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Service Code NDC 51079-986-20
Hospital Charge Code 1712134
Hospital Revenue Code 259
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.15
Rate for Payer: Aetna of CA HMO/PPO $0.10
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.09
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.09
Rate for Payer: Anthem Blue Cross of CA Exchange $0.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.10
Rate for Payer: BCBS Transplant Transplant $0.10
Rate for Payer: Blue Shield of California Commercial $0.11
Rate for Payer: Blue Shield of California EPN $0.08
Rate for Payer: Cash Price $0.08
Rate for Payer: Central Health Plan Commercial $0.14
Rate for Payer: Cigna of CA HMO $0.12
Rate for Payer: Cigna of CA PPO $0.12
Rate for Payer: Dignity Health Commercial/Exchange $0.14
Rate for Payer: EPIC Health Plan Commercial $0.07
Rate for Payer: EPIC Health Plan Transplant $0.07
Rate for Payer: Galaxy Health WC $0.14
Rate for Payer: Global Benefits Group Commercial $0.10
Rate for Payer: Health Management Network EPO/PPO $0.15
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.13
Rate for Payer: IEHP medi-cal $0.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.11
Rate for Payer: LLUH Dept of Risk Management WC $0.03
Rate for Payer: Multiplan Commercial $0.13
Rate for Payer: Networks By Design Commercial $0.11
Rate for Payer: Prime Health Services Commercial $0.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.10
Rate for Payer: Riverside University Health MISP $0.07
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.10
Rate for Payer: TriValley Medical Group Commercial/Senior $0.10
Rate for Payer: United Healthcare All Other Commercial $0.09
Rate for Payer: United Healthcare All Other HMO $0.09
Rate for Payer: United Healthcare HMO Rider $0.09
Rate for Payer: United Healthcare Select/Navigate/Core $0.09
Rate for Payer: Vantage Medical Group Medi-Cal $0.14
Rate for Payer: Vantage Medical Group Senior $0.14
Service Code NDC 64380-742-06
Hospital Charge Code 1712134
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.04
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.06
Rate for Payer: Cigna of CA HMO $0.05
Rate for Payer: Cigna of CA PPO $0.05
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: Galaxy Health WC $0.06
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.05
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.05
Rate for Payer: Prime Health Services Commercial $0.06
Service Code NDC 51079-994-01
Hospital Charge Code ERX27046
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.98
Rate for Payer: Blue Shield of California Commercial $0.82
Rate for Payer: Blue Shield of California EPN $0.58
Rate for Payer: Cash Price $0.49
Rate for Payer: Central Health Plan Commercial $0.87
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: EPIC Health Plan Commercial $0.44
Rate for Payer: Galaxy Health WC $0.93
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.98
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.73
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.82
Rate for Payer: Networks By Design Commercial $0.71
Rate for Payer: Prime Health Services Commercial $0.93
Service Code NDC 51079-994-01
Hospital Charge Code ERX27046
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.98
Rate for Payer: Aetna of CA HMO/PPO $0.66
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.93
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.60
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.60
Rate for Payer: Anthem Blue Cross of CA Exchange $0.53
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.64
Rate for Payer: BCBS Transplant Transplant $0.65
Rate for Payer: Blue Shield of California Commercial $0.69
Rate for Payer: Blue Shield of California EPN $0.53
Rate for Payer: Cash Price $0.49
Rate for Payer: Central Health Plan Commercial $0.87
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $0.93
Rate for Payer: EPIC Health Plan Commercial $0.44
Rate for Payer: EPIC Health Plan Transplant $0.44
Rate for Payer: Galaxy Health WC $0.93
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.98
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.82
Rate for Payer: IEHP medi-cal $0.38
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.73
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.82
Rate for Payer: Networks By Design Commercial $0.71
Rate for Payer: Prime Health Services Commercial $0.93
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.65
Rate for Payer: Riverside University Health MISP $0.44
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.55
Rate for Payer: United Healthcare All Other HMO $0.55
Rate for Payer: United Healthcare HMO Rider $0.55
Rate for Payer: United Healthcare Select/Navigate/Core $0.55
Rate for Payer: Vantage Medical Group Medi-Cal $0.93
Rate for Payer: Vantage Medical Group Senior $0.93
Service Code NDC 51079-994-20
Hospital Charge Code ERX27046
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.98
Rate for Payer: Blue Shield of California Commercial $0.82
Rate for Payer: Blue Shield of California EPN $0.58
Rate for Payer: Cash Price $0.49
Rate for Payer: Central Health Plan Commercial $0.87
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: EPIC Health Plan Commercial $0.44
Rate for Payer: Galaxy Health WC $0.93
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.98
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.73
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.82
Rate for Payer: Networks By Design Commercial $0.71
Rate for Payer: Prime Health Services Commercial $0.93
Service Code NDC 29300-247-16
Hospital Charge Code ERX27046
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.27
Rate for Payer: Aetna of CA HMO/PPO $0.18
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.26
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.17
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.17
Rate for Payer: Anthem Blue Cross of CA Exchange $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.18
Rate for Payer: BCBS Transplant Transplant $0.18
Rate for Payer: Blue Shield of California Commercial $0.19
Rate for Payer: Blue Shield of California EPN $0.15
Rate for Payer: Cash Price $0.14
Rate for Payer: Central Health Plan Commercial $0.24
Rate for Payer: Cigna of CA HMO $0.21
Rate for Payer: Cigna of CA PPO $0.21
Rate for Payer: Dignity Health Commercial/Exchange $0.26
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: EPIC Health Plan Transplant $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.18
Rate for Payer: Health Management Network EPO/PPO $0.27
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.23
Rate for Payer: IEHP medi-cal $0.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.20
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.23
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.18
Rate for Payer: Riverside University Health MISP $0.12
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.18
Rate for Payer: TriValley Medical Group Commercial/Senior $0.18
Rate for Payer: United Healthcare All Other Commercial $0.15
Rate for Payer: United Healthcare All Other HMO $0.15
Rate for Payer: United Healthcare HMO Rider $0.15
Rate for Payer: United Healthcare Select/Navigate/Core $0.15
Rate for Payer: Vantage Medical Group Medi-Cal $0.26
Rate for Payer: Vantage Medical Group Senior $0.26
Service Code NDC 29300-247-16
Hospital Charge Code ERX27046
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.27
Rate for Payer: Blue Shield of California Commercial $0.23
Rate for Payer: Blue Shield of California EPN $0.16
Rate for Payer: Cash Price $0.14
Rate for Payer: Central Health Plan Commercial $0.24
Rate for Payer: Cigna of CA HMO $0.21
Rate for Payer: Cigna of CA PPO $0.21
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.18
Rate for Payer: Health Management Network EPO/PPO $0.27
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.20
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.23
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Service Code NDC 51079-994-20
Hospital Charge Code ERX27046
Hospital Revenue Code 259
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.98
Rate for Payer: Aetna of CA HMO/PPO $0.66
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.93
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.60
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.60
Rate for Payer: Anthem Blue Cross of CA Exchange $0.53
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.64
Rate for Payer: BCBS Transplant Transplant $0.65
Rate for Payer: Blue Shield of California Commercial $0.69
Rate for Payer: Blue Shield of California EPN $0.53
Rate for Payer: Cash Price $0.49
Rate for Payer: Central Health Plan Commercial $0.87
Rate for Payer: Cigna of CA HMO $0.76
Rate for Payer: Cigna of CA PPO $0.76
Rate for Payer: Dignity Health Commercial/Exchange $0.93
Rate for Payer: EPIC Health Plan Commercial $0.44
Rate for Payer: EPIC Health Plan Transplant $0.44
Rate for Payer: Galaxy Health WC $0.93
Rate for Payer: Global Benefits Group Commercial $0.65
Rate for Payer: Health Management Network EPO/PPO $0.98
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.82
Rate for Payer: IEHP medi-cal $0.38
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.73
Rate for Payer: LLUH Dept of Risk Management WC $0.22
Rate for Payer: Multiplan Commercial $0.82
Rate for Payer: Networks By Design Commercial $0.71
Rate for Payer: Prime Health Services Commercial $0.93
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.65
Rate for Payer: Riverside University Health MISP $0.44
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.65
Rate for Payer: TriValley Medical Group Commercial/Senior $0.65
Rate for Payer: United Healthcare All Other Commercial $0.55
Rate for Payer: United Healthcare All Other HMO $0.55
Rate for Payer: United Healthcare HMO Rider $0.55
Rate for Payer: United Healthcare Select/Navigate/Core $0.55
Rate for Payer: Vantage Medical Group Medi-Cal $0.93
Rate for Payer: Vantage Medical Group Senior $0.93
Service Code NDC 68382-180-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.04
Rate for Payer: BCBS Transplant Transplant $0.04
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.05
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.05
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Commercial/Senior $0.04
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 16729-200-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Aetna of CA HMO/PPO $0.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.02
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.02
Rate for Payer: Anthem Blue Cross of CA Exchange $0.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.02
Rate for Payer: BCBS Transplant Transplant $0.02
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: Dignity Health Commercial/Exchange $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.03
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.02
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.02
Rate for Payer: TriValley Medical Group Commercial/Senior $0.02
Rate for Payer: United Healthcare All Other Commercial $0.02
Rate for Payer: United Healthcare All Other HMO $0.02
Rate for Payer: United Healthcare HMO Rider $0.02
Rate for Payer: United Healthcare Select/Navigate/Core $0.02
Rate for Payer: Vantage Medical Group Medi-Cal $0.03
Rate for Payer: Vantage Medical Group Senior $0.03
Service Code NDC 29300-244-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Service Code NDC 51079-985-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.11
Rate for Payer: Blue Shield of California Commercial $0.09
Rate for Payer: Blue Shield of California EPN $0.06
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.10
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: Galaxy Health WC $0.10
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Networks By Design Commercial $0.08
Rate for Payer: Prime Health Services Commercial $0.10
Service Code NDC 68382-180-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Service Code NDC 0093-0053-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Service Code NDC 0093-0053-05
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Blue Shield of California Commercial $0.05
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Service Code NDC 51079-985-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.11
Rate for Payer: Aetna of CA HMO/PPO $0.07
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Anthem Blue Cross of CA Exchange $0.06
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.07
Rate for Payer: BCBS Transplant Transplant $0.07
Rate for Payer: Blue Shield of California Commercial $0.08
Rate for Payer: Blue Shield of California EPN $0.06
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.10
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: Dignity Health Commercial/Exchange $0.10
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: EPIC Health Plan Transplant $0.05
Rate for Payer: Galaxy Health WC $0.10
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.11
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.09
Rate for Payer: IEHP medi-cal $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Networks By Design Commercial $0.08
Rate for Payer: Prime Health Services Commercial $0.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.07
Rate for Payer: Riverside University Health MISP $0.05
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.07
Rate for Payer: TriValley Medical Group Commercial/Senior $0.07
Rate for Payer: United Healthcare All Other Commercial $0.06
Rate for Payer: United Healthcare All Other HMO $0.06
Rate for Payer: United Healthcare HMO Rider $0.06
Rate for Payer: United Healthcare Select/Navigate/Core $0.06
Rate for Payer: Vantage Medical Group Medi-Cal $0.10
Rate for Payer: Vantage Medical Group Senior $0.10
Service Code NDC 0093-0053-05
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.04
Rate for Payer: BCBS Transplant Transplant $0.04
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.05
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.05
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Commercial/Senior $0.04
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 29300-244-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.04
Rate for Payer: BCBS Transplant Transplant $0.04
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.05
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.05
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Commercial/Senior $0.04
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 16729-200-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.04
Rate for Payer: Blue Shield of California Commercial $0.03
Rate for Payer: Blue Shield of California EPN $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Central Health Plan Commercial $0.03
Rate for Payer: Cigna of CA HMO $0.03
Rate for Payer: Cigna of CA PPO $0.03
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: Galaxy Health WC $0.03
Rate for Payer: Global Benefits Group Commercial $0.02
Rate for Payer: Health Management Network EPO/PPO $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.03
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.03
Rate for Payer: Networks By Design Commercial $0.03
Rate for Payer: Prime Health Services Commercial $0.03
Service Code NDC 0093-0053-01
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.03
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.03
Rate for Payer: Anthem Blue Cross of CA Exchange $0.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.04
Rate for Payer: BCBS Transplant Transplant $0.04
Rate for Payer: Blue Shield of California Commercial $0.04
Rate for Payer: Blue Shield of California EPN $0.03
Rate for Payer: Cash Price $0.03
Rate for Payer: Central Health Plan Commercial $0.05
Rate for Payer: Cigna of CA HMO $0.04
Rate for Payer: Cigna of CA PPO $0.04
Rate for Payer: Dignity Health Commercial/Exchange $0.05
Rate for Payer: EPIC Health Plan Commercial $0.02
Rate for Payer: EPIC Health Plan Transplant $0.02
Rate for Payer: Galaxy Health WC $0.05
Rate for Payer: Global Benefits Group Commercial $0.04
Rate for Payer: Health Management Network EPO/PPO $0.05
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.05
Rate for Payer: IEHP medi-cal $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.04
Rate for Payer: LLUH Dept of Risk Management WC $0.01
Rate for Payer: Multiplan Commercial $0.05
Rate for Payer: Networks By Design Commercial $0.04
Rate for Payer: Prime Health Services Commercial $0.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.04
Rate for Payer: TriValley Medical Group Commercial/Senior $0.04
Rate for Payer: United Healthcare All Other Commercial $0.03
Rate for Payer: United Healthcare All Other HMO $0.03
Rate for Payer: United Healthcare HMO Rider $0.03
Rate for Payer: United Healthcare Select/Navigate/Core $0.03
Rate for Payer: Vantage Medical Group Medi-Cal $0.05
Rate for Payer: Vantage Medical Group Senior $0.05
Service Code NDC 51079-985-20
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.11
Rate for Payer: Aetna of CA HMO/PPO $0.07
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.07
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.07
Rate for Payer: Anthem Blue Cross of CA Exchange $0.06
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.07
Rate for Payer: BCBS Transplant Transplant $0.07
Rate for Payer: Blue Shield of California Commercial $0.08
Rate for Payer: Blue Shield of California EPN $0.06
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.10
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: Dignity Health Commercial/Exchange $0.10
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: EPIC Health Plan Transplant $0.05
Rate for Payer: Galaxy Health WC $0.10
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.11
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.09
Rate for Payer: IEHP medi-cal $0.04
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Networks By Design Commercial $0.08
Rate for Payer: Prime Health Services Commercial $0.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.07
Rate for Payer: Riverside University Health MISP $0.05
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.07
Rate for Payer: TriValley Medical Group Commercial/Senior $0.07
Rate for Payer: United Healthcare All Other Commercial $0.06
Rate for Payer: United Healthcare All Other HMO $0.06
Rate for Payer: United Healthcare HMO Rider $0.06
Rate for Payer: United Healthcare Select/Navigate/Core $0.06
Rate for Payer: Vantage Medical Group Medi-Cal $0.10
Rate for Payer: Vantage Medical Group Senior $0.10
Service Code NDC 51079-985-20
Hospital Charge Code 1712021
Hospital Revenue Code 259
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.11
Rate for Payer: Blue Shield of California Commercial $0.09
Rate for Payer: Blue Shield of California EPN $0.06
Rate for Payer: Cash Price $0.05
Rate for Payer: Central Health Plan Commercial $0.10
Rate for Payer: Cigna of CA HMO $0.08
Rate for Payer: Cigna of CA PPO $0.08
Rate for Payer: EPIC Health Plan Commercial $0.05
Rate for Payer: Galaxy Health WC $0.10
Rate for Payer: Global Benefits Group Commercial $0.07
Rate for Payer: Health Management Network EPO/PPO $0.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.08
Rate for Payer: LLUH Dept of Risk Management WC $0.02
Rate for Payer: Multiplan Commercial $0.09
Rate for Payer: Networks By Design Commercial $0.08
Rate for Payer: Prime Health Services Commercial $0.10
Service Code NDC 64380-787-06
Hospital Charge Code ERX29967
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.28
Rate for Payer: Blue Shield of California Commercial $0.23
Rate for Payer: Blue Shield of California EPN $0.17
Rate for Payer: Cash Price $0.14
Rate for Payer: Central Health Plan Commercial $0.25
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Health Management Network EPO/PPO $0.28
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.23
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Service Code NDC 16729-201-01
Hospital Charge Code ERX29967
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.28
Rate for Payer: Blue Shield of California Commercial $0.23
Rate for Payer: Blue Shield of California EPN $0.17
Rate for Payer: Cash Price $0.14
Rate for Payer: Central Health Plan Commercial $0.25
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Health Management Network EPO/PPO $0.28
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.23
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Service Code NDC 16729-201-01
Hospital Charge Code ERX29967
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $0.28
Rate for Payer: Aetna of CA HMO/PPO $0.19
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.26
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.17
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.17
Rate for Payer: Anthem Blue Cross of CA Exchange $0.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.18
Rate for Payer: BCBS Transplant Transplant $0.19
Rate for Payer: Blue Shield of California Commercial $0.19
Rate for Payer: Blue Shield of California EPN $0.15
Rate for Payer: Cash Price $0.14
Rate for Payer: Central Health Plan Commercial $0.25
Rate for Payer: Cigna of CA HMO $0.22
Rate for Payer: Cigna of CA PPO $0.22
Rate for Payer: Dignity Health Commercial/Exchange $0.26
Rate for Payer: EPIC Health Plan Commercial $0.12
Rate for Payer: EPIC Health Plan Transplant $0.12
Rate for Payer: Galaxy Health WC $0.26
Rate for Payer: Global Benefits Group Commercial $0.19
Rate for Payer: Health Management Network EPO/PPO $0.28
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.23
Rate for Payer: IEHP medi-cal $0.11
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.21
Rate for Payer: LLUH Dept of Risk Management WC $0.06
Rate for Payer: Multiplan Commercial $0.23
Rate for Payer: Networks By Design Commercial $0.20
Rate for Payer: Prime Health Services Commercial $0.26
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.19
Rate for Payer: Riverside University Health MISP $0.12
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.19
Rate for Payer: TriValley Medical Group Commercial/Senior $0.19
Rate for Payer: United Healthcare All Other Commercial $0.16
Rate for Payer: United Healthcare All Other HMO $0.16
Rate for Payer: United Healthcare HMO Rider $0.16
Rate for Payer: United Healthcare Select/Navigate/Core $0.16
Rate for Payer: Vantage Medical Group Medi-Cal $0.26
Rate for Payer: Vantage Medical Group Senior $0.26