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Service Code NDC 67877-199-90
Hospital Charge Code 1711579
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 29300-398-19
Hospital Charge Code 1711579
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.04
Rate for Payer: BCBS Transplant Transplant $0.04
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 $0.03
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: Dignity Health Commercial/Exchange $0.05
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.05
Rate for Payer: IEHP medi-cal $0.02
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
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Commercial/Senior $0.04
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 68382-123-16
Hospital Charge Code 1711579
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.03
Rate for Payer: BCBS Transplant Transplant $0.03
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 $0.04
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.04
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.04
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.03
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.03
Rate for Payer: TriValley Medical Group Commercial/Senior $0.03
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Senior $0.04
Service Code NDC 68180-721-09
Hospital Charge Code 1711579
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.06
Rate for Payer: Cigna of CA HMO $0.05
Rate for Payer: Cigna of CA PPO $0.05
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Galaxy Health WC $0.06
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.05
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 $0.05
Rate for Payer: Prime Health Services Commercial $0.06
Service Code NDC 68382-123-16
Hospital Charge Code 1711579
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 60687-496-01
Hospital Charge Code 1711579
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.17
Rate for Payer: Blue Shield of California Commercial $0.14
Rate for Payer: Blue Shield of California EPN $0.10
Rate for Payer: Cash Price $0.09
Rate for Payer: Central Health Plan Commercial $0.15
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: Galaxy Health WC $0.16
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Health Management Network EPO/PPO $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.16
Service Code NDC 0781-2271-01
Hospital Charge Code 1711787
Hospital Revenue Code 259
Min. Negotiated Rate $0.50
Max. Negotiated Rate $2.26
Rate for Payer: Blue Shield of California Commercial $1.88
Rate for Payer: Blue Shield of California EPN $1.34
Rate for Payer: Cash Price $1.13
Rate for Payer: Central Health Plan Commercial $2.01
Rate for Payer: Cigna of CA HMO $1.76
Rate for Payer: Cigna of CA PPO $1.76
Rate for Payer: EPIC Health Plan Commercial $1.00
Rate for Payer: Galaxy Health WC $2.13
Rate for Payer: Global Benefits Group Commercial $1.51
Rate for Payer: Health Management Network EPO/PPO $2.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.67
Rate for Payer: LLUH Dept of Risk Management WC $0.50
Rate for Payer: Multiplan Commercial $1.88
Rate for Payer: Networks By Design Commercial $1.63
Rate for Payer: Prime Health Services Commercial $2.13
Service Code NDC 0781-2271-01
Hospital Charge Code 1711787
Hospital Revenue Code 259
Min. Negotiated Rate $0.50
Max. Negotiated Rate $2.26
Rate for Payer: Aetna of CA HMO/PPO $1.52
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $2.13
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.38
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1.38
Rate for Payer: Anthem Blue Cross of CA Exchange $1.22
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.48
Rate for Payer: BCBS Transplant Transplant $1.51
Rate for Payer: Blue Shield of California Commercial $1.58
Rate for Payer: Blue Shield of California EPN $1.23
Rate for Payer: Cash Price $1.13
Rate for Payer: Central Health Plan Commercial $2.01
Rate for Payer: Cigna of CA HMO $1.76
Rate for Payer: Cigna of CA PPO $1.76
Rate for Payer: Dignity Health Commercial/Exchange $2.13
Rate for Payer: EPIC Health Plan Commercial $1.00
Rate for Payer: EPIC Health Plan Transplant $1.00
Rate for Payer: Galaxy Health WC $2.13
Rate for Payer: Global Benefits Group Commercial $1.51
Rate for Payer: Health Management Network EPO/PPO $2.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.88
Rate for Payer: IEHP medi-cal $0.88
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.67
Rate for Payer: LLUH Dept of Risk Management WC $0.50
Rate for Payer: Multiplan Commercial $1.88
Rate for Payer: Networks By Design Commercial $1.63
Rate for Payer: Prime Health Services Commercial $2.13
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.51
Rate for Payer: Riverside University Health MISP $1.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.51
Rate for Payer: TriValley Medical Group Commercial/Senior $1.51
Rate for Payer: United Healthcare All Other Commercial $1.26
Rate for Payer: United Healthcare All Other HMO $1.26
Rate for Payer: United Healthcare HMO Rider $1.26
Rate for Payer: United Healthcare Select/Navigate/Core $1.26
Rate for Payer: Vantage Medical Group Medi-Cal $2.13
Rate for Payer: Vantage Medical Group Senior $2.13
Service Code NDC 67877-197-90
Hospital Charge Code 1711577
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 67877-197-90
Hospital Charge Code 1711577
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 0904-6369-61
Hospital Charge Code 1711577
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.15
Rate for Payer: Blue Shield of California Commercial $0.13
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.08
Rate for Payer: Central Health Plan Commercial $0.14
Rate for Payer: Cigna of CA HMO $0.12
Rate for Payer: Cigna of CA PPO $0.12
Rate for Payer: EPIC Health Plan Commercial $0.07
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Management Network EPO/PPO $0.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.11
Rate for Payer: Prime Health Services Commercial $0.14
Service Code NDC 68382-121-16
Hospital Charge Code 1711577
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.02
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: EPIC Health Plan Commercial $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: 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
Service Code NDC 0904-6369-61
Hospital Charge Code 1711577
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.15
Rate for Payer: Aetna of CA HMO/PPO $0.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Anthem Blue Cross of CA Exchange $0.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.10
Rate for Payer: BCBS Transplant Transplant $0.10
Rate for Payer: Blue Shield of California Commercial $0.11
Rate for Payer: Blue Shield of California EPN $0.08
Rate for Payer: Cash Price $0.08
Rate for Payer: Central Health Plan Commercial $0.14
Rate for Payer: Cigna of CA HMO $0.12
Rate for Payer: Cigna of CA PPO $0.12
Rate for Payer: Dignity Health Commercial/Exchange $0.14
Rate for Payer: EPIC Health Plan Commercial $0.07
Rate for Payer: EPIC Health Plan Transplant $0.07
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Management Network EPO/PPO $0.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.13
Rate for Payer: IEHP medi-cal $0.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.11
Rate for Payer: Prime Health Services Commercial $0.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.10
Rate for Payer: Riverside University Health MISP $0.07
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.10
Rate for Payer: TriValley Medical Group Commercial/Senior $0.10
Rate for Payer: United Healthcare All Other Commercial $0.09
Rate for Payer: United Healthcare All Other HMO $0.09
Rate for Payer: United Healthcare HMO Rider $0.09
Rate for Payer: United Healthcare Select/Navigate/Core $0.09
Rate for Payer: Vantage Medical Group Medi-Cal $0.14
Rate for Payer: Vantage Medical Group Senior $0.14
Service Code NDC 68382-121-16
Hospital Charge Code 1711577
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 60687-488-11
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.17
Rate for Payer: Blue Shield of California Commercial $0.14
Rate for Payer: Blue Shield of California EPN $0.10
Rate for Payer: Cash Price $0.09
Rate for Payer: Central Health Plan Commercial $0.15
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: Galaxy Health WC $0.16
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Health Management Network EPO/PPO $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.16
Service Code NDC 0904-6370-61
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.09
Rate for Payer: Aetna of CA HMO/PPO $0.06
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 $0.06
Rate for Payer: Blue Shield of California Commercial $0.06
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.08
Rate for Payer: Cigna of CA HMO $0.07
Rate for Payer: Cigna of CA PPO $0.07
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 $0.06
Rate for Payer: Health Management Network EPO/PPO $0.09
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 $0.06
Rate for Payer: Riverside University Health MISP $0.04
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.06
Rate for Payer: TriValley Medical Group Commercial/Senior $0.06
Rate for Payer: United Healthcare All Other Commercial $0.05
Rate for Payer: United Healthcare All Other HMO $0.05
Rate for Payer: United Healthcare HMO Rider $0.05
Rate for Payer: United Healthcare Select/Navigate/Core $0.05
Rate for Payer: Vantage Medical Group Medi-Cal $0.09
Rate for Payer: Vantage Medical Group Senior $0.09
Service Code NDC 60687-488-01
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.17
Rate for Payer: Aetna of CA HMO/PPO $0.12
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.16
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.10
Rate for Payer: Anthem Blue Cross of CA Exchange $0.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.11
Rate for Payer: BCBS Transplant Transplant $0.11
Rate for Payer: Blue Shield of California Commercial $0.12
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.09
Rate for Payer: Central Health Plan Commercial $0.15
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: Dignity Health Commercial/Exchange $0.16
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: EPIC Health Plan Transplant $0.08
Rate for Payer: Galaxy Health WC $0.16
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Health Management Network EPO/PPO $0.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.14
Rate for Payer: IEHP medi-cal $0.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.16
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.11
Rate for Payer: Riverside University Health MISP $0.08
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.11
Rate for Payer: TriValley Medical Group Commercial/Senior $0.11
Rate for Payer: United Healthcare All Other Commercial $0.10
Rate for Payer: United Healthcare All Other HMO $0.10
Rate for Payer: United Healthcare HMO Rider $0.10
Rate for Payer: United Healthcare Select/Navigate/Core $0.10
Rate for Payer: Vantage Medical Group Medi-Cal $0.16
Rate for Payer: Vantage Medical Group Senior $0.16
Service Code NDC 69097-127-05
Hospital Charge Code 1711578
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 0904-6370-61
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.09
Rate for Payer: Blue Shield of California Commercial $0.08
Rate for Payer: Blue Shield of California EPN $0.05
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.08
Rate for Payer: Cigna of CA HMO $0.07
Rate for Payer: Cigna of CA PPO $0.07
Rate for Payer: EPIC Health Plan Commercial $0.04
Rate for Payer: Galaxy Health WC $0.09
Rate for Payer: Global Benefits Group Commercial $0.06
Rate for Payer: Health Management Network EPO/PPO $0.09
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.08
Rate for Payer: Networks By Design Commercial $0.07
Rate for Payer: Prime Health Services Commercial $0.09
Service Code NDC 60687-488-11
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.17
Rate for Payer: Aetna of CA HMO/PPO $0.12
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.16
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.10
Rate for Payer: Anthem Blue Cross of CA Exchange $0.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.11
Rate for Payer: BCBS Transplant Transplant $0.11
Rate for Payer: Blue Shield of California Commercial $0.12
Rate for Payer: Blue Shield of California EPN $0.09
Rate for Payer: Cash Price $0.09
Rate for Payer: Central Health Plan Commercial $0.15
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: Dignity Health Commercial/Exchange $0.16
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: EPIC Health Plan Transplant $0.08
Rate for Payer: Galaxy Health WC $0.16
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Health Management Network EPO/PPO $0.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.14
Rate for Payer: IEHP medi-cal $0.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.16
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.11
Rate for Payer: Riverside University Health MISP $0.08
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.11
Rate for Payer: TriValley Medical Group Commercial/Senior $0.11
Rate for Payer: United Healthcare All Other Commercial $0.10
Rate for Payer: United Healthcare All Other HMO $0.10
Rate for Payer: United Healthcare HMO Rider $0.10
Rate for Payer: United Healthcare Select/Navigate/Core $0.10
Rate for Payer: Vantage Medical Group Medi-Cal $0.16
Rate for Payer: Vantage Medical Group Senior $0.16
Service Code NDC 67877-198-90
Hospital Charge Code 1711578
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 60687-488-01
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.17
Rate for Payer: Blue Shield of California Commercial $0.14
Rate for Payer: Blue Shield of California EPN $0.10
Rate for Payer: Cash Price $0.09
Rate for Payer: Central Health Plan Commercial $0.15
Rate for Payer: Cigna of CA HMO $0.13
Rate for Payer: Cigna of CA PPO $0.13
Rate for Payer: EPIC Health Plan Commercial $0.08
Rate for Payer: Galaxy Health WC $0.16
Rate for Payer: Global Benefits Group Commercial $0.11
Rate for Payer: Health Management Network EPO/PPO $0.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.13
Rate for Payer: LLUH Dept of Risk Management WC $0.04
Rate for Payer: Multiplan Commercial $0.14
Rate for Payer: Networks By Design Commercial $0.12
Rate for Payer: Prime Health Services Commercial $0.16
Service Code NDC 69097-127-05
Hospital Charge Code 1711578
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.03
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.04
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.03
Rate for Payer: BCBS Transplant Transplant $0.03
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 $0.04
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.04
Rate for Payer: Global Benefits Group Commercial $0.03
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.04
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.04
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.04
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.03
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.03
Rate for Payer: TriValley Medical Group Commercial/Senior $0.03
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.04
Rate for Payer: Vantage Medical Group Senior $0.04
Service Code NDC 67877-198-90
Hospital Charge Code 1711578
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 9994-0802-40
Hospital Charge Code 1715304
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