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Charge Type Price  
Service Code CPT J0894
Hospital Charge Code 1755761
Hospital Revenue Code 636
Min. Negotiated Rate $1.43
Max. Negotiated Rate $108.00
Rate for Payer: Aetna of CA HMO/PPO $3.33
Rate for Payer: Aetna of CA HMO/PPO $3.33
Rate for Payer: Aetna of CA HMO/PPO $3.33
Rate for Payer: Aetna of CA HMO/PPO $3.33
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $204.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $201.96
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $102.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $612.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $132.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $396.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $130.68
Rate for Payer: AlphaCare Medical Group Medi-Cal $66.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $130.68
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $66.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $132.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $396.00
Rate for Payer: Anthem Blue Cross of CA Exchange $49.51
Rate for Payer: Anthem Blue Cross of CA Exchange $49.51
Rate for Payer: Anthem Blue Cross of CA Exchange $49.51
Rate for Payer: Anthem Blue Cross of CA Exchange $49.51
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $54.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $54.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $54.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $54.21
Rate for Payer: BCBS Transplant Transplant $432.00
Rate for Payer: BCBS Transplant Transplant $144.00
Rate for Payer: BCBS Transplant Transplant $142.56
Rate for Payer: BCBS Transplant Transplant $72.00
Rate for Payer: Blue Shield of California Commercial $17.16
Rate for Payer: Blue Shield of California Commercial $17.16
Rate for Payer: Blue Shield of California Commercial $17.16
Rate for Payer: Blue Shield of California Commercial $17.16
Rate for Payer: Blue Shield of California EPN $15.60
Rate for Payer: Blue Shield of California EPN $15.60
Rate for Payer: Blue Shield of California EPN $15.60
Rate for Payer: Blue Shield of California EPN $15.60
Rate for Payer: Cash Price $108.00
Rate for Payer: Cash Price $54.00
Rate for Payer: Cash Price $54.00
Rate for Payer: Cash Price $106.92
Rate for Payer: Cash Price $106.92
Rate for Payer: Cash Price $108.00
Rate for Payer: Cash Price $324.00
Rate for Payer: Cash Price $324.00
Rate for Payer: Central Health Plan Commercial $190.08
Rate for Payer: Central Health Plan Commercial $96.00
Rate for Payer: Central Health Plan Commercial $576.00
Rate for Payer: Central Health Plan Commercial $192.00
Rate for Payer: Cigna of CA HMO $84.00
Rate for Payer: Cigna of CA HMO $166.32
Rate for Payer: Cigna of CA HMO $168.00
Rate for Payer: Cigna of CA HMO $504.00
Rate for Payer: Cigna of CA PPO $84.00
Rate for Payer: Cigna of CA PPO $504.00
Rate for Payer: Cigna of CA PPO $168.00
Rate for Payer: Cigna of CA PPO $166.32
Rate for Payer: Dignity Health Commercial/Exchange $204.00
Rate for Payer: Dignity Health Commercial/Exchange $201.96
Rate for Payer: Dignity Health Commercial/Exchange $612.00
Rate for Payer: Dignity Health Commercial/Exchange $102.00
Rate for Payer: EPIC Health Plan Commercial $95.04
Rate for Payer: EPIC Health Plan Commercial $48.00
Rate for Payer: EPIC Health Plan Commercial $96.00
Rate for Payer: EPIC Health Plan Commercial $288.00
Rate for Payer: EPIC Health Plan Transplant $95.04
Rate for Payer: EPIC Health Plan Transplant $96.00
Rate for Payer: EPIC Health Plan Transplant $48.00
Rate for Payer: EPIC Health Plan Transplant $288.00
Rate for Payer: Galaxy Health WC $204.00
Rate for Payer: Galaxy Health WC $612.00
Rate for Payer: Galaxy Health WC $201.96
Rate for Payer: Galaxy Health WC $102.00
Rate for Payer: Global Benefits Group Commercial $144.00
Rate for Payer: Global Benefits Group Commercial $142.56
Rate for Payer: Global Benefits Group Commercial $432.00
Rate for Payer: Global Benefits Group Commercial $72.00
Rate for Payer: Health Management Network EPO/PPO $648.00
Rate for Payer: Health Management Network EPO/PPO $213.84
Rate for Payer: Health Management Network EPO/PPO $216.00
Rate for Payer: Health Management Network EPO/PPO $108.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $180.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $540.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $178.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $90.00
Rate for Payer: IEHP medi-cal $1.43
Rate for Payer: IEHP medi-cal $1.43
Rate for Payer: IEHP medi-cal $1.43
Rate for Payer: IEHP medi-cal $1.43
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $80.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $480.24
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $160.08
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $158.48
Rate for Payer: LLUH Dept of Risk Management WC $24.00
Rate for Payer: LLUH Dept of Risk Management WC $47.52
Rate for Payer: LLUH Dept of Risk Management WC $48.00
Rate for Payer: LLUH Dept of Risk Management WC $144.00
Rate for Payer: Multiplan Commercial $540.00
Rate for Payer: Multiplan Commercial $180.00
Rate for Payer: Multiplan Commercial $178.20
Rate for Payer: Multiplan Commercial $90.00
Rate for Payer: Networks By Design Commercial $120.00
Rate for Payer: Networks By Design Commercial $60.00
Rate for Payer: Networks By Design Commercial $118.80
Rate for Payer: Networks By Design Commercial $360.00
Rate for Payer: Prime Health Services Commercial $204.00
Rate for Payer: Prime Health Services Commercial $612.00
Rate for Payer: Prime Health Services Commercial $201.96
Rate for Payer: Prime Health Services Commercial $102.00
Rate for Payer: Riverside University Health MISP $96.00
Rate for Payer: Riverside University Health MISP $95.04
Rate for Payer: Riverside University Health MISP $48.00
Rate for Payer: Riverside University Health MISP $288.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $144.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $72.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $432.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $142.56
Rate for Payer: TriValley Medical Group Commercial/Senior $144.00
Rate for Payer: TriValley Medical Group Commercial/Senior $432.00
Rate for Payer: TriValley Medical Group Commercial/Senior $72.00
Rate for Payer: TriValley Medical Group Commercial/Senior $142.56
Rate for Payer: United Healthcare All Other Commercial $60.00
Rate for Payer: United Healthcare All Other Commercial $118.80
Rate for Payer: United Healthcare All Other Commercial $120.00
Rate for Payer: United Healthcare All Other Commercial $360.00
Rate for Payer: United Healthcare All Other HMO $360.00
Rate for Payer: United Healthcare All Other HMO $118.80
Rate for Payer: United Healthcare All Other HMO $120.00
Rate for Payer: United Healthcare All Other HMO $60.00
Rate for Payer: United Healthcare HMO Rider $118.80
Rate for Payer: United Healthcare HMO Rider $120.00
Rate for Payer: United Healthcare HMO Rider $360.00
Rate for Payer: United Healthcare HMO Rider $60.00
Rate for Payer: United Healthcare Select/Navigate/Core $120.00
Rate for Payer: United Healthcare Select/Navigate/Core $118.80
Rate for Payer: United Healthcare Select/Navigate/Core $360.00
Rate for Payer: United Healthcare Select/Navigate/Core $60.00
Rate for Payer: Vantage Medical Group Medi-Cal $102.00
Rate for Payer: Vantage Medical Group Medi-Cal $201.96
Rate for Payer: Vantage Medical Group Medi-Cal $612.00
Rate for Payer: Vantage Medical Group Medi-Cal $204.00
Rate for Payer: Vantage Medical Group Senior $102.00
Rate for Payer: Vantage Medical Group Senior $201.96
Rate for Payer: Vantage Medical Group Senior $204.00
Rate for Payer: Vantage Medical Group Senior $612.00
Service Code CPT 26037
Hospital Revenue Code 360
Min. Negotiated Rate $2,960.28
Max. Negotiated Rate $10,567.00
Rate for Payer: Adventist Health Medi-Cal $4,044.21
Rate for Payer: Aetna of CA HMO/PPO $10,567.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $6,066.32
Rate for Payer: AlphaCare Medical Group Medi-Cal $4,448.63
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $4,044.21
Rate for Payer: Anthem Blue Cross of CA Exchange $6,419.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $7,830.00
Rate for Payer: Blue Shield of California Commercial $4,121.55
Rate for Payer: Blue Shield of California EPN $2,960.28
Rate for Payer: Caremore Medicare Advantage $4,044.21
Rate for Payer: Dignity Health Commercial/Exchange $6,066.32
Rate for Payer: EPIC Health Plan Commercial $5,459.68
Rate for Payer: EPIC Health Plan Medicare/Senior $4,044.21
Rate for Payer: EPIC Health Plan Transplant $4,044.21
Rate for Payer: Heritage Provider Network Commercial/Senior $6,632.50
Rate for Payer: IEHP medi-cal $6,672.95
Rate for Payer: IEHP Medicare Advantage $4,044.21
Rate for Payer: Innovage PACE Commercial $6,066.32
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $4,044.21
Rate for Payer: Molina Healthcare of CA Medi-Cal $5,419.24
Rate for Payer: Molina Healthcare of CA Medicare $5,419.24
Rate for Payer: Prime Health Services Medicare $4,286.86
Rate for Payer: Riverside University Health MISP $4,448.63
Rate for Payer: United Healthcare All Other Commercial $5,893.00
Rate for Payer: United Healthcare All Other HMO $7,027.00
Rate for Payer: United Healthcare HMO Rider $4,217.00
Rate for Payer: United Healthcare Select/Navigate/Core $3,918.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $6,066.32
Rate for Payer: Vantage Medical Group Medi-Cal $4,448.63
Rate for Payer: Vantage Medical Group Senior $4,044.21
Service Code NDC 0078-0655-15
Hospital Charge Code ERX206427
Hospital Revenue Code 259
Min. Negotiated Rate $23.39
Max. Negotiated Rate $105.26
Rate for Payer: Blue Shield of California Commercial $87.71
Rate for Payer: Blue Shield of California EPN $62.45
Rate for Payer: Cash Price $52.63
Rate for Payer: Central Health Plan Commercial $93.56
Rate for Payer: Cigna of CA HMO $81.86
Rate for Payer: Cigna of CA PPO $81.86
Rate for Payer: EPIC Health Plan Commercial $46.78
Rate for Payer: Galaxy Health WC $99.41
Rate for Payer: Global Benefits Group Commercial $70.17
Rate for Payer: Health Management Network EPO/PPO $105.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $78.01
Rate for Payer: LLUH Dept of Risk Management WC $23.39
Rate for Payer: Multiplan Commercial $87.71
Rate for Payer: Networks By Design Commercial $76.02
Rate for Payer: Prime Health Services Commercial $99.41
Service Code NDC 0078-0655-15
Hospital Charge Code ERX206427
Hospital Revenue Code 259
Min. Negotiated Rate $23.39
Max. Negotiated Rate $105.26
Rate for Payer: Aetna of CA HMO/PPO $71.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $99.41
Rate for Payer: AlphaCare Medical Group Medi-Cal $64.32
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $64.32
Rate for Payer: Anthem Blue Cross of CA Exchange $56.63
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $69.09
Rate for Payer: BCBS Transplant Transplant $70.17
Rate for Payer: Blue Shield of California Commercial $73.56
Rate for Payer: Blue Shield of California EPN $57.19
Rate for Payer: Cash Price $52.63
Rate for Payer: Central Health Plan Commercial $93.56
Rate for Payer: Cigna of CA HMO $81.86
Rate for Payer: Cigna of CA PPO $81.86
Rate for Payer: Dignity Health Commercial/Exchange $99.41
Rate for Payer: EPIC Health Plan Commercial $46.78
Rate for Payer: EPIC Health Plan Transplant $46.78
Rate for Payer: Galaxy Health WC $99.41
Rate for Payer: Global Benefits Group Commercial $70.17
Rate for Payer: Health Management Network EPO/PPO $105.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $87.71
Rate for Payer: IEHP medi-cal $40.93
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $78.01
Rate for Payer: LLUH Dept of Risk Management WC $23.39
Rate for Payer: Multiplan Commercial $87.71
Rate for Payer: Networks By Design Commercial $76.02
Rate for Payer: Prime Health Services Commercial $99.41
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $70.17
Rate for Payer: Riverside University Health MISP $46.78
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $70.17
Rate for Payer: TriValley Medical Group Commercial/Senior $70.17
Rate for Payer: United Healthcare All Other Commercial $58.48
Rate for Payer: United Healthcare All Other HMO $58.48
Rate for Payer: United Healthcare HMO Rider $58.48
Rate for Payer: United Healthcare Select/Navigate/Core $58.48
Rate for Payer: Vantage Medical Group Medi-Cal $99.41
Rate for Payer: Vantage Medical Group Senior $99.41
Service Code NDC 0078-0469-15
Hospital Charge Code 1712350
Hospital Revenue Code 259
Min. Negotiated Rate $23.39
Max. Negotiated Rate $105.26
Rate for Payer: Blue Shield of California Commercial $87.71
Rate for Payer: Blue Shield of California EPN $62.45
Rate for Payer: Cash Price $52.63
Rate for Payer: Central Health Plan Commercial $93.56
Rate for Payer: Cigna of CA HMO $81.86
Rate for Payer: Cigna of CA PPO $81.86
Rate for Payer: EPIC Health Plan Commercial $46.78
Rate for Payer: Galaxy Health WC $99.41
Rate for Payer: Global Benefits Group Commercial $70.17
Rate for Payer: Health Management Network EPO/PPO $105.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $78.01
Rate for Payer: LLUH Dept of Risk Management WC $23.39
Rate for Payer: Multiplan Commercial $87.71
Rate for Payer: Networks By Design Commercial $76.02
Rate for Payer: Prime Health Services Commercial $99.41
Service Code NDC 45963-455-30
Hospital Charge Code 1712350
Hospital Revenue Code 259
Min. Negotiated Rate $12.02
Max. Negotiated Rate $54.07
Rate for Payer: Aetna of CA HMO/PPO $36.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $51.07
Rate for Payer: AlphaCare Medical Group Medi-Cal $33.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $33.04
Rate for Payer: Anthem Blue Cross of CA Exchange $29.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $35.50
Rate for Payer: BCBS Transplant Transplant $36.05
Rate for Payer: Blue Shield of California Commercial $37.79
Rate for Payer: Blue Shield of California EPN $29.38
Rate for Payer: Cash Price $27.04
Rate for Payer: Central Health Plan Commercial $48.06
Rate for Payer: Cigna of CA HMO $42.06
Rate for Payer: Cigna of CA PPO $42.06
Rate for Payer: Dignity Health Commercial/Exchange $51.07
Rate for Payer: EPIC Health Plan Commercial $24.03
Rate for Payer: EPIC Health Plan Transplant $24.03
Rate for Payer: Galaxy Health WC $51.07
Rate for Payer: Global Benefits Group Commercial $36.05
Rate for Payer: Health Management Network EPO/PPO $54.07
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $45.06
Rate for Payer: IEHP medi-cal $21.03
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $40.07
Rate for Payer: LLUH Dept of Risk Management WC $12.02
Rate for Payer: Multiplan Commercial $45.06
Rate for Payer: Networks By Design Commercial $39.05
Rate for Payer: Prime Health Services Commercial $51.07
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $36.05
Rate for Payer: Riverside University Health MISP $24.03
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $36.05
Rate for Payer: TriValley Medical Group Commercial/Senior $36.05
Rate for Payer: United Healthcare All Other Commercial $30.04
Rate for Payer: United Healthcare All Other HMO $30.04
Rate for Payer: United Healthcare HMO Rider $30.04
Rate for Payer: United Healthcare Select/Navigate/Core $30.04
Rate for Payer: Vantage Medical Group Medi-Cal $51.07
Rate for Payer: Vantage Medical Group Senior $51.07
Service Code NDC 0078-0469-15
Hospital Charge Code 1712350
Hospital Revenue Code 259
Min. Negotiated Rate $23.39
Max. Negotiated Rate $105.26
Rate for Payer: Aetna of CA HMO/PPO $71.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $99.41
Rate for Payer: AlphaCare Medical Group Medi-Cal $64.32
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $64.32
Rate for Payer: Anthem Blue Cross of CA Exchange $56.63
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $69.09
Rate for Payer: BCBS Transplant Transplant $70.17
Rate for Payer: Blue Shield of California Commercial $73.56
Rate for Payer: Blue Shield of California EPN $57.19
Rate for Payer: Cash Price $52.63
Rate for Payer: Central Health Plan Commercial $93.56
Rate for Payer: Cigna of CA HMO $81.86
Rate for Payer: Cigna of CA PPO $81.86
Rate for Payer: Dignity Health Commercial/Exchange $99.41
Rate for Payer: EPIC Health Plan Commercial $46.78
Rate for Payer: EPIC Health Plan Transplant $46.78
Rate for Payer: Galaxy Health WC $99.41
Rate for Payer: Global Benefits Group Commercial $70.17
Rate for Payer: Health Management Network EPO/PPO $105.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $87.71
Rate for Payer: IEHP medi-cal $40.93
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $78.01
Rate for Payer: LLUH Dept of Risk Management WC $23.39
Rate for Payer: Multiplan Commercial $87.71
Rate for Payer: Networks By Design Commercial $76.02
Rate for Payer: Prime Health Services Commercial $99.41
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $70.17
Rate for Payer: Riverside University Health MISP $46.78
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $70.17
Rate for Payer: TriValley Medical Group Commercial/Senior $70.17
Rate for Payer: United Healthcare All Other Commercial $58.48
Rate for Payer: United Healthcare All Other HMO $58.48
Rate for Payer: United Healthcare HMO Rider $58.48
Rate for Payer: United Healthcare Select/Navigate/Core $58.48
Rate for Payer: Vantage Medical Group Medi-Cal $99.41
Rate for Payer: Vantage Medical Group Senior $99.41
Service Code NDC 45963-455-30
Hospital Charge Code 1712350
Hospital Revenue Code 259
Min. Negotiated Rate $12.02
Max. Negotiated Rate $54.07
Rate for Payer: Blue Shield of California Commercial $45.06
Rate for Payer: Blue Shield of California EPN $32.08
Rate for Payer: Cash Price $27.04
Rate for Payer: Central Health Plan Commercial $48.06
Rate for Payer: Cigna of CA HMO $42.06
Rate for Payer: Cigna of CA PPO $42.06
Rate for Payer: EPIC Health Plan Commercial $24.03
Rate for Payer: Galaxy Health WC $51.07
Rate for Payer: Global Benefits Group Commercial $36.05
Rate for Payer: Health Management Network EPO/PPO $54.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $40.07
Rate for Payer: LLUH Dept of Risk Management WC $12.02
Rate for Payer: Multiplan Commercial $45.06
Rate for Payer: Networks By Design Commercial $39.05
Rate for Payer: Prime Health Services Commercial $51.07
Service Code NDC 0078-0470-15
Hospital Charge Code 1712351
Hospital Revenue Code 259
Min. Negotiated Rate $46.78
Max. Negotiated Rate $210.50
Rate for Payer: Blue Shield of California Commercial $175.42
Rate for Payer: Blue Shield of California EPN $124.90
Rate for Payer: Cash Price $105.25
Rate for Payer: Central Health Plan Commercial $187.11
Rate for Payer: Cigna of CA HMO $163.72
Rate for Payer: Cigna of CA PPO $163.72
Rate for Payer: EPIC Health Plan Commercial $93.56
Rate for Payer: Galaxy Health WC $198.81
Rate for Payer: Global Benefits Group Commercial $140.33
Rate for Payer: Health Management Network EPO/PPO $210.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $156.00
Rate for Payer: LLUH Dept of Risk Management WC $46.78
Rate for Payer: Multiplan Commercial $175.42
Rate for Payer: Networks By Design Commercial $152.03
Rate for Payer: Prime Health Services Commercial $198.81
Service Code NDC 0078-0470-15
Hospital Charge Code 1712351
Hospital Revenue Code 259
Min. Negotiated Rate $46.78
Max. Negotiated Rate $210.50
Rate for Payer: Aetna of CA HMO/PPO $142.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $198.81
Rate for Payer: AlphaCare Medical Group Medi-Cal $128.64
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $128.64
Rate for Payer: Anthem Blue Cross of CA Exchange $113.25
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $138.18
Rate for Payer: BCBS Transplant Transplant $140.33
Rate for Payer: Blue Shield of California Commercial $147.12
Rate for Payer: Blue Shield of California EPN $114.37
Rate for Payer: Cash Price $105.25
Rate for Payer: Central Health Plan Commercial $187.11
Rate for Payer: Cigna of CA HMO $163.72
Rate for Payer: Cigna of CA PPO $163.72
Rate for Payer: Dignity Health Commercial/Exchange $198.81
Rate for Payer: EPIC Health Plan Commercial $93.56
Rate for Payer: EPIC Health Plan Transplant $93.56
Rate for Payer: Galaxy Health WC $198.81
Rate for Payer: Global Benefits Group Commercial $140.33
Rate for Payer: Health Management Network EPO/PPO $210.50
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $175.42
Rate for Payer: IEHP medi-cal $81.86
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $156.00
Rate for Payer: LLUH Dept of Risk Management WC $46.78
Rate for Payer: Multiplan Commercial $175.42
Rate for Payer: Networks By Design Commercial $152.03
Rate for Payer: Prime Health Services Commercial $198.81
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $140.33
Rate for Payer: Riverside University Health MISP $93.56
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $140.33
Rate for Payer: TriValley Medical Group Commercial/Senior $140.33
Rate for Payer: United Healthcare All Other Commercial $116.94
Rate for Payer: United Healthcare All Other HMO $116.94
Rate for Payer: United Healthcare HMO Rider $116.94
Rate for Payer: United Healthcare Select/Navigate/Core $116.94
Rate for Payer: Vantage Medical Group Medi-Cal $198.81
Rate for Payer: Vantage Medical Group Senior $198.81
Service Code CPT J0895
Hospital Charge Code 1712428
Hospital Revenue Code 636
Min. Negotiated Rate $9.89
Max. Negotiated Rate $44.50
Rate for Payer: Blue Shield of California Commercial $37.08
Rate for Payer: Blue Shield of California EPN $26.40
Rate for Payer: Cash Price $22.25
Rate for Payer: Central Health Plan Commercial $39.55
Rate for Payer: Cigna of CA HMO $34.61
Rate for Payer: Cigna of CA PPO $34.61
Rate for Payer: EPIC Health Plan Commercial $19.78
Rate for Payer: EPIC Health Plan Transplant $19.78
Rate for Payer: Galaxy Health WC $42.02
Rate for Payer: Global Benefits Group Commercial $29.66
Rate for Payer: Health Management Network EPO/PPO $44.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $32.98
Rate for Payer: LLUH Dept of Risk Management WC $9.89
Rate for Payer: Multiplan Commercial $37.08
Rate for Payer: Networks By Design Commercial $24.72
Rate for Payer: Prime Health Services Commercial $42.02
Service Code CPT J0895
Hospital Charge Code 1712428
Hospital Revenue Code 636
Min. Negotiated Rate $6.90
Max. Negotiated Rate $53.26
Rate for Payer: Aetna of CA HMO/PPO $53.26
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $42.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $27.19
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $27.19
Rate for Payer: Anthem Blue Cross of CA Exchange $26.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $29.35
Rate for Payer: BCBS Transplant Transplant $29.66
Rate for Payer: Blue Shield of California Commercial $14.45
Rate for Payer: Blue Shield of California EPN $13.14
Rate for Payer: Cash Price $22.25
Rate for Payer: Cash Price $22.25
Rate for Payer: Central Health Plan Commercial $39.55
Rate for Payer: Cigna of CA HMO $34.61
Rate for Payer: Cigna of CA PPO $34.61
Rate for Payer: Dignity Health Commercial/Exchange $42.02
Rate for Payer: EPIC Health Plan Commercial $19.78
Rate for Payer: EPIC Health Plan Transplant $19.78
Rate for Payer: Galaxy Health WC $42.02
Rate for Payer: Global Benefits Group Commercial $29.66
Rate for Payer: Health Management Network EPO/PPO $44.50
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $37.08
Rate for Payer: IEHP medi-cal $6.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $32.98
Rate for Payer: LLUH Dept of Risk Management WC $9.89
Rate for Payer: Multiplan Commercial $37.08
Rate for Payer: Networks By Design Commercial $24.72
Rate for Payer: Prime Health Services Commercial $42.02
Rate for Payer: Riverside University Health MISP $19.78
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $29.66
Rate for Payer: TriValley Medical Group Commercial/Senior $29.66
Rate for Payer: United Healthcare All Other Commercial $24.72
Rate for Payer: United Healthcare All Other HMO $24.72
Rate for Payer: United Healthcare HMO Rider $24.72
Rate for Payer: United Healthcare Select/Navigate/Core $24.72
Rate for Payer: Vantage Medical Group Medi-Cal $42.02
Rate for Payer: Vantage Medical Group Senior $42.02
Service Code CPT J0895
Hospital Revenue Code 636
Min. Negotiated Rate $3.11
Max. Negotiated Rate $13.99
Rate for Payer: Blue Shield of California Commercial $11.66
Rate for Payer: Blue Shield of California EPN $8.30
Rate for Payer: Cash Price $6.99
Rate for Payer: Central Health Plan Commercial $12.43
Rate for Payer: Cigna of CA HMO $10.88
Rate for Payer: Cigna of CA PPO $10.88
Rate for Payer: EPIC Health Plan Commercial $6.22
Rate for Payer: EPIC Health Plan Transplant $6.22
Rate for Payer: Galaxy Health WC $13.21
Rate for Payer: Global Benefits Group Commercial $9.32
Rate for Payer: Health Management Network EPO/PPO $13.99
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.37
Rate for Payer: LLUH Dept of Risk Management WC $3.11
Rate for Payer: Multiplan Commercial $11.66
Rate for Payer: Networks By Design Commercial $7.77
Rate for Payer: Prime Health Services Commercial $13.21
Service Code CPT J0895
Hospital Revenue Code 636
Min. Negotiated Rate $3.11
Max. Negotiated Rate $53.26
Rate for Payer: Aetna of CA HMO/PPO $53.26
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $13.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $8.55
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.55
Rate for Payer: Anthem Blue Cross of CA Exchange $26.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $29.35
Rate for Payer: BCBS Transplant Transplant $9.32
Rate for Payer: Blue Shield of California Commercial $14.45
Rate for Payer: Blue Shield of California EPN $13.14
Rate for Payer: Cash Price $6.99
Rate for Payer: Cash Price $6.99
Rate for Payer: Central Health Plan Commercial $12.43
Rate for Payer: Cigna of CA HMO $10.88
Rate for Payer: Cigna of CA PPO $10.88
Rate for Payer: Dignity Health Commercial/Exchange $13.21
Rate for Payer: EPIC Health Plan Commercial $6.22
Rate for Payer: EPIC Health Plan Transplant $6.22
Rate for Payer: Galaxy Health WC $13.21
Rate for Payer: Global Benefits Group Commercial $9.32
Rate for Payer: Health Management Network EPO/PPO $13.99
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $11.66
Rate for Payer: IEHP medi-cal $6.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.37
Rate for Payer: LLUH Dept of Risk Management WC $3.11
Rate for Payer: Multiplan Commercial $11.66
Rate for Payer: Networks By Design Commercial $7.77
Rate for Payer: Prime Health Services Commercial $13.21
Rate for Payer: Riverside University Health MISP $6.22
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $9.32
Rate for Payer: TriValley Medical Group Commercial/Senior $9.32
Rate for Payer: United Healthcare All Other Commercial $7.77
Rate for Payer: United Healthcare All Other HMO $7.77
Rate for Payer: United Healthcare HMO Rider $7.77
Rate for Payer: United Healthcare Select/Navigate/Core $7.77
Rate for Payer: Vantage Medical Group Medi-Cal $13.21
Rate for Payer: Vantage Medical Group Senior $13.21
Service Code CPT J0895
Hospital Charge Code 1720046
Hospital Revenue Code 636
Min. Negotiated Rate $3.11
Max. Negotiated Rate $53.26
Rate for Payer: Aetna of CA HMO/PPO $53.26
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $13.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $8.55
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.55
Rate for Payer: Anthem Blue Cross of CA Exchange $26.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $29.35
Rate for Payer: BCBS Transplant Transplant $9.32
Rate for Payer: Blue Shield of California Commercial $14.45
Rate for Payer: Blue Shield of California EPN $13.14
Rate for Payer: Cash Price $6.99
Rate for Payer: Cash Price $6.99
Rate for Payer: Central Health Plan Commercial $12.43
Rate for Payer: Cigna of CA HMO $10.88
Rate for Payer: Cigna of CA PPO $10.88
Rate for Payer: Dignity Health Commercial/Exchange $13.21
Rate for Payer: EPIC Health Plan Commercial $6.22
Rate for Payer: EPIC Health Plan Transplant $6.22
Rate for Payer: Galaxy Health WC $13.21
Rate for Payer: Global Benefits Group Commercial $9.32
Rate for Payer: Health Management Network EPO/PPO $13.99
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $11.66
Rate for Payer: IEHP medi-cal $6.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.37
Rate for Payer: LLUH Dept of Risk Management WC $3.11
Rate for Payer: Multiplan Commercial $11.66
Rate for Payer: Networks By Design Commercial $7.77
Rate for Payer: Prime Health Services Commercial $13.21
Rate for Payer: Riverside University Health MISP $6.22
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $9.32
Rate for Payer: TriValley Medical Group Commercial/Senior $9.32
Rate for Payer: United Healthcare All Other Commercial $7.77
Rate for Payer: United Healthcare All Other HMO $7.77
Rate for Payer: United Healthcare HMO Rider $7.77
Rate for Payer: United Healthcare Select/Navigate/Core $7.77
Rate for Payer: Vantage Medical Group Medi-Cal $13.21
Rate for Payer: Vantage Medical Group Senior $13.21
Service Code CPT J0895
Hospital Charge Code 1720046
Hospital Revenue Code 636
Min. Negotiated Rate $3.11
Max. Negotiated Rate $13.99
Rate for Payer: Blue Shield of California Commercial $11.66
Rate for Payer: Blue Shield of California EPN $8.30
Rate for Payer: Cash Price $6.99
Rate for Payer: Central Health Plan Commercial $12.43
Rate for Payer: Cigna of CA HMO $10.88
Rate for Payer: Cigna of CA PPO $10.88
Rate for Payer: EPIC Health Plan Commercial $6.22
Rate for Payer: EPIC Health Plan Transplant $6.22
Rate for Payer: Galaxy Health WC $13.21
Rate for Payer: Global Benefits Group Commercial $9.32
Rate for Payer: Health Management Network EPO/PPO $13.99
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.37
Rate for Payer: LLUH Dept of Risk Management WC $3.11
Rate for Payer: Multiplan Commercial $11.66
Rate for Payer: Networks By Design Commercial $7.77
Rate for Payer: Prime Health Services Commercial $13.21
Service Code APR-DRG 1794
Min. Negotiated Rate $65,019.53
Max. Negotiated Rate $77,481.60
Rate for Payer: Adventist Health Medi-Cal $65,019.53
Rate for Payer: IEHP medi-cal $77,481.60
Service Code APR-DRG 1793
Min. Negotiated Rate $47,409.62
Max. Negotiated Rate $56,496.47
Rate for Payer: Adventist Health Medi-Cal $47,409.62
Rate for Payer: IEHP medi-cal $56,496.47
Service Code APR-DRG 1792
Min. Negotiated Rate $38,628.20
Max. Negotiated Rate $46,031.94
Rate for Payer: Adventist Health Medi-Cal $38,628.20
Rate for Payer: IEHP medi-cal $46,031.94
Service Code APR-DRG 1791
Min. Negotiated Rate $34,085.16
Max. Negotiated Rate $40,618.15
Rate for Payer: Adventist Health Medi-Cal $34,085.16
Rate for Payer: IEHP medi-cal $40,618.15
Service Code NDC 68727-800-02
Hospital Charge Code NDG4081463
Hospital Revenue Code 636
Min. Negotiated Rate $95.90
Max. Negotiated Rate $431.57
Rate for Payer: Aetna of CA HMO/PPO $291.21
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $407.59
Rate for Payer: AlphaCare Medical Group Medi-Cal $263.74
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $263.74
Rate for Payer: Anthem Blue Cross of CA Exchange $232.18
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $283.30
Rate for Payer: BCBS Transplant Transplant $287.71
Rate for Payer: Blue Shield of California Commercial $301.62
Rate for Payer: Blue Shield of California EPN $234.49
Rate for Payer: Cash Price $215.78
Rate for Payer: Cash Price $215.78
Rate for Payer: Central Health Plan Commercial $383.62
Rate for Payer: Cigna of CA HMO $335.66
Rate for Payer: Cigna of CA PPO $335.66
Rate for Payer: Dignity Health Commercial/Exchange $407.59
Rate for Payer: EPIC Health Plan Commercial $191.81
Rate for Payer: EPIC Health Plan Transplant $191.81
Rate for Payer: Galaxy Health WC $407.59
Rate for Payer: Global Benefits Group Commercial $287.71
Rate for Payer: Health Management Network EPO/PPO $431.57
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $359.64
Rate for Payer: IEHP medi-cal $167.83
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $319.84
Rate for Payer: LLUH Dept of Risk Management WC $95.90
Rate for Payer: Multiplan Commercial $359.64
Rate for Payer: Networks By Design Commercial $239.76
Rate for Payer: Prime Health Services Commercial $407.59
Rate for Payer: Riverside University Health MISP $191.81
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $287.71
Rate for Payer: TriValley Medical Group Commercial/Senior $287.71
Rate for Payer: United Healthcare All Other Commercial $239.76
Rate for Payer: United Healthcare All Other HMO $239.76
Rate for Payer: United Healthcare HMO Rider $239.76
Rate for Payer: United Healthcare Select/Navigate/Core $239.76
Rate for Payer: Vantage Medical Group Medi-Cal $407.59
Rate for Payer: Vantage Medical Group Senior $407.59
Service Code NDC 68727-800-01
Hospital Charge Code NDG4081463
Hospital Revenue Code 636
Min. Negotiated Rate $95.90
Max. Negotiated Rate $431.57
Rate for Payer: Blue Shield of California Commercial $359.64
Rate for Payer: Blue Shield of California EPN $256.06
Rate for Payer: Cash Price $215.78
Rate for Payer: Central Health Plan Commercial $383.62
Rate for Payer: Cigna of CA HMO $335.66
Rate for Payer: Cigna of CA PPO $335.66
Rate for Payer: EPIC Health Plan Commercial $191.81
Rate for Payer: EPIC Health Plan Transplant $191.81
Rate for Payer: Galaxy Health WC $407.59
Rate for Payer: Global Benefits Group Commercial $287.71
Rate for Payer: Health Management Network EPO/PPO $431.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $319.84
Rate for Payer: LLUH Dept of Risk Management WC $95.90
Rate for Payer: Multiplan Commercial $359.64
Rate for Payer: Networks By Design Commercial $239.76
Rate for Payer: Prime Health Services Commercial $407.59
Service Code NDC 68727-800-02
Hospital Charge Code NDG4081463
Hospital Revenue Code 636
Min. Negotiated Rate $95.90
Max. Negotiated Rate $431.57
Rate for Payer: Blue Shield of California Commercial $359.64
Rate for Payer: Blue Shield of California EPN $256.06
Rate for Payer: Cash Price $215.78
Rate for Payer: Central Health Plan Commercial $383.62
Rate for Payer: Cigna of CA HMO $335.66
Rate for Payer: Cigna of CA PPO $335.66
Rate for Payer: EPIC Health Plan Commercial $191.81
Rate for Payer: EPIC Health Plan Transplant $191.81
Rate for Payer: Galaxy Health WC $407.59
Rate for Payer: Global Benefits Group Commercial $287.71
Rate for Payer: Health Management Network EPO/PPO $431.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $319.84
Rate for Payer: LLUH Dept of Risk Management WC $95.90
Rate for Payer: Multiplan Commercial $359.64
Rate for Payer: Networks By Design Commercial $239.76
Rate for Payer: Prime Health Services Commercial $407.59
Service Code NDC 68727-800-01
Hospital Charge Code NDG4081463
Hospital Revenue Code 636
Min. Negotiated Rate $95.90
Max. Negotiated Rate $431.57
Rate for Payer: Aetna of CA HMO/PPO $291.21
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $407.59
Rate for Payer: AlphaCare Medical Group Medi-Cal $263.74
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $263.74
Rate for Payer: Anthem Blue Cross of CA Exchange $232.18
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $283.30
Rate for Payer: BCBS Transplant Transplant $287.71
Rate for Payer: Blue Shield of California Commercial $301.62
Rate for Payer: Blue Shield of California EPN $234.49
Rate for Payer: Cash Price $215.78
Rate for Payer: Cash Price $215.78
Rate for Payer: Central Health Plan Commercial $383.62
Rate for Payer: Cigna of CA HMO $335.66
Rate for Payer: Cigna of CA PPO $335.66
Rate for Payer: Dignity Health Commercial/Exchange $407.59
Rate for Payer: EPIC Health Plan Commercial $191.81
Rate for Payer: EPIC Health Plan Transplant $191.81
Rate for Payer: Galaxy Health WC $407.59
Rate for Payer: Global Benefits Group Commercial $287.71
Rate for Payer: Health Management Network EPO/PPO $431.57
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $359.64
Rate for Payer: IEHP medi-cal $167.83
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $319.84
Rate for Payer: LLUH Dept of Risk Management WC $95.90
Rate for Payer: Multiplan Commercial $359.64
Rate for Payer: Networks By Design Commercial $239.76
Rate for Payer: Prime Health Services Commercial $407.59
Rate for Payer: Riverside University Health MISP $191.81
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $287.71
Rate for Payer: TriValley Medical Group Commercial/Senior $287.71
Rate for Payer: United Healthcare All Other Commercial $239.76
Rate for Payer: United Healthcare All Other HMO $239.76
Rate for Payer: United Healthcare HMO Rider $239.76
Rate for Payer: United Healthcare Select/Navigate/Core $239.76
Rate for Payer: Vantage Medical Group Medi-Cal $407.59
Rate for Payer: Vantage Medical Group Senior $407.59
Service Code APR-DRG 0424
Min. Negotiated Rate $19,890.38
Max. Negotiated Rate $23,702.71
Rate for Payer: Adventist Health Medi-Cal $19,890.38
Rate for Payer: IEHP medi-cal $23,702.71