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Hospital Charge Code 901603249
Hospital Revenue Code 272
Min. Negotiated Rate $15.17
Max. Negotiated Rate $68.26
Rate for Payer: Aetna of CA HMO/PPO $46.06
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $64.47
Rate for Payer: AlphaCare Medical Group Medi-Cal $41.72
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $41.72
Rate for Payer: Anthem Blue Cross of CA Exchange $36.73
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $44.81
Rate for Payer: BCBS Transplant Transplant $45.51
Rate for Payer: Blue Shield of California Commercial $47.71
Rate for Payer: Blue Shield of California EPN $37.09
Rate for Payer: Cash Price $34.13
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: EPIC Health Plan Commercial $30.34
Rate for Payer: EPIC Health Plan Transplant $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 $68.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $56.89
Rate for Payer: IEHP medi-cal $26.55
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $50.59
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
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $45.51
Rate for Payer: Riverside University Health 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 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 $68.26
Rate for Payer: Cash Price $34.13
Rate for Payer: Central Health Plan Commercial $60.68
Rate for Payer: EPIC Health Plan Commercial $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 $68.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $50.59
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 $24.41
Max. Negotiated Rate $109.85
Rate for Payer: Aetna of CA HMO/PPO $74.13
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $103.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $67.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $67.13
Rate for Payer: Anthem Blue Cross of CA Exchange $59.10
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $72.11
Rate for Payer: BCBS Transplant Transplant $73.24
Rate for Payer: Blue Shield of California Commercial $76.78
Rate for Payer: Blue Shield of California EPN $59.69
Rate for Payer: Cash Price $54.93
Rate for Payer: Central Health Plan Commercial $97.65
Rate for Payer: Cigna of CA HMO $78.12
Rate for Payer: Cigna of CA PPO $90.32
Rate for Payer: Dignity Health Commercial/Exchange $103.75
Rate for Payer: EPIC Health Plan Commercial $48.82
Rate for Payer: EPIC Health Plan Transplant $48.82
Rate for Payer: Galaxy Health WC $103.75
Rate for Payer: Global Benefits Group Commercial $73.24
Rate for Payer: Health Management Network EPO/PPO $109.85
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $91.54
Rate for Payer: IEHP medi-cal $42.72
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $81.41
Rate for Payer: LLUH Dept of Risk Management WC $24.41
Rate for Payer: Multiplan Commercial $91.54
Rate for Payer: Networks By Design Commercial $79.34
Rate for Payer: Prime Health Services Commercial $103.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $73.24
Rate for Payer: Riverside University Health MISP $48.82
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $73.24
Rate for Payer: TriValley Medical Group Commercial/Senior $73.24
Rate for Payer: United Healthcare All Other Commercial $61.03
Rate for Payer: United Healthcare All Other HMO $61.03
Rate for Payer: United Healthcare HMO Rider $61.03
Rate for Payer: United Healthcare Select/Navigate/Core $61.03
Rate for Payer: Vantage Medical Group Medi-Cal $103.75
Rate for Payer: Vantage Medical Group Senior $103.75
Hospital Charge Code 901698448
Hospital Revenue Code 272
Min. Negotiated Rate $24.41
Max. Negotiated Rate $109.85
Rate for Payer: Cash Price $54.93
Rate for Payer: Central Health Plan Commercial $97.65
Rate for Payer: EPIC Health Plan Commercial $48.82
Rate for Payer: Galaxy Health WC $103.75
Rate for Payer: Global Benefits Group Commercial $73.24
Rate for Payer: Health Management Network EPO/PPO $109.85
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $81.41
Rate for Payer: LLUH Dept of Risk Management WC $24.41
Rate for Payer: Multiplan Commercial $91.54
Rate for Payer: Networks By Design Commercial $79.34
Rate for Payer: Prime Health Services Commercial $103.75
Hospital Charge Code 901602923
Hospital Revenue Code 272
Min. Negotiated Rate $4.40
Max. Negotiated Rate $19.78
Rate for Payer: Aetna of CA HMO/PPO $13.35
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $18.68
Rate for Payer: AlphaCare Medical Group Medi-Cal $12.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $12.09
Rate for Payer: Anthem Blue Cross of CA Exchange $10.64
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $12.99
Rate for Payer: BCBS Transplant Transplant $13.19
Rate for Payer: Blue Shield of California Commercial $13.83
Rate for Payer: Blue Shield of California EPN $10.75
Rate for Payer: Cash Price $9.89
Rate for Payer: Central Health Plan Commercial $17.58
Rate for Payer: Cigna of CA HMO $14.07
Rate for Payer: Cigna of CA PPO $16.27
Rate for Payer: Dignity Health Commercial/Exchange $18.68
Rate for Payer: EPIC Health Plan Commercial $8.79
Rate for Payer: EPIC Health Plan Transplant $8.79
Rate for Payer: Galaxy Health WC $18.68
Rate for Payer: Global Benefits Group Commercial $13.19
Rate for Payer: Health Management Network EPO/PPO $19.78
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $16.48
Rate for Payer: IEHP medi-cal $7.69
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.66
Rate for Payer: LLUH Dept of Risk Management WC $4.40
Rate for Payer: Multiplan Commercial $16.48
Rate for Payer: Networks By Design Commercial $14.29
Rate for Payer: Prime Health Services Commercial $18.68
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $13.19
Rate for Payer: Riverside University Health MISP $8.79
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $13.19
Rate for Payer: TriValley Medical Group Commercial/Senior $13.19
Rate for Payer: United Healthcare All Other Commercial $10.99
Rate for Payer: United Healthcare All Other HMO $10.99
Rate for Payer: United Healthcare HMO Rider $10.99
Rate for Payer: United Healthcare Select/Navigate/Core $10.99
Rate for Payer: Vantage Medical Group Medi-Cal $18.68
Rate for Payer: Vantage Medical Group Senior $18.68
Hospital Charge Code 901602923
Hospital Revenue Code 272
Min. Negotiated Rate $4.40
Max. Negotiated Rate $19.78
Rate for Payer: Cash Price $9.89
Rate for Payer: Central Health Plan Commercial $17.58
Rate for Payer: EPIC Health Plan Commercial $8.79
Rate for Payer: Galaxy Health WC $18.68
Rate for Payer: Global Benefits Group Commercial $13.19
Rate for Payer: Health Management Network EPO/PPO $19.78
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.66
Rate for Payer: LLUH Dept of Risk Management WC $4.40
Rate for Payer: Multiplan Commercial $16.48
Rate for Payer: Networks By Design Commercial $14.29
Rate for Payer: Prime Health Services Commercial $18.68
Hospital Charge Code 901602924
Hospital Revenue Code 272
Min. Negotiated Rate $4.40
Max. Negotiated Rate $19.78
Rate for Payer: Aetna of CA HMO/PPO $13.35
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $18.68
Rate for Payer: AlphaCare Medical Group Medi-Cal $12.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $12.09
Rate for Payer: Anthem Blue Cross of CA Exchange $10.64
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $12.99
Rate for Payer: BCBS Transplant Transplant $13.19
Rate for Payer: Blue Shield of California Commercial $13.83
Rate for Payer: Blue Shield of California EPN $10.75
Rate for Payer: Cash Price $9.89
Rate for Payer: Central Health Plan Commercial $17.58
Rate for Payer: Cigna of CA HMO $14.07
Rate for Payer: Cigna of CA PPO $16.27
Rate for Payer: Dignity Health Commercial/Exchange $18.68
Rate for Payer: EPIC Health Plan Commercial $8.79
Rate for Payer: EPIC Health Plan Transplant $8.79
Rate for Payer: Galaxy Health WC $18.68
Rate for Payer: Global Benefits Group Commercial $13.19
Rate for Payer: Health Management Network EPO/PPO $19.78
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $16.48
Rate for Payer: IEHP medi-cal $7.69
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.66
Rate for Payer: LLUH Dept of Risk Management WC $4.40
Rate for Payer: Multiplan Commercial $16.48
Rate for Payer: Networks By Design Commercial $14.29
Rate for Payer: Prime Health Services Commercial $18.68
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $13.19
Rate for Payer: Riverside University Health MISP $8.79
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $13.19
Rate for Payer: TriValley Medical Group Commercial/Senior $13.19
Rate for Payer: United Healthcare All Other Commercial $10.99
Rate for Payer: United Healthcare All Other HMO $10.99
Rate for Payer: United Healthcare HMO Rider $10.99
Rate for Payer: United Healthcare Select/Navigate/Core $10.99
Rate for Payer: Vantage Medical Group Medi-Cal $18.68
Rate for Payer: Vantage Medical Group Senior $18.68
Hospital Charge Code 901602924
Hospital Revenue Code 272
Min. Negotiated Rate $4.40
Max. Negotiated Rate $19.78
Rate for Payer: Cash Price $9.89
Rate for Payer: Central Health Plan Commercial $17.58
Rate for Payer: EPIC Health Plan Commercial $8.79
Rate for Payer: Galaxy Health WC $18.68
Rate for Payer: Global Benefits Group Commercial $13.19
Rate for Payer: Health Management Network EPO/PPO $19.78
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.66
Rate for Payer: LLUH Dept of Risk Management WC $4.40
Rate for Payer: Multiplan Commercial $16.48
Rate for Payer: Networks By Design Commercial $14.29
Rate for Payer: Prime Health Services Commercial $18.68
Hospital Charge Code 901602922
Hospital Revenue Code 272
Min. Negotiated Rate $4.35
Max. Negotiated Rate $19.56
Rate for Payer: Cash Price $9.78
Rate for Payer: Central Health Plan Commercial $17.38
Rate for Payer: EPIC Health Plan Commercial $8.69
Rate for Payer: Galaxy Health WC $18.47
Rate for Payer: Global Benefits Group Commercial $13.04
Rate for Payer: Health Management Network EPO/PPO $19.56
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.49
Rate for Payer: LLUH Dept of Risk Management WC $4.35
Rate for Payer: Multiplan Commercial $16.30
Rate for Payer: Networks By Design Commercial $14.12
Rate for Payer: Prime Health Services Commercial $18.47
Hospital Charge Code 901602922
Hospital Revenue Code 272
Min. Negotiated Rate $4.35
Max. Negotiated Rate $19.56
Rate for Payer: Aetna of CA HMO/PPO $13.20
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $18.47
Rate for Payer: AlphaCare Medical Group Medi-Cal $11.95
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $11.95
Rate for Payer: Anthem Blue Cross of CA Exchange $10.52
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $12.84
Rate for Payer: BCBS Transplant Transplant $13.04
Rate for Payer: Blue Shield of California Commercial $13.67
Rate for Payer: Blue Shield of California EPN $10.63
Rate for Payer: Cash Price $9.78
Rate for Payer: Central Health Plan Commercial $17.38
Rate for Payer: Cigna of CA HMO $13.91
Rate for Payer: Cigna of CA PPO $16.08
Rate for Payer: Dignity Health Commercial/Exchange $18.47
Rate for Payer: EPIC Health Plan Commercial $8.69
Rate for Payer: EPIC Health Plan Transplant $8.69
Rate for Payer: Galaxy Health WC $18.47
Rate for Payer: Global Benefits Group Commercial $13.04
Rate for Payer: Health Management Network EPO/PPO $19.56
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $16.30
Rate for Payer: IEHP medi-cal $7.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.49
Rate for Payer: LLUH Dept of Risk Management WC $4.35
Rate for Payer: Multiplan Commercial $16.30
Rate for Payer: Networks By Design Commercial $14.12
Rate for Payer: Prime Health Services Commercial $18.47
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $13.04
Rate for Payer: Riverside University Health MISP $8.69
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $13.04
Rate for Payer: TriValley Medical Group Commercial/Senior $13.04
Rate for Payer: United Healthcare All Other Commercial $10.86
Rate for Payer: United Healthcare All Other HMO $10.86
Rate for Payer: United Healthcare HMO Rider $10.86
Rate for Payer: United Healthcare Select/Navigate/Core $10.86
Rate for Payer: Vantage Medical Group Medi-Cal $18.47
Rate for Payer: Vantage Medical Group Senior $18.47
Hospital Charge Code 901607287
Hospital Revenue Code 272
Min. Negotiated Rate $3.90
Max. Negotiated Rate $17.57
Rate for Payer: Cash Price $8.78
Rate for Payer: Central Health Plan Commercial $15.62
Rate for Payer: EPIC Health Plan Commercial $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: 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: Aetna of CA HMO/PPO $11.85
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $16.59
Rate for Payer: AlphaCare Medical Group Medi-Cal $10.74
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $10.74
Rate for Payer: Anthem Blue Cross of CA Exchange $9.45
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11.53
Rate for Payer: BCBS Transplant Transplant $11.71
Rate for Payer: Blue Shield of California Commercial $12.28
Rate for Payer: Blue Shield of California EPN $9.55
Rate for Payer: Cash Price $8.78
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: EPIC Health Plan Commercial $7.81
Rate for Payer: EPIC Health Plan Transplant $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: Health Plan of Nevada - Sierra Transplant Other $14.64
Rate for Payer: IEHP medi-cal $6.83
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $13.02
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
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $11.71
Rate for Payer: Riverside University Health 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 Medi-Cal $16.59
Rate for Payer: Vantage Medical Group Senior $16.59
Hospital Charge Code 901698330
Hospital Revenue Code 272
Min. Negotiated Rate $3.46
Max. Negotiated Rate $15.57
Rate for Payer: Cash Price $7.79
Rate for Payer: Central Health Plan Commercial $13.84
Rate for Payer: EPIC Health Plan Commercial $6.92
Rate for Payer: Galaxy Health WC $14.70
Rate for Payer: Global Benefits Group Commercial $10.38
Rate for Payer: Health Management Network EPO/PPO $15.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.54
Rate for Payer: LLUH Dept of Risk Management WC $3.46
Rate for Payer: Multiplan Commercial $12.98
Rate for Payer: Networks By Design Commercial $11.24
Rate for Payer: Prime Health Services Commercial $14.70
Hospital Charge Code 901698330
Hospital Revenue Code 272
Min. Negotiated Rate $3.46
Max. Negotiated Rate $15.57
Rate for Payer: Aetna of CA HMO/PPO $10.51
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $14.70
Rate for Payer: AlphaCare Medical Group Medi-Cal $9.52
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $9.52
Rate for Payer: Anthem Blue Cross of CA Exchange $8.38
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $10.22
Rate for Payer: BCBS Transplant Transplant $10.38
Rate for Payer: Blue Shield of California Commercial $10.88
Rate for Payer: Blue Shield of California EPN $8.46
Rate for Payer: Cash Price $7.79
Rate for Payer: Central Health Plan Commercial $13.84
Rate for Payer: Cigna of CA HMO $11.07
Rate for Payer: Cigna of CA PPO $12.80
Rate for Payer: Dignity Health Commercial/Exchange $14.70
Rate for Payer: EPIC Health Plan Commercial $6.92
Rate for Payer: EPIC Health Plan Transplant $6.92
Rate for Payer: Galaxy Health WC $14.70
Rate for Payer: Global Benefits Group Commercial $10.38
Rate for Payer: Health Management Network EPO/PPO $15.57
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $12.98
Rate for Payer: IEHP medi-cal $6.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $11.54
Rate for Payer: LLUH Dept of Risk Management WC $3.46
Rate for Payer: Multiplan Commercial $12.98
Rate for Payer: Networks By Design Commercial $11.24
Rate for Payer: Prime Health Services Commercial $14.70
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $10.38
Rate for Payer: Riverside University Health MISP $6.92
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $10.38
Rate for Payer: TriValley Medical Group Commercial/Senior $10.38
Rate for Payer: United Healthcare All Other Commercial $8.65
Rate for Payer: United Healthcare All Other HMO $8.65
Rate for Payer: United Healthcare HMO Rider $8.65
Rate for Payer: United Healthcare Select/Navigate/Core $8.65
Rate for Payer: Vantage Medical Group Medi-Cal $14.70
Rate for Payer: Vantage Medical Group Senior $14.70
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: Aetna of CA HMO/PPO $188.37
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $504.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $326.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $326.15
Rate for Payer: Anthem Blue Cross of CA Exchange $287.13
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $350.34
Rate for Payer: BCBS Transplant Transplant $355.80
Rate for Payer: Blue Shield of California Commercial $373.00
Rate for Payer: Blue Shield of California EPN $289.98
Rate for Payer: Cash Price $266.85
Rate for Payer: Cash Price $266.85
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: EPIC Health Plan Commercial $237.20
Rate for Payer: EPIC Health Plan Transplant $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: Health Plan of Nevada - Sierra Transplant Other $444.75
Rate for Payer: IEHP medi-cal $207.55
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $395.53
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
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $355.80
Rate for Payer: Riverside University Health 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 Medi-Cal $504.05
Rate for Payer: Vantage Medical Group Senior $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: Cash Price $266.85
Rate for Payer: Central Health Plan Commercial $474.40
Rate for Payer: EPIC Health Plan Commercial $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: 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 906812333
Hospital Revenue Code 272
Min. Negotiated Rate $161.00
Max. Negotiated Rate $724.50
Rate for Payer: Cash Price $362.25
Rate for Payer: Central Health Plan Commercial $644.00
Rate for Payer: EPIC Health Plan Commercial $322.00
Rate for Payer: Galaxy Health WC $684.25
Rate for Payer: Global Benefits Group Commercial $483.00
Rate for Payer: Health Management Network EPO/PPO $724.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $536.94
Rate for Payer: LLUH Dept of Risk Management WC $161.00
Rate for Payer: Multiplan Commercial $603.75
Rate for Payer: Networks By Design Commercial $523.25
Rate for Payer: Prime Health Services Commercial $684.25
Service Code CPT C1887
Hospital Charge Code 906812333
Hospital Revenue Code 272
Min. Negotiated Rate $161.00
Max. Negotiated Rate $724.50
Rate for Payer: Aetna of CA HMO/PPO $188.37
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $684.25
Rate for Payer: AlphaCare Medical Group Medi-Cal $442.75
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $442.75
Rate for Payer: Anthem Blue Cross of CA Exchange $389.78
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $475.59
Rate for Payer: BCBS Transplant Transplant $483.00
Rate for Payer: Blue Shield of California Commercial $506.34
Rate for Payer: Blue Shield of California EPN $393.64
Rate for Payer: Cash Price $362.25
Rate for Payer: Cash Price $362.25
Rate for Payer: Central Health Plan Commercial $644.00
Rate for Payer: Cigna of CA HMO $515.20
Rate for Payer: Cigna of CA PPO $595.70
Rate for Payer: Dignity Health Commercial/Exchange $684.25
Rate for Payer: EPIC Health Plan Commercial $322.00
Rate for Payer: EPIC Health Plan Transplant $322.00
Rate for Payer: Galaxy Health WC $684.25
Rate for Payer: Global Benefits Group Commercial $483.00
Rate for Payer: Health Management Network EPO/PPO $724.50
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $603.75
Rate for Payer: IEHP medi-cal $281.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $536.94
Rate for Payer: LLUH Dept of Risk Management WC $161.00
Rate for Payer: Multiplan Commercial $603.75
Rate for Payer: Networks By Design Commercial $523.25
Rate for Payer: Prime Health Services Commercial $684.25
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $483.00
Rate for Payer: Riverside University Health MISP $322.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $483.00
Rate for Payer: TriValley Medical Group Commercial/Senior $483.00
Rate for Payer: United Healthcare All Other Commercial $402.50
Rate for Payer: United Healthcare All Other HMO $402.50
Rate for Payer: United Healthcare HMO Rider $402.50
Rate for Payer: United Healthcare Select/Navigate/Core $402.50
Rate for Payer: Vantage Medical Group Medi-Cal $684.25
Rate for Payer: Vantage Medical Group Senior $684.25
Service Code CPT C1887
Hospital Charge Code 906812332
Hospital Revenue Code 272
Min. Negotiated Rate $299.00
Max. Negotiated Rate $1,345.50
Rate for Payer: Cash Price $672.75
Rate for Payer: Central Health Plan Commercial $1,196.00
Rate for Payer: EPIC Health Plan Commercial $598.00
Rate for Payer: Galaxy Health WC $1,270.75
Rate for Payer: Global Benefits Group Commercial $897.00
Rate for Payer: Health Management Network EPO/PPO $1,345.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $997.16
Rate for Payer: LLUH Dept of Risk Management WC $299.00
Rate for Payer: Multiplan Commercial $1,121.25
Rate for Payer: Networks By Design Commercial $971.75
Rate for Payer: Prime Health Services Commercial $1,270.75
Service Code CPT C1887
Hospital Charge Code 906812332
Hospital Revenue Code 272
Min. Negotiated Rate $188.37
Max. Negotiated Rate $1,345.50
Rate for Payer: Aetna of CA HMO/PPO $188.37
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1,270.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $822.25
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $822.25
Rate for Payer: Anthem Blue Cross of CA Exchange $723.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $883.25
Rate for Payer: BCBS Transplant Transplant $897.00
Rate for Payer: Blue Shield of California Commercial $940.36
Rate for Payer: Blue Shield of California EPN $731.06
Rate for Payer: Cash Price $672.75
Rate for Payer: Cash Price $672.75
Rate for Payer: Central Health Plan Commercial $1,196.00
Rate for Payer: Cigna of CA HMO $956.80
Rate for Payer: Cigna of CA PPO $1,106.30
Rate for Payer: Dignity Health Commercial/Exchange $1,270.75
Rate for Payer: EPIC Health Plan Commercial $598.00
Rate for Payer: EPIC Health Plan Transplant $598.00
Rate for Payer: Galaxy Health WC $1,270.75
Rate for Payer: Global Benefits Group Commercial $897.00
Rate for Payer: Health Management Network EPO/PPO $1,345.50
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,121.25
Rate for Payer: IEHP medi-cal $523.25
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $997.16
Rate for Payer: LLUH Dept of Risk Management WC $299.00
Rate for Payer: Multiplan Commercial $1,121.25
Rate for Payer: Networks By Design Commercial $971.75
Rate for Payer: Prime Health Services Commercial $1,270.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $897.00
Rate for Payer: Riverside University Health MISP $598.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $897.00
Rate for Payer: TriValley Medical Group Commercial/Senior $897.00
Rate for Payer: United Healthcare All Other Commercial $747.50
Rate for Payer: United Healthcare All Other HMO $747.50
Rate for Payer: United Healthcare HMO Rider $747.50
Rate for Payer: United Healthcare Select/Navigate/Core $747.50
Rate for Payer: Vantage Medical Group Medi-Cal $1,270.75
Rate for Payer: Vantage Medical Group Senior $1,270.75
Hospital Charge Code 901604923
Hospital Revenue Code 272
Min. Negotiated Rate $443.82
Max. Negotiated Rate $1,997.18
Rate for Payer: Cash Price $998.59
Rate for Payer: Central Health Plan Commercial $1,775.27
Rate for Payer: EPIC Health Plan Commercial $887.64
Rate for Payer: Galaxy Health WC $1,886.23
Rate for Payer: Global Benefits Group Commercial $1,331.45
Rate for Payer: Health Management Network EPO/PPO $1,997.18
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,480.13
Rate for Payer: LLUH Dept of Risk Management WC $443.82
Rate for Payer: Multiplan Commercial $1,664.32
Rate for Payer: Networks By Design Commercial $1,442.41
Rate for Payer: Prime Health Services Commercial $1,886.23
Hospital Charge Code 901604923
Hospital Revenue Code 272
Min. Negotiated Rate $443.82
Max. Negotiated Rate $1,997.18
Rate for Payer: Aetna of CA HMO/PPO $1,347.65
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1,886.23
Rate for Payer: AlphaCare Medical Group Medi-Cal $1,220.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,220.50
Rate for Payer: Anthem Blue Cross of CA Exchange $1,074.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1,311.04
Rate for Payer: BCBS Transplant Transplant $1,331.45
Rate for Payer: Blue Shield of California Commercial $1,395.81
Rate for Payer: Blue Shield of California EPN $1,085.14
Rate for Payer: Cash Price $998.59
Rate for Payer: Central Health Plan Commercial $1,775.27
Rate for Payer: Cigna of CA HMO $1,420.22
Rate for Payer: Cigna of CA PPO $1,642.13
Rate for Payer: Dignity Health Commercial/Exchange $1,886.23
Rate for Payer: EPIC Health Plan Commercial $887.64
Rate for Payer: EPIC Health Plan Transplant $887.64
Rate for Payer: Galaxy Health WC $1,886.23
Rate for Payer: Global Benefits Group Commercial $1,331.45
Rate for Payer: Health Management Network EPO/PPO $1,997.18
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,664.32
Rate for Payer: IEHP medi-cal $776.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,480.13
Rate for Payer: LLUH Dept of Risk Management WC $443.82
Rate for Payer: Multiplan Commercial $1,664.32
Rate for Payer: Networks By Design Commercial $1,442.41
Rate for Payer: Prime Health Services Commercial $1,886.23
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1,331.45
Rate for Payer: Riverside University Health MISP $887.64
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1,331.45
Rate for Payer: TriValley Medical Group Commercial/Senior $1,331.45
Rate for Payer: United Healthcare All Other Commercial $1,109.54
Rate for Payer: United Healthcare All Other HMO $1,109.54
Rate for Payer: United Healthcare HMO Rider $1,109.54
Rate for Payer: United Healthcare Select/Navigate/Core $1,109.54
Rate for Payer: Vantage Medical Group Medi-Cal $1,886.23
Rate for Payer: Vantage Medical Group Senior $1,886.23
Hospital Charge Code 901604606
Hospital Revenue Code 272
Min. Negotiated Rate $164.26
Max. Negotiated Rate $739.15
Rate for Payer: Cash Price $369.58
Rate for Payer: Central Health Plan Commercial $657.02
Rate for Payer: EPIC Health Plan Commercial $328.51
Rate for Payer: Galaxy Health WC $698.09
Rate for Payer: Global Benefits Group Commercial $492.77
Rate for Payer: Health Management Network EPO/PPO $739.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $547.79
Rate for Payer: LLUH Dept of Risk Management WC $164.26
Rate for Payer: Multiplan Commercial $615.96
Rate for Payer: Networks By Design Commercial $533.83
Rate for Payer: Prime Health Services Commercial $698.09
Hospital Charge Code 901604606
Hospital Revenue Code 272
Min. Negotiated Rate $164.26
Max. Negotiated Rate $739.15
Rate for Payer: Aetna of CA HMO/PPO $498.76
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $698.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $451.70
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $451.70
Rate for Payer: Anthem Blue Cross of CA Exchange $397.66
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $485.21
Rate for Payer: BCBS Transplant Transplant $492.77
Rate for Payer: Blue Shield of California Commercial $516.59
Rate for Payer: Blue Shield of California EPN $401.61
Rate for Payer: Cash Price $369.58
Rate for Payer: Central Health Plan Commercial $657.02
Rate for Payer: Cigna of CA HMO $525.62
Rate for Payer: Cigna of CA PPO $607.75
Rate for Payer: Dignity Health Commercial/Exchange $698.09
Rate for Payer: EPIC Health Plan Commercial $328.51
Rate for Payer: EPIC Health Plan Transplant $328.51
Rate for Payer: Galaxy Health WC $698.09
Rate for Payer: Global Benefits Group Commercial $492.77
Rate for Payer: Health Management Network EPO/PPO $739.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $615.96
Rate for Payer: IEHP medi-cal $287.45
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $547.79
Rate for Payer: LLUH Dept of Risk Management WC $164.26
Rate for Payer: Multiplan Commercial $615.96
Rate for Payer: Networks By Design Commercial $533.83
Rate for Payer: Prime Health Services Commercial $698.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $492.77
Rate for Payer: Riverside University Health MISP $328.51
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $492.77
Rate for Payer: TriValley Medical Group Commercial/Senior $492.77
Rate for Payer: United Healthcare All Other Commercial $410.64
Rate for Payer: United Healthcare All Other HMO $410.64
Rate for Payer: United Healthcare HMO Rider $410.64
Rate for Payer: United Healthcare Select/Navigate/Core $410.64
Rate for Payer: Vantage Medical Group Medi-Cal $698.09
Rate for Payer: Vantage Medical Group Senior $698.09
Hospital Charge Code 901605478
Hospital Revenue Code 272
Min. Negotiated Rate $460.00
Max. Negotiated Rate $2,070.00
Rate for Payer: Aetna of CA HMO/PPO $1,396.79
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1,955.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $1,265.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $1,265.00
Rate for Payer: Anthem Blue Cross of CA Exchange $1,113.66
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1,358.84
Rate for Payer: BCBS Transplant Transplant $1,380.00
Rate for Payer: Blue Shield of California Commercial $1,446.70
Rate for Payer: Blue Shield of California EPN $1,124.70
Rate for Payer: Cash Price $1,035.00
Rate for Payer: Central Health Plan Commercial $1,840.00
Rate for Payer: Cigna of CA HMO $1,472.00
Rate for Payer: Cigna of CA PPO $1,702.00
Rate for Payer: Dignity Health Commercial/Exchange $1,955.00
Rate for Payer: EPIC Health Plan Commercial $920.00
Rate for Payer: EPIC Health Plan Transplant $920.00
Rate for Payer: Galaxy Health WC $1,955.00
Rate for Payer: Global Benefits Group Commercial $1,380.00
Rate for Payer: Health Management Network EPO/PPO $2,070.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1,725.00
Rate for Payer: IEHP medi-cal $805.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,534.10
Rate for Payer: LLUH Dept of Risk Management WC $460.00
Rate for Payer: Multiplan Commercial $1,725.00
Rate for Payer: Networks By Design Commercial $1,495.00
Rate for Payer: Prime Health Services Commercial $1,955.00
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1,380.00
Rate for Payer: Riverside University Health MISP $920.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1,380.00
Rate for Payer: TriValley Medical Group Commercial/Senior $1,380.00
Rate for Payer: United Healthcare All Other Commercial $1,150.00
Rate for Payer: United Healthcare All Other HMO $1,150.00
Rate for Payer: United Healthcare HMO Rider $1,150.00
Rate for Payer: United Healthcare Select/Navigate/Core $1,150.00
Rate for Payer: Vantage Medical Group Medi-Cal $1,955.00
Rate for Payer: Vantage Medical Group Senior $1,955.00