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Service Code NDC 67877-503-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.53
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.33
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: EPIC Health Plan Senior $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: Kaiser Permanente of CA Medi-Cal $0.22
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
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 70436-007-04
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Service Code NDC 16729-440-10
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Service Code NDC 67877-503-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.53
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.50
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.32
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.44
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: Blue Shield of California Commercial $0.36
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.33
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: Dignity Health Commercial/Exchange $0.50
Rate for Payer: Dignity Health Medi-Cal $0.50
Rate for Payer: Dignity Health Medicare Advantage $0.50
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $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: InnovAge PACE Commercial $0.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.22
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.41
Rate for Payer: Molina Healthcare of CA Medicare $0.41
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
Rate for Payer: Riverside University Health System MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.35
Rate for Payer: TriValley Medical Group Commercial/Senior $0.35
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.50
Rate for Payer: Vantage Medical Group Medi-Cal $0.50
Rate for Payer: Vantage Medical Group Senior $0.50
Service Code NDC 65862-831-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.51
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.33
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.45
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.51
Rate for Payer: Dignity Health Medi-Cal $0.51
Rate for Payer: Dignity Health Medicare Advantage $0.51
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: InnovAge PACE Commercial $0.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.42
Rate for Payer: Molina Healthcare of CA Medicare $0.42
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Rate for Payer: Riverside University Health System MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Commercial/Senior $0.36
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.51
Rate for Payer: Vantage Medical Group Senior $0.51
Service Code NDC 60687-516-21
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $5.30
Max. Negotiated Rate $23.85
Rate for Payer: Adventist Health Commercial $5.30
Rate for Payer: Aetna of CA HMO/PPO $16.09
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $22.52
Rate for Payer: Alpha Care Medical Group Medi-Cal $14.57
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $19.88
Rate for Payer: Anthem Blue Cross of CA Exchange $12.83
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $15.56
Rate for Payer: Blue Shield of California Commercial $16.19
Rate for Payer: Blue Shield of California EPN $10.57
Rate for Payer: Cash Price $14.57
Rate for Payer: Central Health Plan Commercial $21.20
Rate for Payer: Cigna of CA HMO $18.55
Rate for Payer: Cigna of CA PPO $18.55
Rate for Payer: Dignity Health Commercial/Exchange $22.52
Rate for Payer: Dignity Health Medi-Cal $22.52
Rate for Payer: Dignity Health Medicare Advantage $22.52
Rate for Payer: EPIC Health Plan Commercial $10.60
Rate for Payer: EPIC Health Plan Senior $10.60
Rate for Payer: Galaxy Health WC $22.52
Rate for Payer: Global Benefits Group Commercial $15.90
Rate for Payer: Health Management Network EPO/PPO $23.85
Rate for Payer: InnovAge PACE Commercial $13.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $17.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal $10.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $16.40
Rate for Payer: LLUH Dept of Risk Management WC $5.30
Rate for Payer: Molina Healthcare of CA Medi-Cal $18.55
Rate for Payer: Molina Healthcare of CA Medicare $18.55
Rate for Payer: Multiplan Commercial $19.88
Rate for Payer: Networks By Design Commercial $17.23
Rate for Payer: Prime Health Services Commercial $22.52
Rate for Payer: Riverside University Health System MISP $10.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $15.90
Rate for Payer: TriValley Medical Group Commercial/Senior $15.90
Rate for Payer: United Healthcare All Other Commercial $13.25
Rate for Payer: United Healthcare All Other HMO $13.25
Rate for Payer: United Healthcare HMO Rider $13.25
Rate for Payer: United Healthcare Select/Navigate/Core $13.25
Rate for Payer: Vantage Medical Group Commercial/Exchange $22.52
Rate for Payer: Vantage Medical Group Medi-Cal $22.52
Rate for Payer: Vantage Medical Group Senior $22.52
Service Code NDC 70436-007-04
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.51
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.33
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.45
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.51
Rate for Payer: Dignity Health Medi-Cal $0.51
Rate for Payer: Dignity Health Medicare Advantage $0.51
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: InnovAge PACE Commercial $0.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.42
Rate for Payer: Molina Healthcare of CA Medicare $0.42
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Rate for Payer: Riverside University Health System MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Commercial/Senior $0.36
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.51
Rate for Payer: Vantage Medical Group Senior $0.51
Service Code NDC 69097-410-02
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.51
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.33
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.45
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.51
Rate for Payer: Dignity Health Medi-Cal $0.51
Rate for Payer: Dignity Health Medicare Advantage $0.51
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: InnovAge PACE Commercial $0.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.42
Rate for Payer: Molina Healthcare of CA Medicare $0.42
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Rate for Payer: Riverside University Health System MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Commercial/Senior $0.36
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.51
Rate for Payer: Vantage Medical Group Senior $0.51
Service Code NDC 65862-831-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Service Code NDC 69097-410-02
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Service Code NDC 60687-516-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $5.30
Max. Negotiated Rate $23.85
Rate for Payer: Adventist Health Commercial $5.30
Rate for Payer: Blue Shield of California Commercial $20.48
Rate for Payer: Blue Shield of California EPN $13.36
Rate for Payer: Cash Price $14.57
Rate for Payer: Central Health Plan Commercial $21.20
Rate for Payer: Cigna of CA HMO $18.55
Rate for Payer: Cigna of CA PPO $18.55
Rate for Payer: EPIC Health Plan Commercial $10.60
Rate for Payer: EPIC Health Plan Senior $10.60
Rate for Payer: Galaxy Health WC $22.52
Rate for Payer: Global Benefits Group Commercial $15.90
Rate for Payer: Health Management Network EPO/PPO $23.85
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $17.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal $10.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $16.40
Rate for Payer: LLUH Dept of Risk Management WC $5.30
Rate for Payer: Multiplan Commercial $19.88
Rate for Payer: Networks By Design Commercial $17.23
Rate for Payer: Prime Health Services Commercial $22.52
Service Code NDC 60687-516-11
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $5.30
Max. Negotiated Rate $23.85
Rate for Payer: Adventist Health Commercial $5.30
Rate for Payer: Aetna of CA HMO/PPO $16.09
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $22.52
Rate for Payer: Alpha Care Medical Group Medi-Cal $14.57
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $19.88
Rate for Payer: Anthem Blue Cross of CA Exchange $12.83
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $15.56
Rate for Payer: Blue Shield of California Commercial $16.19
Rate for Payer: Blue Shield of California EPN $10.57
Rate for Payer: Cash Price $14.57
Rate for Payer: Central Health Plan Commercial $21.20
Rate for Payer: Cigna of CA HMO $18.55
Rate for Payer: Cigna of CA PPO $18.55
Rate for Payer: Dignity Health Commercial/Exchange $22.52
Rate for Payer: Dignity Health Medi-Cal $22.52
Rate for Payer: Dignity Health Medicare Advantage $22.52
Rate for Payer: EPIC Health Plan Commercial $10.60
Rate for Payer: EPIC Health Plan Senior $10.60
Rate for Payer: Galaxy Health WC $22.52
Rate for Payer: Global Benefits Group Commercial $15.90
Rate for Payer: Health Management Network EPO/PPO $23.85
Rate for Payer: InnovAge PACE Commercial $13.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $17.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal $10.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $16.40
Rate for Payer: LLUH Dept of Risk Management WC $5.30
Rate for Payer: Molina Healthcare of CA Medi-Cal $18.55
Rate for Payer: Molina Healthcare of CA Medicare $18.55
Rate for Payer: Multiplan Commercial $19.88
Rate for Payer: Networks By Design Commercial $17.23
Rate for Payer: Prime Health Services Commercial $22.52
Rate for Payer: Riverside University Health System MISP $10.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $15.90
Rate for Payer: TriValley Medical Group Commercial/Senior $15.90
Rate for Payer: United Healthcare All Other Commercial $13.25
Rate for Payer: United Healthcare All Other HMO $13.25
Rate for Payer: United Healthcare HMO Rider $13.25
Rate for Payer: United Healthcare Select/Navigate/Core $13.25
Rate for Payer: Vantage Medical Group Commercial/Exchange $22.52
Rate for Payer: Vantage Medical Group Medi-Cal $22.52
Rate for Payer: Vantage Medical Group Senior $22.52
Service Code NDC 16729-440-15
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.51
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.33
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.45
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.51
Rate for Payer: Dignity Health Medi-Cal $0.51
Rate for Payer: Dignity Health Medicare Advantage $0.51
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: InnovAge PACE Commercial $0.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.42
Rate for Payer: Molina Healthcare of CA Medicare $0.42
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Rate for Payer: Riverside University Health System MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Commercial/Senior $0.36
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.51
Rate for Payer: Vantage Medical Group Senior $0.51
Service Code NDC 60687-516-21
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $5.30
Max. Negotiated Rate $23.85
Rate for Payer: Adventist Health Commercial $5.30
Rate for Payer: Blue Shield of California Commercial $20.48
Rate for Payer: Blue Shield of California EPN $13.36
Rate for Payer: Cash Price $14.57
Rate for Payer: Central Health Plan Commercial $21.20
Rate for Payer: Cigna of CA HMO $18.55
Rate for Payer: Cigna of CA PPO $18.55
Rate for Payer: EPIC Health Plan Commercial $10.60
Rate for Payer: EPIC Health Plan Senior $10.60
Rate for Payer: Galaxy Health WC $22.52
Rate for Payer: Global Benefits Group Commercial $15.90
Rate for Payer: Health Management Network EPO/PPO $23.85
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $17.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal $10.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $16.40
Rate for Payer: LLUH Dept of Risk Management WC $5.30
Rate for Payer: Multiplan Commercial $19.88
Rate for Payer: Networks By Design Commercial $17.23
Rate for Payer: Prime Health Services Commercial $22.52
Service Code NDC 16729-440-10
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Aetna of CA HMO/PPO $0.36
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.51
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.33
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.45
Rate for Payer: Anthem Blue Cross of CA Exchange $0.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.35
Rate for Payer: Blue Shield of California Commercial $0.37
Rate for Payer: Blue Shield of California EPN $0.24
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: Dignity Health Commercial/Exchange $0.51
Rate for Payer: Dignity Health Medi-Cal $0.51
Rate for Payer: Dignity Health Medicare Advantage $0.51
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: InnovAge PACE Commercial $0.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.42
Rate for Payer: Molina Healthcare of CA Medicare $0.42
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Rate for Payer: Riverside University Health System MISP $0.24
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.36
Rate for Payer: TriValley Medical Group Commercial/Senior $0.36
Rate for Payer: United Healthcare All Other Commercial $0.30
Rate for Payer: United Healthcare All Other HMO $0.30
Rate for Payer: United Healthcare HMO Rider $0.30
Rate for Payer: United Healthcare Select/Navigate/Core $0.30
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.51
Rate for Payer: Vantage Medical Group Senior $0.51
Service Code NDC 16729-440-15
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.54
Rate for Payer: Adventist Health Commercial $0.12
Rate for Payer: Blue Shield of California Commercial $0.46
Rate for Payer: Blue Shield of California EPN $0.30
Rate for Payer: Cash Price $0.33
Rate for Payer: Central Health Plan Commercial $0.48
Rate for Payer: Cigna of CA HMO $0.42
Rate for Payer: Cigna of CA PPO $0.42
Rate for Payer: EPIC Health Plan Commercial $0.24
Rate for Payer: EPIC Health Plan Senior $0.24
Rate for Payer: Galaxy Health WC $0.51
Rate for Payer: Global Benefits Group Commercial $0.36
Rate for Payer: Health Management Network EPO/PPO $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.37
Rate for Payer: LLUH Dept of Risk Management WC $0.12
Rate for Payer: Multiplan Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.39
Rate for Payer: Prime Health Services Commercial $0.51
Service Code NDC 55513-074-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $12.91
Max. Negotiated Rate $58.09
Rate for Payer: Adventist Health Commercial $12.91
Rate for Payer: Aetna of CA HMO/PPO $39.20
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $54.86
Rate for Payer: Alpha Care Medical Group Medi-Cal $35.50
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $48.41
Rate for Payer: Anthem Blue Cross of CA Exchange $31.25
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $37.90
Rate for Payer: Blue Shield of California Commercial $39.43
Rate for Payer: Blue Shield of California EPN $25.75
Rate for Payer: Cash Price $35.49
Rate for Payer: Central Health Plan Commercial $51.63
Rate for Payer: Cigna of CA HMO $45.18
Rate for Payer: Cigna of CA PPO $45.18
Rate for Payer: Dignity Health Commercial/Exchange $54.86
Rate for Payer: Dignity Health Medi-Cal $54.86
Rate for Payer: Dignity Health Medicare Advantage $54.86
Rate for Payer: EPIC Health Plan Commercial $25.82
Rate for Payer: EPIC Health Plan Senior $25.82
Rate for Payer: Galaxy Health WC $54.86
Rate for Payer: Global Benefits Group Commercial $38.72
Rate for Payer: Health Management Network EPO/PPO $58.09
Rate for Payer: InnovAge PACE Commercial $32.27
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $43.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal $24.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $39.95
Rate for Payer: LLUH Dept of Risk Management WC $12.91
Rate for Payer: Molina Healthcare of CA Medi-Cal $45.18
Rate for Payer: Molina Healthcare of CA Medicare $45.18
Rate for Payer: Multiplan Commercial $48.41
Rate for Payer: Networks By Design Commercial $41.95
Rate for Payer: Prime Health Services Commercial $54.86
Rate for Payer: Riverside University Health System MISP $25.82
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $38.72
Rate for Payer: TriValley Medical Group Commercial/Senior $38.72
Rate for Payer: United Healthcare All Other Commercial $32.27
Rate for Payer: United Healthcare All Other HMO $32.27
Rate for Payer: United Healthcare HMO Rider $32.27
Rate for Payer: United Healthcare Select/Navigate/Core $32.27
Rate for Payer: Vantage Medical Group Commercial/Exchange $54.86
Rate for Payer: Vantage Medical Group Medi-Cal $54.86
Rate for Payer: Vantage Medical Group Senior $54.86
Service Code NDC 69097-411-02
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Blue Shield of California Commercial $0.83
Rate for Payer: Blue Shield of California EPN $0.54
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Service Code NDC 16729-441-10
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Aetna of CA HMO/PPO $0.66
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.92
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.59
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.81
Rate for Payer: Anthem Blue Cross of CA Exchange $0.52
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.63
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $0.92
Rate for Payer: Dignity Health Medi-Cal $0.92
Rate for Payer: Dignity Health Medicare Advantage $0.92
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: InnovAge PACE Commercial $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.76
Rate for Payer: Molina Healthcare of CA Medicare $0.76
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Rate for Payer: Riverside University Health System MISP $0.43
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.54
Rate for Payer: United Healthcare All Other HMO $0.54
Rate for Payer: United Healthcare HMO Rider $0.54
Rate for Payer: United Healthcare Select/Navigate/Core $0.54
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.92
Rate for Payer: Vantage Medical Group Medi-Cal $0.92
Rate for Payer: Vantage Medical Group Senior $0.92
Service Code NDC 16729-441-10
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Blue Shield of California Commercial $0.83
Rate for Payer: Blue Shield of California EPN $0.54
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Service Code NDC 65862-832-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Aetna of CA HMO/PPO $0.66
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.92
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.59
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.81
Rate for Payer: Anthem Blue Cross of CA Exchange $0.52
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.63
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $0.92
Rate for Payer: Dignity Health Medi-Cal $0.92
Rate for Payer: Dignity Health Medicare Advantage $0.92
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: InnovAge PACE Commercial $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.76
Rate for Payer: Molina Healthcare of CA Medicare $0.76
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Rate for Payer: Riverside University Health System MISP $0.43
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.54
Rate for Payer: United Healthcare All Other HMO $0.54
Rate for Payer: United Healthcare HMO Rider $0.54
Rate for Payer: United Healthcare Select/Navigate/Core $0.54
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.92
Rate for Payer: Vantage Medical Group Medi-Cal $0.92
Rate for Payer: Vantage Medical Group Senior $0.92
Service Code NDC 64380-884-04
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Aetna of CA HMO/PPO $0.66
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.92
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.59
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.81
Rate for Payer: Anthem Blue Cross of CA Exchange $0.52
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.63
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $0.92
Rate for Payer: Dignity Health Medi-Cal $0.92
Rate for Payer: Dignity Health Medicare Advantage $0.92
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: InnovAge PACE Commercial $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.76
Rate for Payer: Molina Healthcare of CA Medicare $0.76
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Rate for Payer: Riverside University Health System MISP $0.43
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.54
Rate for Payer: United Healthcare All Other HMO $0.54
Rate for Payer: United Healthcare HMO Rider $0.54
Rate for Payer: United Healthcare Select/Navigate/Core $0.54
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.92
Rate for Payer: Vantage Medical Group Medi-Cal $0.92
Rate for Payer: Vantage Medical Group Senior $0.92
Service Code NDC 69097-411-02
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Aetna of CA HMO/PPO $0.66
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $0.92
Rate for Payer: Alpha Care Medical Group Medi-Cal $0.59
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $0.81
Rate for Payer: Anthem Blue Cross of CA Exchange $0.52
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.63
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $0.92
Rate for Payer: Dignity Health Medi-Cal $0.92
Rate for Payer: Dignity Health Medicare Advantage $0.92
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: InnovAge PACE Commercial $0.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Molina Healthcare of CA Medi-Cal $0.76
Rate for Payer: Molina Healthcare of CA Medicare $0.76
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Rate for Payer: Riverside University Health System MISP $0.43
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.54
Rate for Payer: United Healthcare All Other HMO $0.54
Rate for Payer: United Healthcare HMO Rider $0.54
Rate for Payer: United Healthcare Select/Navigate/Core $0.54
Rate for Payer: Vantage Medical Group Commercial/Exchange $0.92
Rate for Payer: Vantage Medical Group Medi-Cal $0.92
Rate for Payer: Vantage Medical Group Senior $0.92
Service Code NDC 64380-884-04
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.97
Rate for Payer: Adventist Health Commercial $0.22
Rate for Payer: Blue Shield of California Commercial $0.83
Rate for Payer: Blue Shield of California EPN $0.54
Rate for Payer: Cash Price $0.59
Rate for Payer: Central Health Plan Commercial $0.86
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: EPIC Health Plan Commercial $0.43
Rate for Payer: EPIC Health Plan Senior $0.43
Rate for Payer: Galaxy Health WC $0.92
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.97
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $0.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.81
Rate for Payer: Networks By Design Commercial $0.70
Rate for Payer: Prime Health Services Commercial $0.92
Service Code NDC 55513-074-30
Hospital Charge Code 901700029
Hospital Revenue Code 259
Min. Negotiated Rate $12.91
Max. Negotiated Rate $58.09
Rate for Payer: Adventist Health Commercial $12.91
Rate for Payer: Blue Shield of California Commercial $49.89
Rate for Payer: Blue Shield of California EPN $32.53
Rate for Payer: Cash Price $35.49
Rate for Payer: Central Health Plan Commercial $51.63
Rate for Payer: Cigna of CA HMO $45.18
Rate for Payer: Cigna of CA PPO $45.18
Rate for Payer: EPIC Health Plan Commercial $25.82
Rate for Payer: EPIC Health Plan Senior $25.82
Rate for Payer: Galaxy Health WC $54.86
Rate for Payer: Global Benefits Group Commercial $38.72
Rate for Payer: Health Management Network EPO/PPO $58.09
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $43.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal $24.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $39.95
Rate for Payer: LLUH Dept of Risk Management WC $12.91
Rate for Payer: Multiplan Commercial $48.41
Rate for Payer: Networks By Design Commercial $41.95
Rate for Payer: Prime Health Services Commercial $54.86