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Charge Type Price  
Hospital Charge Code 901602815
Hospital Revenue Code 272
Min. Negotiated Rate $176.97
Max. Negotiated Rate $796.37
Rate for Payer: Cash Price $398.19
Rate for Payer: Central Health Plan Commercial $707.89
Rate for Payer: EPIC Health Plan Commercial $353.94
Rate for Payer: Galaxy Health WC $752.13
Rate for Payer: Global Benefits Group Commercial $530.92
Rate for Payer: Health Management Network EPO/PPO $796.37
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $590.20
Rate for Payer: LLUH Dept of Risk Management WC $176.97
Rate for Payer: Multiplan Commercial $663.64
Rate for Payer: Networks By Design Commercial $575.16
Rate for Payer: Prime Health Services Commercial $752.13
Service Code CPT C1729
Hospital Charge Code 901604190
Hospital Revenue Code 278
Min. Negotiated Rate $145.27
Max. Negotiated Rate $653.71
Rate for Payer: Blue Shield of California EPN $387.87
Rate for Payer: Cash Price $326.85
Rate for Payer: Central Health Plan Commercial $581.07
Rate for Payer: Cigna of CA HMO $508.44
Rate for Payer: Cigna of CA PPO $508.44
Rate for Payer: EPIC Health Plan Commercial $290.54
Rate for Payer: EPIC Health Plan Transplant $290.54
Rate for Payer: Galaxy Health WC $617.39
Rate for Payer: Global Benefits Group Commercial $435.80
Rate for Payer: Health Management Network EPO/PPO $653.71
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $484.47
Rate for Payer: LLUH Dept of Risk Management WC $145.27
Rate for Payer: Multiplan Commercial $544.76
Rate for Payer: Prime Health Services Commercial $617.39
Service Code CPT C1729
Hospital Charge Code 901604190
Hospital Revenue Code 278
Min. Negotiated Rate $145.27
Max. Negotiated Rate $653.71
Rate for Payer: Aetna of CA HMO/PPO $312.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $617.39
Rate for Payer: AlphaCare Medical Group Medi-Cal $399.49
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $399.49
Rate for Payer: Anthem Blue Cross of CA Exchange $331.65
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $404.57
Rate for Payer: BCBS Transplant Transplant $435.80
Rate for Payer: Blue Shield of California Commercial $544.76
Rate for Payer: Blue Shield of California EPN $395.13
Rate for Payer: Cash Price $326.85
Rate for Payer: Cash Price $326.85
Rate for Payer: Central Health Plan Commercial $581.07
Rate for Payer: Cigna of CA HMO $508.44
Rate for Payer: Cigna of CA PPO $508.44
Rate for Payer: Dignity Health Commercial/Exchange $617.39
Rate for Payer: EPIC Health Plan Commercial $290.54
Rate for Payer: EPIC Health Plan Transplant $290.54
Rate for Payer: Galaxy Health WC $617.39
Rate for Payer: Global Benefits Group Commercial $435.80
Rate for Payer: Health Management Network EPO/PPO $653.71
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $544.76
Rate for Payer: IEHP medi-cal $254.22
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $484.47
Rate for Payer: LLUH Dept of Risk Management WC $145.27
Rate for Payer: Multiplan Commercial $544.76
Rate for Payer: Networks By Design Commercial $363.17
Rate for Payer: Prime Health Services Commercial $617.39
Rate for Payer: Riverside University Health MISP $290.54
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $435.80
Rate for Payer: TriValley Medical Group Commercial/Senior $435.80
Rate for Payer: United Healthcare All Other Commercial $363.17
Rate for Payer: United Healthcare All Other HMO $363.17
Rate for Payer: United Healthcare HMO Rider $363.17
Rate for Payer: United Healthcare Select/Navigate/Core $363.17
Rate for Payer: Vantage Medical Group Medi-Cal $617.39
Rate for Payer: Vantage Medical Group Senior $617.39
Service Code CPT C1729
Hospital Charge Code 901603300
Hospital Revenue Code 278
Min. Negotiated Rate $124.53
Max. Negotiated Rate $560.39
Rate for Payer: Aetna of CA HMO/PPO $312.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $529.26
Rate for Payer: AlphaCare Medical Group Medi-Cal $342.46
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $342.46
Rate for Payer: Anthem Blue Cross of CA Exchange $284.31
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $346.82
Rate for Payer: BCBS Transplant Transplant $373.60
Rate for Payer: Blue Shield of California Commercial $467.00
Rate for Payer: Blue Shield of California EPN $338.73
Rate for Payer: Cash Price $280.20
Rate for Payer: Cash Price $280.20
Rate for Payer: Central Health Plan Commercial $498.13
Rate for Payer: Cigna of CA HMO $435.86
Rate for Payer: Cigna of CA PPO $435.86
Rate for Payer: Dignity Health Commercial/Exchange $529.26
Rate for Payer: EPIC Health Plan Commercial $249.06
Rate for Payer: EPIC Health Plan Transplant $249.06
Rate for Payer: Galaxy Health WC $529.26
Rate for Payer: Global Benefits Group Commercial $373.60
Rate for Payer: Health Management Network EPO/PPO $560.39
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $467.00
Rate for Payer: IEHP medi-cal $217.93
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $415.31
Rate for Payer: LLUH Dept of Risk Management WC $124.53
Rate for Payer: Multiplan Commercial $467.00
Rate for Payer: Networks By Design Commercial $311.33
Rate for Payer: Prime Health Services Commercial $529.26
Rate for Payer: Riverside University Health MISP $249.06
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $373.60
Rate for Payer: TriValley Medical Group Commercial/Senior $373.60
Rate for Payer: United Healthcare All Other Commercial $311.33
Rate for Payer: United Healthcare All Other HMO $311.33
Rate for Payer: United Healthcare HMO Rider $311.33
Rate for Payer: United Healthcare Select/Navigate/Core $311.33
Rate for Payer: Vantage Medical Group Medi-Cal $529.26
Rate for Payer: Vantage Medical Group Senior $529.26
Service Code CPT C1729
Hospital Charge Code 901603300
Hospital Revenue Code 278
Min. Negotiated Rate $124.53
Max. Negotiated Rate $560.39
Rate for Payer: Blue Shield of California EPN $332.50
Rate for Payer: Cash Price $280.20
Rate for Payer: Central Health Plan Commercial $498.13
Rate for Payer: Cigna of CA HMO $435.86
Rate for Payer: Cigna of CA PPO $435.86
Rate for Payer: EPIC Health Plan Commercial $249.06
Rate for Payer: EPIC Health Plan Transplant $249.06
Rate for Payer: Galaxy Health WC $529.26
Rate for Payer: Global Benefits Group Commercial $373.60
Rate for Payer: Health Management Network EPO/PPO $560.39
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $415.31
Rate for Payer: LLUH Dept of Risk Management WC $124.53
Rate for Payer: Multiplan Commercial $467.00
Rate for Payer: Prime Health Services Commercial $529.26
Service Code CPT C1729
Hospital Charge Code 901604780
Hospital Revenue Code 272
Min. Negotiated Rate $118.04
Max. Negotiated Rate $531.16
Rate for Payer: Cash Price $265.58
Rate for Payer: Central Health Plan Commercial $472.14
Rate for Payer: EPIC Health Plan Commercial $236.07
Rate for Payer: Galaxy Health WC $501.65
Rate for Payer: Global Benefits Group Commercial $354.11
Rate for Payer: Health Management Network EPO/PPO $531.16
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $393.65
Rate for Payer: LLUH Dept of Risk Management WC $118.04
Rate for Payer: Multiplan Commercial $442.64
Rate for Payer: Networks By Design Commercial $383.62
Rate for Payer: Prime Health Services Commercial $501.65
Service Code CPT C1729
Hospital Charge Code 901604780
Hospital Revenue Code 272
Min. Negotiated Rate $118.04
Max. Negotiated Rate $531.16
Rate for Payer: Aetna of CA HMO/PPO $312.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $501.65
Rate for Payer: AlphaCare Medical Group Medi-Cal $324.60
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $324.60
Rate for Payer: Anthem Blue Cross of CA Exchange $285.77
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $348.68
Rate for Payer: BCBS Transplant Transplant $354.11
Rate for Payer: Blue Shield of California Commercial $371.22
Rate for Payer: Blue Shield of California EPN $288.60
Rate for Payer: Cash Price $265.58
Rate for Payer: Cash Price $265.58
Rate for Payer: Central Health Plan Commercial $472.14
Rate for Payer: Cigna of CA HMO $377.72
Rate for Payer: Cigna of CA PPO $436.73
Rate for Payer: Dignity Health Commercial/Exchange $501.65
Rate for Payer: EPIC Health Plan Commercial $236.07
Rate for Payer: EPIC Health Plan Transplant $236.07
Rate for Payer: Galaxy Health WC $501.65
Rate for Payer: Global Benefits Group Commercial $354.11
Rate for Payer: Health Management Network EPO/PPO $531.16
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $442.64
Rate for Payer: IEHP medi-cal $206.56
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $393.65
Rate for Payer: LLUH Dept of Risk Management WC $118.04
Rate for Payer: Multiplan Commercial $442.64
Rate for Payer: Networks By Design Commercial $383.62
Rate for Payer: Prime Health Services Commercial $501.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $354.11
Rate for Payer: Riverside University Health MISP $236.07
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $354.11
Rate for Payer: TriValley Medical Group Commercial/Senior $354.11
Rate for Payer: United Healthcare All Other Commercial $295.09
Rate for Payer: United Healthcare All Other HMO $295.09
Rate for Payer: United Healthcare HMO Rider $295.09
Rate for Payer: United Healthcare Select/Navigate/Core $295.09
Rate for Payer: Vantage Medical Group Medi-Cal $501.65
Rate for Payer: Vantage Medical Group Senior $501.65
Hospital Charge Code 906812008
Hospital Revenue Code 272
Min. Negotiated Rate $60.35
Max. Negotiated Rate $271.59
Rate for Payer: Cash Price $135.80
Rate for Payer: Central Health Plan Commercial $241.42
Rate for Payer: EPIC Health Plan Commercial $120.71
Rate for Payer: Galaxy Health WC $256.50
Rate for Payer: Global Benefits Group Commercial $181.06
Rate for Payer: Health Management Network EPO/PPO $271.59
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $201.28
Rate for Payer: LLUH Dept of Risk Management WC $60.35
Rate for Payer: Multiplan Commercial $226.33
Rate for Payer: Networks By Design Commercial $196.15
Rate for Payer: Prime Health Services Commercial $256.50
Hospital Charge Code 906812008
Hospital Revenue Code 272
Min. Negotiated Rate $60.35
Max. Negotiated Rate $271.59
Rate for Payer: Aetna of CA HMO/PPO $183.26
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $256.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $165.97
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $165.97
Rate for Payer: Anthem Blue Cross of CA Exchange $146.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $178.29
Rate for Payer: BCBS Transplant Transplant $181.06
Rate for Payer: Blue Shield of California Commercial $189.81
Rate for Payer: Blue Shield of California EPN $147.57
Rate for Payer: Cash Price $135.80
Rate for Payer: Central Health Plan Commercial $241.42
Rate for Payer: Cigna of CA HMO $193.13
Rate for Payer: Cigna of CA PPO $223.31
Rate for Payer: Dignity Health Commercial/Exchange $256.50
Rate for Payer: EPIC Health Plan Commercial $120.71
Rate for Payer: EPIC Health Plan Transplant $120.71
Rate for Payer: Galaxy Health WC $256.50
Rate for Payer: Global Benefits Group Commercial $181.06
Rate for Payer: Health Management Network EPO/PPO $271.59
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $226.33
Rate for Payer: IEHP medi-cal $105.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $201.28
Rate for Payer: LLUH Dept of Risk Management WC $60.35
Rate for Payer: Multiplan Commercial $226.33
Rate for Payer: Networks By Design Commercial $196.15
Rate for Payer: Prime Health Services Commercial $256.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $181.06
Rate for Payer: Riverside University Health MISP $120.71
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $181.06
Rate for Payer: TriValley Medical Group Commercial/Senior $181.06
Rate for Payer: United Healthcare All Other Commercial $150.88
Rate for Payer: United Healthcare All Other HMO $150.88
Rate for Payer: United Healthcare HMO Rider $150.88
Rate for Payer: United Healthcare Select/Navigate/Core $150.88
Rate for Payer: Vantage Medical Group Medi-Cal $256.50
Rate for Payer: Vantage Medical Group Senior $256.50
Hospital Charge Code 906812010
Hospital Revenue Code 272
Min. Negotiated Rate $68.07
Max. Negotiated Rate $306.31
Rate for Payer: Cash Price $153.15
Rate for Payer: Central Health Plan Commercial $272.27
Rate for Payer: EPIC Health Plan Commercial $136.14
Rate for Payer: Galaxy Health WC $289.29
Rate for Payer: Global Benefits Group Commercial $204.20
Rate for Payer: Health Management Network EPO/PPO $306.31
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $227.01
Rate for Payer: LLUH Dept of Risk Management WC $68.07
Rate for Payer: Multiplan Commercial $255.26
Rate for Payer: Networks By Design Commercial $221.22
Rate for Payer: Prime Health Services Commercial $289.29
Hospital Charge Code 906812010
Hospital Revenue Code 272
Min. Negotiated Rate $68.07
Max. Negotiated Rate $306.31
Rate for Payer: Aetna of CA HMO/PPO $206.69
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $289.29
Rate for Payer: AlphaCare Medical Group Medi-Cal $187.19
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $187.19
Rate for Payer: Anthem Blue Cross of CA Exchange $164.79
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $201.07
Rate for Payer: BCBS Transplant Transplant $204.20
Rate for Payer: Blue Shield of California Commercial $214.07
Rate for Payer: Blue Shield of California EPN $166.43
Rate for Payer: Cash Price $153.15
Rate for Payer: Central Health Plan Commercial $272.27
Rate for Payer: Cigna of CA HMO $217.82
Rate for Payer: Cigna of CA PPO $251.85
Rate for Payer: Dignity Health Commercial/Exchange $289.29
Rate for Payer: EPIC Health Plan Commercial $136.14
Rate for Payer: EPIC Health Plan Transplant $136.14
Rate for Payer: Galaxy Health WC $289.29
Rate for Payer: Global Benefits Group Commercial $204.20
Rate for Payer: Health Management Network EPO/PPO $306.31
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $255.26
Rate for Payer: IEHP medi-cal $119.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $227.01
Rate for Payer: LLUH Dept of Risk Management WC $68.07
Rate for Payer: Multiplan Commercial $255.26
Rate for Payer: Networks By Design Commercial $221.22
Rate for Payer: Prime Health Services Commercial $289.29
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $204.20
Rate for Payer: Riverside University Health MISP $136.14
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $204.20
Rate for Payer: TriValley Medical Group Commercial/Senior $204.20
Rate for Payer: United Healthcare All Other Commercial $170.17
Rate for Payer: United Healthcare All Other HMO $170.17
Rate for Payer: United Healthcare HMO Rider $170.17
Rate for Payer: United Healthcare Select/Navigate/Core $170.17
Rate for Payer: Vantage Medical Group Medi-Cal $289.29
Rate for Payer: Vantage Medical Group Senior $289.29
Hospital Charge Code 906812368
Hospital Revenue Code 272
Min. Negotiated Rate $75.40
Max. Negotiated Rate $339.30
Rate for Payer: Cash Price $169.65
Rate for Payer: Central Health Plan Commercial $301.60
Rate for Payer: EPIC Health Plan Commercial $150.80
Rate for Payer: Galaxy Health WC $320.45
Rate for Payer: Global Benefits Group Commercial $226.20
Rate for Payer: Health Management Network EPO/PPO $339.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $251.46
Rate for Payer: LLUH Dept of Risk Management WC $75.40
Rate for Payer: Multiplan Commercial $282.75
Rate for Payer: Networks By Design Commercial $245.05
Rate for Payer: Prime Health Services Commercial $320.45
Hospital Charge Code 906812368
Hospital Revenue Code 272
Min. Negotiated Rate $75.40
Max. Negotiated Rate $339.30
Rate for Payer: Aetna of CA HMO/PPO $228.95
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $320.45
Rate for Payer: AlphaCare Medical Group Medi-Cal $207.35
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $207.35
Rate for Payer: Anthem Blue Cross of CA Exchange $182.54
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $222.73
Rate for Payer: BCBS Transplant Transplant $226.20
Rate for Payer: Blue Shield of California Commercial $237.13
Rate for Payer: Blue Shield of California EPN $184.35
Rate for Payer: Cash Price $169.65
Rate for Payer: Central Health Plan Commercial $301.60
Rate for Payer: Cigna of CA HMO $241.28
Rate for Payer: Cigna of CA PPO $278.98
Rate for Payer: Dignity Health Commercial/Exchange $320.45
Rate for Payer: EPIC Health Plan Commercial $150.80
Rate for Payer: EPIC Health Plan Transplant $150.80
Rate for Payer: Galaxy Health WC $320.45
Rate for Payer: Global Benefits Group Commercial $226.20
Rate for Payer: Health Management Network EPO/PPO $339.30
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $282.75
Rate for Payer: IEHP medi-cal $131.95
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $251.46
Rate for Payer: LLUH Dept of Risk Management WC $75.40
Rate for Payer: Multiplan Commercial $282.75
Rate for Payer: Networks By Design Commercial $245.05
Rate for Payer: Prime Health Services Commercial $320.45
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $226.20
Rate for Payer: Riverside University Health MISP $150.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $226.20
Rate for Payer: TriValley Medical Group Commercial/Senior $226.20
Rate for Payer: United Healthcare All Other Commercial $188.50
Rate for Payer: United Healthcare All Other HMO $188.50
Rate for Payer: United Healthcare HMO Rider $188.50
Rate for Payer: United Healthcare Select/Navigate/Core $188.50
Rate for Payer: Vantage Medical Group Medi-Cal $320.45
Rate for Payer: Vantage Medical Group Senior $320.45
Hospital Charge Code 906812275
Hospital Revenue Code 272
Min. Negotiated Rate $93.81
Max. Negotiated Rate $422.14
Rate for Payer: Cash Price $211.07
Rate for Payer: Central Health Plan Commercial $375.23
Rate for Payer: EPIC Health Plan Commercial $187.62
Rate for Payer: Galaxy Health WC $398.68
Rate for Payer: Global Benefits Group Commercial $281.42
Rate for Payer: Health Management Network EPO/PPO $422.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $312.85
Rate for Payer: LLUH Dept of Risk Management WC $93.81
Rate for Payer: Multiplan Commercial $351.78
Rate for Payer: Networks By Design Commercial $304.88
Rate for Payer: Prime Health Services Commercial $398.68
Hospital Charge Code 906812275
Hospital Revenue Code 272
Min. Negotiated Rate $93.81
Max. Negotiated Rate $422.14
Rate for Payer: Aetna of CA HMO/PPO $284.85
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $398.68
Rate for Payer: AlphaCare Medical Group Medi-Cal $257.97
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $257.97
Rate for Payer: Anthem Blue Cross of CA Exchange $227.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $277.11
Rate for Payer: BCBS Transplant Transplant $281.42
Rate for Payer: Blue Shield of California Commercial $295.03
Rate for Payer: Blue Shield of California EPN $229.36
Rate for Payer: Cash Price $211.07
Rate for Payer: Central Health Plan Commercial $375.23
Rate for Payer: Cigna of CA HMO $300.19
Rate for Payer: Cigna of CA PPO $347.09
Rate for Payer: Dignity Health Commercial/Exchange $398.68
Rate for Payer: EPIC Health Plan Commercial $187.62
Rate for Payer: EPIC Health Plan Transplant $187.62
Rate for Payer: Galaxy Health WC $398.68
Rate for Payer: Global Benefits Group Commercial $281.42
Rate for Payer: Health Management Network EPO/PPO $422.14
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $351.78
Rate for Payer: IEHP medi-cal $164.16
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $312.85
Rate for Payer: LLUH Dept of Risk Management WC $93.81
Rate for Payer: Multiplan Commercial $351.78
Rate for Payer: Networks By Design Commercial $304.88
Rate for Payer: Prime Health Services Commercial $398.68
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $281.42
Rate for Payer: Riverside University Health MISP $187.62
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $281.42
Rate for Payer: TriValley Medical Group Commercial/Senior $281.42
Rate for Payer: United Healthcare All Other Commercial $234.52
Rate for Payer: United Healthcare All Other HMO $234.52
Rate for Payer: United Healthcare HMO Rider $234.52
Rate for Payer: United Healthcare Select/Navigate/Core $234.52
Rate for Payer: Vantage Medical Group Medi-Cal $398.68
Rate for Payer: Vantage Medical Group Senior $398.68
Hospital Charge Code 906812636
Hospital Revenue Code 272
Min. Negotiated Rate $396.20
Max. Negotiated Rate $1,782.90
Rate for Payer: Aetna of CA HMO/PPO $1,203.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1,683.85
Rate for Payer: AlphaCare Medical Group Medi-Cal $1,089.55
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,089.55
Rate for Payer: Anthem Blue Cross of CA Exchange $959.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1,170.37
Rate for Payer: BCBS Transplant Transplant $1,188.60
Rate for Payer: Blue Shield of California Commercial $1,246.05
Rate for Payer: Blue Shield of California EPN $968.71
Rate for Payer: Cash Price $891.45
Rate for Payer: Central Health Plan Commercial $1,584.80
Rate for Payer: Cigna of CA HMO $1,267.84
Rate for Payer: Cigna of CA PPO $1,465.94
Rate for Payer: Dignity Health Commercial/Exchange $1,683.85
Rate for Payer: EPIC Health Plan Commercial $792.40
Rate for Payer: EPIC Health Plan Transplant $792.40
Rate for Payer: Galaxy Health WC $1,683.85
Rate for Payer: Global Benefits Group Commercial $1,188.60
Rate for Payer: Health Management Network EPO/PPO $1,782.90
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,485.75
Rate for Payer: IEHP medi-cal $693.35
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,321.33
Rate for Payer: LLUH Dept of Risk Management WC $396.20
Rate for Payer: Multiplan Commercial $1,485.75
Rate for Payer: Networks By Design Commercial $1,287.65
Rate for Payer: Prime Health Services Commercial $1,683.85
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1,188.60
Rate for Payer: Riverside University Health MISP $792.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1,188.60
Rate for Payer: TriValley Medical Group Commercial/Senior $1,188.60
Rate for Payer: United Healthcare All Other Commercial $990.50
Rate for Payer: United Healthcare All Other HMO $990.50
Rate for Payer: United Healthcare HMO Rider $990.50
Rate for Payer: United Healthcare Select/Navigate/Core $990.50
Rate for Payer: Vantage Medical Group Medi-Cal $1,683.85
Rate for Payer: Vantage Medical Group Senior $1,683.85
Hospital Charge Code 906812636
Hospital Revenue Code 272
Min. Negotiated Rate $396.20
Max. Negotiated Rate $1,782.90
Rate for Payer: Cash Price $891.45
Rate for Payer: Central Health Plan Commercial $1,584.80
Rate for Payer: EPIC Health Plan Commercial $792.40
Rate for Payer: Galaxy Health WC $1,683.85
Rate for Payer: Global Benefits Group Commercial $1,188.60
Rate for Payer: Health Management Network EPO/PPO $1,782.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,321.33
Rate for Payer: LLUH Dept of Risk Management WC $396.20
Rate for Payer: Multiplan Commercial $1,485.75
Rate for Payer: Networks By Design Commercial $1,287.65
Rate for Payer: Prime Health Services Commercial $1,683.85
Service Code CPT C1887
Hospital Charge Code 909020053
Hospital Revenue Code 272
Min. Negotiated Rate $188.37
Max. Negotiated Rate $4,713.75
Rate for Payer: Aetna of CA HMO/PPO $188.37
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $4,451.88
Rate for Payer: AlphaCare Medical Group Medi-Cal $2,880.62
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $2,880.62
Rate for Payer: Anthem Blue Cross of CA Exchange $2,536.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,094.32
Rate for Payer: BCBS Transplant Transplant $3,142.50
Rate for Payer: Blue Shield of California Commercial $3,294.39
Rate for Payer: Blue Shield of California EPN $2,561.14
Rate for Payer: Cash Price $2,356.88
Rate for Payer: Cash Price $2,356.88
Rate for Payer: Central Health Plan Commercial $4,190.00
Rate for Payer: Cigna of CA HMO $3,352.00
Rate for Payer: Cigna of CA PPO $3,875.75
Rate for Payer: Dignity Health Commercial/Exchange $4,451.88
Rate for Payer: EPIC Health Plan Commercial $2,095.00
Rate for Payer: EPIC Health Plan Transplant $2,095.00
Rate for Payer: Galaxy Health WC $4,451.88
Rate for Payer: Global Benefits Group Commercial $3,142.50
Rate for Payer: Health Management Network EPO/PPO $4,713.75
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $3,928.12
Rate for Payer: IEHP medi-cal $1,833.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,493.41
Rate for Payer: LLUH Dept of Risk Management WC $1,047.50
Rate for Payer: Multiplan Commercial $3,928.12
Rate for Payer: Networks By Design Commercial $3,404.38
Rate for Payer: Prime Health Services Commercial $4,451.88
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $3,142.50
Rate for Payer: Riverside University Health MISP $2,095.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $3,142.50
Rate for Payer: TriValley Medical Group Commercial/Senior $3,142.50
Rate for Payer: United Healthcare All Other Commercial $2,618.75
Rate for Payer: United Healthcare All Other HMO $2,618.75
Rate for Payer: United Healthcare HMO Rider $2,618.75
Rate for Payer: United Healthcare Select/Navigate/Core $2,618.75
Rate for Payer: Vantage Medical Group Medi-Cal $4,451.88
Rate for Payer: Vantage Medical Group Senior $4,451.88
Service Code CPT C1887
Hospital Charge Code 909020053
Hospital Revenue Code 272
Min. Negotiated Rate $1,047.50
Max. Negotiated Rate $4,713.75
Rate for Payer: Cash Price $2,356.88
Rate for Payer: Central Health Plan Commercial $4,190.00
Rate for Payer: EPIC Health Plan Commercial $2,095.00
Rate for Payer: Galaxy Health WC $4,451.88
Rate for Payer: Global Benefits Group Commercial $3,142.50
Rate for Payer: Health Management Network EPO/PPO $4,713.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $3,493.41
Rate for Payer: LLUH Dept of Risk Management WC $1,047.50
Rate for Payer: Multiplan Commercial $3,928.12
Rate for Payer: Networks By Design Commercial $3,404.38
Rate for Payer: Prime Health Services Commercial $4,451.88
Service Code CPT 36660
Hospital Charge Code 988136660
Hospital Revenue Code 361
Min. Negotiated Rate $79.20
Max. Negotiated Rate $356.40
Rate for Payer: Cash Price $178.20
Rate for Payer: Central Health Plan Commercial $316.80
Rate for Payer: EPIC Health Plan Commercial $158.40
Rate for Payer: Galaxy Health WC $336.60
Rate for Payer: Global Benefits Group Commercial $237.60
Rate for Payer: Health Management Network EPO/PPO $356.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $264.13
Rate for Payer: LLUH Dept of Risk Management WC $79.20
Rate for Payer: Multiplan Commercial $297.00
Rate for Payer: Networks By Design Commercial $257.40
Rate for Payer: Prime Health Services Commercial $336.60
Service Code CPT 36660
Hospital Charge Code 988136660
Hospital Revenue Code 361
Min. Negotiated Rate $79.20
Max. Negotiated Rate $397,400.00
Rate for Payer: Aetna of CA HMO/PPO $390.72
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $336.60
Rate for Payer: AlphaCare Medical Group Medi-Cal $217.80
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $217.80
Rate for Payer: Anthem Blue Cross of CA Exchange $397,400.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,846.00
Rate for Payer: BCBS Transplant Transplant $237.60
Rate for Payer: Blue Shield of California Commercial $3,079.84
Rate for Payer: Blue Shield of California EPN $2,212.08
Rate for Payer: Cash Price $178.20
Rate for Payer: Cash Price $178.20
Rate for Payer: Cash Price $178.20
Rate for Payer: Central Health Plan Commercial $316.80
Rate for Payer: Cigna of CA PPO $293.04
Rate for Payer: Dignity Health Commercial/Exchange $336.60
Rate for Payer: EPIC Health Plan Commercial $158.40
Rate for Payer: EPIC Health Plan Transplant $158.40
Rate for Payer: Galaxy Health WC $336.60
Rate for Payer: Global Benefits Group Commercial $237.60
Rate for Payer: Health Management Network EPO/PPO $356.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $297.00
Rate for Payer: IEHP medi-cal $138.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $264.13
Rate for Payer: LLUH Dept of Risk Management WC $79.20
Rate for Payer: Multiplan Commercial $297.00
Rate for Payer: Networks By Design Commercial $257.40
Rate for Payer: Prime Health Services Commercial $336.60
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $237.60
Rate for Payer: Riverside University Health MISP $158.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $237.60
Rate for Payer: United Healthcare All Other Commercial $4,121.00
Rate for Payer: United Healthcare All Other HMO $4,248.00
Rate for Payer: United Healthcare HMO Rider $2,468.00
Rate for Payer: United Healthcare Select/Navigate/Core $2,257.00
Rate for Payer: Vantage Medical Group Medi-Cal $336.60
Rate for Payer: Vantage Medical Group Senior $336.60
Hospital Charge Code 909020082
Hospital Revenue Code 272
Min. Negotiated Rate $116.00
Max. Negotiated Rate $522.00
Rate for Payer: Aetna of CA HMO/PPO $352.23
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $493.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $319.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $319.00
Rate for Payer: Anthem Blue Cross of CA Exchange $280.84
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $342.66
Rate for Payer: BCBS Transplant Transplant $348.00
Rate for Payer: Blue Shield of California Commercial $364.82
Rate for Payer: Blue Shield of California EPN $283.62
Rate for Payer: Cash Price $261.00
Rate for Payer: Central Health Plan Commercial $464.00
Rate for Payer: Cigna of CA HMO $371.20
Rate for Payer: Cigna of CA PPO $429.20
Rate for Payer: Dignity Health Commercial/Exchange $493.00
Rate for Payer: EPIC Health Plan Commercial $232.00
Rate for Payer: EPIC Health Plan Transplant $232.00
Rate for Payer: Galaxy Health WC $493.00
Rate for Payer: Global Benefits Group Commercial $348.00
Rate for Payer: Health Management Network EPO/PPO $522.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $435.00
Rate for Payer: IEHP medi-cal $203.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $386.86
Rate for Payer: LLUH Dept of Risk Management WC $116.00
Rate for Payer: Multiplan Commercial $435.00
Rate for Payer: Networks By Design Commercial $377.00
Rate for Payer: Prime Health Services Commercial $493.00
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $348.00
Rate for Payer: Riverside University Health MISP $232.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $348.00
Rate for Payer: TriValley Medical Group Commercial/Senior $348.00
Rate for Payer: United Healthcare All Other Commercial $290.00
Rate for Payer: United Healthcare All Other HMO $290.00
Rate for Payer: United Healthcare HMO Rider $290.00
Rate for Payer: United Healthcare Select/Navigate/Core $290.00
Rate for Payer: Vantage Medical Group Medi-Cal $493.00
Rate for Payer: Vantage Medical Group Senior $493.00
Hospital Charge Code 909020082
Hospital Revenue Code 272
Min. Negotiated Rate $116.00
Max. Negotiated Rate $522.00
Rate for Payer: Cash Price $261.00
Rate for Payer: Central Health Plan Commercial $464.00
Rate for Payer: EPIC Health Plan Commercial $232.00
Rate for Payer: Galaxy Health WC $493.00
Rate for Payer: Global Benefits Group Commercial $348.00
Rate for Payer: Health Management Network EPO/PPO $522.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $386.86
Rate for Payer: LLUH Dept of Risk Management WC $116.00
Rate for Payer: Multiplan Commercial $435.00
Rate for Payer: Networks By Design Commercial $377.00
Rate for Payer: Prime Health Services Commercial $493.00
Hospital Charge Code 909081205
Hospital Revenue Code 272
Min. Negotiated Rate $19.80
Max. Negotiated Rate $89.10
Rate for Payer: Aetna of CA HMO/PPO $60.12
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $84.15
Rate for Payer: AlphaCare Medical Group Medi-Cal $54.45
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $54.45
Rate for Payer: Anthem Blue Cross of CA Exchange $47.94
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $58.49
Rate for Payer: BCBS Transplant Transplant $59.40
Rate for Payer: Blue Shield of California Commercial $62.27
Rate for Payer: Blue Shield of California EPN $48.41
Rate for Payer: Cash Price $44.55
Rate for Payer: Central Health Plan Commercial $79.20
Rate for Payer: Cigna of CA HMO $63.36
Rate for Payer: Cigna of CA PPO $73.26
Rate for Payer: Dignity Health Commercial/Exchange $84.15
Rate for Payer: EPIC Health Plan Commercial $39.60
Rate for Payer: EPIC Health Plan Transplant $39.60
Rate for Payer: Galaxy Health WC $84.15
Rate for Payer: Global Benefits Group Commercial $59.40
Rate for Payer: Health Management Network EPO/PPO $89.10
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $74.25
Rate for Payer: IEHP medi-cal $34.65
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $66.03
Rate for Payer: LLUH Dept of Risk Management WC $19.80
Rate for Payer: Multiplan Commercial $74.25
Rate for Payer: Networks By Design Commercial $64.35
Rate for Payer: Prime Health Services Commercial $84.15
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $59.40
Rate for Payer: Riverside University Health MISP $39.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $59.40
Rate for Payer: TriValley Medical Group Commercial/Senior $59.40
Rate for Payer: United Healthcare All Other Commercial $49.50
Rate for Payer: United Healthcare All Other HMO $49.50
Rate for Payer: United Healthcare HMO Rider $49.50
Rate for Payer: United Healthcare Select/Navigate/Core $49.50
Rate for Payer: Vantage Medical Group Medi-Cal $84.15
Rate for Payer: Vantage Medical Group Senior $84.15
Hospital Charge Code 909081205
Hospital Revenue Code 272
Min. Negotiated Rate $19.80
Max. Negotiated Rate $89.10
Rate for Payer: Cash Price $44.55
Rate for Payer: Central Health Plan Commercial $79.20
Rate for Payer: EPIC Health Plan Commercial $39.60
Rate for Payer: Galaxy Health WC $84.15
Rate for Payer: Global Benefits Group Commercial $59.40
Rate for Payer: Health Management Network EPO/PPO $89.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $66.03
Rate for Payer: LLUH Dept of Risk Management WC $19.80
Rate for Payer: Multiplan Commercial $74.25
Rate for Payer: Networks By Design Commercial $64.35
Rate for Payer: Prime Health Services Commercial $84.15