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Service Code NDC 0904-6522-61
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 69618-640-01
Hospital Charge Code 1710631
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Service Code NDC 71399-8245-3
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 71399-8245-3
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 0904-7252-80
Hospital Charge Code 1710631
Hospital Revenue Code 259
Max. Negotiated Rate $0.01
Rate for Payer: Aetna of CA HMO/PPO $0.01
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 Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $0.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.00
Rate for Payer: Central Health Plan Commercial $0.01
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.01
Rate for Payer: EPIC Health Plan Commercial $0.00
Rate for Payer: EPIC Health Plan Transplant $0.00
Rate for Payer: Galaxy Health WC $0.01
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.01
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.01
Rate for Payer: IEHP medi-cal $0.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.01
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.01
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Riverside University Health MISP $0.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.01
Rate for Payer: Vantage Medical Group Senior $0.01
Service Code NDC 0904-6725-59
Hospital Charge Code 1710631
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 46122-702-78
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Service Code NDC 0904-6522-61
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 70677-0058-1
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA Exchange $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.02
Rate for Payer: Cigna of CA PPO $0.02
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.03
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.02
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.02
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 8770143173
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.04
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.04
Service Code NDC 67618-300-10
Hospital Charge Code 1710631
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.20
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: 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 69618-069-58
Hospital Charge Code 1715722
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 71399-8237-8
Hospital Charge Code 1715722
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 71399-8237-8
Hospital Charge Code 1715722
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 69618-069-58
Hospital Charge Code 1715722
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code APR-DRG 7202
Min. Negotiated Rate $7,306.28
Max. Negotiated Rate $8,706.66
Rate for Payer: Adventist Health Medi-Cal $7,306.28
Rate for Payer: IEHP medi-cal $8,706.66
Service Code APR-DRG 7201
Min. Negotiated Rate $5,681.04
Max. Negotiated Rate $6,769.91
Rate for Payer: Adventist Health Medi-Cal $5,681.04
Rate for Payer: IEHP medi-cal $6,769.91
Service Code APR-DRG 7203
Min. Negotiated Rate $10,738.21
Max. Negotiated Rate $12,796.37
Rate for Payer: Adventist Health Medi-Cal $10,738.21
Rate for Payer: IEHP medi-cal $12,796.37
Service Code APR-DRG 7204
Min. Negotiated Rate $18,733.34
Max. Negotiated Rate $22,323.90
Rate for Payer: Adventist Health Medi-Cal $18,733.34
Rate for Payer: IEHP medi-cal $22,323.90
Service Code CPT 30520
Hospital Revenue Code 360
Min. Negotiated Rate $4,022.69
Max. Negotiated Rate $15,354.00
Rate for Payer: Adventist Health Medi-Cal $4,022.69
Rate for Payer: Aetna of CA HMO/PPO $10,567.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $6,034.04
Rate for Payer: AlphaCare Medical Group Medi-Cal $4,424.96
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $4,022.69
Rate for Payer: Anthem Blue Cross of CA Exchange $8,405.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10,254.00
Rate for Payer: Blue Shield of California Commercial $5,824.53
Rate for Payer: Blue Shield of California EPN $4,183.44
Rate for Payer: Caremore Medicare Advantage $4,022.69
Rate for Payer: Dignity Health Commercial/Exchange $6,034.04
Rate for Payer: EPIC Health Plan Commercial $5,430.63
Rate for Payer: EPIC Health Plan Medicare/Senior $4,022.69
Rate for Payer: EPIC Health Plan Transplant $4,022.69
Rate for Payer: Heritage Provider Network Commercial/Senior $6,597.21
Rate for Payer: IEHP medi-cal $6,637.44
Rate for Payer: IEHP Medicare Advantage $4,022.69
Rate for Payer: Innovage PACE Commercial $6,034.04
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $4,022.69
Rate for Payer: Molina Healthcare of CA Medi-Cal $5,390.40
Rate for Payer: Molina Healthcare of CA Medicare $5,390.40
Rate for Payer: Prime Health Services Medicare $4,264.05
Rate for Payer: Riverside University Health MISP $4,424.96
Rate for Payer: United Healthcare All Other Commercial $11,375.00
Rate for Payer: United Healthcare All Other HMO $15,354.00
Rate for Payer: United Healthcare HMO Rider $9,681.00
Rate for Payer: United Healthcare Select/Navigate/Core $8,852.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $6,034.04
Rate for Payer: Vantage Medical Group Medi-Cal $4,424.96
Rate for Payer: Vantage Medical Group Senior $4,022.69
Service Code NDC 65862-013-30
Hospital Charge Code 1711555
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 60687-253-11
Hospital Charge Code 1711555
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.48
Rate for Payer: Blue Shield of California Commercial $0.40
Rate for Payer: Blue Shield of California EPN $0.28
Rate for Payer: Cash Price $0.24
Rate for Payer: Central Health Plan Commercial $0.42
Rate for Payer: Cigna of CA HMO $0.37
Rate for Payer: Cigna of CA PPO $0.37
Rate for Payer: EPIC Health Plan Commercial $0.21
Rate for Payer: Galaxy Health WC $0.45
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Management Network EPO/PPO $0.48
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.35
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.40
Rate for Payer: Networks By Design Commercial $0.34
Rate for Payer: Prime Health Services Commercial $0.45
Service Code NDC 68180-353-06
Hospital Charge Code 1711555
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.11
Rate for Payer: Aetna of CA HMO/PPO $0.07
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Anthem Blue Cross of CA Exchange $0.06
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.07
Rate for Payer: BCBS Transplant Transplant $0.07
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: Central Health Plan Commercial $0.10
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 $0.10
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: EPIC Health Plan Transplant $0.05
Rate for Payer: Galaxy Health WC $0.10
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.11
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.09
Rate for Payer: IEHP medi-cal $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Networks By Design Commercial $0.08
Rate for Payer: Prime Health Services Commercial $0.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.07
Rate for Payer: Riverside University Health MISP $0.05
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 $0.10
Rate for Payer: Vantage Medical Group Senior $0.10
Service Code NDC 69097-835-02
Hospital Charge Code 1711555
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.21
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: Central Health Plan Commercial $0.18
Rate for Payer: Cigna of CA HMO $0.16
Rate for Payer: Cigna of CA PPO $0.16
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Health Management Network EPO/PPO $0.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.17
Rate for Payer: Networks By Design Commercial $0.15
Rate for Payer: Prime Health Services Commercial $0.20
Service Code NDC 69097-835-02
Hospital Charge Code 1711555
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.21
Rate for Payer: Aetna of CA HMO/PPO $0.14
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.13
Rate for Payer: Anthem Blue Cross of CA Exchange $0.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.14
Rate for Payer: BCBS Transplant Transplant $0.14
Rate for Payer: Blue Shield of California Commercial $0.14
Rate for Payer: Blue Shield of California EPN $0.11
Rate for Payer: Cash Price $0.10
Rate for Payer: Central Health Plan Commercial $0.18
Rate for Payer: Cigna of CA HMO $0.16
Rate for Payer: Cigna of CA PPO $0.16
Rate for Payer: Dignity Health Commercial/Exchange $0.20
Rate for Payer: EPIC Health Plan Commercial $0.09
Rate for Payer: EPIC Health Plan Transplant $0.09
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Health Management Network EPO/PPO $0.21
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.17
Rate for Payer: IEHP medi-cal $0.08
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.15
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.17
Rate for Payer: Networks By Design Commercial $0.15
Rate for Payer: Prime Health Services Commercial $0.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.14
Rate for Payer: Riverside University Health MISP $0.09
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.14
Rate for Payer: TriValley Medical Group Commercial/Senior $0.14
Rate for Payer: United Healthcare All Other Commercial $0.12
Rate for Payer: United Healthcare All Other HMO $0.12
Rate for Payer: United Healthcare HMO Rider $0.12
Rate for Payer: United Healthcare Select/Navigate/Core $0.12
Rate for Payer: Vantage Medical Group Medi-Cal $0.20
Rate for Payer: Vantage Medical Group Senior $0.20