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Charge Type Price  
Service Code APR-DRG 0434
Min. Negotiated Rate $30,437.05
Max. Negotiated Rate $36,270.82
Rate for Payer: Adventist Health Medi-Cal $30,437.05
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: IEHP medi-cal $36,270.82
Service Code APR-DRG 9304
Min. Negotiated Rate $27,760.07
Max. Negotiated Rate $34,005.88
Rate for Payer: Adventist Health Medi-Cal $27,760.07
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: IEHP medi-cal $33,080.75
Service Code APR-DRG 9303
Min. Negotiated Rate $14,417.66
Max. Negotiated Rate $34,005.88
Rate for Payer: Adventist Health Medi-Cal $14,417.66
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: IEHP medi-cal $17,181.05
Service Code APR-DRG 9301
Min. Negotiated Rate $7,609.82
Max. Negotiated Rate $34,005.88
Rate for Payer: Adventist Health Medi-Cal $7,609.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: IEHP medi-cal $9,068.37
Service Code APR-DRG 9302
Min. Negotiated Rate $9,161.14
Max. Negotiated Rate $34,005.88
Rate for Payer: Adventist Health Medi-Cal $9,161.14
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: IEHP medi-cal $10,917.02
Service Code NDC 8068116000
Hospital Charge Code 1711088
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
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 Exchange $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 $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $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 Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 904549261
Hospital Charge Code 1711088
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Service Code NDC 8068116000
Hospital Charge Code 1711088
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 4098522368
Hospital Charge Code 1711088
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.04
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.04
Service Code NDC 4098522368
Hospital Charge Code 1711088
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.03
Rate for Payer: BCBS Transplant Transplant $0.03
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.04
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.04
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.04
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.03
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.03
Rate for Payer: TriValley Medical Group Commercial/Senior $0.03
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Senior $0.04
Service Code NDC 904549261
Hospital Charge Code 1711088
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.04
Rate for Payer: BCBS Transplant Transplant $0.04
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.05
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.05
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Commercial/Senior $0.04
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 8068105000
Hospital Charge Code ERX196574
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 Exchange $0.01
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 $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
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: 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 Management Network EPO/PPO $0.03
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
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: Riverside University Health MISP $0.01
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 Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 8068105000
Hospital Charge Code ERX196574
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
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: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
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: Health Management Network EPO/PPO $0.03
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
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 8068100300
Hospital Charge Code ERX196574
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 8068100300
Hospital Charge Code ERX196574
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
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 Exchange $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 $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $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 Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 573051330
Hospital Charge Code NDG121122
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 5434462
Hospital Charge Code 1715264
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 Exchange $0.01
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 $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
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: 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 Management Network EPO/PPO $0.03
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
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: Riverside University Health MISP $0.01
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 Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 5434462
Hospital Charge Code 1715264
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
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: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
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: Health Management Network EPO/PPO $0.03
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
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 573051330
Hospital Charge Code NDG121122
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
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 Exchange $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 $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $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 Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 6961800858
Hospital Charge Code NDG121122
Hospital Revenue Code 259
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
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: Health Management Network EPO/PPO $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $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 6961800858
Hospital Charge Code NDG121122
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 Exchange $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: Central Health Plan Commercial $0.02
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: 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 Management Network EPO/PPO $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $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: Riverside University Health MISP $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 Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 5891401460
Hospital Charge Code ERX121580
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.45
Rate for Payer: Blue Shield of California EPN $0.32
Rate for Payer: Cash Price $0.27
Rate for Payer: Cash Price $0.27
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Service Code NDC 5891401460
Hospital Charge Code ERX121580
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.51
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.33
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.33
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: BCBS Transplant Transplant $0.36
Rate for Payer: Blue Shield of California Commercial $0.38
Rate for Payer: Blue Shield of California EPN $0.29
Rate for Payer: Cash Price $0.27
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.51
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Transplant $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.45
Rate for Payer: IEHP medi-cal $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.36
Rate for Payer: Riverside University Health MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Commercial/Senior $0.36
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Medi-Cal $0.51
Rate for Payer: Vantage Medical Group Senior $0.51
Service Code NDC 0093-1010-42
Hospital Charge Code 1743673
Hospital Revenue Code 259
Min. Negotiated Rate $0.35
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $1.31
Rate for Payer: Blue Shield of California EPN $0.93
Rate for Payer: Cash Price $0.79
Rate for Payer: Cash Price $0.79
Rate for Payer: Central Health Plan Commercial $1.40
Rate for Payer: Cigna of CA HMO $1.22
Rate for Payer: Cigna of CA PPO $1.22
Rate for Payer: EPIC Health Plan Commercial $0.70
Rate for Payer: Galaxy Health WC $1.49
Rate for Payer: Global Benefits Group Commercial $1.05
Rate for Payer: Health Management Network EPO/PPO $1.58
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.17
Rate for Payer: LLUH Dept of Risk Management WC $0.35
Rate for Payer: Multiplan Commercial $1.31
Rate for Payer: Networks By Design Commercial $1.14
Rate for Payer: Prime Health Services Commercial $1.49
Service Code NDC 0093-1010-42
Hospital Charge Code 1743673
Hospital Revenue Code 259
Min. Negotiated Rate $0.35
Max. Negotiated Rate $1.58
Rate for Payer: Aetna of CA HMO/PPO $1.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.49
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.96
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.96
Rate for Payer: Anthem Blue Cross of CA Exchange $0.85
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.03
Rate for Payer: BCBS Transplant Transplant $1.05
Rate for Payer: Blue Shield of California Commercial $1.10
Rate for Payer: Blue Shield of California EPN $0.86
Rate for Payer: Cash Price $0.79
Rate for Payer: Central Health Plan Commercial $1.40
Rate for Payer: Cigna of CA HMO $1.22
Rate for Payer: Cigna of CA PPO $1.22
Rate for Payer: Dignity Health Commercial/Exchange $1.49
Rate for Payer: EPIC Health Plan Commercial $0.70
Rate for Payer: EPIC Health Plan Transplant $0.70
Rate for Payer: Galaxy Health WC $1.49
Rate for Payer: Global Benefits Group Commercial $1.05
Rate for Payer: Health Management Network EPO/PPO $1.58
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.31
Rate for Payer: IEHP medi-cal $0.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.17
Rate for Payer: LLUH Dept of Risk Management WC $0.35
Rate for Payer: Multiplan Commercial $1.31
Rate for Payer: Networks By Design Commercial $1.14
Rate for Payer: Prime Health Services Commercial $1.49
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.05
Rate for Payer: Riverside University Health MISP $0.70
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.05
Rate for Payer: TriValley Medical Group Commercial/Senior $1.05
Rate for Payer: United Healthcare All Other Commercial $0.88
Rate for Payer: United Healthcare All Other HMO $0.88
Rate for Payer: United Healthcare HMO Rider $0.88
Rate for Payer: United Healthcare Select/Navigate/Core $0.88
Rate for Payer: Vantage Medical Group Medi-Cal $1.49
Rate for Payer: Vantage Medical Group Senior $1.49