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Hospital Charge Code 992300011
Hospital Revenue Code 164
Min. Negotiated Rate $1,065.80
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $1,065.80
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $2,398.05
Rate for Payer: Cash Price $2,398.05
Rate for Payer: Cash Price $2,398.05
Rate for Payer: Central Health Plan Commercial $4,263.20
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $3,730.30
Rate for Payer: EPIC Health Plan Commercial $2,131.60
Rate for Payer: EPIC Health Plan Senior $2,131.60
Rate for Payer: Galaxy Health WC $4,529.65
Rate for Payer: Global Benefits Group Commercial $3,197.40
Rate for Payer: Health Management Network EPO/PPO $4,796.10
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,383.91
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $3,144.11
Rate for Payer: LLUH Dept of Risk Management WC $1,065.80
Rate for Payer: Multiplan Commercial $3,996.75
Rate for Payer: Networks By Design Commercial $3,463.85
Rate for Payer: Prime Health Services Commercial $4,529.65
Hospital Charge Code 992312002
Hospital Revenue Code 120
Min. Negotiated Rate $951.40
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $951.40
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Central Health Plan Commercial $3,805.60
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $3,329.90
Rate for Payer: EPIC Health Plan Commercial $1,902.80
Rate for Payer: EPIC Health Plan Senior $1,902.80
Rate for Payer: Galaxy Health WC $4,043.45
Rate for Payer: Global Benefits Group Commercial $2,854.20
Rate for Payer: Health Management Network EPO/PPO $4,281.30
Rate for Payer: Health Net Behavioral $1,500.00
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,020.70
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $2,806.63
Rate for Payer: LLUH Dept of Risk Management WC $951.40
Rate for Payer: Multiplan Commercial $3,567.75
Rate for Payer: Networks By Design Commercial $3,092.05
Rate for Payer: Prime Health Services Commercial $4,043.45
Hospital Charge Code 992313002
Hospital Revenue Code 120
Min. Negotiated Rate $951.40
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $951.40
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Central Health Plan Commercial $3,805.60
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $3,329.90
Rate for Payer: EPIC Health Plan Commercial $1,902.80
Rate for Payer: EPIC Health Plan Senior $1,902.80
Rate for Payer: Galaxy Health WC $4,043.45
Rate for Payer: Global Benefits Group Commercial $2,854.20
Rate for Payer: Health Management Network EPO/PPO $4,281.30
Rate for Payer: Health Net Behavioral $1,500.00
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,020.70
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $2,806.63
Rate for Payer: LLUH Dept of Risk Management WC $951.40
Rate for Payer: Multiplan Commercial $3,567.75
Rate for Payer: Networks By Design Commercial $3,092.05
Rate for Payer: Prime Health Services Commercial $4,043.45
Hospital Charge Code 992313005
Hospital Revenue Code 120
Min. Negotiated Rate $951.40
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $951.40
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Central Health Plan Commercial $3,805.60
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $3,329.90
Rate for Payer: EPIC Health Plan Commercial $1,902.80
Rate for Payer: EPIC Health Plan Senior $1,902.80
Rate for Payer: Galaxy Health WC $4,043.45
Rate for Payer: Global Benefits Group Commercial $2,854.20
Rate for Payer: Health Management Network EPO/PPO $4,281.30
Rate for Payer: Health Net Behavioral $1,500.00
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,020.70
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $2,806.63
Rate for Payer: LLUH Dept of Risk Management WC $951.40
Rate for Payer: Multiplan Commercial $3,567.75
Rate for Payer: Networks By Design Commercial $3,092.05
Rate for Payer: Prime Health Services Commercial $4,043.45
Hospital Charge Code 992312005
Hospital Revenue Code 120
Min. Negotiated Rate $951.40
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $951.40
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Cash Price $2,140.65
Rate for Payer: Central Health Plan Commercial $3,805.60
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $3,329.90
Rate for Payer: EPIC Health Plan Commercial $1,902.80
Rate for Payer: EPIC Health Plan Senior $1,902.80
Rate for Payer: Galaxy Health WC $4,043.45
Rate for Payer: Global Benefits Group Commercial $2,854.20
Rate for Payer: Health Management Network EPO/PPO $4,281.30
Rate for Payer: Health Net Behavioral $1,500.00
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,020.70
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $2,806.63
Rate for Payer: LLUH Dept of Risk Management WC $951.40
Rate for Payer: Multiplan Commercial $3,567.75
Rate for Payer: Networks By Design Commercial $3,092.05
Rate for Payer: Prime Health Services Commercial $4,043.45
Hospital Charge Code 902300022
Hospital Revenue Code 172
Min. Negotiated Rate $2,377.20
Max. Negotiated Rate $14,385.00
Rate for Payer: Adventist Health Commercial $2,377.20
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $5,348.70
Rate for Payer: Cash Price $5,348.70
Rate for Payer: Central Health Plan Commercial $9,508.80
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $8,320.20
Rate for Payer: EPIC Health Plan Commercial $4,754.40
Rate for Payer: EPIC Health Plan Senior $4,754.40
Rate for Payer: Galaxy Health WC $10,103.10
Rate for Payer: Global Benefits Group Commercial $7,131.60
Rate for Payer: Health Management Network EPO/PPO $10,697.40
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $7,547.61
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $7,012.74
Rate for Payer: LLUH Dept of Risk Management WC $2,377.20
Rate for Payer: Multiplan Commercial $8,914.50
Rate for Payer: Prime Health Services Commercial $10,103.10
Hospital Charge Code 902300023
Hospital Revenue Code 172
Min. Negotiated Rate $3,172.00
Max. Negotiated Rate $14,385.00
Rate for Payer: Adventist Health Commercial $3,172.00
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $7,137.00
Rate for Payer: Cash Price $7,137.00
Rate for Payer: Central Health Plan Commercial $12,688.00
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $11,102.00
Rate for Payer: EPIC Health Plan Commercial $6,344.00
Rate for Payer: EPIC Health Plan Senior $6,344.00
Rate for Payer: Galaxy Health WC $13,481.00
Rate for Payer: Global Benefits Group Commercial $9,516.00
Rate for Payer: Health Management Network EPO/PPO $14,274.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $10,071.10
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $9,357.40
Rate for Payer: LLUH Dept of Risk Management WC $3,172.00
Rate for Payer: Multiplan Commercial $11,895.00
Rate for Payer: Prime Health Services Commercial $13,481.00
Hospital Charge Code 902300024
Hospital Revenue Code 173
Min. Negotiated Rate $4,333.40
Max. Negotiated Rate $19,500.30
Rate for Payer: Adventist Health Commercial $4,333.40
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $9,750.15
Rate for Payer: Cash Price $9,750.15
Rate for Payer: Central Health Plan Commercial $17,333.60
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $15,166.90
Rate for Payer: EPIC Health Plan Commercial $8,666.80
Rate for Payer: EPIC Health Plan Senior $8,666.80
Rate for Payer: Galaxy Health WC $18,416.95
Rate for Payer: Global Benefits Group Commercial $13,000.20
Rate for Payer: Health Management Network EPO/PPO $19,500.30
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $13,758.55
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $12,783.53
Rate for Payer: LLUH Dept of Risk Management WC $4,333.40
Rate for Payer: Multiplan Commercial $16,250.25
Rate for Payer: Prime Health Services Commercial $18,416.95
Hospital Charge Code 902300025
Hospital Revenue Code 173
Min. Negotiated Rate $4,599.20
Max. Negotiated Rate $20,696.40
Rate for Payer: Adventist Health Commercial $4,599.20
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $10,348.20
Rate for Payer: Cash Price $10,348.20
Rate for Payer: Central Health Plan Commercial $18,396.80
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $16,097.20
Rate for Payer: EPIC Health Plan Commercial $9,198.40
Rate for Payer: EPIC Health Plan Senior $9,198.40
Rate for Payer: Galaxy Health WC $19,546.60
Rate for Payer: Global Benefits Group Commercial $13,797.60
Rate for Payer: Health Management Network EPO/PPO $20,696.40
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $14,602.46
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $13,567.64
Rate for Payer: LLUH Dept of Risk Management WC $4,599.20
Rate for Payer: Multiplan Commercial $17,247.00
Rate for Payer: Prime Health Services Commercial $19,546.60
Hospital Charge Code 902300026
Hospital Revenue Code 174
Min. Negotiated Rate $5,146.80
Max. Negotiated Rate $23,160.60
Rate for Payer: Adventist Health Commercial $5,146.80
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $11,580.30
Rate for Payer: Cash Price $11,580.30
Rate for Payer: Central Health Plan Commercial $20,587.20
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $18,013.80
Rate for Payer: EPIC Health Plan Commercial $10,293.60
Rate for Payer: EPIC Health Plan Senior $10,293.60
Rate for Payer: Galaxy Health WC $21,873.90
Rate for Payer: Global Benefits Group Commercial $15,440.40
Rate for Payer: Health Management Network EPO/PPO $23,160.60
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $16,341.09
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $15,183.06
Rate for Payer: LLUH Dept of Risk Management WC $5,146.80
Rate for Payer: Multiplan Commercial $19,300.50
Rate for Payer: Prime Health Services Commercial $21,873.90
Hospital Charge Code 902300027
Hospital Revenue Code 174
Min. Negotiated Rate $5,850.00
Max. Negotiated Rate $26,775.90
Rate for Payer: Adventist Health Commercial $5,950.20
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $13,387.95
Rate for Payer: Cash Price $13,387.95
Rate for Payer: Central Health Plan Commercial $23,800.80
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $20,825.70
Rate for Payer: EPIC Health Plan Commercial $11,900.40
Rate for Payer: EPIC Health Plan Senior $11,900.40
Rate for Payer: Galaxy Health WC $25,288.35
Rate for Payer: Global Benefits Group Commercial $17,850.60
Rate for Payer: Health Management Network EPO/PPO $26,775.90
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $18,891.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $17,553.09
Rate for Payer: LLUH Dept of Risk Management WC $5,950.20
Rate for Payer: Multiplan Commercial $22,313.25
Rate for Payer: Prime Health Services Commercial $25,288.35
Hospital Charge Code 992300027
Hospital Revenue Code 174
Min. Negotiated Rate $5,408.80
Max. Negotiated Rate $24,339.60
Rate for Payer: Adventist Health Commercial $5,408.80
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $12,169.80
Rate for Payer: Cash Price $12,169.80
Rate for Payer: Central Health Plan Commercial $21,635.20
Rate for Payer: Cigna of CA HMO $5,850.00
Rate for Payer: Cigna of CA PPO $6,940.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $18,930.80
Rate for Payer: EPIC Health Plan Commercial $10,817.60
Rate for Payer: EPIC Health Plan Senior $10,817.60
Rate for Payer: Galaxy Health WC $22,987.40
Rate for Payer: Global Benefits Group Commercial $16,226.40
Rate for Payer: Health Management Network EPO/PPO $24,339.60
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $17,172.94
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $15,955.96
Rate for Payer: LLUH Dept of Risk Management WC $5,408.80
Rate for Payer: Multiplan Commercial $20,283.00
Rate for Payer: Prime Health Services Commercial $22,987.40
Hospital Charge Code 902358427
Hospital Revenue Code 209
Min. Negotiated Rate $4,650.00
Max. Negotiated Rate $39,143.70
Rate for Payer: Adventist Health Commercial $8,698.60
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $19,571.85
Rate for Payer: Cash Price $19,571.85
Rate for Payer: Cash Price $19,571.85
Rate for Payer: Central Health Plan Commercial $34,794.40
Rate for Payer: Cigna of CA HMO $5,390.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $30,445.10
Rate for Payer: EPIC Health Plan Commercial $17,397.20
Rate for Payer: EPIC Health Plan Senior $17,397.20
Rate for Payer: Galaxy Health WC $36,969.05
Rate for Payer: Global Benefits Group Commercial $26,095.80
Rate for Payer: Health Management Network EPO/PPO $39,143.70
Rate for Payer: Heritage Provider Network Commercial/Senior $4,650.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $27,618.06
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $25,660.87
Rate for Payer: LLUH Dept of Risk Management WC $8,698.60
Rate for Payer: Multiplan Commercial $32,619.75
Rate for Payer: Prime Health Services Commercial $36,969.05
Hospital Charge Code 902341258
Hospital Revenue Code 209
Min. Negotiated Rate $4,650.00
Max. Negotiated Rate $30,892.50
Rate for Payer: Adventist Health Commercial $6,865.00
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $15,446.25
Rate for Payer: Cash Price $15,446.25
Rate for Payer: Cash Price $15,446.25
Rate for Payer: Central Health Plan Commercial $27,460.00
Rate for Payer: Cigna of CA HMO $5,390.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $24,027.50
Rate for Payer: EPIC Health Plan Commercial $13,730.00
Rate for Payer: EPIC Health Plan Senior $13,730.00
Rate for Payer: Galaxy Health WC $29,176.25
Rate for Payer: Global Benefits Group Commercial $20,595.00
Rate for Payer: Health Management Network EPO/PPO $30,892.50
Rate for Payer: Heritage Provider Network Commercial/Senior $4,650.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $21,796.38
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $20,251.75
Rate for Payer: LLUH Dept of Risk Management WC $6,865.00
Rate for Payer: Multiplan Commercial $25,743.75
Rate for Payer: Prime Health Services Commercial $29,176.25
Hospital Charge Code 992341258
Hospital Revenue Code 209
Min. Negotiated Rate $4,650.00
Max. Negotiated Rate $30,892.50
Rate for Payer: Adventist Health Commercial $6,865.00
Rate for Payer: Blue Shield of California Commercial $14,385.00
Rate for Payer: Blue Shield of California EPN $9,086.00
Rate for Payer: Cash Price $15,446.25
Rate for Payer: Cash Price $15,446.25
Rate for Payer: Cash Price $15,446.25
Rate for Payer: Central Health Plan Commercial $27,460.00
Rate for Payer: Cigna of CA HMO $5,390.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $24,027.50
Rate for Payer: EPIC Health Plan Commercial $13,730.00
Rate for Payer: EPIC Health Plan Senior $13,730.00
Rate for Payer: Galaxy Health WC $29,176.25
Rate for Payer: Global Benefits Group Commercial $20,595.00
Rate for Payer: Health Management Network EPO/PPO $30,892.50
Rate for Payer: Heritage Provider Network Commercial/Senior $4,650.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $21,796.38
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $20,251.75
Rate for Payer: LLUH Dept of Risk Management WC $6,865.00
Rate for Payer: Multiplan Commercial $25,743.75
Rate for Payer: Prime Health Services Commercial $29,176.25
Hospital Charge Code 902300020
Hospital Revenue Code 170
Min. Negotiated Rate $557.40
Max. Negotiated Rate $2,508.30
Rate for Payer: Adventist Health Commercial $557.40
Rate for Payer: Blue Shield of California Commercial $1,965.00
Rate for Payer: Blue Shield of California EPN $1,242.00
Rate for Payer: Cash Price $1,254.15
Rate for Payer: Cash Price $1,254.15
Rate for Payer: Central Health Plan Commercial $2,229.60
Rate for Payer: Cigna of CA HMO $945.00
Rate for Payer: Cigna of CA PPO $1,155.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $1,950.90
Rate for Payer: EPIC Health Plan Commercial $1,114.80
Rate for Payer: EPIC Health Plan Senior $1,114.80
Rate for Payer: Galaxy Health WC $2,368.95
Rate for Payer: Global Benefits Group Commercial $1,672.20
Rate for Payer: Health Management Network EPO/PPO $2,508.30
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $1,769.74
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $1,644.33
Rate for Payer: LLUH Dept of Risk Management WC $557.40
Rate for Payer: Multiplan Commercial $2,090.25
Rate for Payer: Prime Health Services Commercial $2,368.95
Hospital Charge Code 902300003
Hospital Revenue Code 122
Min. Negotiated Rate $1,238.80
Max. Negotiated Rate $8,400.00
Rate for Payer: Adventist Health Commercial $1,238.80
Rate for Payer: Blue Shield of California Commercial $7,299.00
Rate for Payer: Blue Shield of California EPN $4,610.00
Rate for Payer: Cash Price $2,787.30
Rate for Payer: Cash Price $2,787.30
Rate for Payer: Cash Price $2,787.30
Rate for Payer: Central Health Plan Commercial $4,955.20
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $4,335.80
Rate for Payer: EPIC Health Plan Commercial $2,477.60
Rate for Payer: EPIC Health Plan Senior $2,477.60
Rate for Payer: Galaxy Health WC $5,264.90
Rate for Payer: Global Benefits Group Commercial $3,716.40
Rate for Payer: Health Management Network EPO/PPO $5,574.60
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,933.19
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $3,654.46
Rate for Payer: LLUH Dept of Risk Management WC $1,238.80
Rate for Payer: Multiplan Commercial $4,645.50
Rate for Payer: Networks By Design Commercial $4,026.10
Rate for Payer: Prime Health Services Commercial $5,264.90
Hospital Charge Code 902300004
Hospital Revenue Code 122
Min. Negotiated Rate $1,546.20
Max. Negotiated Rate $8,400.00
Rate for Payer: Adventist Health Commercial $1,546.20
Rate for Payer: Blue Shield of California Commercial $7,299.00
Rate for Payer: Blue Shield of California EPN $4,610.00
Rate for Payer: Cash Price $3,478.95
Rate for Payer: Cash Price $3,478.95
Rate for Payer: Cash Price $3,478.95
Rate for Payer: Central Health Plan Commercial $6,184.80
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $5,411.70
Rate for Payer: EPIC Health Plan Commercial $3,092.40
Rate for Payer: EPIC Health Plan Senior $3,092.40
Rate for Payer: Galaxy Health WC $6,571.35
Rate for Payer: Global Benefits Group Commercial $4,638.60
Rate for Payer: Health Management Network EPO/PPO $6,957.90
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $4,909.19
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $4,561.29
Rate for Payer: LLUH Dept of Risk Management WC $1,546.20
Rate for Payer: Multiplan Commercial $5,798.25
Rate for Payer: Networks By Design Commercial $5,025.15
Rate for Payer: Prime Health Services Commercial $6,571.35
Hospital Charge Code 902300012
Hospital Revenue Code 164
Min. Negotiated Rate $1,840.60
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $1,840.60
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $4,141.35
Rate for Payer: Cash Price $4,141.35
Rate for Payer: Cash Price $4,141.35
Rate for Payer: Central Health Plan Commercial $7,362.40
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $6,442.10
Rate for Payer: EPIC Health Plan Commercial $3,681.20
Rate for Payer: EPIC Health Plan Senior $3,681.20
Rate for Payer: Galaxy Health WC $7,822.55
Rate for Payer: Global Benefits Group Commercial $5,521.80
Rate for Payer: Health Management Network EPO/PPO $8,282.70
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $5,843.90
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $5,429.77
Rate for Payer: LLUH Dept of Risk Management WC $1,840.60
Rate for Payer: Multiplan Commercial $6,902.25
Rate for Payer: Networks By Design Commercial $5,981.95
Rate for Payer: Prime Health Services Commercial $7,822.55
Hospital Charge Code 902300013
Hospital Revenue Code 164
Min. Negotiated Rate $1,389.20
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $1,389.20
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $3,125.70
Rate for Payer: Cash Price $3,125.70
Rate for Payer: Cash Price $3,125.70
Rate for Payer: Central Health Plan Commercial $5,556.80
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $4,862.20
Rate for Payer: EPIC Health Plan Commercial $2,778.40
Rate for Payer: EPIC Health Plan Senior $2,778.40
Rate for Payer: Galaxy Health WC $5,904.10
Rate for Payer: Global Benefits Group Commercial $4,167.60
Rate for Payer: Health Management Network EPO/PPO $6,251.40
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $4,410.71
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $4,098.14
Rate for Payer: LLUH Dept of Risk Management WC $1,389.20
Rate for Payer: Multiplan Commercial $5,209.50
Rate for Payer: Networks By Design Commercial $4,514.90
Rate for Payer: Prime Health Services Commercial $5,904.10
Service Code CPT G0378
Hospital Charge Code 902350001
Hospital Revenue Code 762
Min. Negotiated Rate $53.80
Max. Negotiated Rate $242.10
Rate for Payer: Adventist Health Commercial $53.80
Rate for Payer: Cash Price $121.05
Rate for Payer: Central Health Plan Commercial $215.20
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $188.30
Rate for Payer: EPIC Health Plan Commercial $107.60
Rate for Payer: EPIC Health Plan Senior $107.60
Rate for Payer: Galaxy Health WC $228.65
Rate for Payer: Global Benefits Group Commercial $161.40
Rate for Payer: Health Management Network EPO/PPO $242.10
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $170.81
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $158.71
Rate for Payer: LLUH Dept of Risk Management WC $53.80
Rate for Payer: Multiplan Commercial $201.75
Rate for Payer: Networks By Design Commercial $174.85
Rate for Payer: Prime Health Services Commercial $228.65
Service Code CPT G0378
Hospital Charge Code 902350001
Hospital Revenue Code 762
Min. Negotiated Rate $53.80
Max. Negotiated Rate $9,601.00
Rate for Payer: Adventist Health Commercial $53.80
Rate for Payer: Aetna of CA HMO/PPO $3,772.00
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $228.65
Rate for Payer: Alpha Care Medical Group Medi-Cal $147.95
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $201.75
Rate for Payer: Anthem Blue Cross of CA Exchange $1,981.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,901.00
Rate for Payer: Blue Shield of California Commercial $170.55
Rate for Payer: Blue Shield of California EPN $107.33
Rate for Payer: Cash Price $121.05
Rate for Payer: Cash Price $121.05
Rate for Payer: Central Health Plan Commercial $215.20
Rate for Payer: Cigna of CA HMO $172.16
Rate for Payer: Cigna of CA PPO $199.06
Rate for Payer: Dignity Health Commercial/Exchange $228.65
Rate for Payer: Dignity Health Medi-Cal $228.65
Rate for Payer: Dignity Health Medicare Advantage $228.65
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $188.30
Rate for Payer: EPIC Health Plan Commercial $107.60
Rate for Payer: EPIC Health Plan Senior $107.60
Rate for Payer: Galaxy Health WC $228.65
Rate for Payer: Global Benefits Group Commercial $161.40
Rate for Payer: Health Management Network EPO/PPO $242.10
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $170.81
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $97.65
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $158.71
Rate for Payer: LLUH Dept of Risk Management WC $53.80
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $188.30
Rate for Payer: Multiplan Commercial $201.75
Rate for Payer: Networks By Design Commercial $174.85
Rate for Payer: Prime Health Services Commercial $228.65
Rate for Payer: Riverside University Health System MISP $107.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $161.40
Rate for Payer: United Healthcare All Other Commercial $9,601.00
Rate for Payer: United Healthcare All Other HMO $8,518.00
Rate for Payer: United Healthcare HMO Rider $6,307.00
Rate for Payer: United Healthcare Select/Navigate/Core $5,779.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $228.65
Rate for Payer: Vantage Medical Group Medi-Cal $228.65
Rate for Payer: Vantage Medical Group Senior $228.65
Hospital Charge Code 902300005
Hospital Revenue Code 122
Min. Negotiated Rate $1,190.60
Max. Negotiated Rate $8,400.00
Rate for Payer: Adventist Health Commercial $1,190.60
Rate for Payer: Blue Shield of California Commercial $7,299.00
Rate for Payer: Blue Shield of California EPN $4,610.00
Rate for Payer: Cash Price $2,678.85
Rate for Payer: Cash Price $2,678.85
Rate for Payer: Cash Price $2,678.85
Rate for Payer: Central Health Plan Commercial $4,762.40
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $4,167.10
Rate for Payer: EPIC Health Plan Commercial $2,381.20
Rate for Payer: EPIC Health Plan Senior $2,381.20
Rate for Payer: Galaxy Health WC $5,060.05
Rate for Payer: Global Benefits Group Commercial $3,571.80
Rate for Payer: Health Management Network EPO/PPO $5,357.70
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $3,780.16
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $3,512.27
Rate for Payer: LLUH Dept of Risk Management WC $1,190.60
Rate for Payer: Multiplan Commercial $4,464.75
Rate for Payer: Networks By Design Commercial $3,869.45
Rate for Payer: Prime Health Services Commercial $5,060.05
Hospital Charge Code 902300014
Hospital Revenue Code 164
Min. Negotiated Rate $1,542.60
Max. Negotiated Rate $8,532.00
Rate for Payer: Adventist Health Commercial $1,542.60
Rate for Payer: Blue Shield of California Commercial $8,532.00
Rate for Payer: Blue Shield of California EPN $5,380.00
Rate for Payer: Cash Price $3,470.85
Rate for Payer: Cash Price $3,470.85
Rate for Payer: Cash Price $3,470.85
Rate for Payer: Central Health Plan Commercial $6,170.40
Rate for Payer: Cigna of CA HMO $5,225.00
Rate for Payer: Cigna of CA PPO $8,400.00
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $5,399.10
Rate for Payer: EPIC Health Plan Commercial $3,085.20
Rate for Payer: EPIC Health Plan Senior $3,085.20
Rate for Payer: Galaxy Health WC $6,556.05
Rate for Payer: Global Benefits Group Commercial $4,627.80
Rate for Payer: Health Management Network EPO/PPO $6,941.70
Rate for Payer: Heritage Provider Network Commercial/Senior $3,970.00
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $4,897.76
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $4,550.67
Rate for Payer: LLUH Dept of Risk Management WC $1,542.60
Rate for Payer: Multiplan Commercial $5,784.75
Rate for Payer: Networks By Design Commercial $5,013.45
Rate for Payer: Prime Health Services Commercial $6,556.05
Service Code CPT 99220
Hospital Charge Code 902350000
Hospital Revenue Code 710
Min. Negotiated Rate $23.80
Max. Negotiated Rate $107.10
Rate for Payer: Adventist Health Commercial $23.80
Rate for Payer: Aetna of CA HMO/PPO $72.27
Rate for Payer: Alpha Care Medical Group Commercial/Exchange $101.15
Rate for Payer: Alpha Care Medical Group Medi-Cal $65.45
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product $89.25
Rate for Payer: Anthem Blue Cross of CA Exchange $57.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $69.22
Rate for Payer: Blue Shield of California Commercial $75.45
Rate for Payer: Blue Shield of California EPN $47.48
Rate for Payer: Cash Price $53.55
Rate for Payer: Central Health Plan Commercial $95.20
Rate for Payer: Cigna of CA HMO $76.16
Rate for Payer: Cigna of CA PPO $88.06
Rate for Payer: Dignity Health Commercial/Exchange $101.15
Rate for Payer: Dignity Health Medi-Cal $101.15
Rate for Payer: Dignity Health Medicare Advantage $101.15
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant $83.30
Rate for Payer: EPIC Health Plan Commercial $47.60
Rate for Payer: EPIC Health Plan Senior $47.60
Rate for Payer: Galaxy Health WC $101.15
Rate for Payer: Global Benefits Group Commercial $71.40
Rate for Payer: Health Management Network EPO/PPO $107.10
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded $75.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal $43.20
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage $70.21
Rate for Payer: LLUH Dept of Risk Management WC $23.80
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare $83.30
Rate for Payer: Multiplan Commercial $89.25
Rate for Payer: Networks By Design Commercial $77.35
Rate for Payer: Prime Health Services Commercial $101.15
Rate for Payer: Riverside University Health System MISP $47.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $71.40
Rate for Payer: TriValley Medical Group Commercial/Senior $71.40
Rate for Payer: United Healthcare All Other Commercial $59.50
Rate for Payer: United Healthcare All Other HMO $59.50
Rate for Payer: United Healthcare HMO Rider $59.50
Rate for Payer: United Healthcare Select/Navigate/Core $59.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $101.15
Rate for Payer: Vantage Medical Group Medi-Cal $101.15
Rate for Payer: Vantage Medical Group Senior $101.15