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Service Code NDC 0093-7472-19
Hospital Charge Code 1712228
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.62
Rate for Payer: Blue Shield of California Commercial $1.35
Rate for Payer: Blue Shield of California EPN $0.96
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.44
Rate for Payer: Cigna of CA HMO $1.26
Rate for Payer: Cigna of CA PPO $1.26
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: Galaxy Health WC $1.53
Rate for Payer: Global Benefits Group Commercial $1.08
Rate for Payer: Health Management Network EPO/PPO $1.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.20
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.35
Rate for Payer: Networks By Design Commercial $1.17
Rate for Payer: Prime Health Services Commercial $1.53
Service Code NDC 0093-7472-19
Hospital Charge Code 1712228
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.62
Rate for Payer: Aetna of CA HMO/PPO $1.09
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.53
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.99
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.99
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 $1.08
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 $1.44
Rate for Payer: Cigna of CA HMO $1.26
Rate for Payer: Cigna of CA PPO $1.26
Rate for Payer: Dignity Health Commercial/Exchange $1.53
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.53
Rate for Payer: Global Benefits Group Commercial $1.08
Rate for Payer: Health Management Network EPO/PPO $1.62
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.35
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.20
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.35
Rate for Payer: Networks By Design Commercial $1.17
Rate for Payer: Prime Health Services Commercial $1.53
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.08
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.08
Rate for Payer: TriValley Medical Group Commercial/Senior $1.08
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 $1.53
Rate for Payer: Vantage Medical Group Senior $1.53
Service Code NDC 57237-088-63
Hospital Charge Code 1712228
Hospital Revenue Code 259
Min. Negotiated Rate $0.24
Max. Negotiated Rate $1.07
Rate for Payer: Blue Shield of California Commercial $0.89
Rate for Payer: Blue Shield of California EPN $0.64
Rate for Payer: Cash Price $0.54
Rate for Payer: Central Health Plan Commercial $0.95
Rate for Payer: Cigna of CA HMO $0.83
Rate for Payer: Cigna of CA PPO $0.83
Rate for Payer: EPIC Health Plan Commercial $0.48
Rate for Payer: Galaxy Health WC $1.01
Rate for Payer: Global Benefits Group Commercial $0.71
Rate for Payer: Health Management Network EPO/PPO $1.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.79
Rate for Payer: LLUH Dept of Risk Management WC $0.24
Rate for Payer: Multiplan Commercial $0.89
Rate for Payer: Networks By Design Commercial $0.77
Rate for Payer: Prime Health Services Commercial $1.01
Service Code NDC 57237-088-63
Hospital Charge Code 1712228
Hospital Revenue Code 259
Min. Negotiated Rate $0.24
Max. Negotiated Rate $1.07
Rate for Payer: Aetna of CA HMO/PPO $0.72
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.01
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.65
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.65
Rate for Payer: Anthem Blue Cross of CA Exchange $0.58
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.70
Rate for Payer: BCBS Transplant Transplant $0.71
Rate for Payer: Blue Shield of California Commercial $0.75
Rate for Payer: Blue Shield of California EPN $0.58
Rate for Payer: Cash Price $0.54
Rate for Payer: Central Health Plan Commercial $0.95
Rate for Payer: Cigna of CA HMO $0.83
Rate for Payer: Cigna of CA PPO $0.83
Rate for Payer: Dignity Health Commercial/Exchange $1.01
Rate for Payer: EPIC Health Plan Commercial $0.48
Rate for Payer: EPIC Health Plan Transplant $0.48
Rate for Payer: Galaxy Health WC $1.01
Rate for Payer: Global Benefits Group Commercial $0.71
Rate for Payer: Health Management Network EPO/PPO $1.07
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.89
Rate for Payer: IEHP medi-cal $0.42
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.79
Rate for Payer: LLUH Dept of Risk Management WC $0.24
Rate for Payer: Multiplan Commercial $0.89
Rate for Payer: Networks By Design Commercial $0.77
Rate for Payer: Prime Health Services Commercial $1.01
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.71
Rate for Payer: Riverside University Health MISP $0.48
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.71
Rate for Payer: TriValley Medical Group Commercial/Senior $0.71
Rate for Payer: United Healthcare All Other Commercial $0.60
Rate for Payer: United Healthcare All Other HMO $0.60
Rate for Payer: United Healthcare HMO Rider $0.60
Rate for Payer: United Healthcare Select/Navigate/Core $0.60
Rate for Payer: Vantage Medical Group Medi-Cal $1.01
Rate for Payer: Vantage Medical Group Senior $1.01
Service Code NDC 68462-465-40
Hospital Charge Code 1712622
Hospital Revenue Code 259
Min. Negotiated Rate $0.29
Max. Negotiated Rate $1.30
Rate for Payer: Blue Shield of California Commercial $1.08
Rate for Payer: Blue Shield of California EPN $0.77
Rate for Payer: Cash Price $0.65
Rate for Payer: Central Health Plan Commercial $1.15
Rate for Payer: Cigna of CA HMO $1.01
Rate for Payer: Cigna of CA PPO $1.01
Rate for Payer: EPIC Health Plan Commercial $0.58
Rate for Payer: Galaxy Health WC $1.22
Rate for Payer: Global Benefits Group Commercial $0.86
Rate for Payer: Health Management Network EPO/PPO $1.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.96
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $1.08
Rate for Payer: Networks By Design Commercial $0.94
Rate for Payer: Prime Health Services Commercial $1.22
Service Code NDC 68462-465-40
Hospital Charge Code 1712622
Hospital Revenue Code 259
Min. Negotiated Rate $0.29
Max. Negotiated Rate $1.30
Rate for Payer: Aetna of CA HMO/PPO $0.87
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.22
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.79
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.79
Rate for Payer: Anthem Blue Cross of CA Exchange $0.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.85
Rate for Payer: BCBS Transplant Transplant $0.86
Rate for Payer: Blue Shield of California Commercial $0.91
Rate for Payer: Blue Shield of California EPN $0.70
Rate for Payer: Cash Price $0.65
Rate for Payer: Central Health Plan Commercial $1.15
Rate for Payer: Cigna of CA HMO $1.01
Rate for Payer: Cigna of CA PPO $1.01
Rate for Payer: Dignity Health Commercial/Exchange $1.22
Rate for Payer: EPIC Health Plan Commercial $0.58
Rate for Payer: EPIC Health Plan Transplant $0.58
Rate for Payer: Galaxy Health WC $1.22
Rate for Payer: Global Benefits Group Commercial $0.86
Rate for Payer: Health Management Network EPO/PPO $1.30
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.08
Rate for Payer: IEHP medi-cal $0.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.96
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $1.08
Rate for Payer: Networks By Design Commercial $0.94
Rate for Payer: Prime Health Services Commercial $1.22
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.86
Rate for Payer: Riverside University Health MISP $0.58
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.86
Rate for Payer: TriValley Medical Group Commercial/Senior $0.86
Rate for Payer: United Healthcare All Other Commercial $0.72
Rate for Payer: United Healthcare All Other HMO $0.72
Rate for Payer: United Healthcare HMO Rider $0.72
Rate for Payer: United Healthcare Select/Navigate/Core $0.72
Rate for Payer: Vantage Medical Group Medi-Cal $1.22
Rate for Payer: Vantage Medical Group Senior $1.22
Service Code NDC 68462-465-99
Hospital Charge Code 1712622
Hospital Revenue Code 259
Min. Negotiated Rate $0.29
Max. Negotiated Rate $1.30
Rate for Payer: Aetna of CA HMO/PPO $0.87
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.22
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.79
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.79
Rate for Payer: Anthem Blue Cross of CA Exchange $0.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.85
Rate for Payer: BCBS Transplant Transplant $0.86
Rate for Payer: Blue Shield of California Commercial $0.91
Rate for Payer: Blue Shield of California EPN $0.70
Rate for Payer: Cash Price $0.65
Rate for Payer: Central Health Plan Commercial $1.15
Rate for Payer: Cigna of CA HMO $1.01
Rate for Payer: Cigna of CA PPO $1.01
Rate for Payer: Dignity Health Commercial/Exchange $1.22
Rate for Payer: EPIC Health Plan Commercial $0.58
Rate for Payer: EPIC Health Plan Transplant $0.58
Rate for Payer: Galaxy Health WC $1.22
Rate for Payer: Global Benefits Group Commercial $0.86
Rate for Payer: Health Management Network EPO/PPO $1.30
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.08
Rate for Payer: IEHP medi-cal $0.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.96
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $1.08
Rate for Payer: Networks By Design Commercial $0.94
Rate for Payer: Prime Health Services Commercial $1.22
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.86
Rate for Payer: Riverside University Health MISP $0.58
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.86
Rate for Payer: TriValley Medical Group Commercial/Senior $0.86
Rate for Payer: United Healthcare All Other Commercial $0.72
Rate for Payer: United Healthcare All Other HMO $0.72
Rate for Payer: United Healthcare HMO Rider $0.72
Rate for Payer: United Healthcare Select/Navigate/Core $0.72
Rate for Payer: Vantage Medical Group Medi-Cal $1.22
Rate for Payer: Vantage Medical Group Senior $1.22
Service Code NDC 68462-465-99
Hospital Charge Code 1712622
Hospital Revenue Code 259
Min. Negotiated Rate $0.29
Max. Negotiated Rate $1.30
Rate for Payer: Blue Shield of California Commercial $1.08
Rate for Payer: Blue Shield of California EPN $0.77
Rate for Payer: Cash Price $0.65
Rate for Payer: Central Health Plan Commercial $1.15
Rate for Payer: Cigna of CA HMO $1.01
Rate for Payer: Cigna of CA PPO $1.01
Rate for Payer: EPIC Health Plan Commercial $0.58
Rate for Payer: Galaxy Health WC $1.22
Rate for Payer: Global Benefits Group Commercial $0.86
Rate for Payer: Health Management Network EPO/PPO $1.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.96
Rate for Payer: LLUH Dept of Risk Management WC $0.29
Rate for Payer: Multiplan Commercial $1.08
Rate for Payer: Networks By Design Commercial $0.94
Rate for Payer: Prime Health Services Commercial $1.22
Service Code ICD 8E0W4CZ
Min. Negotiated Rate $20,000.00
Max. Negotiated Rate $20,000.00
Rate for Payer: Networks By Design Commercial $20,000.00
Service Code NDC 67457-228-05
Hospital Charge Code 1722005
Hospital Revenue Code 250
Min. Negotiated Rate $0.23
Max. Negotiated Rate $1.04
Rate for Payer: Blue Shield of California Commercial $0.87
Rate for Payer: Blue Shield of California EPN $0.62
Rate for Payer: Cash Price $0.52
Rate for Payer: Central Health Plan Commercial $0.93
Rate for Payer: EPIC Health Plan Commercial $0.46
Rate for Payer: Galaxy Health WC $0.99
Rate for Payer: Global Benefits Group Commercial $0.70
Rate for Payer: Health Management Network EPO/PPO $1.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.77
Rate for Payer: LLUH Dept of Risk Management WC $0.23
Rate for Payer: Multiplan Commercial $0.87
Rate for Payer: Networks By Design Commercial $0.75
Rate for Payer: Prime Health Services Commercial $0.99
Service Code NDC 67457-228-05
Hospital Charge Code 1722005
Hospital Revenue Code 250
Min. Negotiated Rate $0.23
Max. Negotiated Rate $1.04
Rate for Payer: Aetna of CA HMO/PPO $0.70
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.99
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.64
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.64
Rate for Payer: Anthem Blue Cross of CA Exchange $0.56
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.69
Rate for Payer: BCBS Transplant Transplant $0.70
Rate for Payer: Blue Shield of California Commercial $0.73
Rate for Payer: Blue Shield of California EPN $0.57
Rate for Payer: Cash Price $0.52
Rate for Payer: Cash Price $0.52
Rate for Payer: Central Health Plan Commercial $0.93
Rate for Payer: Cigna of CA HMO $0.74
Rate for Payer: Cigna of CA PPO $0.86
Rate for Payer: Dignity Health Commercial/Exchange $0.99
Rate for Payer: EPIC Health Plan Commercial $0.46
Rate for Payer: EPIC Health Plan Transplant $0.46
Rate for Payer: Galaxy Health WC $0.99
Rate for Payer: Global Benefits Group Commercial $0.70
Rate for Payer: Health Management Network EPO/PPO $1.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.87
Rate for Payer: IEHP medi-cal $0.41
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.77
Rate for Payer: LLUH Dept of Risk Management WC $0.23
Rate for Payer: Multiplan Commercial $0.87
Rate for Payer: Networks By Design Commercial $0.75
Rate for Payer: Prime Health Services Commercial $0.99
Rate for Payer: Riverside University Health MISP $0.46
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.70
Rate for Payer: TriValley Medical Group Commercial/Senior $0.70
Rate for Payer: United Healthcare All Other Commercial $0.58
Rate for Payer: United Healthcare All Other HMO $0.58
Rate for Payer: United Healthcare HMO Rider $0.58
Rate for Payer: United Healthcare Select/Navigate/Core $0.58
Rate for Payer: Vantage Medical Group Medi-Cal $0.99
Rate for Payer: Vantage Medical Group Senior $0.99
Service Code NDC 72205-200-30
Hospital Charge Code ERX109401
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.65
Rate for Payer: Aetna of CA HMO/PPO $0.44
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.61
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.40
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.40
Rate for Payer: Anthem Blue Cross of CA Exchange $0.35
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.43
Rate for Payer: BCBS Transplant Transplant $0.43
Rate for Payer: Blue Shield of California Commercial $0.45
Rate for Payer: Blue Shield of California EPN $0.35
Rate for Payer: Cash Price $0.32
Rate for Payer: Central Health Plan Commercial $0.58
Rate for Payer: Cigna of CA HMO $0.50
Rate for Payer: Cigna of CA PPO $0.50
Rate for Payer: Dignity Health Commercial/Exchange $0.61
Rate for Payer: EPIC Health Plan Commercial $0.29
Rate for Payer: EPIC Health Plan Transplant $0.29
Rate for Payer: Galaxy Health WC $0.61
Rate for Payer: Global Benefits Group Commercial $0.43
Rate for Payer: Health Management Network EPO/PPO $0.65
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.54
Rate for Payer: IEHP medi-cal $0.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.48
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Multiplan Commercial $0.54
Rate for Payer: Networks By Design Commercial $0.47
Rate for Payer: Prime Health Services Commercial $0.61
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.43
Rate for Payer: Riverside University Health MISP $0.29
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.43
Rate for Payer: TriValley Medical Group Commercial/Senior $0.43
Rate for Payer: United Healthcare All Other Commercial $0.36
Rate for Payer: United Healthcare All Other HMO $0.36
Rate for Payer: United Healthcare HMO Rider $0.36
Rate for Payer: United Healthcare Select/Navigate/Core $0.36
Rate for Payer: Vantage Medical Group Medi-Cal $0.61
Rate for Payer: Vantage Medical Group Senior $0.61
Service Code NDC 72205-200-30
Hospital Charge Code ERX109401
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.65
Rate for Payer: Blue Shield of California Commercial $0.54
Rate for Payer: Blue Shield of California EPN $0.38
Rate for Payer: Cash Price $0.32
Rate for Payer: Central Health Plan Commercial $0.58
Rate for Payer: Cigna of CA HMO $0.50
Rate for Payer: Cigna of CA PPO $0.50
Rate for Payer: EPIC Health Plan Commercial $0.29
Rate for Payer: Galaxy Health WC $0.61
Rate for Payer: Global Benefits Group Commercial $0.43
Rate for Payer: Health Management Network EPO/PPO $0.65
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.48
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Multiplan Commercial $0.54
Rate for Payer: Networks By Design Commercial $0.47
Rate for Payer: Prime Health Services Commercial $0.61
Service Code NDC 0310-0095-30
Hospital Charge Code ERX109401
Hospital Revenue Code 259
Min. Negotiated Rate $3.45
Max. Negotiated Rate $15.52
Rate for Payer: Blue Shield of California Commercial $12.93
Rate for Payer: Blue Shield of California EPN $9.21
Rate for Payer: Cash Price $7.76
Rate for Payer: Central Health Plan Commercial $13.79
Rate for Payer: Cigna of CA HMO $12.07
Rate for Payer: Cigna of CA PPO $12.07
Rate for Payer: EPIC Health Plan Commercial $6.90
Rate for Payer: Galaxy Health WC $14.65
Rate for Payer: Global Benefits Group Commercial $10.34
Rate for Payer: Health Management Network EPO/PPO $15.52
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.50
Rate for Payer: LLUH Dept of Risk Management WC $3.45
Rate for Payer: Multiplan Commercial $12.93
Rate for Payer: Networks By Design Commercial $11.21
Rate for Payer: Prime Health Services Commercial $14.65
Service Code NDC 0310-0095-30
Hospital Charge Code ERX109401
Hospital Revenue Code 259
Min. Negotiated Rate $3.45
Max. Negotiated Rate $15.52
Rate for Payer: Aetna of CA HMO/PPO $10.47
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $14.65
Rate for Payer: AlphaCare Medical Group Medi-Cal $9.48
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $9.48
Rate for Payer: Anthem Blue Cross of CA Exchange $8.35
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.19
Rate for Payer: BCBS Transplant Transplant $10.34
Rate for Payer: Blue Shield of California Commercial $10.84
Rate for Payer: Blue Shield of California EPN $8.43
Rate for Payer: Cash Price $7.76
Rate for Payer: Central Health Plan Commercial $13.79
Rate for Payer: Cigna of CA HMO $12.07
Rate for Payer: Cigna of CA PPO $12.07
Rate for Payer: Dignity Health Commercial/Exchange $14.65
Rate for Payer: EPIC Health Plan Commercial $6.90
Rate for Payer: EPIC Health Plan Transplant $6.90
Rate for Payer: Galaxy Health WC $14.65
Rate for Payer: Global Benefits Group Commercial $10.34
Rate for Payer: Health Management Network EPO/PPO $15.52
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $12.93
Rate for Payer: IEHP medi-cal $6.03
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.50
Rate for Payer: LLUH Dept of Risk Management WC $3.45
Rate for Payer: Multiplan Commercial $12.93
Rate for Payer: Networks By Design Commercial $11.21
Rate for Payer: Prime Health Services Commercial $14.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $10.34
Rate for Payer: Riverside University Health MISP $6.90
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $10.34
Rate for Payer: TriValley Medical Group Commercial/Senior $10.34
Rate for Payer: United Healthcare All Other Commercial $8.62
Rate for Payer: United Healthcare All Other HMO $8.62
Rate for Payer: United Healthcare HMO Rider $8.62
Rate for Payer: United Healthcare Select/Navigate/Core $8.62
Rate for Payer: Vantage Medical Group Medi-Cal $14.65
Rate for Payer: Vantage Medical Group Senior $14.65
Service Code CPT J9319
Hospital Charge Code ERX100344
Hospital Revenue Code 636
Min. Negotiated Rate $31.96
Max. Negotiated Rate $3,454.54
Rate for Payer: Adventist Health Medi-Cal $31.96
Rate for Payer: Aetna of CA HMO/PPO $198.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $39.95
Rate for Payer: AlphaCare Medical Group Medi-Cal $35.16
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $35.16
Rate for Payer: Anthem Blue Cross of CA Exchange $63.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $69.24
Rate for Payer: BCBS Transplant Transplant $2,303.03
Rate for Payer: Blue Shield of California Commercial $2,414.34
Rate for Payer: Blue Shield of California EPN $1,876.97
Rate for Payer: Caremore Medicare Advantage $31.96
Rate for Payer: Cash Price $1,727.27
Rate for Payer: Cash Price $1,727.27
Rate for Payer: Central Health Plan Commercial $3,070.70
Rate for Payer: Cigna of CA HMO $2,686.87
Rate for Payer: Cigna of CA PPO $2,686.87
Rate for Payer: Dignity Health Commercial/Exchange $47.94
Rate for Payer: EPIC Health Plan Commercial $43.15
Rate for Payer: EPIC Health Plan Medicare/Senior $31.96
Rate for Payer: EPIC Health Plan Transplant $31.96
Rate for Payer: Galaxy Health WC $3,262.62
Rate for Payer: Global Benefits Group Commercial $2,303.03
Rate for Payer: Health Management Network EPO/PPO $3,454.54
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $2,878.78
Rate for Payer: Heritage Provider Network Commercial/Senior $52.42
Rate for Payer: IEHP medi-cal $52.74
Rate for Payer: IEHP Medicare Advantage $31.96
Rate for Payer: Innovage PACE Commercial $47.94
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,560.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $31.96
Rate for Payer: LLUH Dept of Risk Management WC $767.68
Rate for Payer: Molina Healthcare of CA Medi-Cal $42.83
Rate for Payer: Molina Healthcare of CA Medicare $42.83
Rate for Payer: Multiplan Commercial $2,878.78
Rate for Payer: Networks By Design Commercial $1,919.19
Rate for Payer: Prime Health Services Commercial $3,262.62
Rate for Payer: Prime Health Services Medicare $33.88
Rate for Payer: Riverside University Health MISP $35.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2,303.03
Rate for Payer: TriValley Medical Group Commercial/Senior $2,303.03
Rate for Payer: United Healthcare All Other Commercial $1,919.19
Rate for Payer: United Healthcare All Other HMO $1,919.19
Rate for Payer: United Healthcare HMO Rider $1,919.19
Rate for Payer: United Healthcare Select/Navigate/Core $1,919.19
Rate for Payer: Vantage Medical Group Commercial/Exchange $47.94
Rate for Payer: Vantage Medical Group Medi-Cal $35.16
Rate for Payer: Vantage Medical Group Senior $31.96
Service Code CPT J9319
Hospital Charge Code ERX100344
Hospital Revenue Code 636
Min. Negotiated Rate $767.68
Max. Negotiated Rate $3,454.54
Rate for Payer: Blue Shield of California Commercial $2,878.78
Rate for Payer: Blue Shield of California EPN $2,049.69
Rate for Payer: Cash Price $1,727.27
Rate for Payer: Central Health Plan Commercial $3,070.70
Rate for Payer: Cigna of CA HMO $2,686.87
Rate for Payer: Cigna of CA PPO $2,686.87
Rate for Payer: EPIC Health Plan Commercial $1,535.35
Rate for Payer: EPIC Health Plan Transplant $1,535.35
Rate for Payer: Galaxy Health WC $3,262.62
Rate for Payer: Global Benefits Group Commercial $2,303.03
Rate for Payer: Health Management Network EPO/PPO $3,454.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2,560.20
Rate for Payer: LLUH Dept of Risk Management WC $767.68
Rate for Payer: Multiplan Commercial $2,878.78
Rate for Payer: Networks By Design Commercial $1,919.19
Rate for Payer: Prime Health Services Commercial $3,262.62
Service Code CPT J2796
Hospital Charge Code ERX226462
Hospital Revenue Code 636
Min. Negotiated Rate $286.20
Max. Negotiated Rate $1,287.90
Rate for Payer: Blue Shield of California Commercial $1,073.25
Rate for Payer: Blue Shield of California EPN $764.15
Rate for Payer: Cash Price $643.95
Rate for Payer: Central Health Plan Commercial $1,144.80
Rate for Payer: Cigna of CA HMO $1,001.70
Rate for Payer: Cigna of CA PPO $1,001.70
Rate for Payer: EPIC Health Plan Commercial $572.40
Rate for Payer: EPIC Health Plan Transplant $572.40
Rate for Payer: Galaxy Health WC $1,216.35
Rate for Payer: Global Benefits Group Commercial $858.60
Rate for Payer: Health Management Network EPO/PPO $1,287.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $954.48
Rate for Payer: LLUH Dept of Risk Management WC $286.20
Rate for Payer: Multiplan Commercial $1,073.25
Rate for Payer: Networks By Design Commercial $715.50
Rate for Payer: Prime Health Services Commercial $1,216.35
Service Code CPT J2796
Hospital Charge Code ERX226462
Hospital Revenue Code 636
Min. Negotiated Rate $85.82
Max. Negotiated Rate $1,287.90
Rate for Payer: Adventist Health Medi-Cal $96.03
Rate for Payer: Aetna of CA HMO/PPO $595.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $120.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $105.63
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $105.63
Rate for Payer: Anthem Blue Cross of CA Exchange $85.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $93.96
Rate for Payer: BCBS Transplant Transplant $858.60
Rate for Payer: Blue Shield of California Commercial $102.94
Rate for Payer: Blue Shield of California EPN $93.58
Rate for Payer: Caremore Medicare Advantage $96.03
Rate for Payer: Cash Price $643.95
Rate for Payer: Cash Price $643.95
Rate for Payer: Central Health Plan Commercial $1,144.80
Rate for Payer: Cigna of CA HMO $1,001.70
Rate for Payer: Cigna of CA PPO $1,001.70
Rate for Payer: Dignity Health Commercial/Exchange $144.04
Rate for Payer: EPIC Health Plan Commercial $129.64
Rate for Payer: EPIC Health Plan Medicare/Senior $96.03
Rate for Payer: EPIC Health Plan Transplant $96.03
Rate for Payer: Galaxy Health WC $1,216.35
Rate for Payer: Global Benefits Group Commercial $858.60
Rate for Payer: Health Management Network EPO/PPO $1,287.90
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,073.25
Rate for Payer: Heritage Provider Network Commercial/Senior $157.48
Rate for Payer: IEHP medi-cal $158.44
Rate for Payer: IEHP Medicare Advantage $96.03
Rate for Payer: Innovage PACE Commercial $144.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $954.48
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $96.03
Rate for Payer: LLUH Dept of Risk Management WC $286.20
Rate for Payer: Molina Healthcare of CA Medi-Cal $128.68
Rate for Payer: Molina Healthcare of CA Medicare $128.68
Rate for Payer: Multiplan Commercial $1,073.25
Rate for Payer: Networks By Design Commercial $715.50
Rate for Payer: Prime Health Services Commercial $1,216.35
Rate for Payer: Prime Health Services Medicare $101.79
Rate for Payer: Riverside University Health MISP $105.63
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $858.60
Rate for Payer: TriValley Medical Group Commercial/Senior $858.60
Rate for Payer: United Healthcare All Other Commercial $715.50
Rate for Payer: United Healthcare All Other HMO $715.50
Rate for Payer: United Healthcare HMO Rider $715.50
Rate for Payer: United Healthcare Select/Navigate/Core $715.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $144.04
Rate for Payer: Vantage Medical Group Medi-Cal $105.63
Rate for Payer: Vantage Medical Group Senior $96.03
Service Code CPT J2796
Hospital Charge Code 1721175
Hospital Revenue Code 636
Min. Negotiated Rate $85.82
Max. Negotiated Rate $2,575.76
Rate for Payer: Adventist Health Medi-Cal $96.03
Rate for Payer: Aetna of CA HMO/PPO $595.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $120.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $105.63
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $105.63
Rate for Payer: Anthem Blue Cross of CA Exchange $85.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $93.96
Rate for Payer: BCBS Transplant Transplant $1,717.18
Rate for Payer: Blue Shield of California Commercial $102.94
Rate for Payer: Blue Shield of California EPN $93.58
Rate for Payer: Caremore Medicare Advantage $96.03
Rate for Payer: Cash Price $1,287.88
Rate for Payer: Cash Price $1,287.88
Rate for Payer: Central Health Plan Commercial $2,289.57
Rate for Payer: Cigna of CA HMO $2,003.37
Rate for Payer: Cigna of CA PPO $2,003.37
Rate for Payer: Dignity Health Commercial/Exchange $144.04
Rate for Payer: EPIC Health Plan Commercial $129.64
Rate for Payer: EPIC Health Plan Medicare/Senior $96.03
Rate for Payer: EPIC Health Plan Transplant $96.03
Rate for Payer: Galaxy Health WC $2,432.67
Rate for Payer: Global Benefits Group Commercial $1,717.18
Rate for Payer: Health Management Network EPO/PPO $2,575.76
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $2,146.47
Rate for Payer: Heritage Provider Network Commercial/Senior $157.48
Rate for Payer: IEHP medi-cal $158.44
Rate for Payer: IEHP Medicare Advantage $96.03
Rate for Payer: Innovage PACE Commercial $144.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,908.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $96.03
Rate for Payer: LLUH Dept of Risk Management WC $572.39
Rate for Payer: Molina Healthcare of CA Medi-Cal $128.68
Rate for Payer: Molina Healthcare of CA Medicare $128.68
Rate for Payer: Multiplan Commercial $2,146.47
Rate for Payer: Networks By Design Commercial $1,430.98
Rate for Payer: Prime Health Services Commercial $2,432.67
Rate for Payer: Prime Health Services Medicare $101.79
Rate for Payer: Riverside University Health MISP $105.63
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1,717.18
Rate for Payer: TriValley Medical Group Commercial/Senior $1,717.18
Rate for Payer: United Healthcare All Other Commercial $1,430.98
Rate for Payer: United Healthcare All Other HMO $1,430.98
Rate for Payer: United Healthcare HMO Rider $1,430.98
Rate for Payer: United Healthcare Select/Navigate/Core $1,430.98
Rate for Payer: Vantage Medical Group Commercial/Exchange $144.04
Rate for Payer: Vantage Medical Group Medi-Cal $105.63
Rate for Payer: Vantage Medical Group Senior $96.03
Service Code CPT J2796
Hospital Charge Code 1721175
Hospital Revenue Code 636
Min. Negotiated Rate $572.39
Max. Negotiated Rate $2,575.76
Rate for Payer: Blue Shield of California Commercial $2,146.47
Rate for Payer: Blue Shield of California EPN $1,528.29
Rate for Payer: Cash Price $1,287.88
Rate for Payer: Central Health Plan Commercial $2,289.57
Rate for Payer: Cigna of CA HMO $2,003.37
Rate for Payer: Cigna of CA PPO $2,003.37
Rate for Payer: EPIC Health Plan Commercial $1,144.78
Rate for Payer: EPIC Health Plan Transplant $1,144.78
Rate for Payer: Galaxy Health WC $2,432.67
Rate for Payer: Global Benefits Group Commercial $1,717.18
Rate for Payer: Health Management Network EPO/PPO $2,575.76
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,908.93
Rate for Payer: LLUH Dept of Risk Management WC $572.39
Rate for Payer: Multiplan Commercial $2,146.47
Rate for Payer: Networks By Design Commercial $1,430.98
Rate for Payer: Prime Health Services Commercial $2,432.67
Service Code CPT J2796
Hospital Charge Code 1721176
Hospital Revenue Code 636
Min. Negotiated Rate $1,144.78
Max. Negotiated Rate $5,151.53
Rate for Payer: Blue Shield of California Commercial $4,292.94
Rate for Payer: Blue Shield of California EPN $3,056.57
Rate for Payer: Cash Price $2,575.76
Rate for Payer: Central Health Plan Commercial $4,579.14
Rate for Payer: Cigna of CA HMO $4,006.74
Rate for Payer: Cigna of CA PPO $4,006.74
Rate for Payer: EPIC Health Plan Commercial $2,289.57
Rate for Payer: EPIC Health Plan Transplant $2,289.57
Rate for Payer: Galaxy Health WC $4,865.33
Rate for Payer: Global Benefits Group Commercial $3,434.35
Rate for Payer: Health Management Network EPO/PPO $5,151.53
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,817.85
Rate for Payer: LLUH Dept of Risk Management WC $1,144.78
Rate for Payer: Multiplan Commercial $4,292.94
Rate for Payer: Networks By Design Commercial $2,861.96
Rate for Payer: Prime Health Services Commercial $4,865.33
Service Code CPT J2796
Hospital Charge Code 1721176
Hospital Revenue Code 636
Min. Negotiated Rate $85.82
Max. Negotiated Rate $5,151.53
Rate for Payer: Adventist Health Medi-Cal $96.03
Rate for Payer: Aetna of CA HMO/PPO $595.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $120.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $105.63
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $105.63
Rate for Payer: Anthem Blue Cross of CA Exchange $85.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $93.96
Rate for Payer: BCBS Transplant Transplant $3,434.35
Rate for Payer: Blue Shield of California Commercial $102.94
Rate for Payer: Blue Shield of California EPN $93.58
Rate for Payer: Caremore Medicare Advantage $96.03
Rate for Payer: Cash Price $2,575.76
Rate for Payer: Cash Price $2,575.76
Rate for Payer: Central Health Plan Commercial $4,579.14
Rate for Payer: Cigna of CA HMO $4,006.74
Rate for Payer: Cigna of CA PPO $4,006.74
Rate for Payer: Dignity Health Commercial/Exchange $144.04
Rate for Payer: EPIC Health Plan Commercial $129.64
Rate for Payer: EPIC Health Plan Medicare/Senior $96.03
Rate for Payer: EPIC Health Plan Transplant $96.03
Rate for Payer: Galaxy Health WC $4,865.33
Rate for Payer: Global Benefits Group Commercial $3,434.35
Rate for Payer: Health Management Network EPO/PPO $5,151.53
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $4,292.94
Rate for Payer: Heritage Provider Network Commercial/Senior $157.48
Rate for Payer: IEHP medi-cal $158.44
Rate for Payer: IEHP Medicare Advantage $96.03
Rate for Payer: Innovage PACE Commercial $144.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,817.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $96.03
Rate for Payer: LLUH Dept of Risk Management WC $1,144.78
Rate for Payer: Molina Healthcare of CA Medi-Cal $128.68
Rate for Payer: Molina Healthcare of CA Medicare $128.68
Rate for Payer: Multiplan Commercial $4,292.94
Rate for Payer: Networks By Design Commercial $2,861.96
Rate for Payer: Prime Health Services Commercial $4,865.33
Rate for Payer: Prime Health Services Medicare $101.79
Rate for Payer: Riverside University Health MISP $105.63
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $3,434.35
Rate for Payer: TriValley Medical Group Commercial/Senior $3,434.35
Rate for Payer: United Healthcare All Other Commercial $2,861.96
Rate for Payer: United Healthcare All Other HMO $2,861.96
Rate for Payer: United Healthcare HMO Rider $2,861.96
Rate for Payer: United Healthcare Select/Navigate/Core $2,861.96
Rate for Payer: Vantage Medical Group Commercial/Exchange $144.04
Rate for Payer: Vantage Medical Group Medi-Cal $105.63
Rate for Payer: Vantage Medical Group Senior $96.03
Service Code NDC 0904-6373-61
Hospital Charge Code 1711813
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.53
Rate for Payer: Blue Shield of California Commercial $0.44
Rate for Payer: Blue Shield of California EPN $0.32
Rate for Payer: Cash Price $0.27
Rate for Payer: Central Health Plan Commercial $0.47
Rate for Payer: Cigna of CA HMO $0.41
Rate for Payer: Cigna of CA PPO $0.41
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: Galaxy Health WC $0.50
Rate for Payer: Global Benefits Group Commercial $0.35
Rate for Payer: Health Management Network EPO/PPO $0.53
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.39
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.44
Rate for Payer: Networks By Design Commercial $0.38
Rate for Payer: Prime Health Services Commercial $0.50
Service Code NDC 60687-577-11
Hospital Charge Code 1711813
Hospital Revenue Code 259
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.59
Rate for Payer: Blue Shield of California Commercial $0.50
Rate for Payer: Blue Shield of California EPN $0.35
Rate for Payer: Cash Price $0.30
Rate for Payer: Central Health Plan Commercial $0.53
Rate for Payer: Cigna of CA HMO $0.46
Rate for Payer: Cigna of CA PPO $0.46
Rate for Payer: EPIC Health Plan Commercial $0.26
Rate for Payer: Galaxy Health WC $0.56
Rate for Payer: Global Benefits Group Commercial $0.40
Rate for Payer: Health Management Network EPO/PPO $0.59
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.44
Rate for Payer: LLUH Dept of Risk Management WC $0.13
Rate for Payer: Multiplan Commercial $0.50
Rate for Payer: Networks By Design Commercial $0.43
Rate for Payer: Prime Health Services Commercial $0.56