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Hospital Charge Code 912154301
Hospital Revenue Code 510
Min. Negotiated Rate $22.80
Max. Negotiated Rate $80.75
Rate for Payer: Aetna of CA HMO/PPO $62.31
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $80.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $52.25
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $52.25
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $56.60
Rate for Payer: BCBS Transplant Transplant $57.00
Rate for Payer: Blue Shield of California Commercial $70.02
Rate for Payer: Blue Shield of California EPN $55.48
Rate for Payer: Cash Price $42.75
Rate for Payer: Cigna of CA HMO $60.80
Rate for Payer: Cigna of CA PPO $70.30
Rate for Payer: Dignity Health Commercial/Exchange $80.75
Rate for Payer: Dignity Health Media $80.75
Rate for Payer: Dignity Health Medi-Cal $80.75
Rate for Payer: EPIC Health Plan Commercial $38.00
Rate for Payer: EPIC Health Plan Transplant $38.00
Rate for Payer: Galaxy Health WC $80.75
Rate for Payer: Global Benefits Group Commercial $57.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $71.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $63.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $36.20
Rate for Payer: LLUH Dept of Risk Management WC $22.80
Rate for Payer: Multiplan Commercial $76.00
Rate for Payer: Networks By Design Commercial $61.75
Rate for Payer: Prime Health Services Commercial $80.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $57.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $57.00
Rate for Payer: TriValley Medical Group Commercial/Senior $57.00
Rate for Payer: United Healthcare All Other Commercial $47.50
Rate for Payer: United Healthcare All Other HMO $47.50
Rate for Payer: United Healthcare HMO Rider $47.50
Rate for Payer: United Healthcare Select/Navigate/Core $47.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $80.75
Rate for Payer: Vantage Medical Group Medi-Cal $80.75
Rate for Payer: Vantage Medical Group Senior $80.75
Hospital Charge Code 912154314
Hospital Revenue Code 510
Min. Negotiated Rate $15.36
Max. Negotiated Rate $54.40
Rate for Payer: Aetna of CA HMO/PPO $41.98
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $54.40
Rate for Payer: AlphaCare Medical Group Medi-Cal $35.20
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $35.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $38.13
Rate for Payer: BCBS Transplant Transplant $38.40
Rate for Payer: Blue Shield of California Commercial $47.17
Rate for Payer: Blue Shield of California EPN $37.38
Rate for Payer: Cash Price $28.80
Rate for Payer: Cigna of CA HMO $40.96
Rate for Payer: Cigna of CA PPO $47.36
Rate for Payer: Dignity Health Commercial/Exchange $54.40
Rate for Payer: Dignity Health Media $54.40
Rate for Payer: Dignity Health Medi-Cal $54.40
Rate for Payer: EPIC Health Plan Commercial $25.60
Rate for Payer: EPIC Health Plan Transplant $25.60
Rate for Payer: Galaxy Health WC $54.40
Rate for Payer: Global Benefits Group Commercial $38.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $48.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $42.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal $24.38
Rate for Payer: LLUH Dept of Risk Management WC $15.36
Rate for Payer: Multiplan Commercial $51.20
Rate for Payer: Networks By Design Commercial $41.60
Rate for Payer: Prime Health Services Commercial $54.40
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $38.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $38.40
Rate for Payer: TriValley Medical Group Commercial/Senior $38.40
Rate for Payer: United Healthcare All Other Commercial $32.00
Rate for Payer: United Healthcare All Other HMO $32.00
Rate for Payer: United Healthcare HMO Rider $32.00
Rate for Payer: United Healthcare Select/Navigate/Core $32.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $54.40
Rate for Payer: Vantage Medical Group Medi-Cal $54.40
Rate for Payer: Vantage Medical Group Senior $54.40
Hospital Charge Code 908600162
Hospital Revenue Code 510
Min. Negotiated Rate $19.20
Max. Negotiated Rate $68.00
Rate for Payer: Cash Price $36.00
Rate for Payer: EPIC Health Plan Commercial $32.00
Rate for Payer: Galaxy Health WC $68.00
Rate for Payer: Global Benefits Group Commercial $48.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $53.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $30.48
Rate for Payer: LLUH Dept of Risk Management WC $19.20
Rate for Payer: Multiplan Commercial $64.00
Rate for Payer: Networks By Design Commercial $52.00
Rate for Payer: Prime Health Services Commercial $68.00
Hospital Charge Code 912154314
Hospital Revenue Code 510
Min. Negotiated Rate $15.36
Max. Negotiated Rate $54.40
Rate for Payer: Cash Price $28.80
Rate for Payer: EPIC Health Plan Commercial $25.60
Rate for Payer: Galaxy Health WC $54.40
Rate for Payer: Global Benefits Group Commercial $38.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $42.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal $24.38
Rate for Payer: LLUH Dept of Risk Management WC $15.36
Rate for Payer: Multiplan Commercial $51.20
Rate for Payer: Networks By Design Commercial $41.60
Rate for Payer: Prime Health Services Commercial $54.40
Hospital Charge Code 908600162
Hospital Revenue Code 510
Min. Negotiated Rate $19.20
Max. Negotiated Rate $68.00
Rate for Payer: Aetna of CA HMO/PPO $52.47
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $68.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $44.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $44.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $47.66
Rate for Payer: BCBS Transplant Transplant $48.00
Rate for Payer: Blue Shield of California Commercial $58.96
Rate for Payer: Blue Shield of California EPN $46.72
Rate for Payer: Cash Price $36.00
Rate for Payer: Cigna of CA HMO $51.20
Rate for Payer: Cigna of CA PPO $59.20
Rate for Payer: Dignity Health Commercial/Exchange $68.00
Rate for Payer: Dignity Health Media $68.00
Rate for Payer: Dignity Health Medi-Cal $68.00
Rate for Payer: EPIC Health Plan Commercial $32.00
Rate for Payer: EPIC Health Plan Transplant $32.00
Rate for Payer: Galaxy Health WC $68.00
Rate for Payer: Global Benefits Group Commercial $48.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $60.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $53.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $30.48
Rate for Payer: LLUH Dept of Risk Management WC $19.20
Rate for Payer: Multiplan Commercial $64.00
Rate for Payer: Networks By Design Commercial $52.00
Rate for Payer: Prime Health Services Commercial $68.00
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $48.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $48.00
Rate for Payer: TriValley Medical Group Commercial/Senior $48.00
Rate for Payer: United Healthcare All Other Commercial $40.00
Rate for Payer: United Healthcare All Other HMO $40.00
Rate for Payer: United Healthcare HMO Rider $40.00
Rate for Payer: United Healthcare Select/Navigate/Core $40.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $68.00
Rate for Payer: Vantage Medical Group Medi-Cal $68.00
Rate for Payer: Vantage Medical Group Senior $68.00
Hospital Charge Code 908600156
Hospital Revenue Code 510
Min. Negotiated Rate $79.92
Max. Negotiated Rate $283.05
Rate for Payer: Aetna of CA HMO/PPO $218.41
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $283.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $183.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $183.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $198.40
Rate for Payer: BCBS Transplant Transplant $199.80
Rate for Payer: Blue Shield of California Commercial $245.42
Rate for Payer: Blue Shield of California EPN $194.47
Rate for Payer: Cash Price $149.85
Rate for Payer: Cigna of CA HMO $213.12
Rate for Payer: Cigna of CA PPO $246.42
Rate for Payer: Dignity Health Commercial/Exchange $283.05
Rate for Payer: Dignity Health Media $283.05
Rate for Payer: Dignity Health Medi-Cal $283.05
Rate for Payer: EPIC Health Plan Commercial $133.20
Rate for Payer: EPIC Health Plan Transplant $133.20
Rate for Payer: Galaxy Health WC $283.05
Rate for Payer: Global Benefits Group Commercial $199.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $249.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $222.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $126.87
Rate for Payer: LLUH Dept of Risk Management WC $79.92
Rate for Payer: Multiplan Commercial $266.40
Rate for Payer: Networks By Design Commercial $216.45
Rate for Payer: Prime Health Services Commercial $283.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $199.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $199.80
Rate for Payer: TriValley Medical Group Commercial/Senior $199.80
Rate for Payer: United Healthcare All Other Commercial $166.50
Rate for Payer: United Healthcare All Other HMO $166.50
Rate for Payer: United Healthcare HMO Rider $166.50
Rate for Payer: United Healthcare Select/Navigate/Core $166.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $283.05
Rate for Payer: Vantage Medical Group Medi-Cal $283.05
Rate for Payer: Vantage Medical Group Senior $283.05
Hospital Charge Code 908600156
Hospital Revenue Code 510
Min. Negotiated Rate $79.92
Max. Negotiated Rate $283.05
Rate for Payer: Cash Price $149.85
Rate for Payer: EPIC Health Plan Commercial $133.20
Rate for Payer: Galaxy Health WC $283.05
Rate for Payer: Global Benefits Group Commercial $199.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $222.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $126.87
Rate for Payer: LLUH Dept of Risk Management WC $79.92
Rate for Payer: Multiplan Commercial $266.40
Rate for Payer: Networks By Design Commercial $216.45
Rate for Payer: Prime Health Services Commercial $283.05
Hospital Charge Code 908600164
Hospital Revenue Code 510
Min. Negotiated Rate $41.04
Max. Negotiated Rate $145.35
Rate for Payer: Cash Price $76.95
Rate for Payer: EPIC Health Plan Commercial $68.40
Rate for Payer: Galaxy Health WC $145.35
Rate for Payer: Global Benefits Group Commercial $102.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $114.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $65.15
Rate for Payer: LLUH Dept of Risk Management WC $41.04
Rate for Payer: Multiplan Commercial $136.80
Rate for Payer: Networks By Design Commercial $111.15
Rate for Payer: Prime Health Services Commercial $145.35
Hospital Charge Code 908600164
Hospital Revenue Code 510
Min. Negotiated Rate $41.04
Max. Negotiated Rate $145.35
Rate for Payer: Aetna of CA HMO/PPO $112.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $145.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $94.05
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $94.05
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $101.88
Rate for Payer: BCBS Transplant Transplant $102.60
Rate for Payer: Blue Shield of California Commercial $126.03
Rate for Payer: Blue Shield of California EPN $99.86
Rate for Payer: Cash Price $76.95
Rate for Payer: Cigna of CA HMO $109.44
Rate for Payer: Cigna of CA PPO $126.54
Rate for Payer: Dignity Health Commercial/Exchange $145.35
Rate for Payer: Dignity Health Media $145.35
Rate for Payer: Dignity Health Medi-Cal $145.35
Rate for Payer: EPIC Health Plan Commercial $68.40
Rate for Payer: EPIC Health Plan Transplant $68.40
Rate for Payer: Galaxy Health WC $145.35
Rate for Payer: Global Benefits Group Commercial $102.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $128.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $114.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal $65.15
Rate for Payer: LLUH Dept of Risk Management WC $41.04
Rate for Payer: Multiplan Commercial $136.80
Rate for Payer: Networks By Design Commercial $111.15
Rate for Payer: Prime Health Services Commercial $145.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $102.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $102.60
Rate for Payer: TriValley Medical Group Commercial/Senior $102.60
Rate for Payer: United Healthcare All Other Commercial $85.50
Rate for Payer: United Healthcare All Other HMO $85.50
Rate for Payer: United Healthcare HMO Rider $85.50
Rate for Payer: United Healthcare Select/Navigate/Core $85.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $145.35
Rate for Payer: Vantage Medical Group Medi-Cal $145.35
Rate for Payer: Vantage Medical Group Senior $145.35
Hospital Charge Code 908603063
Hospital Revenue Code 510
Min. Negotiated Rate $5.76
Max. Negotiated Rate $20.40
Rate for Payer: Cash Price $10.80
Rate for Payer: EPIC Health Plan Commercial $9.60
Rate for Payer: Galaxy Health WC $20.40
Rate for Payer: Global Benefits Group Commercial $14.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $16.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $9.14
Rate for Payer: LLUH Dept of Risk Management WC $5.76
Rate for Payer: Multiplan Commercial $19.20
Rate for Payer: Networks By Design Commercial $15.60
Rate for Payer: Prime Health Services Commercial $20.40
Hospital Charge Code 908603063
Hospital Revenue Code 510
Min. Negotiated Rate $5.76
Max. Negotiated Rate $20.40
Rate for Payer: Aetna of CA HMO/PPO $15.74
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $20.40
Rate for Payer: AlphaCare Medical Group Medi-Cal $13.20
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $13.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $14.30
Rate for Payer: BCBS Transplant Transplant $14.40
Rate for Payer: Blue Shield of California Commercial $17.69
Rate for Payer: Blue Shield of California EPN $14.02
Rate for Payer: Cash Price $10.80
Rate for Payer: Cigna of CA HMO $15.36
Rate for Payer: Cigna of CA PPO $17.76
Rate for Payer: Dignity Health Commercial/Exchange $20.40
Rate for Payer: Dignity Health Media $20.40
Rate for Payer: Dignity Health Medi-Cal $20.40
Rate for Payer: EPIC Health Plan Commercial $9.60
Rate for Payer: EPIC Health Plan Transplant $9.60
Rate for Payer: Galaxy Health WC $20.40
Rate for Payer: Global Benefits Group Commercial $14.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $18.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $16.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $9.14
Rate for Payer: LLUH Dept of Risk Management WC $5.76
Rate for Payer: Multiplan Commercial $19.20
Rate for Payer: Networks By Design Commercial $15.60
Rate for Payer: Prime Health Services Commercial $20.40
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $14.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $14.40
Rate for Payer: TriValley Medical Group Commercial/Senior $14.40
Rate for Payer: United Healthcare All Other Commercial $12.00
Rate for Payer: United Healthcare All Other HMO $12.00
Rate for Payer: United Healthcare HMO Rider $12.00
Rate for Payer: United Healthcare Select/Navigate/Core $12.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $20.40
Rate for Payer: Vantage Medical Group Medi-Cal $20.40
Rate for Payer: Vantage Medical Group Senior $20.40
Hospital Charge Code 902000202
Hospital Revenue Code 942
Min. Negotiated Rate $121.92
Max. Negotiated Rate $785.00
Rate for Payer: Aetna of CA HMO/PPO $333.20
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $431.80
Rate for Payer: AlphaCare Medical Group Medi-Cal $279.40
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $279.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $302.67
Rate for Payer: BCBS Transplant Transplant $304.80
Rate for Payer: Blue Shield of California Commercial $374.40
Rate for Payer: Blue Shield of California EPN $296.67
Rate for Payer: Cash Price $228.60
Rate for Payer: Cash Price $228.60
Rate for Payer: Cigna of CA HMO $325.12
Rate for Payer: Cigna of CA PPO $375.92
Rate for Payer: Dignity Health Commercial/Exchange $431.80
Rate for Payer: Dignity Health Media $431.80
Rate for Payer: Dignity Health Medi-Cal $431.80
Rate for Payer: EPIC Health Plan Commercial $203.20
Rate for Payer: EPIC Health Plan Transplant $203.20
Rate for Payer: Galaxy Health WC $431.80
Rate for Payer: Global Benefits Group Commercial $304.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $381.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $338.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal $193.55
Rate for Payer: LLUH Dept of Risk Management WC $121.92
Rate for Payer: Multiplan Commercial $406.40
Rate for Payer: Networks By Design Commercial $330.20
Rate for Payer: Prime Health Services Commercial $431.80
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $304.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $304.80
Rate for Payer: TriValley Medical Group Commercial/Senior $304.80
Rate for Payer: United Healthcare All Other Commercial $602.00
Rate for Payer: United Healthcare All Other HMO $785.00
Rate for Payer: United Healthcare HMO Rider $593.00
Rate for Payer: United Healthcare Select/Navigate/Core $542.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $431.80
Rate for Payer: Vantage Medical Group Medi-Cal $431.80
Rate for Payer: Vantage Medical Group Senior $431.80
Hospital Charge Code 902000202
Hospital Revenue Code 942
Min. Negotiated Rate $121.92
Max. Negotiated Rate $431.80
Rate for Payer: Cash Price $228.60
Rate for Payer: EPIC Health Plan Commercial $203.20
Rate for Payer: Galaxy Health WC $431.80
Rate for Payer: Global Benefits Group Commercial $304.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $338.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal $193.55
Rate for Payer: LLUH Dept of Risk Management WC $121.92
Rate for Payer: Multiplan Commercial $406.40
Rate for Payer: Networks By Design Commercial $330.20
Rate for Payer: Prime Health Services Commercial $431.80
Hospital Charge Code 902000203
Hospital Revenue Code 942
Min. Negotiated Rate $62.40
Max. Negotiated Rate $221.00
Rate for Payer: Cash Price $117.00
Rate for Payer: EPIC Health Plan Commercial $104.00
Rate for Payer: Galaxy Health WC $221.00
Rate for Payer: Global Benefits Group Commercial $156.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $173.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal $99.06
Rate for Payer: LLUH Dept of Risk Management WC $62.40
Rate for Payer: Multiplan Commercial $208.00
Rate for Payer: Networks By Design Commercial $169.00
Rate for Payer: Prime Health Services Commercial $221.00
Hospital Charge Code 902000203
Hospital Revenue Code 942
Min. Negotiated Rate $62.40
Max. Negotiated Rate $785.00
Rate for Payer: Aetna of CA HMO/PPO $170.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $221.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $143.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $143.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $154.91
Rate for Payer: BCBS Transplant Transplant $156.00
Rate for Payer: Blue Shield of California Commercial $191.62
Rate for Payer: Blue Shield of California EPN $151.84
Rate for Payer: Cash Price $117.00
Rate for Payer: Cash Price $117.00
Rate for Payer: Cigna of CA HMO $166.40
Rate for Payer: Cigna of CA PPO $192.40
Rate for Payer: Dignity Health Commercial/Exchange $221.00
Rate for Payer: Dignity Health Media $221.00
Rate for Payer: Dignity Health Medi-Cal $221.00
Rate for Payer: EPIC Health Plan Commercial $104.00
Rate for Payer: EPIC Health Plan Transplant $104.00
Rate for Payer: Galaxy Health WC $221.00
Rate for Payer: Global Benefits Group Commercial $156.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $195.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $173.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal $99.06
Rate for Payer: LLUH Dept of Risk Management WC $62.40
Rate for Payer: Multiplan Commercial $208.00
Rate for Payer: Networks By Design Commercial $169.00
Rate for Payer: Prime Health Services Commercial $221.00
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $156.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $156.00
Rate for Payer: TriValley Medical Group Commercial/Senior $156.00
Rate for Payer: United Healthcare All Other Commercial $602.00
Rate for Payer: United Healthcare All Other HMO $785.00
Rate for Payer: United Healthcare HMO Rider $593.00
Rate for Payer: United Healthcare Select/Navigate/Core $542.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $221.00
Rate for Payer: Vantage Medical Group Medi-Cal $221.00
Rate for Payer: Vantage Medical Group Senior $221.00
Service Code CPT 97804
Hospital Charge Code 902000205
Hospital Revenue Code 510
Min. Negotiated Rate $26.43
Max. Negotiated Rate $181.05
Rate for Payer: Aetna of CA HMO/PPO $122.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $181.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $117.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $117.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $126.91
Rate for Payer: BCBS Transplant Transplant $127.80
Rate for Payer: Blue Shield of California Commercial $156.98
Rate for Payer: Blue Shield of California EPN $124.39
Rate for Payer: Cash Price $95.85
Rate for Payer: Cash Price $95.85
Rate for Payer: Cigna of CA HMO $136.32
Rate for Payer: Cigna of CA PPO $157.62
Rate for Payer: Dignity Health Commercial/Exchange $181.05
Rate for Payer: Dignity Health Media $181.05
Rate for Payer: Dignity Health Medi-Cal $181.05
Rate for Payer: EPIC Health Plan Commercial $85.20
Rate for Payer: EPIC Health Plan Transplant $85.20
Rate for Payer: Galaxy Health WC $181.05
Rate for Payer: Global Benefits Group Commercial $127.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $159.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $142.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $26.43
Rate for Payer: LLUH Dept of Risk Management WC $51.12
Rate for Payer: Multiplan Commercial $170.40
Rate for Payer: Networks By Design Commercial $138.45
Rate for Payer: Prime Health Services Commercial $181.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $127.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $127.80
Rate for Payer: TriValley Medical Group Commercial/Senior $127.80
Rate for Payer: United Healthcare All Other Commercial $106.50
Rate for Payer: United Healthcare All Other HMO $106.50
Rate for Payer: United Healthcare HMO Rider $106.50
Rate for Payer: United Healthcare Select/Navigate/Core $106.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $181.05
Rate for Payer: Vantage Medical Group Medi-Cal $181.05
Rate for Payer: Vantage Medical Group Senior $181.05
Service Code CPT 97804
Hospital Charge Code 902000205
Hospital Revenue Code 942
Min. Negotiated Rate $51.12
Max. Negotiated Rate $181.05
Rate for Payer: Cash Price $95.85
Rate for Payer: EPIC Health Plan Commercial $85.20
Rate for Payer: Galaxy Health WC $181.05
Rate for Payer: Global Benefits Group Commercial $127.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $142.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $81.15
Rate for Payer: LLUH Dept of Risk Management WC $51.12
Rate for Payer: Multiplan Commercial $170.40
Rate for Payer: Networks By Design Commercial $138.45
Rate for Payer: Prime Health Services Commercial $181.05
Service Code CPT 97804
Hospital Charge Code 902000205
Hospital Revenue Code 510
Min. Negotiated Rate $51.12
Max. Negotiated Rate $181.05
Rate for Payer: Cash Price $95.85
Rate for Payer: EPIC Health Plan Commercial $85.20
Rate for Payer: Galaxy Health WC $181.05
Rate for Payer: Global Benefits Group Commercial $127.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $142.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $81.15
Rate for Payer: LLUH Dept of Risk Management WC $51.12
Rate for Payer: Multiplan Commercial $170.40
Rate for Payer: Networks By Design Commercial $138.45
Rate for Payer: Prime Health Services Commercial $181.05
Service Code CPT 97804
Hospital Charge Code 902000205
Hospital Revenue Code 942
Min. Negotiated Rate $26.43
Max. Negotiated Rate $785.00
Rate for Payer: Aetna of CA HMO/PPO $122.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $181.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $117.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $117.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $126.91
Rate for Payer: BCBS Transplant Transplant $127.80
Rate for Payer: Blue Shield of California Commercial $156.98
Rate for Payer: Blue Shield of California EPN $124.39
Rate for Payer: Cash Price $95.85
Rate for Payer: Cash Price $95.85
Rate for Payer: Cash Price $95.85
Rate for Payer: Cigna of CA HMO $136.32
Rate for Payer: Cigna of CA PPO $157.62
Rate for Payer: Dignity Health Commercial/Exchange $181.05
Rate for Payer: Dignity Health Media $181.05
Rate for Payer: Dignity Health Medi-Cal $181.05
Rate for Payer: EPIC Health Plan Commercial $85.20
Rate for Payer: EPIC Health Plan Transplant $85.20
Rate for Payer: Galaxy Health WC $181.05
Rate for Payer: Global Benefits Group Commercial $127.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $159.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $142.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $26.43
Rate for Payer: LLUH Dept of Risk Management WC $51.12
Rate for Payer: Multiplan Commercial $170.40
Rate for Payer: Networks By Design Commercial $138.45
Rate for Payer: Prime Health Services Commercial $181.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $127.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $127.80
Rate for Payer: TriValley Medical Group Commercial/Senior $127.80
Rate for Payer: United Healthcare All Other Commercial $602.00
Rate for Payer: United Healthcare All Other HMO $785.00
Rate for Payer: United Healthcare HMO Rider $593.00
Rate for Payer: United Healthcare Select/Navigate/Core $542.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $181.05
Rate for Payer: Vantage Medical Group Medi-Cal $181.05
Rate for Payer: Vantage Medical Group Senior $181.05
Service Code CPT 97802
Hospital Charge Code 902000200
Hospital Revenue Code 942
Min. Negotiated Rate $57.66
Max. Negotiated Rate $785.00
Rate for Payer: Aetna of CA HMO/PPO $260.78
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $215.90
Rate for Payer: AlphaCare Medical Group Medi-Cal $139.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $139.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $151.33
Rate for Payer: BCBS Transplant Transplant $152.40
Rate for Payer: Blue Shield of California Commercial $187.20
Rate for Payer: Blue Shield of California EPN $148.34
Rate for Payer: Cash Price $114.30
Rate for Payer: Cash Price $114.30
Rate for Payer: Cash Price $114.30
Rate for Payer: Cigna of CA HMO $162.56
Rate for Payer: Cigna of CA PPO $187.96
Rate for Payer: Dignity Health Commercial/Exchange $215.90
Rate for Payer: Dignity Health Media $215.90
Rate for Payer: Dignity Health Medi-Cal $215.90
Rate for Payer: EPIC Health Plan Commercial $101.60
Rate for Payer: EPIC Health Plan Transplant $101.60
Rate for Payer: Galaxy Health WC $215.90
Rate for Payer: Global Benefits Group Commercial $152.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $190.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $169.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal $57.66
Rate for Payer: LLUH Dept of Risk Management WC $60.96
Rate for Payer: Multiplan Commercial $203.20
Rate for Payer: Networks By Design Commercial $165.10
Rate for Payer: Prime Health Services Commercial $215.90
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $152.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $152.40
Rate for Payer: TriValley Medical Group Commercial/Senior $152.40
Rate for Payer: United Healthcare All Other Commercial $602.00
Rate for Payer: United Healthcare All Other HMO $785.00
Rate for Payer: United Healthcare HMO Rider $593.00
Rate for Payer: United Healthcare Select/Navigate/Core $542.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $215.90
Rate for Payer: Vantage Medical Group Medi-Cal $215.90
Rate for Payer: Vantage Medical Group Senior $215.90
Service Code CPT 97802
Hospital Charge Code 902000200
Hospital Revenue Code 942
Min. Negotiated Rate $60.96
Max. Negotiated Rate $215.90
Rate for Payer: Cash Price $114.30
Rate for Payer: EPIC Health Plan Commercial $101.60
Rate for Payer: Galaxy Health WC $215.90
Rate for Payer: Global Benefits Group Commercial $152.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $169.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal $96.77
Rate for Payer: LLUH Dept of Risk Management WC $60.96
Rate for Payer: Multiplan Commercial $203.20
Rate for Payer: Networks By Design Commercial $165.10
Rate for Payer: Prime Health Services Commercial $215.90
Hospital Charge Code 902000206
Hospital Revenue Code 510
Min. Negotiated Rate $31.68
Max. Negotiated Rate $112.20
Rate for Payer: Cash Price $59.40
Rate for Payer: EPIC Health Plan Commercial $52.80
Rate for Payer: Galaxy Health WC $112.20
Rate for Payer: Global Benefits Group Commercial $79.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $88.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal $50.29
Rate for Payer: LLUH Dept of Risk Management WC $31.68
Rate for Payer: Multiplan Commercial $105.60
Rate for Payer: Networks By Design Commercial $85.80
Rate for Payer: Prime Health Services Commercial $112.20
Hospital Charge Code 902000206
Hospital Revenue Code 510
Min. Negotiated Rate $31.68
Max. Negotiated Rate $112.20
Rate for Payer: Aetna of CA HMO/PPO $86.58
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $112.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $72.60
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $72.60
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $78.65
Rate for Payer: BCBS Transplant Transplant $79.20
Rate for Payer: Blue Shield of California Commercial $97.28
Rate for Payer: Blue Shield of California EPN $77.09
Rate for Payer: Cash Price $59.40
Rate for Payer: Cigna of CA HMO $84.48
Rate for Payer: Cigna of CA PPO $97.68
Rate for Payer: Dignity Health Commercial/Exchange $112.20
Rate for Payer: Dignity Health Media $112.20
Rate for Payer: Dignity Health Medi-Cal $112.20
Rate for Payer: EPIC Health Plan Commercial $52.80
Rate for Payer: EPIC Health Plan Transplant $52.80
Rate for Payer: Galaxy Health WC $112.20
Rate for Payer: Global Benefits Group Commercial $79.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $99.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $88.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal $50.29
Rate for Payer: LLUH Dept of Risk Management WC $31.68
Rate for Payer: Multiplan Commercial $105.60
Rate for Payer: Networks By Design Commercial $85.80
Rate for Payer: Prime Health Services Commercial $112.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $79.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $79.20
Rate for Payer: TriValley Medical Group Commercial/Senior $79.20
Rate for Payer: United Healthcare All Other Commercial $66.00
Rate for Payer: United Healthcare All Other HMO $66.00
Rate for Payer: United Healthcare HMO Rider $66.00
Rate for Payer: United Healthcare Select/Navigate/Core $66.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $112.20
Rate for Payer: Vantage Medical Group Medi-Cal $112.20
Rate for Payer: Vantage Medical Group Senior $112.20
Service Code CPT 97803
Hospital Charge Code 902000201
Hospital Revenue Code 942
Min. Negotiated Rate $51.12
Max. Negotiated Rate $181.05
Rate for Payer: Cash Price $95.85
Rate for Payer: EPIC Health Plan Commercial $85.20
Rate for Payer: Galaxy Health WC $181.05
Rate for Payer: Global Benefits Group Commercial $127.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $142.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $81.15
Rate for Payer: LLUH Dept of Risk Management WC $51.12
Rate for Payer: Multiplan Commercial $170.40
Rate for Payer: Networks By Design Commercial $138.45
Rate for Payer: Prime Health Services Commercial $181.05
Service Code CPT 97803
Hospital Charge Code 902000201
Hospital Revenue Code 510
Min. Negotiated Rate $51.12
Max. Negotiated Rate $181.05
Rate for Payer: Cash Price $95.85
Rate for Payer: EPIC Health Plan Commercial $85.20
Rate for Payer: Galaxy Health WC $181.05
Rate for Payer: Global Benefits Group Commercial $127.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $142.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $81.15
Rate for Payer: LLUH Dept of Risk Management WC $51.12
Rate for Payer: Multiplan Commercial $170.40
Rate for Payer: Networks By Design Commercial $138.45
Rate for Payer: Prime Health Services Commercial $181.05