.80
Rate for Payer: Networks By Design Commercial $2,844.40
Rate for Payer: Prime Health Services Commercial $3,719.60
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2,625.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2,625.60
Rate for Payer: TriValley Medical Group Commercial/Senior $2,625.60
Rate for Payer: United Healthcare All Other Commercial $725.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $696.00
Rate for Payer: United Healthcare Select/Navigate/Core $636.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $292.76
Rate for Payer: Vantage Medical Group Medi-Cal $214.69
Rate for Payer: Vantage Medical Group Senior $195.17
Service Code CPT 94799
Hospital Charge Code 900800400
Hospital Revenue Code 460
Min. Negotiated Rate $1,050.24
Max. Negotiated Rate $3,719.60
Rate for Payer: Cash Price $1,969.20
Rate for Payer: EPIC Health Plan Commercial $1,750.40
Rate for Payer: Galaxy Health WC $3,719.60
Rate for Payer: Global Benefits Group Commercial $2,625.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,918.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,667.26
Rate for Payer: LLUH Dept of Risk Management WC $1,050.24
Rate for Payer: Multiplan Commercial $3,500.80
Rate for Payer: Networks By Design Commercial $2,844.40
Rate for Payer: Prime Health Services Commercial $3,719.60
Service Code CPT 86357
Hospital Charge Code 903900106
Hospital Revenue Code 302
Min. Negotiated Rate $17.04
Max. Negotiated Rate $336.66
Rate for Payer: Aetna of CA HMO/PPO $313.68
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $56.60
Rate for Payer: AlphaCare Medical Group Medi-Cal $41.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $37.73
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $336.66
Rate for Payer: BCBS Transplant Transplant $42.60
Rate for Payer: Blue Shield of California Commercial $45.87
Rate for Payer: Blue Shield of California EPN $36.35
Rate for Payer: Cash Price $31.95
Rate for Payer: Cash Price $31.95
Rate for Payer: Cigna of CA HMO $45.44
Rate for Payer: Cigna of CA PPO $52.54
Rate for Payer: Dignity Health Commercial/Exchange $56.60
Rate for Payer: Dignity Health Media $37.73
Rate for Payer: Dignity Health Medi-Cal $41.50
Rate for Payer: EPIC Health Plan Commercial $50.94
Rate for Payer: EPIC Health Plan Medicare/Senior $37.73
Rate for Payer: EPIC Health Plan Transplant $37.73
Rate for Payer: Galaxy Health WC $60.35
Rate for Payer: Global Benefits Group Commercial $42.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $53.25
Rate for Payer: Heritage Provider Network Commercial $61.88
Rate for Payer: Heritage Provider Network Transplant $61.88
Rate for Payer: IEHP Medi-Cal $61.12
Rate for Payer: IEHP Medi-Cal Transplant $61.12
Rate for Payer: IEHP Medicare Advantage $37.73
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $47.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $63.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $37.73
Rate for Payer: LLUH Dept of Risk Management WC $17.04
Rate for Payer: Molina Healthcare of CA Medi-Cal $47.54
Rate for Payer: Molina Healthcare of CA Medicare $50.56
Rate for Payer: Multiplan Commercial $56.80
Rate for Payer: Networks By Design Commercial $46.15
Rate for Payer: Prime Health Services Commercial $60.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $42.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $42.60
Rate for Payer: TriValley Medical Group Commercial/Senior $42.60
Rate for Payer: United Healthcare All Other Commercial $30.56
Rate for Payer: United Healthcare All Other HMO $30.56
Rate for Payer: United Healthcare HMO Rider $30.56
Rate for Payer: United Healthcare Select/Navigate/Core $30.56
Rate for Payer: Vantage Medical Group Commercial/Exchange $56.60
Rate for Payer: Vantage Medical Group Medi-Cal $41.50
Rate for Payer: Vantage Medical Group Senior $37.73
Service Code CPT 86357
Hospital Charge Code 903900106
Hospital Revenue Code 302
Min. Negotiated Rate $114.24
Max. Negotiated Rate $404.60
Rate for Payer: Cash Price $214.20
Rate for Payer: EPIC Health Plan Commercial $190.40
Rate for Payer: Galaxy Health WC $404.60
Rate for Payer: Global Benefits Group Commercial $285.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $317.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal $181.36
Rate for Payer: LLUH Dept of Risk Management WC $114.24
Rate for Payer: Multiplan Commercial $380.80
Rate for Payer: Networks By Design Commercial $309.40
Rate for Payer: Prime Health Services Commercial $404.60
Service Code CPT 78431
Hospital Charge Code 909308431
Hospital Revenue Code 341
Min. Negotiated Rate $1,486.32
Max. Negotiated Rate $5,264.05
Rate for Payer: Cash Price $2,786.85
Rate for Payer: EPIC Health Plan Commercial $2,477.20
Rate for Payer: Galaxy Health WC $5,264.05
Rate for Payer: Global Benefits Group Commercial $3,715.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $4,130.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2,359.53
Rate for Payer: LLUH Dept of Risk Management WC $1,486.32
Rate for Payer: Multiplan Commercial $4,954.40
Rate for Payer: Networks By Design Commercial $4,025.45
Rate for Payer: Prime Health Services Commercial $5,264.05
Service Code CPT 78431
Hospital Charge Code 909308431
Hospital Revenue Code 341
Min. Negotiated Rate $152.19
Max. Negotiated Rate $10,428.30
Rate for Payer: Aetna of CA HMO/PPO $10,428.30
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $4,426.76
Rate for Payer: AlphaCare Medical Group Medi-Cal $3,246.29
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,951.17
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,689.79
Rate for Payer: BCBS Transplant Transplant $3,715.80
Rate for Payer: Blue Shield of California Commercial $3,660.06
Rate for Payer: Blue Shield of California EPN $2,904.52
Rate for Payer: Cash Price $2,786.85
Rate for Payer: Cash Price $2,786.85
Rate for Payer: Cigna of CA HMO $3,963.52
Rate for Payer: Cigna of CA PPO $4,582.82
Rate for Payer: Dignity Health Commercial/Exchange $4,426.76
Rate for Payer: Dignity Health Media $2,951.17
Rate for Payer: Dignity Health Medi-Cal $3,246.29
Rate for Payer: EPIC Health Plan Commercial $3,984.08
Rate for Payer: EPIC Health Plan Medicare/Senior $2,951.17
Rate for Payer: EPIC Health Plan Transplant $2,951.17
Rate for Payer: Galaxy Health WC $5,264.05
Rate for Payer: Global Benefits Group Commercial $3,715.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $4,644.75
Rate for Payer: Heritage Provider Network Commercial $4,839.92
Rate for Payer: Heritage Provider Network Transplant $4,839.92
Rate for Payer: IEHP Medi-Cal $4,780.90
Rate for Payer: IEHP Medi-Cal Transplant $4,780.90
Rate for Payer: IEHP Medicare Advantage $2,951.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $4,130.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal $152.19
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $2,951.17
Rate for Payer: LLUH Dept of Risk Management WC $1,486.32
Rate for Payer: Molina Healthcare of CA Medi-Cal $3,718.47
Rate for Payer: Molina Healthcare of CA Medicare $3,954.57
Rate for Payer: Multiplan Commercial $4,954.40
Rate for Payer: Networks By Design Commercial $4,025.45
Rate for Payer: Prime Health Services Commercial $5,264.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $3,715.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $3,715.80
Rate for Payer: TriValley Medical Group Commercial/Senior $3,715.80
Rate for Payer: United Healthcare All Other Commercial $5,761.28
Rate for Payer: United Healthcare All Other HMO $5,761.28
Rate for Payer: United Healthcare HMO Rider $5,761.28
Rate for Payer: United Healthcare Select/Navigate/Core $5,761.28
Rate for Payer: Vantage Medical Group Commercial/Exchange $4,426.76
Rate for Payer: Vantage Medical Group Medi-Cal $3,246.29
Rate for Payer: Vantage Medical Group Senior $2,951.17
Service Code CPT 78430
Hospital Charge Code 909308430
Hospital Revenue Code 341
Min. Negotiated Rate $953.04
Max. Negotiated Rate $3,375.35
Rate for Payer: Cash Price $1,786.95
Rate for Payer: EPIC Health Plan Commercial $1,588.40
Rate for Payer: Galaxy Health WC $3,375.35
Rate for Payer: Global Benefits Group Commercial $2,382.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,648.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,512.95
Rate for Payer: LLUH Dept of Risk Management WC $953.04
Rate for Payer: Multiplan Commercial $3,176.80
Rate for Payer: Networks By Design Commercial $2,581.15
Rate for Payer: Prime Health Services Commercial $3,375.35
Service Code CPT 78430
Hospital Charge Code 909308430
Hospital Revenue Code 341
Min. Negotiated Rate $130.68
Max. Negotiated Rate $10,428.30
Rate for Payer: Aetna of CA HMO/PPO $10,428.30
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $2,932.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,150.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,954.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,365.92
Rate for Payer: BCBS Transplant Transplant $2,382.60
Rate for Payer: Blue Shield of California Commercial $2,346.86
Rate for Payer: Blue Shield of California EPN $1,862.40
Rate for Payer: Cash Price $1,786.95
Rate for Payer: Cash Price $1,786.95
Rate for Payer: Cigna of CA HMO $2,541.44
Rate for Payer: Cigna of CA PPO $2,938.54
Rate for Payer: Dignity Health Commercial/Exchange $2,932.02
Rate for Payer: Dignity Health Media $1,954.68
Rate for Payer: Dignity Health Medi-Cal $2,150.15
Rate for Payer: EPIC Health Plan Commercial $2,638.82
Rate for Payer: EPIC Health Plan Medicare/Senior $1,954.68
Rate for Payer: EPIC Health Plan Transplant $1,954.68
Rate for Payer: Galaxy Health WC $3,375.35
Rate for Payer: Global Benefits Group Commercial $2,382.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $2,978.25
Rate for Payer: Heritage Provider Network Commercial $3,205.68
Rate for Payer: Heritage Provider Network Transplant $3,205.68
Rate for Payer: IEHP Medi-Cal $3,166.58
Rate for Payer: IEHP Medi-Cal Transplant $3,166.58
Rate for Payer: IEHP Medicare Advantage $1,954.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,648.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $130.68
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $1,954.68
Rate for Payer: LLUH Dept of Risk Management WC $953.04
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,462.90
Rate for Payer: Molina Healthcare of CA Medicare $2,619.27
Rate for Payer: Multiplan Commercial $3,176.80
Rate for Payer: Networks By Design Commercial $2,581.15
Rate for Payer: Prime Health Services Commercial $3,375.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2,382.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2,382.60
Rate for Payer: TriValley Medical Group Commercial/Senior $2,382.60
Rate for Payer: United Healthcare All Other Commercial $3,694.08
Rate for Payer: United Healthcare All Other HMO $3,694.08
Rate for Payer: United Healthcare HMO Rider $3,694.08
Rate for Payer: United Healthcare Select/Navigate/Core $3,694.08
Rate for Payer: Vantage Medical Group Commercial/Exchange $2,932.02
Rate for Payer: Vantage Medical Group Medi-Cal $2,150.15
Rate for Payer: Vantage Medical Group Senior $1,954.68
Service Code CPT 78429
Hospital Charge Code 909308429
Hospital Revenue Code 341
Min. Negotiated Rate $137.75
Max. Negotiated Rate $10,428.30
Rate for Payer: Aetna of CA HMO/PPO $10,428.30
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $2,932.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,150.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,954.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,365.92
Rate for Payer: BCBS Transplant Transplant $2,382.60
Rate for Payer: Blue Shield of California Commercial $2,346.86
Rate for Payer: Blue Shield of California EPN $1,862.40
Rate for Payer: Cash Price $1,786.95
Rate for Payer: Cash Price $1,786.95
Rate for Payer: Cigna of CA HMO $2,541.44
Rate for Payer: Cigna of CA PPO $2,938.54
Rate for Payer: Dignity Health Commercial/Exchange $2,932.02
Rate for Payer: Dignity Health Media $1,954.68
Rate for Payer: Dignity Health Medi-Cal $2,150.15
Rate for Payer: EPIC Health Plan Commercial $2,638.82
Rate for Payer: EPIC Health Plan Medicare/Senior $1,954.68
Rate for Payer: EPIC Health Plan Transplant $1,954.68
Rate for Payer: Galaxy Health WC $3,375.35
Rate for Payer: Global Benefits Group Commercial $2,382.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $2,978.25
Rate for Payer: Heritage Provider Network Commercial $3,205.68
Rate for Payer: Heritage Provider Network Transplant $3,205.68
Rate for Payer: IEHP Medi-Cal $3,166.58
Rate for Payer: IEHP Medi-Cal Transplant $3,166.58
Rate for Payer: IEHP Medicare Advantage $1,954.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,648.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $137.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $1,954.68
Rate for Payer: LLUH Dept of Risk Management WC $953.04
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,462.90
Rate for Payer: Molina Healthcare of CA Medicare $2,619.27
Rate for Payer: Multiplan Commercial $3,176.80
Rate for Payer: Networks By Design Commercial $2,581.15
Rate for Payer: Prime Health Services Commercial $3,375.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2,382.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2,382.60
Rate for Payer: TriValley Medical Group Commercial/Senior $2,382.60
Rate for Payer: United Healthcare All Other Commercial $3,694.08
Rate for Payer: United Healthcare All Other HMO $3,694.08
Rate for Payer: United Healthcare HMO Rider $3,694.08
Rate for Payer: United Healthcare Select/Navigate/Core $3,694.08
Rate for Payer: Vantage Medical Group Commercial/Exchange $2,932.02
Rate for Payer: Vantage Medical Group Medi-Cal $2,150.15
Rate for Payer: Vantage Medical Group Senior $1,954.68
Service Code CPT 78429
Hospital Charge Code 909308429
Hospital Revenue Code 341
Min. Negotiated Rate $953.04
Max. Negotiated Rate $3,375.35
Rate for Payer: Cash Price $1,786.95
Rate for Payer: EPIC Health Plan Commercial $1,588.40
Rate for Payer: Galaxy Health WC $3,375.35
Rate for Payer: Global Benefits Group Commercial $2,382.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,648.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,512.95
Rate for Payer: LLUH Dept of Risk Management WC $953.04
Rate for Payer: Multiplan Commercial $3,176.80
Rate for Payer: Networks By Design Commercial $2,581.15
Rate for Payer: Prime Health Services Commercial $3,375.35
Service Code CPT 78433
Hospital Charge Code 909308433
Hospital Revenue Code 341
Min. Negotiated Rate $176.95
Max. Negotiated Rate $10,428.30
Rate for Payer: Aetna of CA HMO/PPO $10,428.30
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3,836.66
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,813.55
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,557.77
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,510.21
Rate for Payer: BCBS Transplant Transplant $4,542.00
Rate for Payer: Blue Shield of California Commercial $4,473.87
Rate for Payer: Blue Shield of California EPN $3,550.33
Rate for Payer: Cash Price $3,406.50
Rate for Payer: Cash Price $3,406.50
Rate for Payer: Cigna of CA HMO $4,844.80
Rate for Payer: Cigna of CA PPO $5,601.80
Rate for Payer: Dignity Health Commercial/Exchange $3,836.66
Rate for Payer: Dignity Health Media $2,557.77
Rate for Payer: Dignity Health Medi-Cal $2,813.55
Rate for Payer: EPIC Health Plan Commercial $3,452.99
Rate for Payer: EPIC Health Plan Medicare/Senior $2,557.77
Rate for Payer: EPIC Health Plan Transplant $2,557.77
Rate for Payer: Galaxy Health WC $6,434.50
Rate for Payer: Global Benefits Group Commercial $4,542.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $5,677.50
Rate for Payer: Heritage Provider Network Commercial $4,194.74
Rate for Payer: Heritage Provider Network Transplant $4,194.74
Rate for Payer: IEHP Medi-Cal $4,143.59
Rate for Payer: IEHP Medi-Cal Transplant $4,143.59
Rate for Payer: IEHP Medicare Advantage $2,557.77
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $5,049.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $176.95
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $2,557.77
Rate for Payer: LLUH Dept of Risk Management WC $1,816.80
Rate for Payer: Molina Healthcare of CA Medi-Cal $3,222.79
Rate for Payer: Molina Healthcare of CA Medicare $3,427.41
Rate for Payer: Multiplan Commercial $6,056.00
Rate for Payer: Networks By Design Commercial $4,920.50
Rate for Payer: Prime Health Services Commercial $6,434.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $4,542.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $4,542.00
Rate for Payer: TriValley Medical Group Commercial/Senior $4,542.00
Rate for Payer: United Healthcare All Other Commercial $7,041.28
Rate for Payer: United Healthcare All Other HMO $7,041.28
Rate for Payer: United Healthcare HMO Rider $7,041.28
Rate for Payer: United Healthcare Select/Navigate/Core $7,041.28
Rate for Payer: Vantage Medical Group Commercial/Exchange $3,836.66
Rate for Payer: Vantage Medical Group Medi-Cal $2,813.55
Rate for Payer: Vantage Medical Group Senior $2,557.77
Service Code CPT 78433
Hospital Charge Code 909308433
Hospital Revenue Code 341
Min. Negotiated Rate $1,816.80
Max. Negotiated Rate $6,434.50
Rate for Payer: Cash Price $3,406.50
Rate for Payer: EPIC Health Plan Commercial $3,028.00
Rate for Payer: Galaxy Health WC $6,434.50
Rate for Payer: Global Benefits Group Commercial $4,542.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $5,049.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2,884.17
Rate for Payer: LLUH Dept of Risk Management WC $1,816.80
Rate for Payer: Multiplan Commercial $6,056.00
Rate for Payer: Networks By Design Commercial $4,920.50
Rate for Payer: Prime Health Services Commercial $6,434.50
Service Code CPT 78830
Hospital Charge Code 909308830
Hospital Revenue Code 341
Min. Negotiated Rate $840.24
Max. Negotiated Rate $2,975.85
Rate for Payer: Cash Price $1,575.45
Rate for Payer: EPIC Health Plan Commercial $1,400.40
Rate for Payer: Galaxy Health WC $2,975.85
Rate for Payer: Global Benefits Group Commercial $2,100.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,335.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,333.88
Rate for Payer: LLUH Dept of Risk Management WC $840.24
Rate for Payer: Multiplan Commercial $2,800.80
Rate for Payer: Networks By Design Commercial $2,275.65
Rate for Payer: Prime Health Services Commercial $2,975.85
Service Code CPT 78830
Hospital Charge Code 909308830
Hospital Revenue Code 341
Min. Negotiated Rate $821.67
Max. Negotiated Rate $3,256.45
Rate for Payer: Aetna of CA HMO/PPO $2,754.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $2,661.22
Rate for Payer: AlphaCare Medical Group Medi-Cal $1,951.56
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,774.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,085.90
Rate for Payer: BCBS Transplant Transplant $2,100.60
Rate for Payer: Blue Shield of California Commercial $2,069.09
Rate for Payer: Blue Shield of California EPN $1,641.97
Rate for Payer: Cash Price $1,575.45
Rate for Payer: Cash Price $1,575.45
Rate for Payer: Cigna of CA HMO $2,240.64
Rate for Payer: Cigna of CA PPO $2,590.74
Rate for Payer: Dignity Health Commercial/Exchange $2,661.22
Rate for Payer: Dignity Health Media $1,774.15
Rate for Payer: Dignity Health Medi-Cal $1,951.56
Rate for Payer: EPIC Health Plan Commercial $2,395.10
Rate for Payer: EPIC Health Plan Medicare/Senior $1,774.15
Rate for Payer: EPIC Health Plan Transplant $1,774.15
Rate for Payer: Galaxy Health WC $2,975.85
Rate for Payer: Global Benefits Group Commercial $2,100.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $2,625.75
Rate for Payer: Heritage Provider Network Commercial $2,909.61
Rate for Payer: Heritage Provider Network Transplant $2,909.61
Rate for Payer: IEHP Medi-Cal $2,874.12
Rate for Payer: IEHP Medi-Cal Transplant $2,874.12
Rate for Payer: IEHP Medicare Advantage $1,774.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,335.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal $821.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $1,774.15
Rate for Payer: LLUH Dept of Risk Management WC $840.24
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,235.43
Rate for Payer: Molina Healthcare of CA Medicare $2,377.36
Rate for Payer: Multiplan Commercial $2,800.80
Rate for Payer: Networks By Design Commercial $2,275.65
Rate for Payer: Prime Health Services Commercial $2,975.85
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2,100.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2,100.60
Rate for Payer: TriValley Medical Group Commercial/Senior $2,100.60
Rate for Payer: United Healthcare All Other Commercial $3,256.45
Rate for Payer: United Healthcare All Other HMO $3,256.45
Rate for Payer: United Healthcare HMO Rider $3,256.45
Rate for Payer: United Healthcare Select/Navigate/Core $3,256.45
Rate for Payer: Vantage Medical Group Commercial/Exchange $2,661.22
Rate for Payer: Vantage Medical Group Medi-Cal $1,951.56
Rate for Payer: Vantage Medical Group Senior $1,774.15
Service Code CPT 78832
Hospital Charge Code 909308832
Hospital Revenue Code 341
Min. Negotiated Rate $953.04
Max. Negotiated Rate $3,375.35
Rate for Payer: Cash Price $1,786.95
Rate for Payer: EPIC Health Plan Commercial $1,588.40
Rate for Payer: Galaxy Health WC $3,375.35
Rate for Payer: Global Benefits Group Commercial $2,382.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,648.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,512.95
Rate for Payer: LLUH Dept of Risk Management WC $953.04
Rate for Payer: Multiplan Commercial $3,176.80
Rate for Payer: Networks By Design Commercial $2,581.15
Rate for Payer: Prime Health Services Commercial $3,375.35
Service Code CPT 78832
Hospital Charge Code 909308832
Hospital Revenue Code 341
Min. Negotiated Rate $953.04
Max. Negotiated Rate $3,694.08
Rate for Payer: Aetna of CA HMO/PPO $2,754.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $2,932.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,150.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,954.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,365.92
Rate for Payer: BCBS Transplant Transplant $2,382.60
Rate for Payer: Blue Shield of California Commercial $2,346.86
Rate for Payer: Blue Shield of California EPN $1,862.40
Rate for Payer: Cash Price $1,786.95
Rate for Payer: Cash Price $1,786.95
Rate for Payer: Cigna of CA HMO $2,541.44
Rate for Payer: Cigna of CA PPO $2,938.54
Rate for Payer: Dignity Health Commercial/Exchange $2,932.02
Rate for Payer: Dignity Health Media $1,954.68
Rate for Payer: Dignity Health Medi-Cal $2,150.15
Rate for Payer: EPIC Health Plan Commercial $2,638.82
Rate for Payer: EPIC Health Plan Medicare/Senior $1,954.68
Rate for Payer: EPIC Health Plan Transplant $1,954.68
Rate for Payer: Galaxy Health WC $3,375.35
Rate for Payer: Global Benefits Group Commercial $2,382.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $2,978.25
Rate for Payer: Heritage Provider Network Commercial $3,205.68
Rate for Payer: Heritage Provider Network Transplant $3,205.68
Rate for Payer: IEHP Medi-Cal $3,166.58
Rate for Payer: IEHP Medi-Cal Transplant $3,166.58
Rate for Payer: IEHP Medicare Advantage $1,954.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,648.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal $1,563.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $1,954.68
Rate for Payer: LLUH Dept of Risk Management WC $953.04
Rate for Payer: Molina Healthcare of CA Medi-Cal $2,462.90
Rate for Payer: Molina Healthcare of CA Medicare $2,619.27
Rate for Payer: Multiplan Commercial $3,176.80
Rate for Payer: Networks By Design Commercial $2,581.15
Rate for Payer: Prime Health Services Commercial $3,375.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2,382.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2,382.60
Rate for Payer: TriValley Medical Group Commercial/Senior $2,382.60
Rate for Payer: United Healthcare All Other Commercial $3,694.08
Rate for Payer: United Healthcare All Other HMO $3,694.08
Rate for Payer: United Healthcare HMO Rider $3,694.08
Rate for Payer: United Healthcare Select/Navigate/Core $3,694.08
Rate for Payer: Vantage Medical Group Commercial/Exchange $2,932.02
Rate for Payer: Vantage Medical Group Medi-Cal $2,150.15
Rate for Payer: Vantage Medical Group Senior $1,954.68
Service Code CPT 88104
Hospital Charge Code 903800214
Hospital Revenue Code 311
Min. Negotiated Rate $21.60
Max. Negotiated Rate $76.50
Rate for Payer: Cash Price $40.50
Rate for Payer: EPIC Health Plan Commercial $36.00
Rate for Payer: Galaxy Health WC $76.50
Rate for Payer: Global Benefits Group Commercial $54.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $60.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal $34.29
Rate for Payer: LLUH Dept of Risk Management WC $21.60
Rate for Payer: Multiplan Commercial $72.00
Rate for Payer: Networks By Design Commercial $58.50
Rate for Payer: Prime Health Services Commercial $76.50
Service Code CPT 88104
Hospital Charge Code 903800214
Hospital Revenue Code 311
Min. Negotiated Rate $21.60
Max. Negotiated Rate $239.16
Rate for Payer: Aetna of CA HMO/PPO $239.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $75.16
Rate for Payer: AlphaCare Medical Group Medi-Cal $55.12
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $50.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $57.86
Rate for Payer: BCBS Transplant Transplant $54.00
Rate for Payer: Blue Shield of California Commercial $58.14
Rate for Payer: Blue Shield of California EPN $46.08
Rate for Payer: Cash Price $40.50
Rate for Payer: Cash Price $40.50
Rate for Payer: Cigna of CA HMO $57.60
Rate for Payer: Cigna of CA PPO $66.60
Rate for Payer: Dignity Health Commercial/Exchange $75.16
Rate for Payer: Dignity Health Media $50.11
Rate for Payer: Dignity Health Medi-Cal $55.12
Rate for Payer: EPIC Health Plan Commercial $67.65
Rate for Payer: EPIC Health Plan Medicare/Senior $50.11
Rate for Payer: EPIC Health Plan Transplant $50.11
Rate for Payer: Galaxy Health WC $76.50
Rate for Payer: Global Benefits Group Commercial $54.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $67.50
Rate for Payer: Heritage Provider Network Commercial $82.18
Rate for Payer: Heritage Provider Network Transplant $82.18
Rate for Payer: IEHP Medi-Cal $81.18
Rate for Payer: IEHP Medi-Cal Transplant $81.18
Rate for Payer: IEHP Medicare Advantage $50.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $60.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal $49.06
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $50.11
Rate for Payer: LLUH Dept of Risk Management WC $21.60
Rate for Payer: Molina Healthcare of CA Medi-Cal $63.14
Rate for Payer: Molina Healthcare of CA Medicare $67.15
Rate for Payer: Multiplan Commercial $72.00
Rate for Payer: Networks By Design Commercial $58.50
Rate for Payer: Prime Health Services Commercial $76.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $54.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $54.00
Rate for Payer: TriValley Medical Group Commercial/Senior $54.00
Rate for Payer: United Healthcare All Other Commercial $28.00
Rate for Payer: United Healthcare All Other HMO $28.00
Rate for Payer: United Healthcare HMO Rider $28.00
Rate for Payer: United Healthcare Select/Navigate/Core $28.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $75.16
Rate for Payer: Vantage Medical Group Medi-Cal $55.12
Rate for Payer: Vantage Medical Group Senior $50.11
Service Code CPT 88112
Hospital Charge Code 903800213
Hospital Revenue Code 310
Min. Negotiated Rate $24.24
Max. Negotiated Rate $85.85
Rate for Payer: Cash Price $45.45
Rate for Payer: EPIC Health Plan Commercial $40.40
Rate for Payer: Galaxy Health WC $85.85
Rate for Payer: Global Benefits Group Commercial $60.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $67.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal $38.48
Rate for Payer: LLUH Dept of Risk Management WC $24.24
Rate for Payer: Multiplan Commercial $80.80
Rate for Payer: Networks By Design Commercial $65.65
Rate for Payer: Prime Health Services Commercial $85.85
Service Code CPT 88112
Hospital Charge Code 903800213
Hospital Revenue Code 310
Min. Negotiated Rate $24.24
Max. Negotiated Rate $403.37
Rate for Payer: Aetna of CA HMO/PPO $293.31
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $101.55
Rate for Payer: AlphaCare Medical Group Medi-Cal $74.47
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $67.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $403.37
Rate for Payer: BCBS Transplant Transplant $60.60
Rate for Payer: Blue Shield of California Commercial $65.25
Rate for Payer: Blue Shield of California EPN $51.71
Rate for Payer: Cash Price $45.45
Rate for Payer: Cash Price $45.45
Rate for Payer: Cigna of CA HMO $64.64
Rate for Payer: Cigna of CA PPO $74.74
Rate for Payer: Dignity Health Commercial/Exchange $101.55
Rate for Payer: Dignity Health Media $67.70
Rate for Payer: Dignity Health Medi-Cal $74.47
Rate for Payer: EPIC Health Plan Commercial $91.40
Rate for Payer: EPIC Health Plan Medicare/Senior $67.70
Rate for Payer: EPIC Health Plan Transplant $67.70
Rate for Payer: Galaxy Health WC $85.85
Rate for Payer: Global Benefits Group Commercial $60.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $75.75
Rate for Payer: Heritage Provider Network Commercial $111.03
Rate for Payer: Heritage Provider Network Transplant $111.03
Rate for Payer: IEHP Medi-Cal $109.67
Rate for Payer: IEHP Medi-Cal Transplant $109.67
Rate for Payer: IEHP Medicare Advantage $67.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $67.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal $115.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $67.70
Rate for Payer: LLUH Dept of Risk Management WC $24.24
Rate for Payer: Molina Healthcare of CA Medi-Cal $85.30
Rate for Payer: Molina Healthcare of CA Medicare $90.72
Rate for Payer: Multiplan Commercial $80.80
Rate for Payer: Networks By Design Commercial $65.65
Rate for Payer: Prime Health Services Commercial $85.85
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $60.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $60.60
Rate for Payer: TriValley Medical Group Commercial/Senior $60.60
Rate for Payer: United Healthcare All Other Commercial $41.11
Rate for Payer: United Healthcare All Other HMO $41.11
Rate for Payer: United Healthcare HMO Rider $41.11
Rate for Payer: United Healthcare Select/Navigate/Core $41.11
Rate for Payer: Vantage Medical Group Commercial/Exchange $101.55
Rate for Payer: Vantage Medical Group Medi-Cal $74.47
Rate for Payer: Vantage Medical Group Senior $67.70