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Service Code NDC 5789641501
Hospital Charge Code 901700029
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.00
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.02
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.01
Rate for Payer: Alpha Care 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 $0.01
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: Dignity Health Medi-Cal $0.02
Rate for Payer: Dignity Health Medicare Advantage $0.02
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.01
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.01
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.01
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: Riverside University Health System 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 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 7139982453
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
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: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
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 7139910173
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.03
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.02
Rate for Payer: Alpha Care 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 $0.02
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: Dignity Health Medi-Cal $0.03
Rate for Payer: Dignity Health Medicare Advantage $0.03
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.01
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.03
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: Riverside University Health System 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 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 6961864001
Hospital Charge Code 901700029
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Adventist Health Commercial $0.00
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 $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.01
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $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 7139910173
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
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: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
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 5723730124
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA HMO/PPO $0.03
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.04
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.03
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.04
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: 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: Dignity Health Medi-Cal $0.04
Rate for Payer: Dignity Health Medicare Advantage $0.04
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.02
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.04
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: Riverside University Health System 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 Commercial/Exchange $0.04
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Senior $0.04
Service Code NDC 6961806958
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
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: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
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 5789647208
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
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: 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: Emerging Therapy Solutions (LifeTrac) Transplant $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $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 5789647208
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA HMO/PPO $0.03
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.04
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.03
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.04
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: 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: Dignity Health Medi-Cal $0.04
Rate for Payer: Dignity Health Medicare Advantage $0.04
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.02
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.04
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: Riverside University Health System 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 Commercial/Exchange $0.04
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Senior $0.04
Service Code NDC 7139900278
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
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: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
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 5723730124
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Adventist Health Commercial $0.01
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: 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: Emerging Therapy Solutions (LifeTrac) Transplant $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $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 7139900278
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.03
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.02
Rate for Payer: Alpha Care 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 $0.02
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: Dignity Health Medi-Cal $0.03
Rate for Payer: Dignity Health Medicare Advantage $0.03
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.01
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.03
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: Riverside University Health System 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 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 6961806958
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Adventist Health Commercial $0.01
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.03
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.02
Rate for Payer: Alpha Care 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 $0.02
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: Dignity Health Medi-Cal $0.03
Rate for Payer: Dignity Health Medicare Advantage $0.03
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Senior $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 Foundation Hospitals Commercial/Self Funded $0.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.01
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.03
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: Riverside University Health System 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 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 MSDRG 549
Min. Negotiated Rate $6,823.00
Max. Negotiated Rate $31,772.30
Rate for Payer: Aetna of CA HMO/PPO $31,772.30
Rate for Payer: Anthem Blue Cross of CA Exchange $20,523.61
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $28,733.77
Rate for Payer: EPIC Health Plan Commercial $28,959.76
Rate for Payer: EPIC Health Plan Senior $19,306.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $17,551.37
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $24,571.92
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $23,518.84
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $17,551.37
Rate for Payer: Prime Health Services Medicare $18,604.45
Rate for Payer: United Healthcare All Other Commercial $10,506.00
Rate for Payer: United Healthcare All Other HMO $8,385.00
Rate for Payer: United Healthcare HMO Rider $7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core $6,823.00
Service Code MSDRG 548
Min. Negotiated Rate $6,823.00
Max. Negotiated Rate $50,819.36
Rate for Payer: Aetna of CA HMO/PPO $50,819.36
Rate for Payer: Anthem Blue Cross of CA Exchange $32,827.23
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $45,959.28
Rate for Payer: EPIC Health Plan Commercial $45,428.91
Rate for Payer: EPIC Health Plan Senior $30,285.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $27,532.67
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $38,545.74
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $36,893.78
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $27,532.67
Rate for Payer: Prime Health Services Medicare $29,184.63
Rate for Payer: United Healthcare All Other Commercial $10,506.00
Rate for Payer: United Healthcare All Other HMO $8,385.00
Rate for Payer: United Healthcare HMO Rider $7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core $6,823.00
Service Code MSDRG 550
Min. Negotiated Rate $6,823.00
Max. Negotiated Rate $23,005.44
Rate for Payer: Aetna of CA HMO/PPO $23,005.44
Rate for Payer: Anthem Blue Cross of CA Exchange $14,860.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $20,805.33
Rate for Payer: EPIC Health Plan Commercial $21,379.45
Rate for Payer: EPIC Health Plan Senior $14,252.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $12,957.24
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $18,140.14
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $17,362.70
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $12,957.24
Rate for Payer: Prime Health Services Medicare $13,734.67
Rate for Payer: United Healthcare All Other Commercial $10,506.00
Rate for Payer: United Healthcare All Other HMO $8,385.00
Rate for Payer: United Healthcare HMO Rider $7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core $6,823.00
Service Code APR-DRG 7201
Min. Negotiated Rate $6,223.21
Max. Negotiated Rate $9,853.42
Rate for Payer: Adventist Health Medi-Cal $6,223.21
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal $7,415.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $9,853.42
Service Code APR-DRG 7203
Min. Negotiated Rate $12,922.20
Max. Negotiated Rate $20,460.15
Rate for Payer: Adventist Health Medi-Cal $12,922.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal $15,398.95
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $20,460.15
Service Code APR-DRG 7204
Min. Negotiated Rate $23,527.86
Max. Negotiated Rate $37,252.44
Rate for Payer: Adventist Health Medi-Cal $23,527.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal $28,037.37
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $37,252.44
Service Code APR-DRG 7202
Min. Negotiated Rate $8,521.93
Max. Negotiated Rate $13,493.06
Rate for Payer: Adventist Health Medi-Cal $8,521.93
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal $10,155.30
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $13,493.06
Service Code MSDRG 870
Min. Negotiated Rate $6,823.00
Max. Negotiated Rate $181,911.66
Rate for Payer: Aetna of CA HMO/PPO $181,911.66
Rate for Payer: Anthem Blue Cross of CA Exchange $117,507.51
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $164,514.66
Rate for Payer: EPIC Health Plan Commercial $158,778.63
Rate for Payer: EPIC Health Plan Senior $105,852.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $96,229.47
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $134,721.26
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $128,947.49
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $96,229.47
Rate for Payer: Prime Health Services Medicare $102,003.24
Rate for Payer: United Healthcare All Other Commercial $10,506.00
Rate for Payer: United Healthcare All Other HMO $8,385.00
Rate for Payer: United Healthcare HMO Rider $7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core $6,823.00
Service Code MSDRG 871
Min. Negotiated Rate $6,823.00
Max. Negotiated Rate $51,124.66
Rate for Payer: Aetna of CA HMO/PPO $51,124.66
Rate for Payer: Anthem Blue Cross of CA Exchange $33,024.44
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $46,235.39
Rate for Payer: EPIC Health Plan Commercial $45,692.89
Rate for Payer: EPIC Health Plan Senior $30,461.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $27,692.66
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $38,769.72
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $37,108.16
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $27,692.66
Rate for Payer: Prime Health Services Medicare $29,354.22
Rate for Payer: United Healthcare All Other Commercial $10,506.00
Rate for Payer: United Healthcare All Other HMO $8,385.00
Rate for Payer: United Healthcare HMO Rider $7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core $6,823.00
Service Code MSDRG 872
Min. Negotiated Rate $6,823.00
Max. Negotiated Rate $26,932.23
Rate for Payer: Aetna of CA HMO/PPO $26,932.23
Rate for Payer: Anthem Blue Cross of CA Exchange $17,397.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $24,356.59
Rate for Payer: EPIC Health Plan Commercial $24,774.75
Rate for Payer: EPIC Health Plan Senior $16,516.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $15,015.00
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $21,021.00
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $20,120.10
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $15,015.00
Rate for Payer: Prime Health Services Medicare $15,915.90
Rate for Payer: United Healthcare All Other Commercial $10,506.00
Rate for Payer: United Healthcare All Other HMO $8,385.00
Rate for Payer: United Healthcare HMO Rider $7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core $6,823.00
Service Code CPT 30520
Hospital Revenue Code 360
Min. Negotiated Rate $640.36
Max. Negotiated Rate $27,467.00
Rate for Payer: Adventist Health Medi-Cal $4,264.23
Rate for Payer: Aetna of CA HMO/PPO $27,467.00
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $6,396.35
Rate for Payer: Alpha Care Medical Group Medi-Cal $4,690.65
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $4,264.23
Rate for Payer: Anthem Blue Cross of CA Exchange $8,405.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,687.00
Rate for Payer: Anthem Blue Cross of CA Workers' Comp $6,565.51
Rate for Payer: Blue Shield of California Commercial $6,228.07
Rate for Payer: Blue Shield of California EPN $3,914.40
Rate for Payer: Dignity Health Commercial/Exchange $6,396.35
Rate for Payer: Dignity Health Medi-Cal $4,690.65
Rate for Payer: Dignity Health Medicare Advantage $4,264.23
Rate for Payer: EPIC Health Plan Commercial $7,035.98
Rate for Payer: EPIC Health Plan Senior $4,690.65
Rate for Payer: Heritage Provider Network Commercial/Senior $6,993.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal $640.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage $4,264.23
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $707.37
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $5,969.92
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $5,714.07
Rate for Payer: Multiplan WC $6,565.51
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage $4,264.23
Rate for Payer: Preferred Health Network WC $6,699.50
Rate for Payer: Prime Health Services Medicare $4,520.08
Rate for Payer: Prime Health Services WC $6,498.52
Rate for Payer: Riverside University Health System MISP $4,690.65
Rate for Payer: United Healthcare All Other HMO $16,122.00
Rate for Payer: United Healthcare HMO Rider $10,165.00
Rate for Payer: United Healthcare Select/Navigate/Core $9,312.00
Rate for Payer: Upland Medical Group Pediatric $4,264.23
Rate for Payer: Vantage Medical Group Commercial/Exchange $6,396.35
Rate for Payer: Vantage Medical Group Medi-Cal $4,690.65
Rate for Payer: Vantage Medical Group Senior $4,264.23
Service Code NDC 6068725301
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.48
Rate for Payer: Adventist Health Commercial $0.11
Rate for Payer: Aetna of CA HMO/PPO $0.32
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.45
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.29
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.40
Rate for Payer: Anthem Blue Cross of CA Exchange $0.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.31
Rate for Payer: Blue Shield of California Commercial $0.34
Rate for Payer: Blue Shield of California EPN $0.21
Rate for Payer: Cash Price $0.24
Rate for Payer: Central Health Plan Commercial $0.42
Rate for Payer: Cigna of CA HMO $0.37
Rate for Payer: Cigna of CA PPO $0.37
Rate for Payer: Dignity Health Commercial/Exchange $0.45
Rate for Payer: Dignity Health Medi-Cal $0.45
Rate for Payer: Dignity Health Medicare Advantage $0.45
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $0.37
Rate for Payer: EPIC Health Plan Commercial $0.21
Rate for Payer: EPIC Health Plan Senior $0.21
Rate for Payer: Galaxy Health WC $0.45
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Management Network EPO/PPO $0.48
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $0.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $0.19
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $0.31
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $0.37
Rate for Payer: Multiplan Commercial $0.40
Rate for Payer: Networks By Design Commercial $0.34
Rate for Payer: Prime Health Services Commercial $0.45
Rate for Payer: Riverside University Health System MISP $0.21
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 $0.45
Rate for Payer: Vantage Medical Group Medi-Cal $0.45
Rate for Payer: Vantage Medical Group Senior $0.45