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Charge Type Price  
Service Code APR-DRG 7531
Min. Negotiated Rate $4,792.80
Max. Negotiated Rate $6,247.90
Rate for Payer: IEHP Medi-Cal $4,792.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal $6,247.90
Service Code APR-DRG 7532
Min. Negotiated Rate $6,474.29
Max. Negotiated Rate $8,439.90
Rate for Payer: IEHP Medi-Cal $6,474.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal $8,439.90
Service Code APR-DRG 7533
Min. Negotiated Rate $11,467.07
Max. Negotiated Rate $14,948.50
Rate for Payer: IEHP Medi-Cal $11,467.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $14,948.50
Service Code NDC 58980-415-12
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Blue Shield of California Commercial $0.20
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Service Code NDC 58980-415-01
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Blue Shield of California Commercial $0.20
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Service Code NDC 68784-102-12
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Aetna of CA HMO/PPO $0.18
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.24
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.17
Rate for Payer: BCBS Transplant Transplant $0.17
Rate for Payer: Blue Shield of California Commercial $0.21
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: Dignity Health Commercial/Exchange $0.24
Rate for Payer: Dignity Health Media $0.24
Rate for Payer: Dignity Health Medi-Cal $0.24
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: EPIC Health Plan Transplant $0.11
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.17
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.17
Rate for Payer: TriValley Medical Group Commercial/Senior $0.17
Rate for Payer: United Healthcare All Other Commercial $0.14
Rate for Payer: United Healthcare All Other HMO $0.14
Rate for Payer: United Healthcare HMO Rider $0.14
Rate for Payer: United Healthcare Select/Navigate/Core $0.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.24
Rate for Payer: Vantage Medical Group Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 0574-7050-50
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.27
Rate for Payer: Blue Shield of California Commercial $0.23
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.14
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: EPIC Health Plan Commercial $0.13
Rate for Payer: Galaxy Health WC $0.27
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.26
Rate for Payer: Networks By Design Commercial $0.21
Rate for Payer: Prime Health Services Commercial $0.27
Service Code NDC 8142102102
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.28
Max. Negotiated Rate $0.98
Rate for Payer: Aetna of CA HMO/PPO $0.75
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.98
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.63
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.63
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.69
Rate for Payer: BCBS Transplant Transplant $0.69
Rate for Payer: Blue Shield of California Commercial $0.85
Rate for Payer: Blue Shield of California EPN $0.67
Rate for Payer: Cash Price $0.52
Rate for Payer: Cigna of CA HMO $0.81
Rate for Payer: Cigna of CA PPO $0.81
Rate for Payer: Dignity Health Commercial/Exchange $0.98
Rate for Payer: Dignity Health Media $0.98
Rate for Payer: Dignity Health Medi-Cal $0.98
Rate for Payer: EPIC Health Plan Commercial $0.46
Rate for Payer: EPIC Health Plan Transplant $0.46
Rate for Payer: Galaxy Health WC $0.98
Rate for Payer: Global Benefits Group Commercial $0.69
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.86
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.44
Rate for Payer: LLUH Dept of Risk Management WC $0.28
Rate for Payer: Multiplan Commercial $0.92
Rate for Payer: Networks By Design Commercial $0.75
Rate for Payer: Prime Health Services Commercial $0.98
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.69
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.69
Rate for Payer: TriValley Medical Group Commercial/Senior $0.69
Rate for Payer: United Healthcare All Other Commercial $0.58
Rate for Payer: United Healthcare All Other HMO $0.58
Rate for Payer: United Healthcare HMO Rider $0.58
Rate for Payer: United Healthcare Select/Navigate/Core $0.58
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.98
Rate for Payer: Vantage Medical Group Medi-Cal $0.98
Rate for Payer: Vantage Medical Group Senior $0.98
Service Code NDC 71399-8460-5
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.26
Rate for Payer: Aetna of CA HMO/PPO $0.20
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.26
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.17
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.17
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.18
Rate for Payer: BCBS Transplant Transplant $0.19
Rate for Payer: Blue Shield of California Commercial $0.23
Rate for Payer: Blue Shield of California EPN $0.18
Rate for Payer: Cash Price $0.14
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: Dignity Health Commercial/Exchange $0.26
Rate for Payer: Dignity Health Media $0.26
Rate for Payer: Dignity Health Medi-Cal $0.26
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: EPIC Health Plan Transplant $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.23
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.25
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.19
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.19
Rate for Payer: TriValley Medical Group Commercial/Senior $0.19
Rate for Payer: United Healthcare All Other Commercial $0.16
Rate for Payer: United Healthcare All Other HMO $0.16
Rate for Payer: United Healthcare HMO Rider $0.16
Rate for Payer: United Healthcare Select/Navigate/Core $0.16
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.26
Rate for Payer: Vantage Medical Group Medi-Cal $0.26
Rate for Payer: Vantage Medical Group Senior $0.26
Service Code NDC 8142102101
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.32
Max. Negotiated Rate $1.13
Rate for Payer: Blue Shield of California Commercial $0.95
Rate for Payer: Blue Shield of California EPN $0.68
Rate for Payer: Cash Price $0.60
Rate for Payer: Cigna of CA HMO $0.93
Rate for Payer: Cigna of CA PPO $0.93
Rate for Payer: EPIC Health Plan Commercial $0.53
Rate for Payer: Galaxy Health WC $1.13
Rate for Payer: Global Benefits Group Commercial $0.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.51
Rate for Payer: LLUH Dept of Risk Management WC $0.32
Rate for Payer: Multiplan Commercial $1.06
Rate for Payer: Networks By Design Commercial $0.86
Rate for Payer: Prime Health Services Commercial $1.13
Service Code NDC 68784-102-12
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Blue Shield of California Commercial $0.20
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Service Code NDC 8142102102
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.28
Max. Negotiated Rate $0.98
Rate for Payer: Blue Shield of California Commercial $0.82
Rate for Payer: Blue Shield of California EPN $0.59
Rate for Payer: Cash Price $0.52
Rate for Payer: Cigna of CA HMO $0.81
Rate for Payer: Cigna of CA PPO $0.81
Rate for Payer: EPIC Health Plan Commercial $0.46
Rate for Payer: Galaxy Health WC $0.98
Rate for Payer: Global Benefits Group Commercial $0.69
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.44
Rate for Payer: LLUH Dept of Risk Management WC $0.28
Rate for Payer: Multiplan Commercial $0.92
Rate for Payer: Networks By Design Commercial $0.75
Rate for Payer: Prime Health Services Commercial $0.98
Service Code NDC 58980-415-12
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Aetna of CA HMO/PPO $0.18
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.24
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.17
Rate for Payer: BCBS Transplant Transplant $0.17
Rate for Payer: Blue Shield of California Commercial $0.21
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: Dignity Health Commercial/Exchange $0.24
Rate for Payer: Dignity Health Media $0.24
Rate for Payer: Dignity Health Medi-Cal $0.24
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: EPIC Health Plan Transplant $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.17
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.17
Rate for Payer: TriValley Medical Group Commercial/Senior $0.17
Rate for Payer: United Healthcare All Other Commercial $0.14
Rate for Payer: United Healthcare All Other HMO $0.14
Rate for Payer: United Healthcare HMO Rider $0.14
Rate for Payer: United Healthcare Select/Navigate/Core $0.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.24
Rate for Payer: Vantage Medical Group Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 0574-7050-12
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.36
Rate for Payer: Aetna of CA HMO/PPO $0.28
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.36
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.23
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.25
Rate for Payer: BCBS Transplant Transplant $0.25
Rate for Payer: Blue Shield of California Commercial $0.31
Rate for Payer: Blue Shield of California EPN $0.25
Rate for Payer: Cash Price $0.19
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: Dignity Health Commercial/Exchange $0.36
Rate for Payer: Dignity Health Media $0.36
Rate for Payer: Dignity Health Medi-Cal $0.36
Rate for Payer: EPIC Health Plan Commercial $0.17
Rate for Payer: EPIC Health Plan Transplant $0.17
Rate for Payer: Galaxy Health WC $0.36
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.32
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.10
Rate for Payer: Multiplan Commercial $0.34
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.36
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.25
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.25
Rate for Payer: TriValley Medical Group Commercial/Senior $0.25
Rate for Payer: United Healthcare All Other Commercial $0.21
Rate for Payer: United Healthcare All Other HMO $0.21
Rate for Payer: United Healthcare HMO Rider $0.21
Rate for Payer: United Healthcare Select/Navigate/Core $0.21
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.36
Rate for Payer: Vantage Medical Group Medi-Cal $0.36
Rate for Payer: Vantage Medical Group Senior $0.36
Service Code NDC 8142102101
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.32
Max. Negotiated Rate $1.13
Rate for Payer: Aetna of CA HMO/PPO $0.87
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.13
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.73
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.73
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.79
Rate for Payer: BCBS Transplant Transplant $0.80
Rate for Payer: Blue Shield of California Commercial $0.98
Rate for Payer: Blue Shield of California EPN $0.78
Rate for Payer: Cash Price $0.60
Rate for Payer: Cigna of CA HMO $0.93
Rate for Payer: Cigna of CA PPO $0.93
Rate for Payer: Dignity Health Commercial/Exchange $1.13
Rate for Payer: Dignity Health Media $1.13
Rate for Payer: Dignity Health Medi-Cal $1.13
Rate for Payer: EPIC Health Plan Commercial $0.53
Rate for Payer: EPIC Health Plan Transplant $0.53
Rate for Payer: Galaxy Health WC $1.13
Rate for Payer: Global Benefits Group Commercial $0.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.51
Rate for Payer: LLUH Dept of Risk Management WC $0.32
Rate for Payer: Multiplan Commercial $1.06
Rate for Payer: Networks By Design Commercial $0.86
Rate for Payer: Prime Health Services Commercial $1.13
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.80
Rate for Payer: TriValley Medical Group Commercial/Senior $0.80
Rate for Payer: United Healthcare All Other Commercial $0.67
Rate for Payer: United Healthcare All Other HMO $0.67
Rate for Payer: United Healthcare HMO Rider $0.67
Rate for Payer: United Healthcare Select/Navigate/Core $0.67
Rate for Payer: Vantage Medical Group Commercial/Exchange $1.13
Rate for Payer: Vantage Medical Group Medi-Cal $1.13
Rate for Payer: Vantage Medical Group Senior $1.13
Service Code NDC 0574-7050-12
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.36
Rate for Payer: Blue Shield of California Commercial $0.30
Rate for Payer: Blue Shield of California EPN $0.22
Rate for Payer: Cash Price $0.19
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: EPIC Health Plan Commercial $0.17
Rate for Payer: Galaxy Health WC $0.36
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.10
Rate for Payer: Multiplan Commercial $0.34
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.36
Service Code NDC 58980-415-01
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.24
Rate for Payer: Aetna of CA HMO/PPO $0.18
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.24
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.17
Rate for Payer: BCBS Transplant Transplant $0.17
Rate for Payer: Blue Shield of California Commercial $0.21
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.13
Rate for Payer: Cigna of CA HMO $0.20
Rate for Payer: Cigna of CA PPO $0.20
Rate for Payer: Dignity Health Commercial/Exchange $0.24
Rate for Payer: Dignity Health Media $0.24
Rate for Payer: Dignity Health Medi-Cal $0.24
Rate for Payer: EPIC Health Plan Commercial $0.11
Rate for Payer: EPIC Health Plan Transplant $0.11
Rate for Payer: Galaxy Health WC $0.24
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.22
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.17
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.17
Rate for Payer: TriValley Medical Group Commercial/Senior $0.17
Rate for Payer: United Healthcare All Other Commercial $0.14
Rate for Payer: United Healthcare All Other HMO $0.14
Rate for Payer: United Healthcare HMO Rider $0.14
Rate for Payer: United Healthcare Select/Navigate/Core $0.14
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.24
Rate for Payer: Vantage Medical Group Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 0574-7050-50
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.27
Rate for Payer: BCBS Transplant Transplant $0.19
Rate for Payer: Aetna of CA HMO/PPO $0.21
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.27
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.18
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.18
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.19
Rate for Payer: Blue Shield of California Commercial $0.24
Rate for Payer: Blue Shield of California EPN $0.19
Rate for Payer: Cash Price $0.14
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: Dignity Health Commercial/Exchange $0.27
Rate for Payer: Dignity Health Media $0.27
Rate for Payer: Dignity Health Medi-Cal $0.27
Rate for Payer: EPIC Health Plan Commercial $0.13
Rate for Payer: EPIC Health Plan Transplant $0.13
Rate for Payer: Galaxy Health WC $0.27
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.24
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.26
Rate for Payer: Networks By Design Commercial $0.21
Rate for Payer: Prime Health Services Commercial $0.27
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.19
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.19
Rate for Payer: TriValley Medical Group Commercial/Senior $0.19
Rate for Payer: United Healthcare All Other Commercial $0.16
Rate for Payer: United Healthcare All Other HMO $0.16
Rate for Payer: United Healthcare HMO Rider $0.16
Rate for Payer: United Healthcare Select/Navigate/Core $0.16
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.27
Rate for Payer: Vantage Medical Group Medi-Cal $0.27
Rate for Payer: Vantage Medical Group Senior $0.27
Service Code NDC 71399-8460-5
Hospital Charge Code 1748045
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.26
Rate for Payer: Blue Shield of California Commercial $0.22
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.14
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.12
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.25
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Service Code NDC 0904-6407-61
Hospital Charge Code 1710522
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO $0.02
Rate for Payer: Cigna of CA PPO $0.02
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: Dignity Health Media $0.03
Rate for Payer: Dignity Health Medi-Cal $0.03
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.02
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 0904-6748-60
Hospital Charge Code 1710522
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Service Code NDC 57896-441-01
Hospital Charge Code 1710522
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Service Code NDC 57896-441-01
Hospital Charge Code 1710522
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: Dignity Health Media $0.02
Rate for Payer: Dignity Health Medi-Cal $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 0904-6407-61
Hospital Charge Code 1710522
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO $0.02
Rate for Payer: Cigna of CA PPO $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.02
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 0904-6748-60
Hospital Charge Code 1710522
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: Dignity Health Media $0.02
Rate for Payer: Dignity Health Medi-Cal $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02