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Service Code NDC 0904-0430-06
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.52
Max. Negotiated Rate $2.36
Rate for Payer: Blue Shield of California Commercial $1.96
Rate for Payer: Blue Shield of California EPN $1.40
Rate for Payer: Cash Price $1.18
Rate for Payer: Central Health Plan Commercial $2.10
Rate for Payer: Cigna of CA HMO $1.83
Rate for Payer: Cigna of CA PPO $1.83
Rate for Payer: EPIC Health Plan Commercial $1.05
Rate for Payer: Galaxy Health WC $2.23
Rate for Payer: Global Benefits Group Commercial $1.57
Rate for Payer: Health Management Network EPO/PPO $2.36
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.75
Rate for Payer: LLUH Dept of Risk Management WC $0.52
Rate for Payer: Multiplan Commercial $1.96
Rate for Payer: Networks By Design Commercial $1.70
Rate for Payer: Prime Health Services Commercial $2.23
Service Code NDC 50268-279-11
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
Max. Negotiated Rate $3.86
Rate for Payer: Aetna of CA HMO/PPO $2.61
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.65
Rate for Payer: AlphaCare Medical Group Medi-Cal $2.36
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.36
Rate for Payer: Anthem Blue Cross of CA Exchange $2.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2.53
Rate for Payer: BCBS Transplant Transplant $2.57
Rate for Payer: Blue Shield of California Commercial $2.70
Rate for Payer: Blue Shield of California EPN $2.10
Rate for Payer: Cash Price $1.93
Rate for Payer: Central Health Plan Commercial $3.43
Rate for Payer: Cigna of CA HMO $3.00
Rate for Payer: Cigna of CA PPO $3.00
Rate for Payer: Dignity Health Commercial/Exchange $3.65
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: EPIC Health Plan Transplant $1.72
Rate for Payer: Galaxy Health WC $3.65
Rate for Payer: Global Benefits Group Commercial $2.57
Rate for Payer: Health Management Network EPO/PPO $3.86
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3.22
Rate for Payer: IEHP medi-cal $1.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.86
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.22
Rate for Payer: Networks By Design Commercial $2.79
Rate for Payer: Prime Health Services Commercial $3.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2.57
Rate for Payer: Riverside University Health MISP $1.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2.57
Rate for Payer: TriValley Medical Group Commercial/Senior $2.57
Rate for Payer: United Healthcare All Other Commercial $2.14
Rate for Payer: United Healthcare All Other HMO $2.14
Rate for Payer: United Healthcare HMO Rider $2.14
Rate for Payer: United Healthcare Select/Navigate/Core $2.14
Rate for Payer: Vantage Medical Group Medi-Cal $3.65
Rate for Payer: Vantage Medical Group Senior $3.65
Service Code NDC 50268-279-15
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
Max. Negotiated Rate $3.86
Rate for Payer: Aetna of CA HMO/PPO $2.61
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $3.65
Rate for Payer: AlphaCare Medical Group Medi-Cal $2.36
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2.36
Rate for Payer: Anthem Blue Cross of CA Exchange $2.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2.53
Rate for Payer: BCBS Transplant Transplant $2.57
Rate for Payer: Blue Shield of California Commercial $2.70
Rate for Payer: Blue Shield of California EPN $2.10
Rate for Payer: Cash Price $1.93
Rate for Payer: Central Health Plan Commercial $3.43
Rate for Payer: Cigna of CA HMO $3.00
Rate for Payer: Cigna of CA PPO $3.00
Rate for Payer: Dignity Health Commercial/Exchange $3.65
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: EPIC Health Plan Transplant $1.72
Rate for Payer: Galaxy Health WC $3.65
Rate for Payer: Global Benefits Group Commercial $2.57
Rate for Payer: Health Management Network EPO/PPO $3.86
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3.22
Rate for Payer: IEHP medi-cal $1.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.86
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.22
Rate for Payer: Networks By Design Commercial $2.79
Rate for Payer: Prime Health Services Commercial $3.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $2.57
Rate for Payer: Riverside University Health MISP $1.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $2.57
Rate for Payer: TriValley Medical Group Commercial/Senior $2.57
Rate for Payer: United Healthcare All Other Commercial $2.14
Rate for Payer: United Healthcare All Other HMO $2.14
Rate for Payer: United Healthcare HMO Rider $2.14
Rate for Payer: United Healthcare Select/Navigate/Core $2.14
Rate for Payer: Vantage Medical Group Medi-Cal $3.65
Rate for Payer: Vantage Medical Group Senior $3.65
Service Code NDC 50268-279-15
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
Max. Negotiated Rate $3.86
Rate for Payer: Blue Shield of California Commercial $3.22
Rate for Payer: Blue Shield of California EPN $2.29
Rate for Payer: Cash Price $1.93
Rate for Payer: Central Health Plan Commercial $3.43
Rate for Payer: Cigna of CA HMO $3.00
Rate for Payer: Cigna of CA PPO $3.00
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: Galaxy Health WC $3.65
Rate for Payer: Global Benefits Group Commercial $2.57
Rate for Payer: Health Management Network EPO/PPO $3.86
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.86
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.22
Rate for Payer: Networks By Design Commercial $2.79
Rate for Payer: Prime Health Services Commercial $3.65
Service Code NDC 0904-0430-06
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.52
Max. Negotiated Rate $2.36
Rate for Payer: Aetna of CA HMO/PPO $1.59
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $2.23
Rate for Payer: AlphaCare Medical Group Medi-Cal $1.44
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1.44
Rate for Payer: Anthem Blue Cross of CA Exchange $1.27
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.55
Rate for Payer: BCBS Transplant Transplant $1.57
Rate for Payer: Blue Shield of California Commercial $1.65
Rate for Payer: Blue Shield of California EPN $1.28
Rate for Payer: Cash Price $1.18
Rate for Payer: Central Health Plan Commercial $2.10
Rate for Payer: Cigna of CA HMO $1.83
Rate for Payer: Cigna of CA PPO $1.83
Rate for Payer: Dignity Health Commercial/Exchange $2.23
Rate for Payer: EPIC Health Plan Commercial $1.05
Rate for Payer: EPIC Health Plan Transplant $1.05
Rate for Payer: Galaxy Health WC $2.23
Rate for Payer: Global Benefits Group Commercial $1.57
Rate for Payer: Health Management Network EPO/PPO $2.36
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.96
Rate for Payer: IEHP medi-cal $0.92
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.75
Rate for Payer: LLUH Dept of Risk Management WC $0.52
Rate for Payer: Multiplan Commercial $1.96
Rate for Payer: Networks By Design Commercial $1.70
Rate for Payer: Prime Health Services Commercial $2.23
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.57
Rate for Payer: Riverside University Health MISP $1.05
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.57
Rate for Payer: TriValley Medical Group Commercial/Senior $1.57
Rate for Payer: United Healthcare All Other Commercial $1.31
Rate for Payer: United Healthcare All Other HMO $1.31
Rate for Payer: United Healthcare HMO Rider $1.31
Rate for Payer: United Healthcare Select/Navigate/Core $1.31
Rate for Payer: Vantage Medical Group Medi-Cal $2.23
Rate for Payer: Vantage Medical Group Senior $2.23
Service Code NDC 42806-312-50
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.22
Rate for Payer: Aetna of CA HMO/PPO $0.15
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.13
Rate for Payer: Anthem Blue Cross of CA Exchange $0.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.14
Rate for Payer: BCBS Transplant Transplant $0.14
Rate for Payer: Blue Shield of California Commercial $0.15
Rate for Payer: Blue Shield of California EPN $0.12
Rate for Payer: Cash Price $0.11
Rate for Payer: Central Health Plan Commercial $0.19
Rate for Payer: Cigna of CA HMO $0.17
Rate for Payer: Cigna of CA PPO $0.17
Rate for Payer: Dignity Health Commercial/Exchange $0.20
Rate for Payer: EPIC Health Plan Commercial $0.10
Rate for Payer: EPIC Health Plan Transplant $0.10
Rate for Payer: Galaxy Health WC $0.20
Rate for Payer: Global Benefits Group Commercial $0.14
Rate for Payer: Health Management Network EPO/PPO $0.22
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.18
Rate for Payer: IEHP medi-cal $0.08
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.05
Rate for Payer: Multiplan Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.16
Rate for Payer: Prime Health Services Commercial $0.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.14
Rate for Payer: Riverside University Health MISP $0.10
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.14
Rate for Payer: TriValley Medical Group Commercial/Senior $0.14
Rate for Payer: United Healthcare All Other Commercial $0.12
Rate for Payer: United Healthcare All Other HMO $0.12
Rate for Payer: United Healthcare HMO Rider $0.12
Rate for Payer: United Healthcare Select/Navigate/Core $0.12
Rate for Payer: Vantage Medical Group Medi-Cal $0.20
Rate for Payer: Vantage Medical Group Senior $0.20
Service Code NDC 50268-279-11
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.86
Max. Negotiated Rate $3.86
Rate for Payer: Blue Shield of California Commercial $3.22
Rate for Payer: Blue Shield of California EPN $2.29
Rate for Payer: Cash Price $1.93
Rate for Payer: Central Health Plan Commercial $3.43
Rate for Payer: Cigna of CA HMO $3.00
Rate for Payer: Cigna of CA PPO $3.00
Rate for Payer: EPIC Health Plan Commercial $1.72
Rate for Payer: Galaxy Health WC $3.65
Rate for Payer: Global Benefits Group Commercial $2.57
Rate for Payer: Health Management Network EPO/PPO $3.86
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.86
Rate for Payer: LLUH Dept of Risk Management WC $0.86
Rate for Payer: Multiplan Commercial $3.22
Rate for Payer: Networks By Design Commercial $2.79
Rate for Payer: Prime Health Services Commercial $3.65
Service Code NDC 0904-0430-04
Hospital Charge Code ERX2625
Hospital Revenue Code 259
Min. Negotiated Rate $0.87
Max. Negotiated Rate $3.92
Rate for Payer: Blue Shield of California Commercial $3.26
Rate for Payer: Blue Shield of California EPN $2.32
Rate for Payer: Cash Price $1.96
Rate for Payer: Central Health Plan Commercial $3.48
Rate for Payer: Cigna of CA HMO $3.04
Rate for Payer: Cigna of CA PPO $3.04
Rate for Payer: EPIC Health Plan Commercial $1.74
Rate for Payer: Galaxy Health WC $3.70
Rate for Payer: Global Benefits Group Commercial $2.61
Rate for Payer: Health Management Network EPO/PPO $3.92
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $2.90
Rate for Payer: LLUH Dept of Risk Management WC $0.87
Rate for Payer: Multiplan Commercial $3.26
Rate for Payer: Networks By Design Commercial $2.83
Rate for Payer: Prime Health Services Commercial $3.70
Service Code NDC 0143-9802-50
Hospital Charge Code 1711308
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.31
Rate for Payer: Aetna of CA HMO/PPO $0.21
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.29
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.19
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.19
Rate for Payer: Anthem Blue Cross of CA Exchange $0.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.20
Rate for Payer: BCBS Transplant Transplant $0.20
Rate for Payer: Blue Shield of California Commercial $0.21
Rate for Payer: Blue Shield of California EPN $0.17
Rate for Payer: Cash Price $0.15
Rate for Payer: Central Health Plan Commercial $0.27
Rate for Payer: Cigna of CA HMO $0.24
Rate for Payer: Cigna of CA PPO $0.24
Rate for Payer: Dignity Health Commercial/Exchange $0.29
Rate for Payer: EPIC Health Plan Commercial $0.14
Rate for Payer: EPIC Health Plan Transplant $0.14
Rate for Payer: Galaxy Health WC $0.29
Rate for Payer: Global Benefits Group Commercial $0.20
Rate for Payer: Health Management Network EPO/PPO $0.31
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.26
Rate for Payer: IEHP medi-cal $0.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.23
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.26
Rate for Payer: Networks By Design Commercial $0.22
Rate for Payer: Prime Health Services Commercial $0.29
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.20
Rate for Payer: Riverside University Health MISP $0.14
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.20
Rate for Payer: TriValley Medical Group Commercial/Senior $0.20
Rate for Payer: United Healthcare All Other Commercial $0.17
Rate for Payer: United Healthcare All Other HMO $0.17
Rate for Payer: United Healthcare HMO Rider $0.17
Rate for Payer: United Healthcare Select/Navigate/Core $0.17
Rate for Payer: Vantage Medical Group Medi-Cal $0.29
Rate for Payer: Vantage Medical Group Senior $0.29
Service Code NDC 0143-9802-50
Hospital Charge Code 1711308
Hospital Revenue Code 259
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.31
Rate for Payer: Blue Shield of California Commercial $0.26
Rate for Payer: Blue Shield of California EPN $0.18
Rate for Payer: Cash Price $0.15
Rate for Payer: Central Health Plan Commercial $0.27
Rate for Payer: Cigna of CA HMO $0.24
Rate for Payer: Cigna of CA PPO $0.24
Rate for Payer: EPIC Health Plan Commercial $0.14
Rate for Payer: Galaxy Health WC $0.29
Rate for Payer: Global Benefits Group Commercial $0.20
Rate for Payer: Health Management Network EPO/PPO $0.31
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.23
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: Multiplan Commercial $0.26
Rate for Payer: Networks By Design Commercial $0.22
Rate for Payer: Prime Health Services Commercial $0.29
Service Code NDC 68382-707-18
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.91
Rate for Payer: Blue Shield of California Commercial $0.76
Rate for Payer: Blue Shield of California EPN $0.54
Rate for Payer: Cash Price $0.45
Rate for Payer: Central Health Plan Commercial $0.81
Rate for Payer: Cigna of CA HMO $0.71
Rate for Payer: Cigna of CA PPO $0.71
Rate for Payer: EPIC Health Plan Commercial $0.40
Rate for Payer: Galaxy Health WC $0.86
Rate for Payer: Global Benefits Group Commercial $0.61
Rate for Payer: Health Management Network EPO/PPO $0.91
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.20
Rate for Payer: Multiplan Commercial $0.76
Rate for Payer: Networks By Design Commercial $0.66
Rate for Payer: Prime Health Services Commercial $0.86
Service Code NDC 68084-743-33
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.61
Rate for Payer: Aetna of CA HMO/PPO $1.09
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.52
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.98
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.98
Rate for Payer: Anthem Blue Cross of CA Exchange $0.87
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.06
Rate for Payer: BCBS Transplant Transplant $1.07
Rate for Payer: Blue Shield of California Commercial $1.13
Rate for Payer: Blue Shield of California EPN $0.88
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: Dignity Health Commercial/Exchange $1.52
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.34
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.07
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.07
Rate for Payer: TriValley Medical Group Commercial/Senior $1.07
Rate for Payer: United Healthcare All Other Commercial $0.90
Rate for Payer: United Healthcare All Other HMO $0.90
Rate for Payer: United Healthcare HMO Rider $0.90
Rate for Payer: United Healthcare Select/Navigate/Core $0.90
Rate for Payer: Vantage Medical Group Medi-Cal $1.52
Rate for Payer: Vantage Medical Group Senior $1.52
Service Code NDC 68084-743-32
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.61
Rate for Payer: Aetna of CA HMO/PPO $1.09
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.52
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.98
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.98
Rate for Payer: Anthem Blue Cross of CA Exchange $0.87
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.06
Rate for Payer: BCBS Transplant Transplant $1.07
Rate for Payer: Blue Shield of California Commercial $1.13
Rate for Payer: Blue Shield of California EPN $0.88
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: Dignity Health Commercial/Exchange $1.52
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: EPIC Health Plan Transplant $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.34
Rate for Payer: IEHP medi-cal $0.63
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.07
Rate for Payer: Riverside University Health MISP $0.72
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.07
Rate for Payer: TriValley Medical Group Commercial/Senior $1.07
Rate for Payer: United Healthcare All Other Commercial $0.90
Rate for Payer: United Healthcare All Other HMO $0.90
Rate for Payer: United Healthcare HMO Rider $0.90
Rate for Payer: United Healthcare Select/Navigate/Core $0.90
Rate for Payer: Vantage Medical Group Medi-Cal $1.52
Rate for Payer: Vantage Medical Group Senior $1.52
Service Code NDC 68084-743-11
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Blue Shield of California Commercial $0.96
Rate for Payer: Blue Shield of California EPN $0.68
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Service Code NDC 68382-707-18
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.91
Rate for Payer: Aetna of CA HMO/PPO $0.61
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.86
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.56
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.56
Rate for Payer: Anthem Blue Cross of CA Exchange $0.49
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.60
Rate for Payer: BCBS Transplant Transplant $0.61
Rate for Payer: Blue Shield of California Commercial $0.64
Rate for Payer: Blue Shield of California EPN $0.49
Rate for Payer: Cash Price $0.45
Rate for Payer: Central Health Plan Commercial $0.81
Rate for Payer: Cigna of CA HMO $0.71
Rate for Payer: Cigna of CA PPO $0.71
Rate for Payer: Dignity Health Commercial/Exchange $0.86
Rate for Payer: EPIC Health Plan Commercial $0.40
Rate for Payer: EPIC Health Plan Transplant $0.40
Rate for Payer: Galaxy Health WC $0.86
Rate for Payer: Global Benefits Group Commercial $0.61
Rate for Payer: Health Management Network EPO/PPO $0.91
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.76
Rate for Payer: IEHP medi-cal $0.35
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.20
Rate for Payer: Multiplan Commercial $0.76
Rate for Payer: Networks By Design Commercial $0.66
Rate for Payer: Prime Health Services Commercial $0.86
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.61
Rate for Payer: Riverside University Health MISP $0.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.61
Rate for Payer: TriValley Medical Group Commercial/Senior $0.61
Rate for Payer: United Healthcare All Other Commercial $0.51
Rate for Payer: United Healthcare All Other HMO $0.51
Rate for Payer: United Healthcare HMO Rider $0.51
Rate for Payer: United Healthcare Select/Navigate/Core $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.86
Rate for Payer: Vantage Medical Group Senior $0.86
Service Code NDC 68084-743-33
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.61
Rate for Payer: Blue Shield of California Commercial $1.34
Rate for Payer: Blue Shield of California EPN $0.96
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Service Code NDC 60687-716-11
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Blue Shield of California Commercial $0.96
Rate for Payer: Blue Shield of California EPN $0.68
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Service Code NDC 68084-743-32
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.36
Max. Negotiated Rate $1.61
Rate for Payer: Blue Shield of California Commercial $1.34
Rate for Payer: Blue Shield of California EPN $0.96
Rate for Payer: Cash Price $0.81
Rate for Payer: Central Health Plan Commercial $1.43
Rate for Payer: Cigna of CA HMO $1.25
Rate for Payer: Cigna of CA PPO $1.25
Rate for Payer: EPIC Health Plan Commercial $0.72
Rate for Payer: Galaxy Health WC $1.52
Rate for Payer: Global Benefits Group Commercial $1.07
Rate for Payer: Health Management Network EPO/PPO $1.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.19
Rate for Payer: LLUH Dept of Risk Management WC $0.36
Rate for Payer: Multiplan Commercial $1.34
Rate for Payer: Networks By Design Commercial $1.16
Rate for Payer: Prime Health Services Commercial $1.52
Service Code NDC 68084-743-21
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Aetna of CA HMO/PPO $0.78
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.70
Rate for Payer: Anthem Blue Cross of CA Exchange $0.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.76
Rate for Payer: BCBS Transplant Transplant $0.77
Rate for Payer: Blue Shield of California Commercial $0.81
Rate for Payer: Blue Shield of California EPN $0.63
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: Dignity Health Commercial/Exchange $1.09
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: EPIC Health Plan Transplant $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.96
Rate for Payer: IEHP medi-cal $0.45
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.77
Rate for Payer: Riverside University Health MISP $0.51
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.77
Rate for Payer: TriValley Medical Group Commercial/Senior $0.77
Rate for Payer: United Healthcare All Other Commercial $0.64
Rate for Payer: United Healthcare All Other HMO $0.64
Rate for Payer: United Healthcare HMO Rider $0.64
Rate for Payer: United Healthcare Select/Navigate/Core $0.64
Rate for Payer: Vantage Medical Group Medi-Cal $1.09
Rate for Payer: Vantage Medical Group Senior $1.09
Service Code NDC 68084-743-11
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Aetna of CA HMO/PPO $0.78
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.70
Rate for Payer: Anthem Blue Cross of CA Exchange $0.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.76
Rate for Payer: BCBS Transplant Transplant $0.77
Rate for Payer: Blue Shield of California Commercial $0.81
Rate for Payer: Blue Shield of California EPN $0.63
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: Dignity Health Commercial/Exchange $1.09
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: EPIC Health Plan Transplant $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.96
Rate for Payer: IEHP medi-cal $0.45
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.77
Rate for Payer: Riverside University Health MISP $0.51
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.77
Rate for Payer: TriValley Medical Group Commercial/Senior $0.77
Rate for Payer: United Healthcare All Other Commercial $0.64
Rate for Payer: United Healthcare All Other HMO $0.64
Rate for Payer: United Healthcare HMO Rider $0.64
Rate for Payer: United Healthcare Select/Navigate/Core $0.64
Rate for Payer: Vantage Medical Group Medi-Cal $1.09
Rate for Payer: Vantage Medical Group Senior $1.09
Service Code NDC 60687-716-21
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Blue Shield of California Commercial $0.96
Rate for Payer: Blue Shield of California EPN $0.68
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Service Code NDC 60687-716-21
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Aetna of CA HMO/PPO $0.78
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.70
Rate for Payer: Anthem Blue Cross of CA Exchange $0.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.76
Rate for Payer: BCBS Transplant Transplant $0.77
Rate for Payer: Blue Shield of California Commercial $0.81
Rate for Payer: Blue Shield of California EPN $0.63
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: Dignity Health Commercial/Exchange $1.09
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: EPIC Health Plan Transplant $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.96
Rate for Payer: IEHP medi-cal $0.45
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.77
Rate for Payer: Riverside University Health MISP $0.51
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.77
Rate for Payer: TriValley Medical Group Commercial/Senior $0.77
Rate for Payer: United Healthcare All Other Commercial $0.64
Rate for Payer: United Healthcare All Other HMO $0.64
Rate for Payer: United Healthcare HMO Rider $0.64
Rate for Payer: United Healthcare Select/Navigate/Core $0.64
Rate for Payer: Vantage Medical Group Medi-Cal $1.09
Rate for Payer: Vantage Medical Group Senior $1.09
Service Code NDC 68084-743-21
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Blue Shield of California Commercial $0.96
Rate for Payer: Blue Shield of California EPN $0.68
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Service Code NDC 60687-716-11
Hospital Charge Code ERX9900
Hospital Revenue Code 259
Min. Negotiated Rate $0.26
Max. Negotiated Rate $1.15
Rate for Payer: Aetna of CA HMO/PPO $0.78
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.70
Rate for Payer: Anthem Blue Cross of CA Exchange $0.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.76
Rate for Payer: BCBS Transplant Transplant $0.77
Rate for Payer: Blue Shield of California Commercial $0.81
Rate for Payer: Blue Shield of California EPN $0.63
Rate for Payer: Cash Price $0.58
Rate for Payer: Central Health Plan Commercial $1.02
Rate for Payer: Cigna of CA HMO $0.90
Rate for Payer: Cigna of CA PPO $0.90
Rate for Payer: Dignity Health Commercial/Exchange $1.09
Rate for Payer: EPIC Health Plan Commercial $0.51
Rate for Payer: EPIC Health Plan Transplant $0.51
Rate for Payer: Galaxy Health WC $1.09
Rate for Payer: Global Benefits Group Commercial $0.77
Rate for Payer: Health Management Network EPO/PPO $1.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.96
Rate for Payer: IEHP medi-cal $0.45
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.85
Rate for Payer: LLUH Dept of Risk Management WC $0.26
Rate for Payer: Multiplan Commercial $0.96
Rate for Payer: Networks By Design Commercial $0.83
Rate for Payer: Prime Health Services Commercial $1.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.77
Rate for Payer: Riverside University Health MISP $0.51
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.77
Rate for Payer: TriValley Medical Group Commercial/Senior $0.77
Rate for Payer: United Healthcare All Other Commercial $0.64
Rate for Payer: United Healthcare All Other HMO $0.64
Rate for Payer: United Healthcare HMO Rider $0.64
Rate for Payer: United Healthcare Select/Navigate/Core $0.64
Rate for Payer: Vantage Medical Group Medi-Cal $1.09
Rate for Payer: Vantage Medical Group Senior $1.09
Service Code NDC 23155-135-25
Hospital Charge Code 1712560
Hospital Revenue Code 259
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.91
Rate for Payer: Aetna of CA HMO/PPO $0.61
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.86
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.56
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.56
Rate for Payer: Anthem Blue Cross of CA Exchange $0.49
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.60
Rate for Payer: BCBS Transplant Transplant $0.61
Rate for Payer: Blue Shield of California Commercial $0.64
Rate for Payer: Blue Shield of California EPN $0.49
Rate for Payer: Cash Price $0.45
Rate for Payer: Central Health Plan Commercial $0.81
Rate for Payer: Cigna of CA HMO $0.71
Rate for Payer: Cigna of CA PPO $0.71
Rate for Payer: Dignity Health Commercial/Exchange $0.86
Rate for Payer: EPIC Health Plan Commercial $0.40
Rate for Payer: EPIC Health Plan Transplant $0.40
Rate for Payer: Galaxy Health WC $0.86
Rate for Payer: Global Benefits Group Commercial $0.61
Rate for Payer: Health Management Network EPO/PPO $0.91
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.76
Rate for Payer: IEHP medi-cal $0.35
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.67
Rate for Payer: LLUH Dept of Risk Management WC $0.20
Rate for Payer: Multiplan Commercial $0.76
Rate for Payer: Networks By Design Commercial $0.66
Rate for Payer: Prime Health Services Commercial $0.86
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.61
Rate for Payer: Riverside University Health MISP $0.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.61
Rate for Payer: TriValley Medical Group Commercial/Senior $0.61
Rate for Payer: United Healthcare All Other Commercial $0.51
Rate for Payer: United Healthcare All Other HMO $0.51
Rate for Payer: United Healthcare HMO Rider $0.51
Rate for Payer: United Healthcare Select/Navigate/Core $0.51
Rate for Payer: Vantage Medical Group Medi-Cal $0.86
Rate for Payer: Vantage Medical Group Senior $0.86