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Service Code NDC 68084-996-11
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.61
Rate for Payer: Aetna of CA HMO/PPO $1.09
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.52
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.98
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.98
Rate for Payer: Anthem Blue Cross of CA Exchange $0.87
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.06
Rate for Payer: BCBS Transplant Transplant $1.07
Rate for Payer: Blue Shield of California Commercial $1.13
Rate for Payer: Blue Shield of California EPN $0.88
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: Dignity Health Commercial/Exchange $1.52
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.34
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.07
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.07
Rate for Payer: TriValley Medical Group Commercial/Senior $1.07
Rate for Payer: United Healthcare All Other Commercial $0.90
Rate for Payer: United Healthcare All Other HMO $0.90
Rate for Payer: United Healthcare HMO Rider $0.90
Rate for Payer: United Healthcare Select/Navigate/Core $0.90
Rate for Payer: Vantage Medical Group Medi-Cal $1.52
Rate for Payer: Vantage Medical Group Senior $1.52
Service Code NDC 68084-996-11
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
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 $1.34
Rate for Payer: Blue Shield of California EPN $0.96
Rate for Payer: Cash Price $0.81
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Service Code NDC 51079-630-01
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
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 $1.36
Rate for Payer: Blue Shield of California EPN $0.97
Rate for Payer: Cash Price $0.81
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.45
Rate for Payer: Cigna of CA HMO $1.27
Rate for Payer: Cigna of CA PPO $1.27
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: Galaxy Health WC $1.54
Rate for Payer: Global Benefits Group Commercial $1.09
Rate for Payer: Health Management Network EPO/PPO $1.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.21
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.36
Rate for Payer: Networks By Design Commercial $1.18
Rate for Payer: Prime Health Services Commercial $1.54
Service Code NDC 70010-084-01
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
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 $0.17
Rate for Payer: Blue Shield of California EPN $0.12
Rate for Payer: Cash Price $0.10
Rate for Payer: Cash Price $0.10
Rate for Payer: Central Health Plan Commercial $0.18
Rate for Payer: Cigna of CA HMO $0.15
Rate for Payer: Cigna of CA PPO $0.15
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: Galaxy Health WC $0.19
Rate for Payer: Global Benefits Group Commercial $0.13
Rate for Payer: Health Management Network EPO/PPO $0.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.17
Rate for Payer: Networks By Design Commercial $0.14
Rate for Payer: Prime Health Services Commercial $0.19
Service Code NDC 51079-630-20
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
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 $1.36
Rate for Payer: Blue Shield of California EPN $0.97
Rate for Payer: Cash Price $0.81
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.45
Rate for Payer: Cigna of CA HMO $1.27
Rate for Payer: Cigna of CA PPO $1.27
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: Galaxy Health WC $1.54
Rate for Payer: Global Benefits Group Commercial $1.09
Rate for Payer: Health Management Network EPO/PPO $1.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.21
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.36
Rate for Payer: Networks By Design Commercial $1.18
Rate for Payer: Prime Health Services Commercial $1.54
Service Code NDC 51079-630-20
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.63
Rate for Payer: Aetna of CA HMO/PPO $1.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.54
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1.00
Rate for Payer: Anthem Blue Cross of CA Exchange $0.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.07
Rate for Payer: BCBS Transplant Transplant $1.09
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $0.89
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.45
Rate for Payer: Cigna of CA HMO $1.27
Rate for Payer: Cigna of CA PPO $1.27
Rate for Payer: Dignity Health Commercial/Exchange $1.54
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.54
Rate for Payer: Global Benefits Group Commercial $1.09
Rate for Payer: Health Management Network EPO/PPO $1.63
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.36
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.21
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.36
Rate for Payer: Networks By Design Commercial $1.18
Rate for Payer: Prime Health Services Commercial $1.54
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.09
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.09
Rate for Payer: TriValley Medical Group Commercial/Senior $1.09
Rate for Payer: United Healthcare All Other Commercial $0.91
Rate for Payer: United Healthcare All Other HMO $0.91
Rate for Payer: United Healthcare HMO Rider $0.91
Rate for Payer: United Healthcare Select/Navigate/Core $0.91
Rate for Payer: Vantage Medical Group Medi-Cal $1.54
Rate for Payer: Vantage Medical Group Senior $1.54
Service Code NDC 68084-996-01
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.61
Rate for Payer: Aetna of CA HMO/PPO $1.09
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.52
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.98
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.98
Rate for Payer: Anthem Blue Cross of CA Exchange $0.87
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.06
Rate for Payer: BCBS Transplant Transplant $1.07
Rate for Payer: Blue Shield of California Commercial $1.13
Rate for Payer: Blue Shield of California EPN $0.88
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: Dignity Health Commercial/Exchange $1.52
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.34
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.07
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.07
Rate for Payer: TriValley Medical Group Commercial/Senior $1.07
Rate for Payer: United Healthcare All Other Commercial $0.90
Rate for Payer: United Healthcare All Other HMO $0.90
Rate for Payer: United Healthcare HMO Rider $0.90
Rate for Payer: United Healthcare Select/Navigate/Core $0.90
Rate for Payer: Vantage Medical Group Medi-Cal $1.52
Rate for Payer: Vantage Medical Group Senior $1.52
Service Code NDC 51079-630-01
Hospital Charge Code 1710580
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.63
Rate for Payer: Aetna of CA HMO/PPO $1.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.54
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1.00
Rate for Payer: Anthem Blue Cross of CA Exchange $0.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.07
Rate for Payer: BCBS Transplant Transplant $1.09
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $0.89
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.45
Rate for Payer: Cigna of CA HMO $1.27
Rate for Payer: Cigna of CA PPO $1.27
Rate for Payer: Dignity Health Commercial/Exchange $1.54
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.54
Rate for Payer: Global Benefits Group Commercial $1.09
Rate for Payer: Health Management Network EPO/PPO $1.63
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.36
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.21
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.36
Rate for Payer: Networks By Design Commercial $1.18
Rate for Payer: Prime Health Services Commercial $1.54
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.09
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.09
Rate for Payer: TriValley Medical Group Commercial/Senior $1.09
Rate for Payer: United Healthcare All Other Commercial $0.91
Rate for Payer: United Healthcare All Other HMO $0.91
Rate for Payer: United Healthcare HMO Rider $0.91
Rate for Payer: United Healthcare Select/Navigate/Core $0.91
Rate for Payer: Vantage Medical Group Medi-Cal $1.54
Rate for Payer: Vantage Medical Group Senior $1.54
Service Code NDC 70010-085-01
Hospital Charge Code 1710593
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
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 $0.20
Rate for Payer: Blue Shield of California EPN $0.14
Rate for Payer: Cash Price $0.12
Rate for Payer: Cash Price $0.12
Rate for Payer: Central Health Plan Commercial $0.21
Rate for Payer: Cigna of CA HMO $0.18
Rate for Payer: Cigna of CA PPO $0.18
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: Galaxy Health WC $0.22
Rate for Payer: Global Benefits Group Commercial $0.16
Rate for Payer: Health Management Network EPO/PPO $0.23
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.17
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.20
Rate for Payer: Networks By Design Commercial $0.17
Rate for Payer: Prime Health Services Commercial $0.22
Service Code NDC 70954-020-10
Hospital Charge Code 1710593
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 $0.22
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 $0.23
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 $0.12
Rate for Payer: Galaxy Health WC $0.25
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Health Management Network EPO/PPO $0.26
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 $0.22
Rate for Payer: Networks By Design Commercial $0.19
Rate for Payer: Prime Health Services Commercial $0.25
Service Code NDC 59762-5320-1
Hospital Charge Code 1710593
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
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 $0.41
Rate for Payer: Blue Shield of California EPN $0.29
Rate for Payer: Cash Price $0.24
Rate for Payer: Cash Price $0.24
Rate for Payer: Central Health Plan Commercial $0.43
Rate for Payer: Cigna of CA HMO $0.38
Rate for Payer: Cigna of CA PPO $0.38
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: Galaxy Health WC $0.46
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Management Network EPO/PPO $0.49
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.36
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.41
Rate for Payer: Networks By Design Commercial $0.35
Rate for Payer: Prime Health Services Commercial $0.46
Service Code NDC 70954-020-10
Hospital Charge Code 1710593
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.26
Rate for Payer: Aetna of CA HMO/PPO $0.18
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.25
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.16
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.16
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 $0.23
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 $0.25
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: EPIC Health Plan Transplant $0.12
Rate for Payer: Galaxy Health WC $0.25
Rate for Payer: Global Benefits Group Commercial $0.17
Rate for Payer: Health Management Network EPO/PPO $0.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.22
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 $0.22
Rate for Payer: Networks By Design Commercial $0.19
Rate for Payer: Prime Health Services Commercial $0.25
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.17
Rate for Payer: Riverside University Health MISP $0.12
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 $0.15
Rate for Payer: United Healthcare All Other HMO $0.15
Rate for Payer: United Healthcare HMO Rider $0.15
Rate for Payer: United Healthcare Select/Navigate/Core $0.15
Rate for Payer: Vantage Medical Group Medi-Cal $0.25
Rate for Payer: Vantage Medical Group Senior $0.25
Service Code NDC 70010-085-01
Hospital Charge Code 1710593
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.23
Rate for Payer: IEHP medi-cal $0.09
Rate for Payer: Aetna of CA HMO/PPO $0.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.22
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.14
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.14
Rate for Payer: Anthem Blue Cross of CA Exchange $0.13
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.15
Rate for Payer: BCBS Transplant Transplant $0.16
Rate for Payer: Blue Shield of California Commercial $0.16
Rate for Payer: Blue Shield of California EPN $0.13
Rate for Payer: Cash Price $0.12
Rate for Payer: Central Health Plan Commercial $0.21
Rate for Payer: Cigna of CA HMO $0.18
Rate for Payer: Cigna of CA PPO $0.18
Rate for Payer: Dignity Health Commercial/Exchange $0.22
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: EPIC Health Plan Transplant $0.10
Rate for Payer: Galaxy Health WC $0.22
Rate for Payer: Global Benefits Group Commercial $0.16
Rate for Payer: Health Management Network EPO/PPO $0.23
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.17
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.20
Rate for Payer: Networks By Design Commercial $0.17
Rate for Payer: Prime Health Services Commercial $0.22
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.16
Rate for Payer: Riverside University Health MISP $0.10
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.16
Rate for Payer: TriValley Medical Group Commercial/Senior $0.16
Rate for Payer: United Healthcare All Other Commercial $0.13
Rate for Payer: United Healthcare All Other HMO $0.13
Rate for Payer: United Healthcare HMO Rider $0.13
Rate for Payer: United Healthcare Select/Navigate/Core $0.13
Rate for Payer: Vantage Medical Group Medi-Cal $0.22
Rate for Payer: Vantage Medical Group Senior $0.22
Service Code NDC 59762-5320-1
Hospital Charge Code 1710593
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.49
Rate for Payer: Aetna of CA HMO/PPO $0.33
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.46
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.30
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.30
Rate for Payer: Anthem Blue Cross of CA Exchange $0.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.32
Rate for Payer: BCBS Transplant Transplant $0.32
Rate for Payer: Blue Shield of California Commercial $0.34
Rate for Payer: Blue Shield of California EPN $0.26
Rate for Payer: Cash Price $0.24
Rate for Payer: Central Health Plan Commercial $0.43
Rate for Payer: Cigna of CA HMO $0.38
Rate for Payer: Cigna of CA PPO $0.38
Rate for Payer: Dignity Health Commercial/Exchange $0.46
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: EPIC Health Plan Transplant $0.22
Rate for Payer: Galaxy Health WC $0.46
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Management Network EPO/PPO $0.49
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.41
Rate for Payer: IEHP medi-cal $0.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.36
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.41
Rate for Payer: Networks By Design Commercial $0.35
Rate for Payer: Prime Health Services Commercial $0.46
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.32
Rate for Payer: Riverside University Health MISP $0.22
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 Medi-Cal $0.46
Rate for Payer: Vantage Medical Group Senior $0.46
Service Code NDC 0093-4069-01
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.31
Max. Negotiated Rate $1.41
Rate for Payer: Aetna of CA HMO/PPO $0.95
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.33
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.86
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.86
Rate for Payer: Anthem Blue Cross of CA Exchange $0.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.93
Rate for Payer: BCBS Transplant Transplant $0.94
Rate for Payer: Blue Shield of California Commercial $0.99
Rate for Payer: Blue Shield of California EPN $0.77
Rate for Payer: Cash Price $0.71
Rate for Payer: Central Health Plan Commercial $1.26
Rate for Payer: Cigna of CA HMO $1.10
Rate for Payer: Cigna of CA PPO $1.10
Rate for Payer: Dignity Health Commercial/Exchange $1.33
Rate for Payer: EPIC Health Plan Commercial $0.63
Rate for Payer: EPIC Health Plan Transplant $0.63
Rate for Payer: Galaxy Health WC $1.33
Rate for Payer: Global Benefits Group Commercial $0.94
Rate for Payer: Health Management Network EPO/PPO $1.41
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.18
Rate for Payer: IEHP medi-cal $0.55
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.05
Rate for Payer: LLUH Dept of Risk Management WC $0.31
Rate for Payer: Multiplan Commercial $1.18
Rate for Payer: Networks By Design Commercial $1.02
Rate for Payer: Prime Health Services Commercial $1.33
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.94
Rate for Payer: Riverside University Health MISP $0.63
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.94
Rate for Payer: TriValley Medical Group Commercial/Senior $0.94
Rate for Payer: United Healthcare All Other Commercial $0.79
Rate for Payer: United Healthcare All Other HMO $0.79
Rate for Payer: United Healthcare HMO Rider $0.79
Rate for Payer: United Healthcare Select/Navigate/Core $0.79
Rate for Payer: Vantage Medical Group Medi-Cal $1.33
Rate for Payer: Vantage Medical Group Senior $1.33
Service Code NDC 51079-632-01
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
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 $3.23
Rate for Payer: Blue Shield of California EPN $2.30
Rate for Payer: Cash Price $1.94
Rate for Payer: Cash Price $1.94
Rate for Payer: Central Health Plan Commercial $3.45
Rate for Payer: Cigna of CA HMO $3.02
Rate for Payer: Cigna of CA PPO $3.02
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: Galaxy Health WC $3.66
Rate for Payer: Global Benefits Group Commercial $2.59
Rate for Payer: Health Management Network EPO/PPO $3.88
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.87
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.23
Rate for Payer: Networks By Design Commercial $2.80
Rate for Payer: Prime Health Services Commercial $3.66
Service Code NDC 51079-632-20
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
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 $3.23
Rate for Payer: Blue Shield of California EPN $2.30
Rate for Payer: Cash Price $1.94
Rate for Payer: Cash Price $1.94
Rate for Payer: Central Health Plan Commercial $3.45
Rate for Payer: Cigna of CA HMO $3.02
Rate for Payer: Cigna of CA PPO $3.02
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: Galaxy Health WC $3.66
Rate for Payer: Global Benefits Group Commercial $2.59
Rate for Payer: Health Management Network EPO/PPO $3.88
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.87
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.23
Rate for Payer: Networks By Design Commercial $2.80
Rate for Payer: Prime Health Services Commercial $3.66
Service Code NDC 70954-021-10
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.37
Rate for Payer: Aetna of CA HMO/PPO $0.25
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.23
Rate for Payer: Anthem Blue Cross of CA Exchange $0.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.24
Rate for Payer: BCBS Transplant Transplant $0.25
Rate for Payer: Blue Shield of California Commercial $0.26
Rate for Payer: Blue Shield of California EPN $0.20
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: Dignity Health Commercial/Exchange $0.35
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.31
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 $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.25
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.25
Rate for Payer: TriValley Medical Group Commercial/Senior $0.25
Rate for Payer: United Healthcare All Other Commercial $0.21
Rate for Payer: United Healthcare All Other HMO $0.21
Rate for Payer: United Healthcare HMO Rider $0.21
Rate for Payer: United Healthcare Select/Navigate/Core $0.21
Rate for Payer: Vantage Medical Group Medi-Cal $0.35
Rate for Payer: Vantage Medical Group Senior $0.35
Service Code NDC 59762-5350-1
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.79
Rate for Payer: Aetna of CA HMO/PPO $0.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.48
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.48
Rate for Payer: Anthem Blue Cross of CA Exchange $0.43
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.52
Rate for Payer: BCBS Transplant Transplant $0.53
Rate for Payer: Blue Shield of California Commercial $0.55
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.40
Rate for Payer: Central Health Plan Commercial $0.70
Rate for Payer: Cigna of CA HMO $0.62
Rate for Payer: Cigna of CA PPO $0.62
Rate for Payer: Dignity Health Commercial/Exchange $0.75
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: EPIC Health Plan Transplant $0.35
Rate for Payer: Galaxy Health WC $0.75
Rate for Payer: Global Benefits Group Commercial $0.53
Rate for Payer: Health Management Network EPO/PPO $0.79
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.66
Rate for Payer: IEHP medi-cal $0.31
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.59
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.66
Rate for Payer: Networks By Design Commercial $0.57
Rate for Payer: Prime Health Services Commercial $0.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.53
Rate for Payer: Riverside University Health MISP $0.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.53
Rate for Payer: TriValley Medical Group Commercial/Senior $0.53
Rate for Payer: United Healthcare All Other Commercial $0.44
Rate for Payer: United Healthcare All Other HMO $0.44
Rate for Payer: United Healthcare HMO Rider $0.44
Rate for Payer: United Healthcare Select/Navigate/Core $0.44
Rate for Payer: Vantage Medical Group Medi-Cal $0.75
Rate for Payer: Vantage Medical Group Senior $0.75
Service Code NDC 51079-632-01
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
Max. Negotiated Rate $3.88
Rate for Payer: Aetna of CA HMO/PPO $2.62
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.66
Rate for Payer: AlphaCare Medical Group Medi-Cal $2.37
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.37
Rate for Payer: Anthem Blue Cross of CA Exchange $2.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2.55
Rate for Payer: BCBS Transplant Transplant $2.59
Rate for Payer: Blue Shield of California Commercial $2.71
Rate for Payer: Blue Shield of California EPN $2.11
Rate for Payer: Cash Price $1.94
Rate for Payer: Central Health Plan Commercial $3.45
Rate for Payer: Cigna of CA HMO $3.02
Rate for Payer: Cigna of CA PPO $3.02
Rate for Payer: Dignity Health Commercial/Exchange $3.66
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: EPIC Health Plan Transplant $1.72
Rate for Payer: Galaxy Health WC $3.66
Rate for Payer: Global Benefits Group Commercial $2.59
Rate for Payer: Health Management Network EPO/PPO $3.88
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3.23
Rate for Payer: IEHP medi-cal $1.51
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.87
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.23
Rate for Payer: Networks By Design Commercial $2.80
Rate for Payer: Prime Health Services Commercial $3.66
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2.59
Rate for Payer: Riverside University Health MISP $1.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2.59
Rate for Payer: TriValley Medical Group Commercial/Senior $2.59
Rate for Payer: United Healthcare All Other Commercial $2.16
Rate for Payer: United Healthcare All Other HMO $2.16
Rate for Payer: United Healthcare HMO Rider $2.16
Rate for Payer: United Healthcare Select/Navigate/Core $2.16
Rate for Payer: Vantage Medical Group Medi-Cal $3.66
Rate for Payer: Vantage Medical Group Senior $3.66
Service Code NDC 0093-4069-01
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.31
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 $1.18
Rate for Payer: Blue Shield of California EPN $0.84
Rate for Payer: Cash Price $0.71
Rate for Payer: Cash Price $0.71
Rate for Payer: Central Health Plan Commercial $1.26
Rate for Payer: Cigna of CA HMO $1.10
Rate for Payer: Cigna of CA PPO $1.10
Rate for Payer: EPIC Health Plan Commercial $0.63
Rate for Payer: Galaxy Health WC $1.33
Rate for Payer: Global Benefits Group Commercial $0.94
Rate for Payer: Health Management Network EPO/PPO $1.41
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.05
Rate for Payer: LLUH Dept of Risk Management WC $0.31
Rate for Payer: Multiplan Commercial $1.18
Rate for Payer: Networks By Design Commercial $1.02
Rate for Payer: Prime Health Services Commercial $1.33
Service Code NDC 70954-021-20
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.37
Rate for Payer: Aetna of CA HMO/PPO $0.25
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.23
Rate for Payer: Anthem Blue Cross of CA Exchange $0.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.24
Rate for Payer: BCBS Transplant Transplant $0.25
Rate for Payer: Blue Shield of California Commercial $0.26
Rate for Payer: Blue Shield of California EPN $0.20
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: Dignity Health Commercial/Exchange $0.35
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.31
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 $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.25
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.25
Rate for Payer: TriValley Medical Group Commercial/Senior $0.25
Rate for Payer: United Healthcare All Other Commercial $0.21
Rate for Payer: United Healthcare All Other HMO $0.21
Rate for Payer: United Healthcare HMO Rider $0.21
Rate for Payer: United Healthcare Select/Navigate/Core $0.21
Rate for Payer: Vantage Medical Group Medi-Cal $0.35
Rate for Payer: Vantage Medical Group Senior $0.35
Service Code NDC 70954-021-10
Hospital Charge Code 1710615
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 $0.31
Rate for Payer: Blue Shield of California EPN $0.22
Rate for Payer: Cash Price $0.18
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
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 $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35
Service Code NDC 59762-5350-1
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
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 $0.66
Rate for Payer: Blue Shield of California EPN $0.47
Rate for Payer: Cash Price $0.40
Rate for Payer: Cash Price $0.40
Rate for Payer: Central Health Plan Commercial $0.70
Rate for Payer: Cigna of CA HMO $0.62
Rate for Payer: Cigna of CA PPO $0.62
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: Galaxy Health WC $0.75
Rate for Payer: Global Benefits Group Commercial $0.53
Rate for Payer: Health Management Network EPO/PPO $0.79
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.59
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.66
Rate for Payer: Networks By Design Commercial $0.57
Rate for Payer: Prime Health Services Commercial $0.75
Service Code NDC 51079-632-20
Hospital Charge Code 1710615
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
Max. Negotiated Rate $3.88
Rate for Payer: Aetna of CA HMO/PPO $2.62
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.66
Rate for Payer: AlphaCare Medical Group Medi-Cal $2.37
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.37
Rate for Payer: Anthem Blue Cross of CA Exchange $2.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2.55
Rate for Payer: BCBS Transplant Transplant $2.59
Rate for Payer: Blue Shield of California Commercial $2.71
Rate for Payer: Blue Shield of California EPN $2.11
Rate for Payer: Cash Price $1.94
Rate for Payer: Central Health Plan Commercial $3.45
Rate for Payer: Cigna of CA HMO $3.02
Rate for Payer: Cigna of CA PPO $3.02
Rate for Payer: Dignity Health Commercial/Exchange $3.66
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: EPIC Health Plan Transplant $1.72
Rate for Payer: Galaxy Health WC $3.66
Rate for Payer: Global Benefits Group Commercial $2.59
Rate for Payer: Health Management Network EPO/PPO $3.88
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3.23
Rate for Payer: IEHP medi-cal $1.51
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.87
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.23
Rate for Payer: Networks By Design Commercial $2.80
Rate for Payer: Prime Health Services Commercial $3.66
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2.59
Rate for Payer: Riverside University Health MISP $1.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2.59
Rate for Payer: TriValley Medical Group Commercial/Senior $2.59
Rate for Payer: United Healthcare All Other Commercial $2.16
Rate for Payer: United Healthcare All Other HMO $2.16
Rate for Payer: United Healthcare HMO Rider $2.16
Rate for Payer: United Healthcare Select/Navigate/Core $2.16
Rate for Payer: Vantage Medical Group Medi-Cal $3.66
Rate for Payer: Vantage Medical Group Senior $3.66