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Service Code CPT C1758
Hospital Charge Code 901607397
Hospital Revenue Code 272
Min. Negotiated Rate $1.12
Max. Negotiated Rate $5.02
Rate for Payer: Adventist Health Commercial $1.12
Rate for Payer: Aetna of CA HMO/PPO $3.39
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $4.74
Rate for Payer: Alpha Care Medical Group Medi-Cal $3.07
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $4.18
Rate for Payer: Anthem Blue Cross of CA Exchange $2.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3.28
Rate for Payer: Blue Shield of California Commercial $3.41
Rate for Payer: Blue Shield of California EPN $2.23
Rate for Payer: Cash Price $3.07
Rate for Payer: Central Health Plan Commercial $4.46
Rate for Payer: Cigna of CA HMO $3.57
Rate for Payer: Cigna of CA PPO $4.13
Rate for Payer: Dignity Health Commercial/Exchange $4.74
Rate for Payer: Dignity Health Medi-Cal $4.74
Rate for Payer: Dignity Health Medicare Advantage $4.74
Rate for Payer: EPIC Health Plan Commercial $2.23
Rate for Payer: EPIC Health Plan Senior $2.23
Rate for Payer: Galaxy Health WC $4.74
Rate for Payer: Global Benefits Group Commercial $3.35
Rate for Payer: Health Management Network EPO/PPO $5.02
Rate for Payer: InnovAge PACE Commercial $2.79
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $3.45
Rate for Payer: LLUH Dept of Risk Management WC $1.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $3.91
Rate for Payer: Molina Healthcare of CA Medicare $3.91
Rate for Payer: Multiplan Commercial $4.18
Rate for Payer: Networks By Design Commercial $3.63
Rate for Payer: Prime Health Services Commercial $4.74
Rate for Payer: Riverside University Health System MISP $2.23
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $3.35
Rate for Payer: TriValley Medical Group Commercial/Senior $3.35
Rate for Payer: United Healthcare All Other Commercial $2.79
Rate for Payer: United Healthcare All Other HMO $2.79
Rate for Payer: United Healthcare HMO Rider $2.79
Rate for Payer: United Healthcare Select/Navigate/Core $2.79
Rate for Payer: Vantage Medical Group Commercial/Exchange $4.74
Rate for Payer: Vantage Medical Group Medi-Cal $4.74
Rate for Payer: Vantage Medical Group Senior $4.74
Hospital Charge Code 901607556
Hospital Revenue Code 272
Min. Negotiated Rate $1.12
Max. Negotiated Rate $5.02
Rate for Payer: Adventist Health Commercial $1.12
Rate for Payer: Cash Price $3.07
Rate for Payer: Central Health Plan Commercial $4.46
Rate for Payer: EPIC Health Plan Commercial $2.23
Rate for Payer: EPIC Health Plan Senior $2.23
Rate for Payer: Galaxy Health WC $4.74
Rate for Payer: Global Benefits Group Commercial $3.35
Rate for Payer: Health Management Network EPO/PPO $5.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $3.45
Rate for Payer: LLUH Dept of Risk Management WC $1.12
Rate for Payer: Multiplan Commercial $4.18
Rate for Payer: Networks By Design Commercial $3.63
Rate for Payer: Prime Health Services Commercial $4.74
Hospital Charge Code 901607556
Hospital Revenue Code 272
Min. Negotiated Rate $1.12
Max. Negotiated Rate $5.02
Rate for Payer: Adventist Health Commercial $1.12
Rate for Payer: Aetna of CA HMO/PPO $3.39
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $4.74
Rate for Payer: Alpha Care Medical Group Medi-Cal $3.07
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $4.18
Rate for Payer: Anthem Blue Cross of CA Exchange $2.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3.28
Rate for Payer: Blue Shield of California Commercial $3.41
Rate for Payer: Blue Shield of California EPN $2.23
Rate for Payer: Cash Price $3.07
Rate for Payer: Central Health Plan Commercial $4.46
Rate for Payer: Cigna of CA HMO $3.57
Rate for Payer: Cigna of CA PPO $4.13
Rate for Payer: Dignity Health Commercial/Exchange $4.74
Rate for Payer: Dignity Health Medi-Cal $4.74
Rate for Payer: Dignity Health Medicare Advantage $4.74
Rate for Payer: EPIC Health Plan Commercial $2.23
Rate for Payer: EPIC Health Plan Senior $2.23
Rate for Payer: Galaxy Health WC $4.74
Rate for Payer: Global Benefits Group Commercial $3.35
Rate for Payer: Health Management Network EPO/PPO $5.02
Rate for Payer: InnovAge PACE Commercial $2.79
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal $2.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $3.45
Rate for Payer: LLUH Dept of Risk Management WC $1.12
Rate for Payer: Molina Healthcare of CA Medi-Cal $3.91
Rate for Payer: Molina Healthcare of CA Medicare $3.91
Rate for Payer: Multiplan Commercial $4.18
Rate for Payer: Networks By Design Commercial $3.63
Rate for Payer: Prime Health Services Commercial $4.74
Rate for Payer: Riverside University Health System MISP $2.23
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $3.35
Rate for Payer: TriValley Medical Group Commercial/Senior $3.35
Rate for Payer: United Healthcare All Other Commercial $2.79
Rate for Payer: United Healthcare All Other HMO $2.79
Rate for Payer: United Healthcare HMO Rider $2.79
Rate for Payer: United Healthcare Select/Navigate/Core $2.79
Rate for Payer: Vantage Medical Group Commercial/Exchange $4.74
Rate for Payer: Vantage Medical Group Medi-Cal $4.74
Rate for Payer: Vantage Medical Group Senior $4.74
Hospital Charge Code 901698668
Hospital Revenue Code 272
Min. Negotiated Rate $3.87
Max. Negotiated Rate $17.41
Rate for Payer: Adventist Health Commercial $3.87
Rate for Payer: Aetna of CA HMO/PPO $11.75
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $16.45
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.64
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $14.51
Rate for Payer: Anthem Blue Cross of CA Exchange $9.37
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11.36
Rate for Payer: Blue Shield of California Commercial $11.82
Rate for Payer: Blue Shield of California EPN $7.72
Rate for Payer: Cash Price $10.64
Rate for Payer: Central Health Plan Commercial $15.48
Rate for Payer: Cigna of CA HMO $12.38
Rate for Payer: Cigna of CA PPO $14.32
Rate for Payer: Dignity Health Commercial/Exchange $16.45
Rate for Payer: Dignity Health Medi-Cal $16.45
Rate for Payer: Dignity Health Medicare Advantage $16.45
Rate for Payer: EPIC Health Plan Commercial $7.74
Rate for Payer: EPIC Health Plan Senior $7.74
Rate for Payer: Galaxy Health WC $16.45
Rate for Payer: Global Benefits Group Commercial $11.61
Rate for Payer: Health Management Network EPO/PPO $17.41
Rate for Payer: InnovAge PACE Commercial $9.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.98
Rate for Payer: LLUH Dept of Risk Management WC $3.87
Rate for Payer: Molina Healthcare of CA Medi-Cal $13.54
Rate for Payer: Molina Healthcare of CA Medicare $13.54
Rate for Payer: Multiplan Commercial $14.51
Rate for Payer: Networks By Design Commercial $12.58
Rate for Payer: Prime Health Services Commercial $16.45
Rate for Payer: Riverside University Health System MISP $7.74
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $11.61
Rate for Payer: TriValley Medical Group Commercial/Senior $11.61
Rate for Payer: United Healthcare All Other Commercial $9.68
Rate for Payer: United Healthcare All Other HMO $9.68
Rate for Payer: United Healthcare HMO Rider $9.68
Rate for Payer: United Healthcare Select/Navigate/Core $9.68
Rate for Payer: Vantage Medical Group Commercial/Exchange $16.45
Rate for Payer: Vantage Medical Group Medi-Cal $16.45
Rate for Payer: Vantage Medical Group Senior $16.45
Hospital Charge Code 901698668
Hospital Revenue Code 272
Min. Negotiated Rate $3.87
Max. Negotiated Rate $17.41
Rate for Payer: Adventist Health Commercial $3.87
Rate for Payer: Cash Price $10.64
Rate for Payer: Central Health Plan Commercial $15.48
Rate for Payer: EPIC Health Plan Commercial $7.74
Rate for Payer: EPIC Health Plan Senior $7.74
Rate for Payer: Galaxy Health WC $16.45
Rate for Payer: Global Benefits Group Commercial $11.61
Rate for Payer: Health Management Network EPO/PPO $17.41
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.98
Rate for Payer: LLUH Dept of Risk Management WC $3.87
Rate for Payer: Multiplan Commercial $14.51
Rate for Payer: Networks By Design Commercial $12.58
Rate for Payer: Prime Health Services Commercial $16.45
Hospital Charge Code 901602925
Hospital Revenue Code 272
Min. Negotiated Rate $3.67
Max. Negotiated Rate $16.53
Rate for Payer: Adventist Health Commercial $3.67
Rate for Payer: Cash Price $10.10
Rate for Payer: Central Health Plan Commercial $14.70
Rate for Payer: EPIC Health Plan Commercial $7.35
Rate for Payer: EPIC Health Plan Senior $7.35
Rate for Payer: Galaxy Health WC $15.61
Rate for Payer: Global Benefits Group Commercial $11.02
Rate for Payer: Health Management Network EPO/PPO $16.53
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.37
Rate for Payer: LLUH Dept of Risk Management WC $3.67
Rate for Payer: Multiplan Commercial $13.78
Rate for Payer: Networks By Design Commercial $11.94
Rate for Payer: Prime Health Services Commercial $15.61
Hospital Charge Code 901602925
Hospital Revenue Code 272
Min. Negotiated Rate $3.67
Max. Negotiated Rate $16.53
Rate for Payer: Adventist Health Commercial $3.67
Rate for Payer: Aetna of CA HMO/PPO $11.16
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $15.61
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.10
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $13.78
Rate for Payer: Anthem Blue Cross of CA Exchange $8.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.79
Rate for Payer: Blue Shield of California Commercial $11.22
Rate for Payer: Blue Shield of California EPN $7.33
Rate for Payer: Cash Price $10.10
Rate for Payer: Central Health Plan Commercial $14.70
Rate for Payer: Cigna of CA HMO $11.76
Rate for Payer: Cigna of CA PPO $13.59
Rate for Payer: Dignity Health Commercial/Exchange $15.61
Rate for Payer: Dignity Health Medi-Cal $15.61
Rate for Payer: Dignity Health Medicare Advantage $15.61
Rate for Payer: EPIC Health Plan Commercial $7.35
Rate for Payer: EPIC Health Plan Senior $7.35
Rate for Payer: Galaxy Health WC $15.61
Rate for Payer: Global Benefits Group Commercial $11.02
Rate for Payer: Health Management Network EPO/PPO $16.53
Rate for Payer: InnovAge PACE Commercial $9.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.37
Rate for Payer: LLUH Dept of Risk Management WC $3.67
Rate for Payer: Molina Healthcare of CA Medi-Cal $12.86
Rate for Payer: Molina Healthcare of CA Medicare $12.86
Rate for Payer: Multiplan Commercial $13.78
Rate for Payer: Networks By Design Commercial $11.94
Rate for Payer: Prime Health Services Commercial $15.61
Rate for Payer: Riverside University Health System MISP $7.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $11.02
Rate for Payer: TriValley Medical Group Commercial/Senior $11.02
Rate for Payer: United Healthcare All Other Commercial $9.19
Rate for Payer: United Healthcare All Other HMO $9.19
Rate for Payer: United Healthcare HMO Rider $9.19
Rate for Payer: United Healthcare Select/Navigate/Core $9.19
Rate for Payer: Vantage Medical Group Commercial/Exchange $15.61
Rate for Payer: Vantage Medical Group Medi-Cal $15.61
Rate for Payer: Vantage Medical Group Senior $15.61
Hospital Charge Code 901698692
Hospital Revenue Code 272
Min. Negotiated Rate $41.71
Max. Negotiated Rate $187.68
Rate for Payer: Adventist Health Commercial $41.71
Rate for Payer: Cash Price $114.69
Rate for Payer: Central Health Plan Commercial $166.82
Rate for Payer: EPIC Health Plan Commercial $83.41
Rate for Payer: EPIC Health Plan Senior $83.41
Rate for Payer: Galaxy Health WC $177.25
Rate for Payer: Global Benefits Group Commercial $125.12
Rate for Payer: Health Management Network EPO/PPO $187.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $139.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal $79.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $129.08
Rate for Payer: LLUH Dept of Risk Management WC $41.71
Rate for Payer: Multiplan Commercial $156.40
Rate for Payer: Networks By Design Commercial $135.54
Rate for Payer: Prime Health Services Commercial $177.25
Hospital Charge Code 901698692
Hospital Revenue Code 272
Min. Negotiated Rate $41.71
Max. Negotiated Rate $187.68
Rate for Payer: Adventist Health Commercial $41.71
Rate for Payer: Aetna of CA HMO/PPO $126.64
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $177.25
Rate for Payer: Alpha Care Medical Group Medi-Cal $114.69
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $156.40
Rate for Payer: Anthem Blue Cross of CA Exchange $100.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $122.47
Rate for Payer: Blue Shield of California Commercial $127.41
Rate for Payer: Blue Shield of California EPN $83.20
Rate for Payer: Cash Price $114.69
Rate for Payer: Central Health Plan Commercial $166.82
Rate for Payer: Cigna of CA HMO $133.46
Rate for Payer: Cigna of CA PPO $154.31
Rate for Payer: Dignity Health Commercial/Exchange $177.25
Rate for Payer: Dignity Health Medi-Cal $177.25
Rate for Payer: Dignity Health Medicare Advantage $177.25
Rate for Payer: EPIC Health Plan Commercial $83.41
Rate for Payer: EPIC Health Plan Senior $83.41
Rate for Payer: Galaxy Health WC $177.25
Rate for Payer: Global Benefits Group Commercial $125.12
Rate for Payer: Health Management Network EPO/PPO $187.68
Rate for Payer: InnovAge PACE Commercial $104.27
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $139.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal $79.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $129.08
Rate for Payer: LLUH Dept of Risk Management WC $41.71
Rate for Payer: Molina Healthcare of CA Medi-Cal $145.97
Rate for Payer: Molina Healthcare of CA Medicare $145.97
Rate for Payer: Multiplan Commercial $156.40
Rate for Payer: Networks By Design Commercial $135.54
Rate for Payer: Prime Health Services Commercial $177.25
Rate for Payer: Riverside University Health System MISP $83.41
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $125.12
Rate for Payer: TriValley Medical Group Commercial/Senior $125.12
Rate for Payer: United Healthcare All Other Commercial $104.27
Rate for Payer: United Healthcare All Other HMO $104.27
Rate for Payer: United Healthcare HMO Rider $104.27
Rate for Payer: United Healthcare Select/Navigate/Core $104.27
Rate for Payer: Vantage Medical Group Commercial/Exchange $177.25
Rate for Payer: Vantage Medical Group Medi-Cal $177.25
Rate for Payer: Vantage Medical Group Senior $177.25
Hospital Charge Code 901603249
Hospital Revenue Code 272
Min. Negotiated Rate $15.17
Max. Negotiated Rate $68.27
Rate for Payer: Adventist Health Commercial $15.17
Rate for Payer: Aetna of CA HMO/PPO $46.06
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $64.47
Rate for Payer: Alpha Care Medical Group Medi-Cal $41.72
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $56.89
Rate for Payer: Anthem Blue Cross of CA Exchange $36.73
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $44.55
Rate for Payer: Blue Shield of California Commercial $46.34
Rate for Payer: Blue Shield of California EPN $30.26
Rate for Payer: Cash Price $41.72
Rate for Payer: Central Health Plan Commercial $60.68
Rate for Payer: Cigna of CA HMO $48.54
Rate for Payer: Cigna of CA PPO $56.13
Rate for Payer: Dignity Health Commercial/Exchange $64.47
Rate for Payer: Dignity Health Medi-Cal $64.47
Rate for Payer: Dignity Health Medicare Advantage $64.47
Rate for Payer: EPIC Health Plan Commercial $30.34
Rate for Payer: EPIC Health Plan Senior $30.34
Rate for Payer: Galaxy Health WC $64.47
Rate for Payer: Global Benefits Group Commercial $45.51
Rate for Payer: Health Management Network EPO/PPO $68.27
Rate for Payer: InnovAge PACE Commercial $37.92
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $50.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $28.90
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $46.95
Rate for Payer: LLUH Dept of Risk Management WC $15.17
Rate for Payer: Molina Healthcare of CA Medi-Cal $53.09
Rate for Payer: Molina Healthcare of CA Medicare $53.09
Rate for Payer: Multiplan Commercial $56.89
Rate for Payer: Networks By Design Commercial $49.30
Rate for Payer: Prime Health Services Commercial $64.47
Rate for Payer: Riverside University Health System MISP $30.34
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $45.51
Rate for Payer: TriValley Medical Group Commercial/Senior $45.51
Rate for Payer: United Healthcare All Other Commercial $37.92
Rate for Payer: United Healthcare All Other HMO $37.92
Rate for Payer: United Healthcare HMO Rider $37.92
Rate for Payer: United Healthcare Select/Navigate/Core $37.92
Rate for Payer: Vantage Medical Group Commercial/Exchange $64.47
Rate for Payer: Vantage Medical Group Medi-Cal $64.47
Rate for Payer: Vantage Medical Group Senior $64.47
Hospital Charge Code 901603249
Hospital Revenue Code 272
Min. Negotiated Rate $15.17
Max. Negotiated Rate $68.27
Rate for Payer: Adventist Health Commercial $15.17
Rate for Payer: Cash Price $41.72
Rate for Payer: Central Health Plan Commercial $60.68
Rate for Payer: EPIC Health Plan Commercial $30.34
Rate for Payer: EPIC Health Plan Senior $30.34
Rate for Payer: Galaxy Health WC $64.47
Rate for Payer: Global Benefits Group Commercial $45.51
Rate for Payer: Health Management Network EPO/PPO $68.27
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $50.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $28.90
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $46.95
Rate for Payer: LLUH Dept of Risk Management WC $15.17
Rate for Payer: Multiplan Commercial $56.89
Rate for Payer: Networks By Design Commercial $49.30
Rate for Payer: Prime Health Services Commercial $64.47
Hospital Charge Code 901698448
Hospital Revenue Code 272
Min. Negotiated Rate $27.54
Max. Negotiated Rate $123.94
Rate for Payer: Adventist Health Commercial $27.54
Rate for Payer: Cash Price $75.74
Rate for Payer: Central Health Plan Commercial $110.17
Rate for Payer: EPIC Health Plan Commercial $55.08
Rate for Payer: EPIC Health Plan Senior $55.08
Rate for Payer: Galaxy Health WC $117.05
Rate for Payer: Global Benefits Group Commercial $82.63
Rate for Payer: Health Management Network EPO/PPO $123.94
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $91.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal $52.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $85.24
Rate for Payer: LLUH Dept of Risk Management WC $27.54
Rate for Payer: Multiplan Commercial $103.28
Rate for Payer: Networks By Design Commercial $89.51
Rate for Payer: Prime Health Services Commercial $117.05
Hospital Charge Code 901698448
Hospital Revenue Code 272
Min. Negotiated Rate $27.54
Max. Negotiated Rate $123.94
Rate for Payer: Adventist Health Commercial $27.54
Rate for Payer: Aetna of CA HMO/PPO $83.63
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $117.05
Rate for Payer: Alpha Care Medical Group Medi-Cal $75.74
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $103.28
Rate for Payer: Anthem Blue Cross of CA Exchange $66.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $80.88
Rate for Payer: Blue Shield of California Commercial $84.14
Rate for Payer: Blue Shield of California EPN $54.95
Rate for Payer: Cash Price $75.74
Rate for Payer: Central Health Plan Commercial $110.17
Rate for Payer: Cigna of CA HMO $88.13
Rate for Payer: Cigna of CA PPO $101.91
Rate for Payer: Dignity Health Commercial/Exchange $117.05
Rate for Payer: Dignity Health Medi-Cal $117.05
Rate for Payer: Dignity Health Medicare Advantage $117.05
Rate for Payer: EPIC Health Plan Commercial $55.08
Rate for Payer: EPIC Health Plan Senior $55.08
Rate for Payer: Galaxy Health WC $117.05
Rate for Payer: Global Benefits Group Commercial $82.63
Rate for Payer: Health Management Network EPO/PPO $123.94
Rate for Payer: InnovAge PACE Commercial $68.86
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $91.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal $52.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $85.24
Rate for Payer: LLUH Dept of Risk Management WC $27.54
Rate for Payer: Molina Healthcare of CA Medi-Cal $96.40
Rate for Payer: Molina Healthcare of CA Medicare $96.40
Rate for Payer: Multiplan Commercial $103.28
Rate for Payer: Networks By Design Commercial $89.51
Rate for Payer: Prime Health Services Commercial $117.05
Rate for Payer: Riverside University Health System MISP $55.08
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $82.63
Rate for Payer: TriValley Medical Group Commercial/Senior $82.63
Rate for Payer: United Healthcare All Other Commercial $68.86
Rate for Payer: United Healthcare All Other HMO $68.86
Rate for Payer: United Healthcare HMO Rider $68.86
Rate for Payer: United Healthcare Select/Navigate/Core $68.86
Rate for Payer: Vantage Medical Group Commercial/Exchange $117.05
Rate for Payer: Vantage Medical Group Medi-Cal $117.05
Rate for Payer: Vantage Medical Group Senior $117.05
Hospital Charge Code 901602923
Hospital Revenue Code 272
Min. Negotiated Rate $3.67
Max. Negotiated Rate $16.53
Rate for Payer: Adventist Health Commercial $3.67
Rate for Payer: Cash Price $10.10
Rate for Payer: Central Health Plan Commercial $14.70
Rate for Payer: EPIC Health Plan Commercial $7.35
Rate for Payer: EPIC Health Plan Senior $7.35
Rate for Payer: Galaxy Health WC $15.61
Rate for Payer: Global Benefits Group Commercial $11.02
Rate for Payer: Health Management Network EPO/PPO $16.53
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.37
Rate for Payer: LLUH Dept of Risk Management WC $3.67
Rate for Payer: Multiplan Commercial $13.78
Rate for Payer: Networks By Design Commercial $11.94
Rate for Payer: Prime Health Services Commercial $15.61
Hospital Charge Code 901602923
Hospital Revenue Code 272
Min. Negotiated Rate $3.67
Max. Negotiated Rate $16.53
Rate for Payer: Adventist Health Commercial $3.67
Rate for Payer: Aetna of CA HMO/PPO $11.16
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $15.61
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.10
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $13.78
Rate for Payer: Anthem Blue Cross of CA Exchange $8.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.79
Rate for Payer: Blue Shield of California Commercial $11.22
Rate for Payer: Blue Shield of California EPN $7.33
Rate for Payer: Cash Price $10.10
Rate for Payer: Central Health Plan Commercial $14.70
Rate for Payer: Cigna of CA HMO $11.76
Rate for Payer: Cigna of CA PPO $13.59
Rate for Payer: Dignity Health Commercial/Exchange $15.61
Rate for Payer: Dignity Health Medi-Cal $15.61
Rate for Payer: Dignity Health Medicare Advantage $15.61
Rate for Payer: EPIC Health Plan Commercial $7.35
Rate for Payer: EPIC Health Plan Senior $7.35
Rate for Payer: Galaxy Health WC $15.61
Rate for Payer: Global Benefits Group Commercial $11.02
Rate for Payer: Health Management Network EPO/PPO $16.53
Rate for Payer: InnovAge PACE Commercial $9.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.37
Rate for Payer: LLUH Dept of Risk Management WC $3.67
Rate for Payer: Molina Healthcare of CA Medi-Cal $12.86
Rate for Payer: Molina Healthcare of CA Medicare $12.86
Rate for Payer: Multiplan Commercial $13.78
Rate for Payer: Networks By Design Commercial $11.94
Rate for Payer: Prime Health Services Commercial $15.61
Rate for Payer: Riverside University Health System MISP $7.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $11.02
Rate for Payer: TriValley Medical Group Commercial/Senior $11.02
Rate for Payer: United Healthcare All Other Commercial $9.19
Rate for Payer: United Healthcare All Other HMO $9.19
Rate for Payer: United Healthcare HMO Rider $9.19
Rate for Payer: United Healthcare Select/Navigate/Core $9.19
Rate for Payer: Vantage Medical Group Commercial/Exchange $15.61
Rate for Payer: Vantage Medical Group Medi-Cal $15.61
Rate for Payer: Vantage Medical Group Senior $15.61
Hospital Charge Code 901602924
Hospital Revenue Code 272
Min. Negotiated Rate $3.67
Max. Negotiated Rate $16.53
Rate for Payer: Adventist Health Commercial $3.67
Rate for Payer: Aetna of CA HMO/PPO $11.16
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $15.61
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.10
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $13.78
Rate for Payer: Anthem Blue Cross of CA Exchange $8.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.79
Rate for Payer: Blue Shield of California Commercial $11.22
Rate for Payer: Blue Shield of California EPN $7.33
Rate for Payer: Cash Price $10.10
Rate for Payer: Central Health Plan Commercial $14.70
Rate for Payer: Cigna of CA HMO $11.76
Rate for Payer: Cigna of CA PPO $13.59
Rate for Payer: Dignity Health Commercial/Exchange $15.61
Rate for Payer: Dignity Health Medi-Cal $15.61
Rate for Payer: Dignity Health Medicare Advantage $15.61
Rate for Payer: EPIC Health Plan Commercial $7.35
Rate for Payer: EPIC Health Plan Senior $7.35
Rate for Payer: Galaxy Health WC $15.61
Rate for Payer: Global Benefits Group Commercial $11.02
Rate for Payer: Health Management Network EPO/PPO $16.53
Rate for Payer: InnovAge PACE Commercial $9.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.37
Rate for Payer: LLUH Dept of Risk Management WC $3.67
Rate for Payer: Molina Healthcare of CA Medi-Cal $12.86
Rate for Payer: Molina Healthcare of CA Medicare $12.86
Rate for Payer: Multiplan Commercial $13.78
Rate for Payer: Networks By Design Commercial $11.94
Rate for Payer: Prime Health Services Commercial $15.61
Rate for Payer: Riverside University Health System MISP $7.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $11.02
Rate for Payer: TriValley Medical Group Commercial/Senior $11.02
Rate for Payer: United Healthcare All Other Commercial $9.19
Rate for Payer: United Healthcare All Other HMO $9.19
Rate for Payer: United Healthcare HMO Rider $9.19
Rate for Payer: United Healthcare Select/Navigate/Core $9.19
Rate for Payer: Vantage Medical Group Commercial/Exchange $15.61
Rate for Payer: Vantage Medical Group Medi-Cal $15.61
Rate for Payer: Vantage Medical Group Senior $15.61
Hospital Charge Code 901602924
Hospital Revenue Code 272
Min. Negotiated Rate $3.67
Max. Negotiated Rate $16.53
Rate for Payer: Adventist Health Commercial $3.67
Rate for Payer: Cash Price $10.10
Rate for Payer: Central Health Plan Commercial $14.70
Rate for Payer: EPIC Health Plan Commercial $7.35
Rate for Payer: EPIC Health Plan Senior $7.35
Rate for Payer: Galaxy Health WC $15.61
Rate for Payer: Global Benefits Group Commercial $11.02
Rate for Payer: Health Management Network EPO/PPO $16.53
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $12.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $11.37
Rate for Payer: LLUH Dept of Risk Management WC $3.67
Rate for Payer: Multiplan Commercial $13.78
Rate for Payer: Networks By Design Commercial $11.94
Rate for Payer: Prime Health Services Commercial $15.61
Hospital Charge Code 901602922
Hospital Revenue Code 272
Min. Negotiated Rate $3.48
Max. Negotiated Rate $15.64
Rate for Payer: Adventist Health Commercial $3.48
Rate for Payer: Cash Price $9.56
Rate for Payer: Central Health Plan Commercial $13.90
Rate for Payer: EPIC Health Plan Commercial $6.95
Rate for Payer: EPIC Health Plan Senior $6.95
Rate for Payer: Galaxy Health WC $14.77
Rate for Payer: Global Benefits Group Commercial $10.43
Rate for Payer: Health Management Network EPO/PPO $15.64
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $6.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $10.76
Rate for Payer: LLUH Dept of Risk Management WC $3.48
Rate for Payer: Multiplan Commercial $13.04
Rate for Payer: Networks By Design Commercial $11.30
Rate for Payer: Prime Health Services Commercial $14.77
Hospital Charge Code 901602922
Hospital Revenue Code 272
Min. Negotiated Rate $3.48
Max. Negotiated Rate $15.64
Rate for Payer: Adventist Health Commercial $3.48
Rate for Payer: Aetna of CA HMO/PPO $10.55
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $14.77
Rate for Payer: Alpha Care Medical Group Medi-Cal $9.56
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $13.04
Rate for Payer: Anthem Blue Cross of CA Exchange $8.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.21
Rate for Payer: Blue Shield of California Commercial $10.62
Rate for Payer: Blue Shield of California EPN $6.93
Rate for Payer: Cash Price $9.56
Rate for Payer: Central Health Plan Commercial $13.90
Rate for Payer: Cigna of CA HMO $11.12
Rate for Payer: Cigna of CA PPO $12.86
Rate for Payer: Dignity Health Commercial/Exchange $14.77
Rate for Payer: Dignity Health Medi-Cal $14.77
Rate for Payer: Dignity Health Medicare Advantage $14.77
Rate for Payer: EPIC Health Plan Commercial $6.95
Rate for Payer: EPIC Health Plan Senior $6.95
Rate for Payer: Galaxy Health WC $14.77
Rate for Payer: Global Benefits Group Commercial $10.43
Rate for Payer: Health Management Network EPO/PPO $15.64
Rate for Payer: InnovAge PACE Commercial $8.69
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal $6.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $10.76
Rate for Payer: LLUH Dept of Risk Management WC $3.48
Rate for Payer: Molina Healthcare of CA Medi-Cal $12.17
Rate for Payer: Molina Healthcare of CA Medicare $12.17
Rate for Payer: Multiplan Commercial $13.04
Rate for Payer: Networks By Design Commercial $11.30
Rate for Payer: Prime Health Services Commercial $14.77
Rate for Payer: Riverside University Health System MISP $6.95
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $10.43
Rate for Payer: TriValley Medical Group Commercial/Senior $10.43
Rate for Payer: United Healthcare All Other Commercial $8.69
Rate for Payer: United Healthcare All Other HMO $8.69
Rate for Payer: United Healthcare HMO Rider $8.69
Rate for Payer: United Healthcare Select/Navigate/Core $8.69
Rate for Payer: Vantage Medical Group Commercial/Exchange $14.77
Rate for Payer: Vantage Medical Group Medi-Cal $14.77
Rate for Payer: Vantage Medical Group Senior $14.77
Hospital Charge Code 901607287
Hospital Revenue Code 272
Min. Negotiated Rate $3.90
Max. Negotiated Rate $17.57
Rate for Payer: Adventist Health Commercial $3.90
Rate for Payer: Cash Price $10.74
Rate for Payer: Central Health Plan Commercial $15.62
Rate for Payer: EPIC Health Plan Commercial $7.81
Rate for Payer: EPIC Health Plan Senior $7.81
Rate for Payer: Galaxy Health WC $16.59
Rate for Payer: Global Benefits Group Commercial $11.71
Rate for Payer: Health Management Network EPO/PPO $17.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $13.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $12.08
Rate for Payer: LLUH Dept of Risk Management WC $3.90
Rate for Payer: Multiplan Commercial $14.64
Rate for Payer: Networks By Design Commercial $12.69
Rate for Payer: Prime Health Services Commercial $16.59
Hospital Charge Code 901607287
Hospital Revenue Code 272
Min. Negotiated Rate $3.90
Max. Negotiated Rate $17.57
Rate for Payer: Adventist Health Commercial $3.90
Rate for Payer: Aetna of CA HMO/PPO $11.85
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $16.59
Rate for Payer: Alpha Care Medical Group Medi-Cal $10.74
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $14.64
Rate for Payer: Anthem Blue Cross of CA Exchange $9.45
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11.46
Rate for Payer: Blue Shield of California Commercial $11.93
Rate for Payer: Blue Shield of California EPN $7.79
Rate for Payer: Cash Price $10.74
Rate for Payer: Central Health Plan Commercial $15.62
Rate for Payer: Cigna of CA HMO $12.49
Rate for Payer: Cigna of CA PPO $14.44
Rate for Payer: Dignity Health Commercial/Exchange $16.59
Rate for Payer: Dignity Health Medi-Cal $16.59
Rate for Payer: Dignity Health Medicare Advantage $16.59
Rate for Payer: EPIC Health Plan Commercial $7.81
Rate for Payer: EPIC Health Plan Senior $7.81
Rate for Payer: Galaxy Health WC $16.59
Rate for Payer: Global Benefits Group Commercial $11.71
Rate for Payer: Health Management Network EPO/PPO $17.57
Rate for Payer: InnovAge PACE Commercial $9.76
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $13.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal $7.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $12.08
Rate for Payer: LLUH Dept of Risk Management WC $3.90
Rate for Payer: Molina Healthcare of CA Medi-Cal $13.66
Rate for Payer: Molina Healthcare of CA Medicare $13.66
Rate for Payer: Multiplan Commercial $14.64
Rate for Payer: Networks By Design Commercial $12.69
Rate for Payer: Prime Health Services Commercial $16.59
Rate for Payer: Riverside University Health System MISP $7.81
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $11.71
Rate for Payer: TriValley Medical Group Commercial/Senior $11.71
Rate for Payer: United Healthcare All Other Commercial $9.76
Rate for Payer: United Healthcare All Other HMO $9.76
Rate for Payer: United Healthcare HMO Rider $9.76
Rate for Payer: United Healthcare Select/Navigate/Core $9.76
Rate for Payer: Vantage Medical Group Commercial/Exchange $16.59
Rate for Payer: Vantage Medical Group Medi-Cal $16.59
Rate for Payer: Vantage Medical Group Senior $16.59
Hospital Charge Code 901698330
Hospital Revenue Code 272
Min. Negotiated Rate $3.44
Max. Negotiated Rate $15.50
Rate for Payer: Adventist Health Commercial $3.44
Rate for Payer: Cash Price $9.47
Rate for Payer: Central Health Plan Commercial $13.78
Rate for Payer: EPIC Health Plan Commercial $6.89
Rate for Payer: EPIC Health Plan Senior $6.89
Rate for Payer: Galaxy Health WC $14.64
Rate for Payer: Global Benefits Group Commercial $10.33
Rate for Payer: Health Management Network EPO/PPO $15.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal $6.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $10.66
Rate for Payer: LLUH Dept of Risk Management WC $3.44
Rate for Payer: Multiplan Commercial $12.91
Rate for Payer: Networks By Design Commercial $11.19
Rate for Payer: Prime Health Services Commercial $14.64
Hospital Charge Code 901698330
Hospital Revenue Code 272
Min. Negotiated Rate $3.44
Max. Negotiated Rate $15.50
Rate for Payer: Adventist Health Commercial $3.44
Rate for Payer: Aetna of CA HMO/PPO $10.46
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $14.64
Rate for Payer: Alpha Care Medical Group Medi-Cal $9.47
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $12.91
Rate for Payer: Anthem Blue Cross of CA Exchange $8.34
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.11
Rate for Payer: Blue Shield of California Commercial $10.52
Rate for Payer: Blue Shield of California EPN $6.87
Rate for Payer: Cash Price $9.47
Rate for Payer: Central Health Plan Commercial $13.78
Rate for Payer: Cigna of CA HMO $11.02
Rate for Payer: Cigna of CA PPO $12.74
Rate for Payer: Dignity Health Commercial/Exchange $14.64
Rate for Payer: Dignity Health Medi-Cal $14.64
Rate for Payer: Dignity Health Medicare Advantage $14.64
Rate for Payer: EPIC Health Plan Commercial $6.89
Rate for Payer: EPIC Health Plan Senior $6.89
Rate for Payer: Galaxy Health WC $14.64
Rate for Payer: Global Benefits Group Commercial $10.33
Rate for Payer: Health Management Network EPO/PPO $15.50
Rate for Payer: InnovAge PACE Commercial $8.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal $6.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $10.66
Rate for Payer: LLUH Dept of Risk Management WC $3.44
Rate for Payer: Molina Healthcare of CA Medi-Cal $12.05
Rate for Payer: Molina Healthcare of CA Medicare $12.05
Rate for Payer: Multiplan Commercial $12.91
Rate for Payer: Networks By Design Commercial $11.19
Rate for Payer: Prime Health Services Commercial $14.64
Rate for Payer: Riverside University Health System MISP $6.89
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $10.33
Rate for Payer: TriValley Medical Group Commercial/Senior $10.33
Rate for Payer: United Healthcare All Other Commercial $8.61
Rate for Payer: United Healthcare All Other HMO $8.61
Rate for Payer: United Healthcare HMO Rider $8.61
Rate for Payer: United Healthcare Select/Navigate/Core $8.61
Rate for Payer: Vantage Medical Group Commercial/Exchange $14.64
Rate for Payer: Vantage Medical Group Medi-Cal $14.64
Rate for Payer: Vantage Medical Group Senior $14.64
Service Code CPT C1887
Hospital Charge Code 906812384
Hospital Revenue Code 272
Min. Negotiated Rate $118.60
Max. Negotiated Rate $533.70
Rate for Payer: Adventist Health Commercial $118.60
Rate for Payer: Cash Price $326.15
Rate for Payer: Central Health Plan Commercial $474.40
Rate for Payer: EPIC Health Plan Commercial $237.20
Rate for Payer: EPIC Health Plan Senior $237.20
Rate for Payer: Galaxy Health WC $504.05
Rate for Payer: Global Benefits Group Commercial $355.80
Rate for Payer: Health Management Network EPO/PPO $533.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $395.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal $225.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $367.07
Rate for Payer: LLUH Dept of Risk Management WC $118.60
Rate for Payer: Multiplan Commercial $444.75
Rate for Payer: Networks By Design Commercial $385.45
Rate for Payer: Prime Health Services Commercial $504.05
Service Code CPT C1887
Hospital Charge Code 906812384
Hospital Revenue Code 272
Min. Negotiated Rate $118.60
Max. Negotiated Rate $533.70
Rate for Payer: Adventist Health Commercial $118.60
Rate for Payer: Aetna of CA HMO/PPO $360.13
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $504.05
Rate for Payer: Alpha Care Medical Group Medi-Cal $326.15
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $444.75
Rate for Payer: Anthem Blue Cross of CA Exchange $287.13
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $348.27
Rate for Payer: Blue Shield of California Commercial $362.32
Rate for Payer: Blue Shield of California EPN $236.61
Rate for Payer: Cash Price $326.15
Rate for Payer: Central Health Plan Commercial $474.40
Rate for Payer: Cigna of CA HMO $379.52
Rate for Payer: Cigna of CA PPO $438.82
Rate for Payer: Dignity Health Commercial/Exchange $504.05
Rate for Payer: Dignity Health Medi-Cal $504.05
Rate for Payer: Dignity Health Medicare Advantage $504.05
Rate for Payer: EPIC Health Plan Commercial $237.20
Rate for Payer: EPIC Health Plan Senior $237.20
Rate for Payer: Galaxy Health WC $504.05
Rate for Payer: Global Benefits Group Commercial $355.80
Rate for Payer: Health Management Network EPO/PPO $533.70
Rate for Payer: InnovAge PACE Commercial $296.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $395.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal $225.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $367.07
Rate for Payer: LLUH Dept of Risk Management WC $118.60
Rate for Payer: Molina Healthcare of CA Medi-Cal $415.10
Rate for Payer: Molina Healthcare of CA Medicare $415.10
Rate for Payer: Multiplan Commercial $444.75
Rate for Payer: Networks By Design Commercial $385.45
Rate for Payer: Prime Health Services Commercial $504.05
Rate for Payer: Riverside University Health System MISP $237.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $355.80
Rate for Payer: TriValley Medical Group Commercial/Senior $355.80
Rate for Payer: United Healthcare All Other Commercial $296.50
Rate for Payer: United Healthcare All Other HMO $296.50
Rate for Payer: United Healthcare HMO Rider $296.50
Rate for Payer: United Healthcare Select/Navigate/Core $296.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $504.05
Rate for Payer: Vantage Medical Group Medi-Cal $504.05
Rate for Payer: Vantage Medical Group Senior $504.05