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Service Code NDC 0054-0064-47
Hospital Charge Code 1715969
Hospital Revenue Code 636
Min. Negotiated Rate $0.48
Max. Negotiated Rate $1.72
Rate for Payer: Aetna of CA HMO/PPO $1.32
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $1.72
Rate for Payer: Alpha Care Medical Group Medi-Cal $1.11
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $1.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.20
Rate for Payer: Blue Distinction Transplant $1.21
Rate for Payer: Blue Shield of California Commercial $1.49
Rate for Payer: Blue Shield of California EPN $1.18
Rate for Payer: Cash Price $0.91
Rate for Payer: Cigna of CA HMO $1.41
Rate for Payer: Cigna of CA PPO $1.41
Rate for Payer: Dignity Health Commercial/Exchange $1.72
Rate for Payer: Dignity Health Media $1.72
Rate for Payer: Dignity Health Medi-Cal $1.72
Rate for Payer: EPIC Health Plan Commercial $0.81
Rate for Payer: EPIC Health Plan Transplant $0.81
Rate for Payer: Galaxy Health WC $1.72
Rate for Payer: Global Benefits Group Commercial $1.21
Rate for Payer: Health Plan of Nevada (Sierra) Other $1.52
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.77
Rate for Payer: LLUH Dept of Risk Management WC $0.48
Rate for Payer: Multiplan Commercial $1.62
Rate for Payer: Networks By Design Commercial $1.01
Rate for Payer: Prime Health Services Commercial $1.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.21
Rate for Payer: TriValley Medical Group Commercial/Senior $1.21
Rate for Payer: United Healthcare All Other Commercial $1.01
Rate for Payer: United Healthcare All Other HMO $1.01
Rate for Payer: United Healthcare HMO Rider $1.01
Rate for Payer: United Healthcare Select/Navigate/Core $1.01
Rate for Payer: Vantage Medical Group Commercial/Exchange $1.72
Rate for Payer: Vantage Medical Group Medi-Cal $1.72
Rate for Payer: Vantage Medical Group Senior $1.72
Service Code NDC 16714-671-02
Hospital Charge Code 1715969
Hospital Revenue Code 636
Min. Negotiated Rate $0.41
Max. Negotiated Rate $1.44
Rate for Payer: Blue Shield of California Commercial $1.21
Rate for Payer: Blue Shield of California EPN $0.87
Rate for Payer: Cash Price $0.77
Rate for Payer: Cigna of CA HMO $1.19
Rate for Payer: Cigna of CA PPO $1.19
Rate for Payer: EPIC Health Plan Commercial $0.68
Rate for Payer: EPIC Health Plan Transplant $0.68
Rate for Payer: Galaxy Health WC $1.44
Rate for Payer: Global Benefits Group Commercial $1.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.65
Rate for Payer: LLUH Dept of Risk Management WC $0.41
Rate for Payer: Multiplan Commercial $1.36
Rate for Payer: Networks By Design Commercial $0.85
Rate for Payer: Prime Health Services Commercial $1.44
Rate for Payer: United Healthcare All Other Commercial $0.64
Rate for Payer: United Healthcare All Other HMO $0.63
Rate for Payer: United Healthcare HMO Rider $0.61
Rate for Payer: United Healthcare Select/Navigate/Core $0.56
Service Code NDC 68084-220-11
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.77
Rate for Payer: Aetna of CA HMO/PPO $0.59
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.77
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.50
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.54
Rate for Payer: Blue Distinction Transplant $0.54
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.53
Rate for Payer: Cash Price $0.41
Rate for Payer: Cigna of CA HMO $0.63
Rate for Payer: Cigna of CA PPO $0.63
Rate for Payer: Dignity Health Commercial/Exchange $0.77
Rate for Payer: Dignity Health Media $0.77
Rate for Payer: Dignity Health Medi-Cal $0.77
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Transplant $0.36
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Global Benefits Group Commercial $0.54
Rate for Payer: Health Plan of Nevada (Sierra) Other $0.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.34
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.72
Rate for Payer: Networks By Design Commercial $0.59
Rate for Payer: Prime Health Services Commercial $0.77
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.54
Rate for Payer: TriValley Medical Group Commercial/Senior $0.54
Rate for Payer: United Healthcare All Other Commercial $0.45
Rate for Payer: United Healthcare All Other HMO $0.45
Rate for Payer: United Healthcare HMO Rider $0.45
Rate for Payer: United Healthcare Select/Navigate/Core $0.45
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.77
Rate for Payer: Vantage Medical Group Senior $0.77
Service Code NDC 68084-220-01
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.77
Rate for Payer: Blue Shield of California Commercial $0.64
Rate for Payer: Blue Shield of California EPN $0.46
Rate for Payer: Cash Price $0.41
Rate for Payer: Cigna of CA HMO $0.63
Rate for Payer: Cigna of CA PPO $0.63
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Global Benefits Group Commercial $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.34
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.72
Rate for Payer: Networks By Design Commercial $0.59
Rate for Payer: Prime Health Services Commercial $0.77
Service Code NDC 71930-017-30
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.46
Rate for Payer: Blue Shield of California Commercial $0.38
Rate for Payer: Blue Shield of California EPN $0.28
Rate for Payer: Cash Price $0.24
Rate for Payer: Cigna of CA HMO $0.38
Rate for Payer: Cigna of CA PPO $0.38
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: Galaxy Health WC $0.46
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.13
Rate for Payer: Multiplan Commercial $0.43
Rate for Payer: Networks By Design Commercial $0.35
Rate for Payer: Prime Health Services Commercial $0.46
Service Code NDC 68084-220-11
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.77
Rate for Payer: Blue Shield of California Commercial $0.64
Rate for Payer: Blue Shield of California EPN $0.46
Rate for Payer: Cash Price $0.41
Rate for Payer: Cigna of CA HMO $0.63
Rate for Payer: Cigna of CA PPO $0.63
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Global Benefits Group Commercial $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.34
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.72
Rate for Payer: Networks By Design Commercial $0.59
Rate for Payer: Prime Health Services Commercial $0.77
Service Code NDC 57237-075-30
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.15
Rate for Payer: Blue Shield of California Commercial $0.13
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.08
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: EPIC Health Plan Commercial $0.07
Rate for Payer: Galaxy Health WC $0.15
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.15
Service Code NDC 71930-017-30
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.46
Rate for Payer: Aetna of CA HMO/PPO $0.35
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.46
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.30
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.32
Rate for Payer: Blue Distinction Transplant $0.32
Rate for Payer: Blue Shield of California Commercial $0.40
Rate for Payer: Blue Shield of California EPN $0.32
Rate for Payer: Cash Price $0.24
Rate for Payer: Cigna of CA HMO $0.38
Rate for Payer: Cigna of CA PPO $0.38
Rate for Payer: Dignity Health Commercial/Exchange $0.46
Rate for Payer: Dignity Health Media $0.46
Rate for Payer: Dignity Health Medi-Cal $0.46
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: EPIC Health Plan Transplant $0.22
Rate for Payer: Galaxy Health WC $0.46
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Plan of Nevada (Sierra) Other $0.41
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.13
Rate for Payer: Multiplan Commercial $0.43
Rate for Payer: Networks By Design Commercial $0.35
Rate for Payer: Prime Health Services Commercial $0.46
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.32
Rate for Payer: TriValley Medical Group Commercial/Senior $0.32
Rate for Payer: United Healthcare All Other Commercial $0.27
Rate for Payer: United Healthcare All Other HMO $0.27
Rate for Payer: United Healthcare HMO Rider $0.27
Rate for Payer: United Healthcare Select/Navigate/Core $0.27
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.46
Rate for Payer: Vantage Medical Group Medi-Cal $0.46
Rate for Payer: Vantage Medical Group Senior $0.46
Service Code NDC 68084-220-01
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.77
Rate for Payer: Aetna of CA HMO/PPO $0.59
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.77
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.50
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.54
Rate for Payer: Blue Distinction Transplant $0.54
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.53
Rate for Payer: Cash Price $0.41
Rate for Payer: Cigna of CA HMO $0.63
Rate for Payer: Cigna of CA PPO $0.63
Rate for Payer: Dignity Health Commercial/Exchange $0.77
Rate for Payer: Dignity Health Media $0.77
Rate for Payer: Dignity Health Medi-Cal $0.77
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Transplant $0.36
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Global Benefits Group Commercial $0.54
Rate for Payer: Health Plan of Nevada (Sierra) Other $0.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.34
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.72
Rate for Payer: Networks By Design Commercial $0.59
Rate for Payer: Prime Health Services Commercial $0.77
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.54
Rate for Payer: TriValley Medical Group Commercial/Senior $0.54
Rate for Payer: United Healthcare All Other Commercial $0.45
Rate for Payer: United Healthcare All Other HMO $0.45
Rate for Payer: United Healthcare HMO Rider $0.45
Rate for Payer: United Healthcare Select/Navigate/Core $0.45
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.77
Rate for Payer: Vantage Medical Group Senior $0.77
Service Code NDC 57237-075-30
Hospital Charge Code 1711570
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.15
Rate for Payer: Aetna of CA HMO/PPO $0.12
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.15
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.10
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.10
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.11
Rate for Payer: Blue Distinction Transplant $0.11
Rate for Payer: Blue Shield of California Commercial $0.13
Rate for Payer: Blue Shield of California EPN $0.11
Rate for Payer: Cash Price $0.08
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: Dignity Health Commercial/Exchange $0.15
Rate for Payer: Dignity Health Media $0.15
Rate for Payer: Dignity Health Medi-Cal $0.15
Rate for Payer: EPIC Health Plan Commercial $0.07
Rate for Payer: EPIC Health Plan Transplant $0.07
Rate for Payer: Galaxy Health WC $0.15
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Health Plan of Nevada (Sierra) Other $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.11
Rate for Payer: TriValley Medical Group Commercial/Senior $0.11
Rate for Payer: United Healthcare All Other Commercial $0.09
Rate for Payer: United Healthcare All Other HMO $0.09
Rate for Payer: United Healthcare HMO Rider $0.09
Rate for Payer: United Healthcare Select/Navigate/Core $0.09
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.15
Rate for Payer: Vantage Medical Group Medi-Cal $0.15
Rate for Payer: Vantage Medical Group Senior $0.15
Service Code NDC 57237-076-30
Hospital Charge Code 1711594
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.19
Rate for Payer: Blue Shield of California Commercial $0.16
Rate for Payer: Blue Shield of California EPN $0.11
Rate for Payer: Cash Price $0.10
Rate for Payer: Cigna of CA HMO $0.15
Rate for Payer: Cigna of CA PPO $0.15
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: Galaxy Health WC $0.19
Rate for Payer: Global Benefits Group Commercial $0.13
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.14
Rate for Payer: Prime Health Services Commercial $0.19
Service Code NDC 57237-076-30
Hospital Charge Code 1711594
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.19
Rate for Payer: Aetna of CA HMO/PPO $0.14
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.19
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.12
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.13
Rate for Payer: Blue Distinction Transplant $0.13
Rate for Payer: Blue Shield of California Commercial $0.16
Rate for Payer: Blue Shield of California EPN $0.13
Rate for Payer: Cash Price $0.10
Rate for Payer: Cigna of CA HMO $0.15
Rate for Payer: Cigna of CA PPO $0.15
Rate for Payer: Dignity Health Commercial/Exchange $0.19
Rate for Payer: Dignity Health Media $0.19
Rate for Payer: Dignity Health Medi-Cal $0.19
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: EPIC Health Plan Transplant $0.09
Rate for Payer: Galaxy Health WC $0.19
Rate for Payer: Global Benefits Group Commercial $0.13
Rate for Payer: Health Plan of Nevada (Sierra) Other $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.14
Rate for Payer: Prime Health Services Commercial $0.19
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.13
Rate for Payer: TriValley Medical Group Commercial/Senior $0.13
Rate for Payer: United Healthcare All Other Commercial $0.11
Rate for Payer: United Healthcare All Other HMO $0.11
Rate for Payer: United Healthcare HMO Rider $0.11
Rate for Payer: United Healthcare Select/Navigate/Core $0.11
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.19
Rate for Payer: Vantage Medical Group Medi-Cal $0.19
Rate for Payer: Vantage Medical Group Senior $0.19
Service Code NDC 0904-6552-61
Hospital Charge Code 1711594
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.65
Rate for Payer: Aetna of CA HMO/PPO $0.50
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.65
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.42
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.45
Rate for Payer: Blue Distinction Transplant $0.46
Rate for Payer: Blue Shield of California Commercial $0.56
Rate for Payer: Blue Shield of California EPN $0.44
Rate for Payer: Cash Price $0.34
Rate for Payer: Cigna of CA HMO $0.53
Rate for Payer: Cigna of CA PPO $0.53
Rate for Payer: Dignity Health Commercial/Exchange $0.65
Rate for Payer: Dignity Health Media $0.65
Rate for Payer: Dignity Health Medi-Cal $0.65
Rate for Payer: EPIC Health Plan Commercial $0.30
Rate for Payer: EPIC Health Plan Transplant $0.30
Rate for Payer: Galaxy Health WC $0.65
Rate for Payer: Global Benefits Group Commercial $0.46
Rate for Payer: Health Plan of Nevada (Sierra) Other $0.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.29
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.61
Rate for Payer: Networks By Design Commercial $0.49
Rate for Payer: Prime Health Services Commercial $0.65
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.46
Rate for Payer: TriValley Medical Group Commercial/Senior $0.46
Rate for Payer: United Healthcare All Other Commercial $0.38
Rate for Payer: United Healthcare All Other HMO $0.38
Rate for Payer: United Healthcare HMO Rider $0.38
Rate for Payer: United Healthcare Select/Navigate/Core $0.38
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.65
Rate for Payer: Vantage Medical Group Medi-Cal $0.65
Rate for Payer: Vantage Medical Group Senior $0.65
Service Code NDC 0904-6552-61
Hospital Charge Code 1711594
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.65
Rate for Payer: Blue Shield of California Commercial $0.54
Rate for Payer: Blue Shield of California EPN $0.39
Rate for Payer: Cash Price $0.34
Rate for Payer: Cigna of CA HMO $0.53
Rate for Payer: Cigna of CA PPO $0.53
Rate for Payer: EPIC Health Plan Commercial $0.30
Rate for Payer: Galaxy Health WC $0.65
Rate for Payer: Global Benefits Group Commercial $0.46
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.29
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.61
Rate for Payer: Networks By Design Commercial $0.49
Rate for Payer: Prime Health Services Commercial $0.65
Service Code CPT J2405
Hospital Charge Code 1721066
Hospital Revenue Code 636
Min. Negotiated Rate $0.07
Max. Negotiated Rate $12.02
Rate for Payer: Aetna of CA HMO/PPO $0.62
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.24
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.15
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $12.02
Rate for Payer: Blue Distinction Transplant $0.17
Rate for Payer: Blue Shield of California Commercial $0.21
Rate for Payer: Blue Shield of California EPN $0.22
Rate for Payer: Cash Price $0.13
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) Other $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal $8.66
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 $0.14
Rate for Payer: Prime Health Services Commercial $0.24
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 CPT J2405
Hospital Charge Code 1721066
Hospital Revenue Code 636
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: 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: 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 $0.14
Rate for Payer: Prime Health Services Commercial $0.24
Rate for Payer: United Healthcare All Other Commercial $0.11
Rate for Payer: United Healthcare All Other HMO $0.10
Rate for Payer: United Healthcare HMO Rider $0.10
Rate for Payer: United Healthcare Select/Navigate/Core $0.09
Service Code APR-DRG 0212
Min. Negotiated Rate $30,099.53
Max. Negotiated Rate $39,237.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $30,099.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal $39,237.81
Service Code APR-DRG 0211
Min. Negotiated Rate $23,645.65
Max. Negotiated Rate $30,824.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $23,645.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal $30,824.52
Service Code APR-DRG 0214
Min. Negotiated Rate $70,258.07
Max. Negotiated Rate $91,588.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $70,258.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal $91,588.57
Service Code APR-DRG 0213
Min. Negotiated Rate $45,031.61
Max. Negotiated Rate $58,703.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $45,031.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal $58,703.29
Service Code APR-DRG 0203
Min. Negotiated Rate $41,461.84
Max. Negotiated Rate $54,049.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $41,461.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal $54,049.74
Service Code APR-DRG 0202
Min. Negotiated Rate $30,302.23
Max. Negotiated Rate $39,502.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $30,302.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal $39,502.04
Service Code APR-DRG 0204
Min. Negotiated Rate $64,819.08
Max. Negotiated Rate $84,498.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $64,819.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal $84,498.28
Service Code APR-DRG 0201
Min. Negotiated Rate $25,223.74
Max. Negotiated Rate $32,881.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $25,223.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal $32,881.72
Service Code APR-DRG 0244
Min. Negotiated Rate $46,981.11
Max. Negotiated Rate $61,244.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $46,981.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal $61,244.68