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Service Code NDC 49035-304-10
Hospital Charge Code 1740040
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
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 $0.07
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.04
Rate for Payer: Cash Price $0.04
Rate for Payer: Central Health Plan Commercial $0.07
Rate for Payer: Cigna of CA HMO $0.06
Rate for Payer: Cigna of CA PPO $0.06
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Galaxy Health WC $0.08
Rate for Payer: Global Benefits Group Commercial $0.05
Rate for Payer: Health Management Network EPO/PPO $0.08
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.06
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.07
Rate for Payer: Networks By Design Commercial $0.06
Rate for Payer: Prime Health Services Commercial $0.08
Service Code NDC 4110081123
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
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 $0.37
Rate for Payer: Blue Shield of California EPN $0.26
Rate for Payer: Cash Price $0.22
Rate for Payer: Cash Price $0.22
Rate for Payer: Central Health Plan Commercial $0.39
Rate for Payer: Cigna of CA HMO $0.34
Rate for Payer: Cigna of CA PPO $0.34
Rate for Payer: EPIC Health Plan Commercial $0.20
Rate for Payer: Galaxy Health WC $0.42
Rate for Payer: Global Benefits Group Commercial $0.29
Rate for Payer: Health Management Network EPO/PPO $0.44
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.33
Rate for Payer: LLUH Dept of Risk Management WC $0.10
Rate for Payer: Multiplan Commercial $0.37
Rate for Payer: Networks By Design Commercial $0.32
Rate for Payer: Prime Health Services Commercial $0.42
Service Code NDC 37000-803-01
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.36
Rate for Payer: Aetna of CA HMO/PPO $0.24
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.34
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.22
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.22
Rate for Payer: Anthem Blue Cross of CA Exchange $0.19
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.24
Rate for Payer: BCBS Transplant Transplant $0.24
Rate for Payer: Blue Shield of California Commercial $0.25
Rate for Payer: Blue Shield of California EPN $0.20
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.32
Rate for Payer: Cigna of CA HMO $0.28
Rate for Payer: Cigna of CA PPO $0.28
Rate for Payer: Dignity Health Commercial/Exchange $0.34
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.34
Rate for Payer: Global Benefits Group Commercial $0.24
Rate for Payer: Health Management Network EPO/PPO $0.36
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.30
Rate for Payer: IEHP medi-cal $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.30
Rate for Payer: Networks By Design Commercial $0.26
Rate for Payer: Prime Health Services Commercial $0.34
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.24
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.24
Rate for Payer: TriValley Medical Group Commercial/Senior $0.24
Rate for Payer: United Healthcare All Other Commercial $0.20
Rate for Payer: United Healthcare All Other HMO $0.20
Rate for Payer: United Healthcare HMO Rider $0.20
Rate for Payer: United Healthcare Select/Navigate/Core $0.20
Rate for Payer: Vantage Medical Group Medi-Cal $0.34
Rate for Payer: Vantage Medical Group Senior $0.34
Service Code NDC 11523-1167-6
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.34
Rate for Payer: Aetna of CA HMO/PPO $0.23
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.32
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.21
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.21
Rate for Payer: Anthem Blue Cross of CA Exchange $0.18
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.22
Rate for Payer: BCBS Transplant Transplant $0.23
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 $0.17
Rate for Payer: Central Health Plan Commercial $0.30
Rate for Payer: Cigna of CA HMO $0.27
Rate for Payer: Cigna of CA PPO $0.27
Rate for Payer: Dignity Health Commercial/Exchange $0.32
Rate for Payer: EPIC Health Plan Commercial $0.15
Rate for Payer: EPIC Health Plan Transplant $0.15
Rate for Payer: Galaxy Health WC $0.32
Rate for Payer: Global Benefits Group Commercial $0.23
Rate for Payer: Health Management Network EPO/PPO $0.34
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.29
Rate for Payer: IEHP medi-cal $0.13
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.25
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.29
Rate for Payer: Networks By Design Commercial $0.25
Rate for Payer: Prime Health Services Commercial $0.32
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.23
Rate for Payer: Riverside University Health MISP $0.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.23
Rate for Payer: TriValley Medical Group Commercial/Senior $0.23
Rate for Payer: United Healthcare All Other Commercial $0.19
Rate for Payer: United Healthcare All Other HMO $0.19
Rate for Payer: United Healthcare HMO Rider $0.19
Rate for Payer: United Healthcare Select/Navigate/Core $0.19
Rate for Payer: Vantage Medical Group Medi-Cal $0.32
Rate for Payer: Vantage Medical Group Senior $0.32
Service Code NDC 11523-1167-6
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
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 $0.29
Rate for Payer: Blue Shield of California EPN $0.20
Rate for Payer: Cash Price $0.17
Rate for Payer: Cash Price $0.17
Rate for Payer: Central Health Plan Commercial $0.30
Rate for Payer: Cigna of CA HMO $0.27
Rate for Payer: Cigna of CA PPO $0.27
Rate for Payer: EPIC Health Plan Commercial $0.15
Rate for Payer: Galaxy Health WC $0.32
Rate for Payer: Global Benefits Group Commercial $0.23
Rate for Payer: Health Management Network EPO/PPO $0.34
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.25
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.29
Rate for Payer: Networks By Design Commercial $0.25
Rate for Payer: Prime Health Services Commercial $0.32
Service Code NDC 0904-7006-35
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
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 $0.12
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.07
Rate for Payer: Cash Price $0.07
Rate for Payer: Central Health Plan Commercial $0.13
Rate for Payer: Cigna of CA HMO $0.11
Rate for Payer: Cigna of CA PPO $0.11
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Management Network EPO/PPO $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.12
Rate for Payer: Networks By Design Commercial $0.10
Rate for Payer: Prime Health Services Commercial $0.14
Service Code NDC 46122-165-10
Hospital Charge Code 1740040
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
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 $0.08
Rate for Payer: Blue Shield of California EPN $0.06
Rate for Payer: Cash Price $0.05
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.09
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Galaxy Health WC $0.09
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.08
Rate for Payer: Networks By Design Commercial $0.07
Rate for Payer: Prime Health Services Commercial $0.09
Service Code NDC 5002443100
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.29
Rate for Payer: Aetna of CA HMO/PPO $0.19
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 Exchange $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.19
Rate for Payer: BCBS Transplant Transplant $0.19
Rate for Payer: Blue Shield of California Commercial $0.20
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.14
Rate for Payer: Central Health Plan Commercial $0.26
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: 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 Management Network EPO/PPO $0.29
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.24
Rate for Payer: IEHP medi-cal $0.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.24
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: Riverside University Health MISP $0.13
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 Medi-Cal $0.27
Rate for Payer: Vantage Medical Group Senior $0.27
Service Code NDC 0904-7006-35
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.14
Rate for Payer: Aetna of CA HMO/PPO $0.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Anthem Blue Cross of CA Exchange $0.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.09
Rate for Payer: BCBS Transplant Transplant $0.10
Rate for Payer: Blue Shield of California Commercial $0.10
Rate for Payer: Blue Shield of California EPN $0.08
Rate for Payer: Cash Price $0.07
Rate for Payer: Central Health Plan Commercial $0.13
Rate for Payer: Cigna of CA HMO $0.11
Rate for Payer: Cigna of CA PPO $0.11
Rate for Payer: Dignity Health Commercial/Exchange $0.14
Rate for Payer: EPIC Health Plan Commercial $0.06
Rate for Payer: EPIC Health Plan Transplant $0.06
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Management Network EPO/PPO $0.14
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.12
Rate for Payer: IEHP medi-cal $0.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.12
Rate for Payer: Networks By Design Commercial $0.10
Rate for Payer: Prime Health Services Commercial $0.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.10
Rate for Payer: Riverside University Health MISP $0.06
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.10
Rate for Payer: TriValley Medical Group Commercial/Senior $0.10
Rate for Payer: United Healthcare All Other Commercial $0.08
Rate for Payer: United Healthcare All Other HMO $0.08
Rate for Payer: United Healthcare HMO Rider $0.08
Rate for Payer: United Healthcare Select/Navigate/Core $0.08
Rate for Payer: Vantage Medical Group Medi-Cal $0.14
Rate for Payer: Vantage Medical Group Senior $0.14
Service Code NDC 8770189900
Hospital Charge Code 1740040
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.10
Rate for Payer: Aetna of CA HMO/PPO $0.07
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.06
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.06
Rate for Payer: Anthem Blue Cross of CA Exchange $0.05
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.06
Rate for Payer: BCBS Transplant Transplant $0.07
Rate for Payer: Blue Shield of California Commercial $0.07
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.09
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: Dignity Health Commercial/Exchange $0.09
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: EPIC Health Plan Transplant $0.04
Rate for Payer: Galaxy Health WC $0.09
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.10
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.08
Rate for Payer: IEHP medi-cal $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.08
Rate for Payer: Networks By Design Commercial $0.07
Rate for Payer: Prime Health Services Commercial $0.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.07
Rate for Payer: Riverside University Health MISP $0.04
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.07
Rate for Payer: TriValley Medical Group Commercial/Senior $0.07
Rate for Payer: United Healthcare All Other Commercial $0.06
Rate for Payer: United Healthcare All Other HMO $0.06
Rate for Payer: United Healthcare HMO Rider $0.06
Rate for Payer: United Healthcare Select/Navigate/Core $0.06
Rate for Payer: Vantage Medical Group Medi-Cal $0.09
Rate for Payer: Vantage Medical Group Senior $0.09
Service Code NDC 0067-5500-50
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.25
Rate for Payer: Aetna of CA HMO/PPO $0.17
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 Exchange $0.14
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 $0.18
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.13
Rate for Payer: Central Health Plan Commercial $0.22
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: 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 Management Network EPO/PPO $0.25
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.21
Rate for Payer: IEHP medi-cal $0.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.21
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: Riverside University Health MISP $0.11
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 Medi-Cal $0.24
Rate for Payer: Vantage Medical Group Senior $0.24
Service Code NDC 0067-5500-50
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
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 $0.21
Rate for Payer: Blue Shield of California EPN $0.15
Rate for Payer: Cash Price $0.13
Rate for Payer: Cash Price $0.13
Rate for Payer: Central Health Plan Commercial $0.22
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: Health Management Network EPO/PPO $0.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.19
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.21
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Prime Health Services Commercial $0.24
Service Code NDC 45802-410-59
Hospital Charge Code 1740040
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
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 $0.06
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.04
Rate for Payer: Cash Price $0.04
Rate for Payer: Central Health Plan Commercial $0.06
Rate for Payer: Cigna of CA HMO $0.06
Rate for Payer: Cigna of CA PPO $0.06
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Galaxy Health WC $0.07
Rate for Payer: Global Benefits Group Commercial $0.05
Rate for Payer: Health Management Network EPO/PPO $0.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.06
Rate for Payer: Networks By Design Commercial $0.05
Rate for Payer: Prime Health Services Commercial $0.07
Service Code NDC 2390001252
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
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 $0.30
Rate for Payer: Blue Shield of California EPN $0.21
Rate for Payer: Cash Price $0.18
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.32
Rate for Payer: Cigna of CA HMO $0.28
Rate for Payer: Cigna of CA PPO $0.28
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: Galaxy Health WC $0.34
Rate for Payer: Global Benefits Group Commercial $0.24
Rate for Payer: Health Management Network EPO/PPO $0.36
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.30
Rate for Payer: Networks By Design Commercial $0.26
Rate for Payer: Prime Health Services Commercial $0.34
Service Code NDC 4110081123
Hospital Charge Code 1740011
Hospital Revenue Code 259
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.44
Rate for Payer: Aetna of CA HMO/PPO $0.30
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.42
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.27
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.27
Rate for Payer: Anthem Blue Cross of CA Exchange $0.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.29
Rate for Payer: BCBS Transplant Transplant $0.29
Rate for Payer: Blue Shield of California Commercial $0.31
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.22
Rate for Payer: Central Health Plan Commercial $0.39
Rate for Payer: Cigna of CA HMO $0.34
Rate for Payer: Cigna of CA PPO $0.34
Rate for Payer: Dignity Health Commercial/Exchange $0.42
Rate for Payer: EPIC Health Plan Commercial $0.20
Rate for Payer: EPIC Health Plan Transplant $0.20
Rate for Payer: Galaxy Health WC $0.42
Rate for Payer: Global Benefits Group Commercial $0.29
Rate for Payer: Health Management Network EPO/PPO $0.44
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.37
Rate for Payer: IEHP medi-cal $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.33
Rate for Payer: LLUH Dept of Risk Management WC $0.10
Rate for Payer: Multiplan Commercial $0.37
Rate for Payer: Networks By Design Commercial $0.32
Rate for Payer: Prime Health Services Commercial $0.42
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.29
Rate for Payer: Riverside University Health MISP $0.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.29
Rate for Payer: TriValley Medical Group Commercial/Senior $0.29
Rate for Payer: United Healthcare All Other Commercial $0.25
Rate for Payer: United Healthcare All Other HMO $0.25
Rate for Payer: United Healthcare HMO Rider $0.25
Rate for Payer: United Healthcare Select/Navigate/Core $0.25
Rate for Payer: Vantage Medical Group Medi-Cal $0.42
Rate for Payer: Vantage Medical Group Senior $0.42
Service Code NDC 45802-410-59
Hospital Charge Code 1740040
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.07
Rate for Payer: Aetna of CA HMO/PPO $0.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.07
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.04
Rate for Payer: Anthem Blue Cross of CA Exchange $0.04
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.05
Rate for Payer: BCBS Transplant Transplant $0.05
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.04
Rate for Payer: Central Health Plan Commercial $0.06
Rate for Payer: Cigna of CA HMO $0.06
Rate for Payer: Cigna of CA PPO $0.06
Rate for Payer: Dignity Health Commercial/Exchange $0.07
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: EPIC Health Plan Transplant $0.03
Rate for Payer: Galaxy Health WC $0.07
Rate for Payer: Global Benefits Group Commercial $0.05
Rate for Payer: Health Management Network EPO/PPO $0.07
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.06
Rate for Payer: IEHP medi-cal $0.03
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.06
Rate for Payer: Networks By Design Commercial $0.05
Rate for Payer: Prime Health Services Commercial $0.07
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.05
Rate for Payer: Riverside University Health MISP $0.03
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.05
Rate for Payer: TriValley Medical Group Commercial/Senior $0.05
Rate for Payer: United Healthcare All Other Commercial $0.04
Rate for Payer: United Healthcare All Other HMO $0.04
Rate for Payer: United Healthcare HMO Rider $0.04
Rate for Payer: United Healthcare Select/Navigate/Core $0.04
Rate for Payer: Vantage Medical Group Medi-Cal $0.07
Rate for Payer: Vantage Medical Group Senior $0.07
Service Code NDC 0904-6761-30
Hospital Charge Code 1740040
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
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 $0.06
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.04
Rate for Payer: Cash Price $0.04
Rate for Payer: Central Health Plan Commercial $0.06
Rate for Payer: Cigna of CA HMO $0.06
Rate for Payer: Cigna of CA PPO $0.06
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Galaxy Health WC $0.07
Rate for Payer: Global Benefits Group Commercial $0.05
Rate for Payer: Health Management Network EPO/PPO $0.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.06
Rate for Payer: Networks By Design Commercial $0.05
Rate for Payer: Prime Health Services Commercial $0.07
Service Code CPT J2590
Hospital Charge Code 1720915
Hospital Revenue Code 636
Min. Negotiated Rate $0.22
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $1.26
Rate for Payer: Blue Shield of California Commercial $0.81
Rate for Payer: Blue Shield of California EPN $0.58
Rate for Payer: Blue Shield of California EPN $0.90
Rate for Payer: Cash Price $0.49
Rate for Payer: Cash Price $0.49
Rate for Payer: Cash Price $0.76
Rate for Payer: Cash Price $0.76
Rate for Payer: Central Health Plan Commercial $1.34
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA HMO $1.18
Rate for Payer: Cigna of CA PPO $1.18
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Commercial $0.67
Rate for Payer: EPIC Health Plan Transplant $0.43
Rate for Payer: EPIC Health Plan Transplant $0.67
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Galaxy Health WC $1.43
Rate for Payer: Global Benefits Group Commercial $1.01
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $1.51
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: LLUH Dept of Risk Management WC $0.34
Rate for Payer: Multiplan Commercial $1.26
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.54
Rate for Payer: Networks By Design Commercial $0.84
Rate for Payer: Prime Health Services Commercial $0.92
Rate for Payer: Prime Health Services Commercial $1.43
Service Code CPT J2590
Hospital Charge Code 1757732
Hospital Revenue Code 636
Min. Negotiated Rate $0.83
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 $3.10
Rate for Payer: Blue Shield of California EPN $2.21
Rate for Payer: Cash Price $1.86
Rate for Payer: Cash Price $1.86
Rate for Payer: Central Health Plan Commercial $3.31
Rate for Payer: Cigna of CA HMO $2.90
Rate for Payer: Cigna of CA PPO $2.90
Rate for Payer: EPIC Health Plan Commercial $1.66
Rate for Payer: EPIC Health Plan Transplant $1.66
Rate for Payer: Galaxy Health WC $3.52
Rate for Payer: Global Benefits Group Commercial $2.48
Rate for Payer: Health Management Network EPO/PPO $3.73
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.76
Rate for Payer: LLUH Dept of Risk Management WC $0.83
Rate for Payer: Multiplan Commercial $3.10
Rate for Payer: Networks By Design Commercial $2.07
Rate for Payer: Prime Health Services Commercial $3.52
Service Code CPT J2590
Hospital Charge Code 1720915
Hospital Revenue Code 636
Min. Negotiated Rate $0.34
Max. Negotiated Rate $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.43
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.92
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.92
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.59
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.92
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.59
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: BCBS Transplant Transplant $1.01
Rate for Payer: BCBS Transplant Transplant $0.65
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Cash Price $0.76
Rate for Payer: Cash Price $0.49
Rate for Payer: Cash Price $0.49
Rate for Payer: Cash Price $0.76
Rate for Payer: Central Health Plan Commercial $1.34
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA HMO $1.18
Rate for Payer: Cigna of CA PPO $1.18
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $1.43
Rate for Payer: Dignity Health Commercial/Exchange $0.92
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Commercial $0.67
Rate for Payer: EPIC Health Plan Transplant $0.67
Rate for Payer: EPIC Health Plan Transplant $0.43
Rate for Payer: Galaxy Health WC $1.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $1.01
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: Health Management Network EPO/PPO $1.51
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.81
Rate for Payer: IEHP medi-cal $0.59
Rate for Payer: IEHP medi-cal $0.38
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.12
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: LLUH Dept of Risk Management WC $0.34
Rate for Payer: Multiplan Commercial $1.26
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.54
Rate for Payer: Networks By Design Commercial $0.84
Rate for Payer: Prime Health Services Commercial $0.92
Rate for Payer: Prime Health Services Commercial $1.43
Rate for Payer: Riverside University Health MISP $0.67
Rate for Payer: Riverside University Health MISP $0.43
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.01
Rate for Payer: TriValley Medical Group Commercial/Senior $1.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.84
Rate for Payer: United Healthcare All Other Commercial $0.54
Rate for Payer: United Healthcare All Other HMO $0.84
Rate for Payer: United Healthcare All Other HMO $0.54
Rate for Payer: United Healthcare HMO Rider $0.54
Rate for Payer: United Healthcare HMO Rider $0.84
Rate for Payer: United Healthcare Select/Navigate/Core $0.54
Rate for Payer: United Healthcare Select/Navigate/Core $0.84
Rate for Payer: Vantage Medical Group Medi-Cal $1.43
Rate for Payer: Vantage Medical Group Medi-Cal $0.92
Rate for Payer: Vantage Medical Group Senior $1.43
Rate for Payer: Vantage Medical Group Senior $0.92
Service Code CPT J2590
Hospital Charge Code 1757732
Hospital Revenue Code 636
Min. Negotiated Rate $0.83
Max. Negotiated Rate $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.52
Rate for Payer: AlphaCare Medical Group Medi-Cal $2.28
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.28
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: BCBS Transplant Transplant $2.48
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Cash Price $1.86
Rate for Payer: Cash Price $1.86
Rate for Payer: Central Health Plan Commercial $3.31
Rate for Payer: Cigna of CA HMO $2.90
Rate for Payer: Cigna of CA PPO $2.90
Rate for Payer: Dignity Health Commercial/Exchange $3.52
Rate for Payer: EPIC Health Plan Commercial $1.66
Rate for Payer: EPIC Health Plan Transplant $1.66
Rate for Payer: Galaxy Health WC $3.52
Rate for Payer: Global Benefits Group Commercial $2.48
Rate for Payer: Health Management Network EPO/PPO $3.73
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3.10
Rate for Payer: IEHP medi-cal $1.45
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.76
Rate for Payer: LLUH Dept of Risk Management WC $0.83
Rate for Payer: Multiplan Commercial $3.10
Rate for Payer: Networks By Design Commercial $2.07
Rate for Payer: Prime Health Services Commercial $3.52
Rate for Payer: Riverside University Health MISP $1.66
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2.48
Rate for Payer: TriValley Medical Group Commercial/Senior $2.48
Rate for Payer: United Healthcare All Other Commercial $2.07
Rate for Payer: United Healthcare All Other HMO $2.07
Rate for Payer: United Healthcare HMO Rider $2.07
Rate for Payer: United Healthcare Select/Navigate/Core $2.07
Rate for Payer: Vantage Medical Group Medi-Cal $3.52
Rate for Payer: Vantage Medical Group Senior $3.52
Service Code CPT J2590
Hospital Charge Code NDG117335
Hospital Revenue Code 636
Max. Negotiated Rate $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
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: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: BCBS Transplant Transplant $0.03
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Central Health Plan Commercial $0.04
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA HMO $0.02
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Cigna of CA PPO $0.02
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.01
Rate for Payer: EPIC Health Plan Commercial $0.00
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.00
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Galaxy Health WC $0.01
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.03
Rate for Payer: Health Management Network EPO/PPO $0.01
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.01
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.00
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $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: LLUH Dept of Risk Management WC $0.00
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Multiplan Commercial $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Networks By Design Commercial $0.02
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.01
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Riverside University Health MISP $0.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.03
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.03
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Medi-Cal $0.01
Rate for Payer: Vantage Medical Group Senior $0.01
Rate for Payer: Vantage Medical Group Senior $0.04
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code CPT J2590
Hospital Revenue Code 636
Max. Negotiated Rate $8.53
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: Aetna of CA HMO/PPO $8.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.01
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
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: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA Exchange $1.80
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.97
Rate for Payer: BCBS Transplant Transplant $0.03
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $1.04
Rate for Payer: Blue Shield of California EPN $1.04
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: Central Health Plan Commercial $0.01
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.01
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Commercial $0.00
Rate for Payer: EPIC Health Plan Transplant $0.00
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Galaxy Health WC $0.01
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.01
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: Health Plan of Nevada - Sierra Transplant Other $0.01
Rate for Payer: IEHP medi-cal $0.00
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
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: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Riverside University Health MISP $0.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.03
Rate for Payer: TriValley Medical Group Commercial/Senior $0.03
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
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 Medi-Cal $0.01
Rate for Payer: Vantage Medical Group Senior $0.04
Rate for Payer: Vantage Medical Group Senior $0.01
Service Code CPT J2590
Hospital Revenue Code 636
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: 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 Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Blue Shield of California EPN $0.01
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: Central Health Plan Commercial $0.01
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.00
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.00
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.01
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Management Network EPO/PPO $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $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: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Multiplan Commercial $0.01
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.04
Service Code CPT J2590
Hospital Charge Code NDG117335
Hospital Revenue Code 636
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $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 Commercial $0.01
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.02
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.04
Rate for Payer: Central Health Plan Commercial $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 HMO $0.04
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Cigna of CA PPO $0.02
Rate for Payer: EPIC Health Plan Commercial $0.00
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: EPIC Health Plan Transplant $0.00
Rate for Payer: Galaxy Health WC $0.01
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.01
Rate for Payer: Health Management Network EPO/PPO $0.03
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $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: LLUH Dept of Risk Management WC $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Multiplan Commercial $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.04