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Service Code NDC 60687-596-32
Hospital Charge Code 1711870
Hospital Revenue Code 259
Min. Negotiated Rate $3.24
Max. Negotiated Rate $14.58
Rate for Payer: Aetna of CA HMO/PPO $9.84
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $13.77
Rate for Payer: AlphaCare Medical Group Medi-Cal $8.91
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.91
Rate for Payer: Anthem Blue Cross of CA Exchange $7.84
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9.57
Rate for Payer: BCBS Transplant Transplant $9.72
Rate for Payer: Blue Shield of California Commercial $10.19
Rate for Payer: Blue Shield of California EPN $7.92
Rate for Payer: Cash Price $7.29
Rate for Payer: Central Health Plan Commercial $12.96
Rate for Payer: Cigna of CA HMO $11.34
Rate for Payer: Cigna of CA PPO $11.34
Rate for Payer: Dignity Health Commercial/Exchange $13.77
Rate for Payer: EPIC Health Plan Commercial $6.48
Rate for Payer: EPIC Health Plan Transplant $6.48
Rate for Payer: Galaxy Health WC $13.77
Rate for Payer: Global Benefits Group Commercial $9.72
Rate for Payer: Health Management Network EPO/PPO $14.58
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $12.15
Rate for Payer: IEHP medi-cal $5.67
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.81
Rate for Payer: LLUH Dept of Risk Management WC $3.24
Rate for Payer: Multiplan Commercial $12.15
Rate for Payer: Networks By Design Commercial $10.53
Rate for Payer: Prime Health Services Commercial $13.77
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $9.72
Rate for Payer: Riverside University Health MISP $6.48
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $9.72
Rate for Payer: TriValley Medical Group Commercial/Senior $9.72
Rate for Payer: United Healthcare All Other Commercial $8.10
Rate for Payer: United Healthcare All Other HMO $8.10
Rate for Payer: United Healthcare HMO Rider $8.10
Rate for Payer: United Healthcare Select/Navigate/Core $8.10
Rate for Payer: Vantage Medical Group Medi-Cal $13.77
Rate for Payer: Vantage Medical Group Senior $13.77
Service Code NDC 60687-596-33
Hospital Charge Code 1711870
Hospital Revenue Code 259
Min. Negotiated Rate $3.24
Max. Negotiated Rate $14.58
Rate for Payer: Blue Shield of California Commercial $12.15
Rate for Payer: Blue Shield of California EPN $8.65
Rate for Payer: Cash Price $7.29
Rate for Payer: Central Health Plan Commercial $12.96
Rate for Payer: Cigna of CA HMO $11.34
Rate for Payer: Cigna of CA PPO $11.34
Rate for Payer: EPIC Health Plan Commercial $6.48
Rate for Payer: Galaxy Health WC $13.77
Rate for Payer: Global Benefits Group Commercial $9.72
Rate for Payer: Health Management Network EPO/PPO $14.58
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.81
Rate for Payer: LLUH Dept of Risk Management WC $3.24
Rate for Payer: Multiplan Commercial $12.15
Rate for Payer: Networks By Design Commercial $10.53
Rate for Payer: Prime Health Services Commercial $13.77
Service Code NDC 60687-596-33
Hospital Charge Code 1711870
Hospital Revenue Code 259
Min. Negotiated Rate $3.24
Max. Negotiated Rate $14.58
Rate for Payer: Aetna of CA HMO/PPO $9.84
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $13.77
Rate for Payer: AlphaCare Medical Group Medi-Cal $8.91
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $8.91
Rate for Payer: Anthem Blue Cross of CA Exchange $7.84
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9.57
Rate for Payer: BCBS Transplant Transplant $9.72
Rate for Payer: Blue Shield of California Commercial $10.19
Rate for Payer: Blue Shield of California EPN $7.92
Rate for Payer: Cash Price $7.29
Rate for Payer: Central Health Plan Commercial $12.96
Rate for Payer: Cigna of CA HMO $11.34
Rate for Payer: Cigna of CA PPO $11.34
Rate for Payer: Dignity Health Commercial/Exchange $13.77
Rate for Payer: EPIC Health Plan Commercial $6.48
Rate for Payer: EPIC Health Plan Transplant $6.48
Rate for Payer: Galaxy Health WC $13.77
Rate for Payer: Global Benefits Group Commercial $9.72
Rate for Payer: Health Management Network EPO/PPO $14.58
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $12.15
Rate for Payer: IEHP medi-cal $5.67
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.81
Rate for Payer: LLUH Dept of Risk Management WC $3.24
Rate for Payer: Multiplan Commercial $12.15
Rate for Payer: Networks By Design Commercial $10.53
Rate for Payer: Prime Health Services Commercial $13.77
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $9.72
Rate for Payer: Riverside University Health MISP $6.48
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $9.72
Rate for Payer: TriValley Medical Group Commercial/Senior $9.72
Rate for Payer: United Healthcare All Other Commercial $8.10
Rate for Payer: United Healthcare All Other HMO $8.10
Rate for Payer: United Healthcare HMO Rider $8.10
Rate for Payer: United Healthcare Select/Navigate/Core $8.10
Rate for Payer: Vantage Medical Group Medi-Cal $13.77
Rate for Payer: Vantage Medical Group Senior $13.77
Service Code NDC 0574-9855-10
Hospital Charge Code 1711870
Hospital Revenue Code 259
Min. Negotiated Rate $0.24
Max. Negotiated Rate $1.07
Rate for Payer: Blue Shield of California Commercial $0.89
Rate for Payer: Blue Shield of California EPN $0.64
Rate for Payer: Cash Price $0.54
Rate for Payer: Central Health Plan Commercial $0.95
Rate for Payer: Cigna of CA HMO $0.83
Rate for Payer: Cigna of CA PPO $0.83
Rate for Payer: EPIC Health Plan Commercial $0.48
Rate for Payer: Galaxy Health WC $1.01
Rate for Payer: Global Benefits Group Commercial $0.71
Rate for Payer: Health Management Network EPO/PPO $1.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.79
Rate for Payer: LLUH Dept of Risk Management WC $0.24
Rate for Payer: Multiplan Commercial $0.89
Rate for Payer: Networks By Design Commercial $0.77
Rate for Payer: Prime Health Services Commercial $1.01
Service Code NDC 60687-596-32
Hospital Charge Code 1711870
Hospital Revenue Code 259
Min. Negotiated Rate $3.24
Max. Negotiated Rate $14.58
Rate for Payer: Blue Shield of California Commercial $12.15
Rate for Payer: Blue Shield of California EPN $8.65
Rate for Payer: Cash Price $7.29
Rate for Payer: Central Health Plan Commercial $12.96
Rate for Payer: Cigna of CA HMO $11.34
Rate for Payer: Cigna of CA PPO $11.34
Rate for Payer: EPIC Health Plan Commercial $6.48
Rate for Payer: Galaxy Health WC $13.77
Rate for Payer: Global Benefits Group Commercial $9.72
Rate for Payer: Health Management Network EPO/PPO $14.58
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $10.81
Rate for Payer: LLUH Dept of Risk Management WC $3.24
Rate for Payer: Multiplan Commercial $12.15
Rate for Payer: Networks By Design Commercial $10.53
Rate for Payer: Prime Health Services Commercial $13.77
Service Code NDC 51079-020-03
Hospital Charge Code 1711870
Hospital Revenue Code 259
Min. Negotiated Rate $4.38
Max. Negotiated Rate $19.70
Rate for Payer: Aetna of CA HMO/PPO $13.29
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $18.61
Rate for Payer: AlphaCare Medical Group Medi-Cal $12.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $12.04
Rate for Payer: Anthem Blue Cross of CA Exchange $10.60
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $12.93
Rate for Payer: BCBS Transplant Transplant $13.13
Rate for Payer: Blue Shield of California Commercial $13.77
Rate for Payer: Blue Shield of California EPN $10.70
Rate for Payer: Cash Price $9.85
Rate for Payer: Central Health Plan Commercial $17.51
Rate for Payer: Cigna of CA HMO $15.32
Rate for Payer: Cigna of CA PPO $15.32
Rate for Payer: Dignity Health Commercial/Exchange $18.61
Rate for Payer: EPIC Health Plan Commercial $8.76
Rate for Payer: EPIC Health Plan Transplant $8.76
Rate for Payer: Galaxy Health WC $18.61
Rate for Payer: Global Benefits Group Commercial $13.13
Rate for Payer: Health Management Network EPO/PPO $19.70
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $16.42
Rate for Payer: IEHP medi-cal $7.66
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.60
Rate for Payer: LLUH Dept of Risk Management WC $4.38
Rate for Payer: Multiplan Commercial $16.42
Rate for Payer: Networks By Design Commercial $14.23
Rate for Payer: Prime Health Services Commercial $18.61
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $13.13
Rate for Payer: Riverside University Health MISP $8.76
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $13.13
Rate for Payer: TriValley Medical Group Commercial/Senior $13.13
Rate for Payer: United Healthcare All Other Commercial $10.94
Rate for Payer: United Healthcare All Other HMO $10.94
Rate for Payer: United Healthcare HMO Rider $10.94
Rate for Payer: United Healthcare Select/Navigate/Core $10.94
Rate for Payer: Vantage Medical Group Medi-Cal $18.61
Rate for Payer: Vantage Medical Group Senior $18.61
Service Code NDC 0186-0370-28
Hospital Charge Code 1744122
Hospital Revenue Code 259
Min. Negotiated Rate $10.61
Max. Negotiated Rate $47.76
Rate for Payer: Aetna of CA HMO/PPO $32.23
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $45.11
Rate for Payer: AlphaCare Medical Group Medi-Cal $29.19
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $29.19
Rate for Payer: Anthem Blue Cross of CA Exchange $25.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $31.35
Rate for Payer: BCBS Transplant Transplant $31.84
Rate for Payer: Blue Shield of California Commercial $33.38
Rate for Payer: Blue Shield of California EPN $25.95
Rate for Payer: Cash Price $23.88
Rate for Payer: Central Health Plan Commercial $42.46
Rate for Payer: Cigna of CA HMO $37.15
Rate for Payer: Cigna of CA PPO $37.15
Rate for Payer: Dignity Health Commercial/Exchange $45.11
Rate for Payer: EPIC Health Plan Commercial $21.23
Rate for Payer: EPIC Health Plan Transplant $21.23
Rate for Payer: Galaxy Health WC $45.11
Rate for Payer: Global Benefits Group Commercial $31.84
Rate for Payer: Health Management Network EPO/PPO $47.76
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $39.80
Rate for Payer: IEHP medi-cal $18.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $35.40
Rate for Payer: LLUH Dept of Risk Management WC $10.61
Rate for Payer: Multiplan Commercial $39.80
Rate for Payer: Networks By Design Commercial $34.50
Rate for Payer: Prime Health Services Commercial $45.11
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $31.84
Rate for Payer: Riverside University Health MISP $21.23
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $31.84
Rate for Payer: TriValley Medical Group Commercial/Senior $31.84
Rate for Payer: United Healthcare All Other Commercial $26.54
Rate for Payer: United Healthcare All Other HMO $26.54
Rate for Payer: United Healthcare HMO Rider $26.54
Rate for Payer: United Healthcare Select/Navigate/Core $26.54
Rate for Payer: Vantage Medical Group Medi-Cal $45.11
Rate for Payer: Vantage Medical Group Senior $45.11
Service Code NDC 0186-0370-28
Hospital Charge Code 1744122
Hospital Revenue Code 259
Min. Negotiated Rate $10.61
Max. Negotiated Rate $47.76
Rate for Payer: Blue Shield of California Commercial $39.80
Rate for Payer: Blue Shield of California EPN $28.34
Rate for Payer: Cash Price $23.88
Rate for Payer: Central Health Plan Commercial $42.46
Rate for Payer: Cigna of CA HMO $37.15
Rate for Payer: Cigna of CA PPO $37.15
Rate for Payer: EPIC Health Plan Commercial $21.23
Rate for Payer: Galaxy Health WC $45.11
Rate for Payer: Global Benefits Group Commercial $31.84
Rate for Payer: Health Management Network EPO/PPO $47.76
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $35.40
Rate for Payer: LLUH Dept of Risk Management WC $10.61
Rate for Payer: Multiplan Commercial $39.80
Rate for Payer: Networks By Design Commercial $34.50
Rate for Payer: Prime Health Services Commercial $45.11
Service Code NDC 0186-0372-20
Hospital Charge Code NDG81453
Hospital Revenue Code 259
Min. Negotiated Rate $8.04
Max. Negotiated Rate $36.17
Rate for Payer: Aetna of CA HMO/PPO $24.41
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $34.16
Rate for Payer: AlphaCare Medical Group Medi-Cal $22.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $22.10
Rate for Payer: Anthem Blue Cross of CA Exchange $19.46
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $23.74
Rate for Payer: BCBS Transplant Transplant $24.11
Rate for Payer: Blue Shield of California Commercial $25.28
Rate for Payer: Blue Shield of California EPN $19.65
Rate for Payer: Cash Price $18.09
Rate for Payer: Central Health Plan Commercial $32.15
Rate for Payer: Cigna of CA HMO $28.13
Rate for Payer: Cigna of CA PPO $28.13
Rate for Payer: Dignity Health Commercial/Exchange $34.16
Rate for Payer: EPIC Health Plan Commercial $16.08
Rate for Payer: EPIC Health Plan Transplant $16.08
Rate for Payer: Galaxy Health WC $34.16
Rate for Payer: Global Benefits Group Commercial $24.11
Rate for Payer: Health Management Network EPO/PPO $36.17
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $30.14
Rate for Payer: IEHP medi-cal $14.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $26.81
Rate for Payer: LLUH Dept of Risk Management WC $8.04
Rate for Payer: Multiplan Commercial $30.14
Rate for Payer: Networks By Design Commercial $26.12
Rate for Payer: Prime Health Services Commercial $34.16
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $24.11
Rate for Payer: Riverside University Health MISP $16.08
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $24.11
Rate for Payer: TriValley Medical Group Commercial/Senior $24.11
Rate for Payer: United Healthcare All Other Commercial $20.10
Rate for Payer: United Healthcare All Other HMO $20.10
Rate for Payer: United Healthcare HMO Rider $20.10
Rate for Payer: United Healthcare Select/Navigate/Core $20.10
Rate for Payer: Vantage Medical Group Medi-Cal $34.16
Rate for Payer: Vantage Medical Group Senior $34.16
Service Code NDC 0186-0372-28
Hospital Charge Code 1744123
Hospital Revenue Code 259
Min. Negotiated Rate $8.02
Max. Negotiated Rate $36.11
Rate for Payer: Blue Shield of California Commercial $30.09
Rate for Payer: Blue Shield of California EPN $21.42
Rate for Payer: Cash Price $18.05
Rate for Payer: Central Health Plan Commercial $32.10
Rate for Payer: Cigna of CA HMO $28.08
Rate for Payer: Cigna of CA PPO $28.08
Rate for Payer: EPIC Health Plan Commercial $16.05
Rate for Payer: Galaxy Health WC $34.10
Rate for Payer: Global Benefits Group Commercial $24.07
Rate for Payer: Health Management Network EPO/PPO $36.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $26.76
Rate for Payer: LLUH Dept of Risk Management WC $8.02
Rate for Payer: Multiplan Commercial $30.09
Rate for Payer: Networks By Design Commercial $26.08
Rate for Payer: Prime Health Services Commercial $34.10
Service Code NDC 0186-0372-20
Hospital Charge Code NDG81453
Hospital Revenue Code 259
Min. Negotiated Rate $8.04
Max. Negotiated Rate $36.17
Rate for Payer: Blue Shield of California Commercial $30.14
Rate for Payer: Blue Shield of California EPN $21.46
Rate for Payer: Cash Price $18.09
Rate for Payer: Central Health Plan Commercial $32.15
Rate for Payer: Cigna of CA HMO $28.13
Rate for Payer: Cigna of CA PPO $28.13
Rate for Payer: EPIC Health Plan Commercial $16.08
Rate for Payer: Galaxy Health WC $34.16
Rate for Payer: Global Benefits Group Commercial $24.11
Rate for Payer: Health Management Network EPO/PPO $36.17
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $26.81
Rate for Payer: LLUH Dept of Risk Management WC $8.04
Rate for Payer: Multiplan Commercial $30.14
Rate for Payer: Networks By Design Commercial $26.12
Rate for Payer: Prime Health Services Commercial $34.16
Service Code NDC 0186-0372-28
Hospital Charge Code 1744123
Hospital Revenue Code 259
Min. Negotiated Rate $8.02
Max. Negotiated Rate $36.11
Rate for Payer: Aetna of CA HMO/PPO $24.36
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $34.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $22.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $22.07
Rate for Payer: Anthem Blue Cross of CA Exchange $19.43
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $23.70
Rate for Payer: BCBS Transplant Transplant $24.07
Rate for Payer: Blue Shield of California Commercial $25.24
Rate for Payer: Blue Shield of California EPN $19.62
Rate for Payer: Cash Price $18.05
Rate for Payer: Central Health Plan Commercial $32.10
Rate for Payer: Cigna of CA HMO $28.08
Rate for Payer: Cigna of CA PPO $28.08
Rate for Payer: Dignity Health Commercial/Exchange $34.10
Rate for Payer: EPIC Health Plan Commercial $16.05
Rate for Payer: EPIC Health Plan Transplant $16.05
Rate for Payer: Galaxy Health WC $34.10
Rate for Payer: Global Benefits Group Commercial $24.07
Rate for Payer: Health Management Network EPO/PPO $36.11
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $30.09
Rate for Payer: IEHP medi-cal $14.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $26.76
Rate for Payer: LLUH Dept of Risk Management WC $8.02
Rate for Payer: Multiplan Commercial $30.09
Rate for Payer: Networks By Design Commercial $26.08
Rate for Payer: Prime Health Services Commercial $34.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $24.07
Rate for Payer: Riverside University Health MISP $16.05
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $24.07
Rate for Payer: TriValley Medical Group Commercial/Senior $24.07
Rate for Payer: United Healthcare All Other Commercial $20.06
Rate for Payer: United Healthcare All Other HMO $20.06
Rate for Payer: United Healthcare HMO Rider $20.06
Rate for Payer: United Healthcare Select/Navigate/Core $20.06
Rate for Payer: Vantage Medical Group Medi-Cal $34.10
Rate for Payer: Vantage Medical Group Senior $34.10
Service Code CPT S0171
Hospital Charge Code 1720423
Hospital Revenue Code 636
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.35
Rate for Payer: Blue Shield of California Commercial $0.29
Rate for Payer: Blue Shield of California Commercial $0.27
Rate for Payer: Blue Shield of California Commercial $0.30
Rate for Payer: Blue Shield of California EPN $0.21
Rate for Payer: Blue Shield of California EPN $0.19
Rate for Payer: Blue Shield of California EPN $0.21
Rate for Payer: Cash Price $0.18
Rate for Payer: Cash Price $0.16
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.29
Rate for Payer: Central Health Plan Commercial $0.31
Rate for Payer: Central Health Plan Commercial $0.32
Rate for Payer: Cigna of CA HMO $0.28
Rate for Payer: Cigna of CA HMO $0.25
Rate for Payer: Cigna of CA HMO $0.27
Rate for Payer: Cigna of CA PPO $0.28
Rate for Payer: Cigna of CA PPO $0.25
Rate for Payer: Cigna of CA PPO $0.27
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Commercial $0.14
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: EPIC Health Plan Transplant $0.14
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.31
Rate for Payer: Galaxy Health WC $0.33
Rate for Payer: Galaxy Health WC $0.34
Rate for Payer: Global Benefits Group Commercial $0.22
Rate for Payer: Global Benefits Group Commercial $0.23
Rate for Payer: Global Benefits Group Commercial $0.24
Rate for Payer: Health Management Network EPO/PPO $0.35
Rate for Payer: Health Management Network EPO/PPO $0.36
Rate for Payer: Health Management Network EPO/PPO $0.32
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.24
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.30
Rate for Payer: Multiplan Commercial $0.27
Rate for Payer: Multiplan Commercial $0.29
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.34
Rate for Payer: Prime Health Services Commercial $0.33
Rate for Payer: Prime Health Services Commercial $0.31
Service Code CPT S0171
Hospital Charge Code 1720424
Hospital Revenue Code 636
Min. Negotiated Rate $0.16
Max. Negotiated Rate $0.74
Rate for Payer: Blue Shield of California Commercial $0.62
Rate for Payer: Blue Shield of California Commercial $0.68
Rate for Payer: Blue Shield of California Commercial $0.68
Rate for Payer: Blue Shield of California EPN $0.49
Rate for Payer: Blue Shield of California EPN $0.44
Rate for Payer: Blue Shield of California EPN $0.48
Rate for Payer: Cash Price $0.41
Rate for Payer: Cash Price $0.37
Rate for Payer: Cash Price $0.41
Rate for Payer: Central Health Plan Commercial $0.73
Rate for Payer: Central Health Plan Commercial $0.66
Rate for Payer: Central Health Plan Commercial $0.72
Rate for Payer: Cigna of CA HMO $0.57
Rate for Payer: Cigna of CA HMO $0.63
Rate for Payer: Cigna of CA HMO $0.64
Rate for Payer: Cigna of CA PPO $0.57
Rate for Payer: Cigna of CA PPO $0.64
Rate for Payer: Cigna of CA PPO $0.63
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Commercial $0.33
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Transplant $0.33
Rate for Payer: EPIC Health Plan Transplant $0.36
Rate for Payer: EPIC Health Plan Transplant $0.36
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Galaxy Health WC $0.70
Rate for Payer: Global Benefits Group Commercial $0.49
Rate for Payer: Global Benefits Group Commercial $0.54
Rate for Payer: Global Benefits Group Commercial $0.55
Rate for Payer: Health Management Network EPO/PPO $0.74
Rate for Payer: Health Management Network EPO/PPO $0.81
Rate for Payer: Health Management Network EPO/PPO $0.82
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.55
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.60
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: LLUH Dept of Risk Management WC $0.16
Rate for Payer: Multiplan Commercial $0.62
Rate for Payer: Multiplan Commercial $0.68
Rate for Payer: Multiplan Commercial $0.68
Rate for Payer: Networks By Design Commercial $0.46
Rate for Payer: Networks By Design Commercial $0.41
Rate for Payer: Networks By Design Commercial $0.45
Rate for Payer: Prime Health Services Commercial $0.77
Rate for Payer: Prime Health Services Commercial $0.77
Rate for Payer: Prime Health Services Commercial $0.70
Service Code CPT S0171
Hospital Charge Code 1720424
Hospital Revenue Code 636
Min. Negotiated Rate $0.16
Max. Negotiated Rate $1.42
Rate for Payer: Aetna of CA HMO/PPO $0.50
Rate for Payer: Aetna of CA HMO/PPO $0.55
Rate for Payer: Aetna of CA HMO/PPO $0.55
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.70
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.77
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.77
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.45
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.45
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.50
Rate for Payer: Anthem Blue Cross of CA Exchange $1.30
Rate for Payer: Anthem Blue Cross of CA Exchange $1.30
Rate for Payer: Anthem Blue Cross of CA Exchange $1.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.42
Rate for Payer: BCBS Transplant Transplant $0.54
Rate for Payer: BCBS Transplant Transplant $0.55
Rate for Payer: BCBS Transplant Transplant $0.49
Rate for Payer: Blue Shield of California Commercial $1.11
Rate for Payer: Blue Shield of California Commercial $1.11
Rate for Payer: Blue Shield of California Commercial $1.11
Rate for Payer: Blue Shield of California EPN $1.01
Rate for Payer: Blue Shield of California EPN $1.01
Rate for Payer: Blue Shield of California EPN $1.01
Rate for Payer: Cash Price $0.37
Rate for Payer: Cash Price $0.37
Rate for Payer: Cash Price $0.41
Rate for Payer: Cash Price $0.41
Rate for Payer: Cash Price $0.41
Rate for Payer: Cash Price $0.41
Rate for Payer: Central Health Plan Commercial $0.66
Rate for Payer: Central Health Plan Commercial $0.73
Rate for Payer: Central Health Plan Commercial $0.72
Rate for Payer: Cigna of CA HMO $0.64
Rate for Payer: Cigna of CA HMO $0.57
Rate for Payer: Cigna of CA HMO $0.63
Rate for Payer: Cigna of CA PPO $0.63
Rate for Payer: Cigna of CA PPO $0.64
Rate for Payer: Cigna of CA PPO $0.57
Rate for Payer: Dignity Health Commercial/Exchange $0.77
Rate for Payer: Dignity Health Commercial/Exchange $0.77
Rate for Payer: Dignity Health Commercial/Exchange $0.70
Rate for Payer: EPIC Health Plan Commercial $0.33
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Commercial $0.36
Rate for Payer: EPIC Health Plan Transplant $0.36
Rate for Payer: EPIC Health Plan Transplant $0.33
Rate for Payer: EPIC Health Plan Transplant $0.36
Rate for Payer: Galaxy Health WC $0.70
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Galaxy Health WC $0.77
Rate for Payer: Global Benefits Group Commercial $0.54
Rate for Payer: Global Benefits Group Commercial $0.55
Rate for Payer: Global Benefits Group Commercial $0.49
Rate for Payer: Health Management Network EPO/PPO $0.81
Rate for Payer: Health Management Network EPO/PPO $0.82
Rate for Payer: Health Management Network EPO/PPO $0.74
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.68
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.62
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.68
Rate for Payer: IEHP medi-cal $0.29
Rate for Payer: IEHP medi-cal $0.32
Rate for Payer: IEHP medi-cal $0.32
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.55
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.61
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: LLUH Dept of Risk Management WC $0.16
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.68
Rate for Payer: Multiplan Commercial $0.62
Rate for Payer: Multiplan Commercial $0.68
Rate for Payer: Networks By Design Commercial $0.45
Rate for Payer: Networks By Design Commercial $0.46
Rate for Payer: Networks By Design Commercial $0.41
Rate for Payer: Prime Health Services Commercial $0.77
Rate for Payer: Prime Health Services Commercial $0.77
Rate for Payer: Prime Health Services Commercial $0.70
Rate for Payer: Riverside University Health MISP $0.36
Rate for Payer: Riverside University Health MISP $0.36
Rate for Payer: Riverside University Health MISP $0.33
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.54
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.55
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.49
Rate for Payer: TriValley Medical Group Commercial/Senior $0.49
Rate for Payer: TriValley Medical Group Commercial/Senior $0.55
Rate for Payer: TriValley Medical Group Commercial/Senior $0.54
Rate for Payer: United Healthcare All Other Commercial $0.46
Rate for Payer: United Healthcare All Other Commercial $0.45
Rate for Payer: United Healthcare All Other Commercial $0.41
Rate for Payer: United Healthcare All Other HMO $0.41
Rate for Payer: United Healthcare All Other HMO $0.45
Rate for Payer: United Healthcare All Other HMO $0.46
Rate for Payer: United Healthcare HMO Rider $0.45
Rate for Payer: United Healthcare HMO Rider $0.41
Rate for Payer: United Healthcare HMO Rider $0.46
Rate for Payer: United Healthcare Select/Navigate/Core $0.45
Rate for Payer: United Healthcare Select/Navigate/Core $0.41
Rate for Payer: United Healthcare Select/Navigate/Core $0.46
Rate for Payer: Vantage Medical Group Medi-Cal $0.70
Rate for Payer: Vantage Medical Group Medi-Cal $0.77
Rate for Payer: Vantage Medical Group Medi-Cal $0.77
Rate for Payer: Vantage Medical Group Senior $0.70
Rate for Payer: Vantage Medical Group Senior $0.77
Rate for Payer: Vantage Medical Group Senior $0.77
Service Code CPT S0171
Hospital Charge Code 1720423
Hospital Revenue Code 636
Min. Negotiated Rate $0.08
Max. Negotiated Rate $1.42
Rate for Payer: Aetna of CA HMO/PPO $0.24
Rate for Payer: Aetna of CA HMO/PPO $0.24
Rate for Payer: Aetna of CA HMO/PPO $0.22
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.31
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.33
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.34
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.22
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.20
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.21
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.22
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.20
Rate for Payer: Anthem Blue Cross of CA Exchange $1.30
Rate for Payer: Anthem Blue Cross of CA Exchange $1.30
Rate for Payer: Anthem Blue Cross of CA Exchange $1.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $1.42
Rate for Payer: BCBS Transplant Transplant $0.24
Rate for Payer: BCBS Transplant Transplant $0.22
Rate for Payer: BCBS Transplant Transplant $0.23
Rate for Payer: Blue Shield of California Commercial $1.11
Rate for Payer: Blue Shield of California Commercial $1.11
Rate for Payer: Blue Shield of California Commercial $1.11
Rate for Payer: Blue Shield of California EPN $1.01
Rate for Payer: Blue Shield of California EPN $1.01
Rate for Payer: Blue Shield of California EPN $1.01
Rate for Payer: Cash Price $0.16
Rate for Payer: Cash Price $0.18
Rate for Payer: Cash Price $0.18
Rate for Payer: Cash Price $0.16
Rate for Payer: Cash Price $0.18
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.32
Rate for Payer: Central Health Plan Commercial $0.29
Rate for Payer: Central Health Plan Commercial $0.31
Rate for Payer: Cigna of CA HMO $0.27
Rate for Payer: Cigna of CA HMO $0.28
Rate for Payer: Cigna of CA HMO $0.25
Rate for Payer: Cigna of CA PPO $0.25
Rate for Payer: Cigna of CA PPO $0.28
Rate for Payer: Cigna of CA PPO $0.27
Rate for Payer: Dignity Health Commercial/Exchange $0.33
Rate for Payer: Dignity Health Commercial/Exchange $0.34
Rate for Payer: Dignity Health Commercial/Exchange $0.31
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Commercial $0.14
Rate for Payer: EPIC Health Plan Transplant $0.14
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.31
Rate for Payer: Galaxy Health WC $0.33
Rate for Payer: Galaxy Health WC $0.34
Rate for Payer: Global Benefits Group Commercial $0.24
Rate for Payer: Global Benefits Group Commercial $0.23
Rate for Payer: Global Benefits Group Commercial $0.22
Rate for Payer: Health Management Network EPO/PPO $0.36
Rate for Payer: Health Management Network EPO/PPO $0.35
Rate for Payer: Health Management Network EPO/PPO $0.32
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.30
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.29
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.27
Rate for Payer: IEHP medi-cal $0.13
Rate for Payer: IEHP medi-cal $0.14
Rate for Payer: IEHP medi-cal $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.24
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.07
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.29
Rate for Payer: Multiplan Commercial $0.30
Rate for Payer: Multiplan Commercial $0.27
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Networks By Design Commercial $0.18
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.34
Rate for Payer: Prime Health Services Commercial $0.31
Rate for Payer: Prime Health Services Commercial $0.33
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Riverside University Health MISP $0.14
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.22
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.23
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.24
Rate for Payer: TriValley Medical Group Commercial/Senior $0.22
Rate for Payer: TriValley Medical Group Commercial/Senior $0.23
Rate for Payer: TriValley Medical Group Commercial/Senior $0.24
Rate for Payer: United Healthcare All Other Commercial $0.20
Rate for Payer: United Healthcare All Other Commercial $0.18
Rate for Payer: United Healthcare All Other Commercial $0.20
Rate for Payer: United Healthcare All Other HMO $0.20
Rate for Payer: United Healthcare All Other HMO $0.20
Rate for Payer: United Healthcare All Other HMO $0.18
Rate for Payer: United Healthcare HMO Rider $0.20
Rate for Payer: United Healthcare HMO Rider $0.18
Rate for Payer: United Healthcare HMO Rider $0.20
Rate for Payer: United Healthcare Select/Navigate/Core $0.18
Rate for Payer: United Healthcare Select/Navigate/Core $0.20
Rate for Payer: United Healthcare Select/Navigate/Core $0.20
Rate for Payer: Vantage Medical Group Medi-Cal $0.31
Rate for Payer: Vantage Medical Group Medi-Cal $0.34
Rate for Payer: Vantage Medical Group Medi-Cal $0.33
Rate for Payer: Vantage Medical Group Senior $0.31
Rate for Payer: Vantage Medical Group Senior $0.33
Rate for Payer: Vantage Medical Group Senior $0.34
Service Code NDC 0185-0128-05
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.49
Rate for Payer: Aetna of CA HMO/PPO $0.33
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.46
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.30
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.30
Rate for Payer: Anthem Blue Cross of CA Exchange $0.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.32
Rate for Payer: BCBS Transplant Transplant $0.32
Rate for Payer: Blue Shield of California Commercial $0.34
Rate for Payer: Blue Shield of California EPN $0.26
Rate for Payer: Cash Price $0.24
Rate for Payer: Central Health Plan Commercial $0.43
Rate for Payer: Cigna of CA HMO $0.38
Rate for Payer: Cigna of CA PPO $0.38
Rate for Payer: Dignity Health Commercial/Exchange $0.46
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: EPIC Health Plan Transplant $0.22
Rate for Payer: Galaxy Health WC $0.46
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Management Network EPO/PPO $0.49
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.41
Rate for Payer: IEHP medi-cal $0.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.36
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.41
Rate for Payer: Networks By Design Commercial $0.35
Rate for Payer: Prime Health Services Commercial $0.46
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.32
Rate for Payer: Riverside University Health MISP $0.22
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.32
Rate for Payer: TriValley Medical Group Commercial/Senior $0.32
Rate for Payer: United Healthcare All Other Commercial $0.27
Rate for Payer: United Healthcare All Other HMO $0.27
Rate for Payer: United Healthcare HMO Rider $0.27
Rate for Payer: United Healthcare Select/Navigate/Core $0.27
Rate for Payer: Vantage Medical Group Medi-Cal $0.46
Rate for Payer: Vantage Medical Group Senior $0.46
Service Code NDC 69238-1489-1
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.37
Rate for Payer: Aetna of CA HMO/PPO $0.25
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.23
Rate for Payer: Anthem Blue Cross of CA Exchange $0.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.24
Rate for Payer: BCBS Transplant Transplant $0.25
Rate for Payer: Blue Shield of California Commercial $0.26
Rate for Payer: Blue Shield of California EPN $0.20
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: Dignity Health Commercial/Exchange $0.35
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.31
Rate for Payer: IEHP medi-cal $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.25
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.25
Rate for Payer: TriValley Medical Group Commercial/Senior $0.25
Rate for Payer: United Healthcare All Other Commercial $0.21
Rate for Payer: United Healthcare All Other HMO $0.21
Rate for Payer: United Healthcare HMO Rider $0.21
Rate for Payer: United Healthcare Select/Navigate/Core $0.21
Rate for Payer: Vantage Medical Group Medi-Cal $0.35
Rate for Payer: Vantage Medical Group Senior $0.35
Service Code NDC 0832-0540-11
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.62
Rate for Payer: Aetna of CA HMO/PPO $0.42
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.59
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.38
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.38
Rate for Payer: Anthem Blue Cross of CA Exchange $0.33
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.41
Rate for Payer: BCBS Transplant Transplant $0.41
Rate for Payer: Blue Shield of California Commercial $0.43
Rate for Payer: Blue Shield of California EPN $0.34
Rate for Payer: Cash Price $0.31
Rate for Payer: Central Health Plan Commercial $0.55
Rate for Payer: Cigna of CA HMO $0.48
Rate for Payer: Cigna of CA PPO $0.48
Rate for Payer: Dignity Health Commercial/Exchange $0.59
Rate for Payer: EPIC Health Plan Commercial $0.28
Rate for Payer: EPIC Health Plan Transplant $0.28
Rate for Payer: Galaxy Health WC $0.59
Rate for Payer: Global Benefits Group Commercial $0.41
Rate for Payer: Health Management Network EPO/PPO $0.62
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.52
Rate for Payer: IEHP medi-cal $0.24
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.46
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Multiplan Commercial $0.52
Rate for Payer: Networks By Design Commercial $0.45
Rate for Payer: Prime Health Services Commercial $0.59
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.41
Rate for Payer: Riverside University Health MISP $0.28
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.41
Rate for Payer: TriValley Medical Group Commercial/Senior $0.41
Rate for Payer: United Healthcare All Other Commercial $0.35
Rate for Payer: United Healthcare All Other HMO $0.35
Rate for Payer: United Healthcare HMO Rider $0.35
Rate for Payer: United Healthcare Select/Navigate/Core $0.35
Rate for Payer: Vantage Medical Group Medi-Cal $0.59
Rate for Payer: Vantage Medical Group Senior $0.59
Service Code NDC 69238-1489-1
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.37
Rate for Payer: Blue Shield of California Commercial $0.31
Rate for Payer: Blue Shield of California EPN $0.22
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35
Service Code NDC 0185-0128-05
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.49
Rate for Payer: Blue Shield of California Commercial $0.41
Rate for Payer: Blue Shield of California EPN $0.29
Rate for Payer: Cash Price $0.24
Rate for Payer: Central Health Plan Commercial $0.43
Rate for Payer: Cigna of CA HMO $0.38
Rate for Payer: Cigna of CA PPO $0.38
Rate for Payer: EPIC Health Plan Commercial $0.22
Rate for Payer: Galaxy Health WC $0.46
Rate for Payer: Global Benefits Group Commercial $0.32
Rate for Payer: Health Management Network EPO/PPO $0.49
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.36
Rate for Payer: LLUH Dept of Risk Management WC $0.11
Rate for Payer: Multiplan Commercial $0.41
Rate for Payer: Networks By Design Commercial $0.35
Rate for Payer: Prime Health Services Commercial $0.46
Service Code NDC 42799-119-01
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.37
Rate for Payer: Aetna of CA HMO/PPO $0.25
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.23
Rate for Payer: Anthem Blue Cross of CA Exchange $0.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.24
Rate for Payer: BCBS Transplant Transplant $0.25
Rate for Payer: Blue Shield of California Commercial $0.26
Rate for Payer: Blue Shield of California EPN $0.20
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: Dignity Health Commercial/Exchange $0.35
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: EPIC Health Plan Transplant $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.31
Rate for Payer: IEHP medi-cal $0.14
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.25
Rate for Payer: Riverside University Health MISP $0.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.25
Rate for Payer: TriValley Medical Group Commercial/Senior $0.25
Rate for Payer: United Healthcare All Other Commercial $0.21
Rate for Payer: United Healthcare All Other HMO $0.21
Rate for Payer: United Healthcare HMO Rider $0.21
Rate for Payer: United Healthcare Select/Navigate/Core $0.21
Rate for Payer: Vantage Medical Group Medi-Cal $0.35
Rate for Payer: Vantage Medical Group Senior $0.35
Service Code NDC 50268-130-11
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.30
Max. Negotiated Rate $1.37
Rate for Payer: Blue Shield of California Commercial $1.14
Rate for Payer: Blue Shield of California EPN $0.81
Rate for Payer: Cash Price $0.68
Rate for Payer: Central Health Plan Commercial $1.22
Rate for Payer: Cigna of CA HMO $1.06
Rate for Payer: Cigna of CA PPO $1.06
Rate for Payer: EPIC Health Plan Commercial $0.61
Rate for Payer: Galaxy Health WC $1.29
Rate for Payer: Global Benefits Group Commercial $0.91
Rate for Payer: Health Management Network EPO/PPO $1.37
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.01
Rate for Payer: LLUH Dept of Risk Management WC $0.30
Rate for Payer: Multiplan Commercial $1.14
Rate for Payer: Networks By Design Commercial $0.99
Rate for Payer: Prime Health Services Commercial $1.29
Service Code NDC 0832-0540-11
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.62
Rate for Payer: Blue Shield of California Commercial $0.52
Rate for Payer: Blue Shield of California EPN $0.37
Rate for Payer: Cash Price $0.31
Rate for Payer: Central Health Plan Commercial $0.55
Rate for Payer: Cigna of CA HMO $0.48
Rate for Payer: Cigna of CA PPO $0.48
Rate for Payer: EPIC Health Plan Commercial $0.28
Rate for Payer: Galaxy Health WC $0.59
Rate for Payer: Global Benefits Group Commercial $0.41
Rate for Payer: Health Management Network EPO/PPO $0.62
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.46
Rate for Payer: LLUH Dept of Risk Management WC $0.14
Rate for Payer: Multiplan Commercial $0.52
Rate for Payer: Networks By Design Commercial $0.45
Rate for Payer: Prime Health Services Commercial $0.59
Service Code NDC 42799-119-01
Hospital Charge Code 1712005
Hospital Revenue Code 259
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.37
Rate for Payer: Blue Shield of California Commercial $0.31
Rate for Payer: Blue Shield of California EPN $0.22
Rate for Payer: Cash Price $0.18
Rate for Payer: Central Health Plan Commercial $0.33
Rate for Payer: Cigna of CA HMO $0.29
Rate for Payer: Cigna of CA PPO $0.29
Rate for Payer: EPIC Health Plan Commercial $0.16
Rate for Payer: Galaxy Health WC $0.35
Rate for Payer: Global Benefits Group Commercial $0.25
Rate for Payer: Health Management Network EPO/PPO $0.37
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.27
Rate for Payer: LLUH Dept of Risk Management WC $0.08
Rate for Payer: Multiplan Commercial $0.31
Rate for Payer: Networks By Design Commercial $0.27
Rate for Payer: Prime Health Services Commercial $0.35