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Service Code CPT 97750
Hospital Charge Code 900417750
Hospital Revenue Code 420
Min. Negotiated Rate $79.80
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $128.42
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $193.80
Rate for Payer: AlphaCare Medical Group Medi-Cal $125.40
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $125.40
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $136.80
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $102.60
Rate for Payer: Cash Price $102.60
Rate for Payer: Cash Price $102.60
Rate for Payer: Cash Price $102.60
Rate for Payer: Central Health Plan Commercial $182.40
Rate for Payer: Cigna of CA HMO $145.92
Rate for Payer: Cigna of CA PPO $168.72
Rate for Payer: Dignity Health Commercial/Exchange $193.80
Rate for Payer: EPIC Health Plan Commercial $91.20
Rate for Payer: EPIC Health Plan Transplant $91.20
Rate for Payer: Galaxy Health WC $193.80
Rate for Payer: Global Benefits Group Commercial $136.80
Rate for Payer: Health Management Network EPO/PPO $205.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $171.00
Rate for Payer: IEHP medi-cal $79.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $152.08
Rate for Payer: LLUH Dept of Risk Management WC $93.48
Rate for Payer: Multiplan Commercial $171.00
Rate for Payer: Networks By Design Commercial $148.20
Rate for Payer: Prime Health Services Commercial $193.80
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $136.80
Rate for Payer: Riverside University Health MISP $91.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $136.80
Rate for Payer: TriValley Medical Group Commercial/Senior $136.80
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $193.80
Rate for Payer: Vantage Medical Group Senior $193.80
Service Code CPT 97750
Hospital Charge Code 900417750
Hospital Revenue Code 420
Min. Negotiated Rate $45.60
Max. Negotiated Rate $205.20
Rate for Payer: Cash Price $102.60
Rate for Payer: Central Health Plan Commercial $182.40
Rate for Payer: EPIC Health Plan Commercial $91.20
Rate for Payer: Galaxy Health WC $193.80
Rate for Payer: Global Benefits Group Commercial $136.80
Rate for Payer: Health Management Network EPO/PPO $205.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $152.08
Rate for Payer: LLUH Dept of Risk Management WC $45.60
Rate for Payer: Multiplan Commercial $171.00
Rate for Payer: Networks By Design Commercial $148.20
Rate for Payer: Prime Health Services Commercial $193.80
Service Code CPT 97750
Hospital Charge Code 905103156
Hospital Revenue Code 420
Min. Negotiated Rate $79.80
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $128.42
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $193.80
Rate for Payer: AlphaCare Medical Group Medi-Cal $125.40
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $125.40
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $136.80
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $102.60
Rate for Payer: Cash Price $102.60
Rate for Payer: Cash Price $102.60
Rate for Payer: Cash Price $102.60
Rate for Payer: Central Health Plan Commercial $182.40
Rate for Payer: Cigna of CA HMO $145.92
Rate for Payer: Cigna of CA PPO $168.72
Rate for Payer: Dignity Health Commercial/Exchange $193.80
Rate for Payer: EPIC Health Plan Commercial $91.20
Rate for Payer: EPIC Health Plan Transplant $91.20
Rate for Payer: Galaxy Health WC $193.80
Rate for Payer: Global Benefits Group Commercial $136.80
Rate for Payer: Health Management Network EPO/PPO $205.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $171.00
Rate for Payer: IEHP medi-cal $79.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $152.08
Rate for Payer: LLUH Dept of Risk Management WC $93.48
Rate for Payer: Multiplan Commercial $171.00
Rate for Payer: Networks By Design Commercial $148.20
Rate for Payer: Prime Health Services Commercial $193.80
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $136.80
Rate for Payer: Riverside University Health MISP $91.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $136.80
Rate for Payer: TriValley Medical Group Commercial/Senior $136.80
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $193.80
Rate for Payer: Vantage Medical Group Senior $193.80
Service Code CPT 97750
Hospital Charge Code 905103156
Hospital Revenue Code 420
Min. Negotiated Rate $45.60
Max. Negotiated Rate $205.20
Rate for Payer: Cash Price $102.60
Rate for Payer: Central Health Plan Commercial $182.40
Rate for Payer: EPIC Health Plan Commercial $91.20
Rate for Payer: Galaxy Health WC $193.80
Rate for Payer: Global Benefits Group Commercial $136.80
Rate for Payer: Health Management Network EPO/PPO $205.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $152.08
Rate for Payer: LLUH Dept of Risk Management WC $45.60
Rate for Payer: Multiplan Commercial $171.00
Rate for Payer: Networks By Design Commercial $148.20
Rate for Payer: Prime Health Services Commercial $193.80
Service Code CPT 99367
Hospital Charge Code 908600144
Hospital Revenue Code 510
Min. Negotiated Rate $21.20
Max. Negotiated Rate $95.40
Rate for Payer: Cash Price $47.70
Rate for Payer: Central Health Plan Commercial $84.80
Rate for Payer: EPIC Health Plan Commercial $42.40
Rate for Payer: Galaxy Health WC $90.10
Rate for Payer: Global Benefits Group Commercial $63.60
Rate for Payer: Health Management Network EPO/PPO $95.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $70.70
Rate for Payer: LLUH Dept of Risk Management WC $21.20
Rate for Payer: Multiplan Commercial $79.50
Rate for Payer: Networks By Design Commercial $68.90
Rate for Payer: Prime Health Services Commercial $90.10
Service Code CPT 99367
Hospital Charge Code 908600144
Hospital Revenue Code 510
Min. Negotiated Rate $21.20
Max. Negotiated Rate $287.64
Rate for Payer: Aetna of CA HMO/PPO $287.64
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $90.10
Rate for Payer: AlphaCare Medical Group Medi-Cal $58.30
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $58.30
Rate for Payer: Anthem Blue Cross of CA Exchange $51.33
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $62.62
Rate for Payer: BCBS Transplant Transplant $63.60
Rate for Payer: Blue Shield of California Commercial $66.67
Rate for Payer: Blue Shield of California EPN $51.83
Rate for Payer: Cash Price $47.70
Rate for Payer: Cash Price $47.70
Rate for Payer: Central Health Plan Commercial $84.80
Rate for Payer: Cigna of CA HMO $67.84
Rate for Payer: Cigna of CA PPO $78.44
Rate for Payer: Dignity Health Commercial/Exchange $90.10
Rate for Payer: EPIC Health Plan Commercial $42.40
Rate for Payer: EPIC Health Plan Transplant $42.40
Rate for Payer: Galaxy Health WC $90.10
Rate for Payer: Global Benefits Group Commercial $63.60
Rate for Payer: Health Management Network EPO/PPO $95.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $79.50
Rate for Payer: IEHP medi-cal $37.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $70.70
Rate for Payer: LLUH Dept of Risk Management WC $21.20
Rate for Payer: Multiplan Commercial $79.50
Rate for Payer: Networks By Design Commercial $68.90
Rate for Payer: Prime Health Services Commercial $90.10
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $63.60
Rate for Payer: Riverside University Health MISP $42.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $63.60
Rate for Payer: TriValley Medical Group Commercial/Senior $63.60
Rate for Payer: United Healthcare All Other Commercial $53.00
Rate for Payer: United Healthcare All Other HMO $53.00
Rate for Payer: United Healthcare HMO Rider $53.00
Rate for Payer: United Healthcare Select/Navigate/Core $53.00
Rate for Payer: Vantage Medical Group Medi-Cal $90.10
Rate for Payer: Vantage Medical Group Senior $90.10
Service Code CPT 93464
Hospital Charge Code 906811411
Hospital Revenue Code 481
Min. Negotiated Rate $180.60
Max. Negotiated Rate $1,834.00
Rate for Payer: Aetna of CA HMO/PPO $954.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $767.55
Rate for Payer: AlphaCare Medical Group Medi-Cal $496.65
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $496.65
Rate for Payer: Anthem Blue Cross of CA Exchange $1,378.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $533.49
Rate for Payer: BCBS Transplant Transplant $541.80
Rate for Payer: Blue Shield of California Commercial $951.13
Rate for Payer: Blue Shield of California EPN $683.14
Rate for Payer: Cash Price $406.35
Rate for Payer: Cash Price $406.35
Rate for Payer: Cash Price $406.35
Rate for Payer: Central Health Plan Commercial $722.40
Rate for Payer: Cigna of CA PPO $668.22
Rate for Payer: Dignity Health Commercial/Exchange $767.55
Rate for Payer: EPIC Health Plan Commercial $361.20
Rate for Payer: EPIC Health Plan Transplant $361.20
Rate for Payer: Galaxy Health WC $767.55
Rate for Payer: Global Benefits Group Commercial $541.80
Rate for Payer: Health Management Network EPO/PPO $812.70
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $677.25
Rate for Payer: IEHP medi-cal $316.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $602.30
Rate for Payer: LLUH Dept of Risk Management WC $180.60
Rate for Payer: Multiplan Commercial $677.25
Rate for Payer: Networks By Design Commercial $586.95
Rate for Payer: Prime Health Services Commercial $767.55
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $541.80
Rate for Payer: Riverside University Health MISP $361.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $541.80
Rate for Payer: TriValley Medical Group Commercial/Senior $1,800.00
Rate for Payer: United Healthcare All Other Commercial $1,834.00
Rate for Payer: United Healthcare All Other HMO $1,517.00
Rate for Payer: United Healthcare HMO Rider $1,041.00
Rate for Payer: United Healthcare Select/Navigate/Core $951.00
Rate for Payer: Vantage Medical Group Medi-Cal $767.55
Rate for Payer: Vantage Medical Group Senior $767.55
Service Code CPT 93464
Hospital Charge Code 906820000
Hospital Revenue Code 481
Min. Negotiated Rate $180.60
Max. Negotiated Rate $812.70
Rate for Payer: Cash Price $406.35
Rate for Payer: Central Health Plan Commercial $722.40
Rate for Payer: EPIC Health Plan Commercial $361.20
Rate for Payer: Galaxy Health WC $767.55
Rate for Payer: Global Benefits Group Commercial $541.80
Rate for Payer: Health Management Network EPO/PPO $812.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $602.30
Rate for Payer: LLUH Dept of Risk Management WC $180.60
Rate for Payer: Multiplan Commercial $677.25
Rate for Payer: Networks By Design Commercial $586.95
Rate for Payer: Prime Health Services Commercial $767.55
Service Code CPT 93464
Hospital Charge Code 906811411
Hospital Revenue Code 481
Min. Negotiated Rate $180.60
Max. Negotiated Rate $812.70
Rate for Payer: Cash Price $406.35
Rate for Payer: Central Health Plan Commercial $722.40
Rate for Payer: EPIC Health Plan Commercial $361.20
Rate for Payer: Galaxy Health WC $767.55
Rate for Payer: Global Benefits Group Commercial $541.80
Rate for Payer: Health Management Network EPO/PPO $812.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $602.30
Rate for Payer: LLUH Dept of Risk Management WC $180.60
Rate for Payer: Multiplan Commercial $677.25
Rate for Payer: Networks By Design Commercial $586.95
Rate for Payer: Prime Health Services Commercial $767.55
Service Code CPT 93464
Hospital Charge Code 906820000
Hospital Revenue Code 481
Min. Negotiated Rate $180.60
Max. Negotiated Rate $1,834.00
Rate for Payer: Aetna of CA HMO/PPO $954.16
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $767.55
Rate for Payer: AlphaCare Medical Group Medi-Cal $496.65
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $496.65
Rate for Payer: Anthem Blue Cross of CA Exchange $1,378.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $533.49
Rate for Payer: BCBS Transplant Transplant $541.80
Rate for Payer: Blue Shield of California Commercial $951.13
Rate for Payer: Blue Shield of California EPN $683.14
Rate for Payer: Cash Price $406.35
Rate for Payer: Cash Price $406.35
Rate for Payer: Cash Price $406.35
Rate for Payer: Central Health Plan Commercial $722.40
Rate for Payer: Cigna of CA PPO $668.22
Rate for Payer: Dignity Health Commercial/Exchange $767.55
Rate for Payer: EPIC Health Plan Commercial $361.20
Rate for Payer: EPIC Health Plan Transplant $361.20
Rate for Payer: Galaxy Health WC $767.55
Rate for Payer: Global Benefits Group Commercial $541.80
Rate for Payer: Health Management Network EPO/PPO $812.70
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $677.25
Rate for Payer: IEHP medi-cal $316.05
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $602.30
Rate for Payer: LLUH Dept of Risk Management WC $180.60
Rate for Payer: Multiplan Commercial $677.25
Rate for Payer: Networks By Design Commercial $586.95
Rate for Payer: Prime Health Services Commercial $767.55
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $541.80
Rate for Payer: Riverside University Health MISP $361.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $541.80
Rate for Payer: TriValley Medical Group Commercial/Senior $1,800.00
Rate for Payer: United Healthcare All Other Commercial $1,834.00
Rate for Payer: United Healthcare All Other HMO $1,517.00
Rate for Payer: United Healthcare HMO Rider $1,041.00
Rate for Payer: United Healthcare Select/Navigate/Core $951.00
Rate for Payer: Vantage Medical Group Medi-Cal $767.55
Rate for Payer: Vantage Medical Group Senior $767.55
Hospital Charge Code 905103310
Hospital Revenue Code 420
Min. Negotiated Rate $56.70
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $98.38
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $137.70
Rate for Payer: AlphaCare Medical Group Medi-Cal $89.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $89.10
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $97.20
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $72.90
Rate for Payer: Cash Price $72.90
Rate for Payer: Cash Price $72.90
Rate for Payer: Central Health Plan Commercial $129.60
Rate for Payer: Cigna of CA HMO $103.68
Rate for Payer: Cigna of CA PPO $119.88
Rate for Payer: Dignity Health Commercial/Exchange $137.70
Rate for Payer: EPIC Health Plan Commercial $64.80
Rate for Payer: EPIC Health Plan Transplant $64.80
Rate for Payer: Galaxy Health WC $137.70
Rate for Payer: Global Benefits Group Commercial $97.20
Rate for Payer: Health Management Network EPO/PPO $145.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $121.50
Rate for Payer: IEHP medi-cal $56.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $108.05
Rate for Payer: LLUH Dept of Risk Management WC $66.42
Rate for Payer: Multiplan Commercial $121.50
Rate for Payer: Networks By Design Commercial $105.30
Rate for Payer: Prime Health Services Commercial $137.70
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $97.20
Rate for Payer: Riverside University Health MISP $64.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $97.20
Rate for Payer: TriValley Medical Group Commercial/Senior $97.20
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $137.70
Rate for Payer: Vantage Medical Group Senior $137.70
Hospital Charge Code 905103310
Hospital Revenue Code 420
Min. Negotiated Rate $32.40
Max. Negotiated Rate $145.80
Rate for Payer: Cash Price $72.90
Rate for Payer: Central Health Plan Commercial $129.60
Rate for Payer: EPIC Health Plan Commercial $64.80
Rate for Payer: Galaxy Health WC $137.70
Rate for Payer: Global Benefits Group Commercial $97.20
Rate for Payer: Health Management Network EPO/PPO $145.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $108.05
Rate for Payer: LLUH Dept of Risk Management WC $32.40
Rate for Payer: Multiplan Commercial $121.50
Rate for Payer: Networks By Design Commercial $105.30
Rate for Payer: Prime Health Services Commercial $137.70
Hospital Charge Code 900413922
Hospital Revenue Code 420
Min. Negotiated Rate $56.70
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $98.38
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $137.70
Rate for Payer: AlphaCare Medical Group Medi-Cal $89.10
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $89.10
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $97.20
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $72.90
Rate for Payer: Cash Price $72.90
Rate for Payer: Cash Price $72.90
Rate for Payer: Central Health Plan Commercial $129.60
Rate for Payer: Cigna of CA HMO $103.68
Rate for Payer: Cigna of CA PPO $119.88
Rate for Payer: Dignity Health Commercial/Exchange $137.70
Rate for Payer: EPIC Health Plan Commercial $64.80
Rate for Payer: EPIC Health Plan Transplant $64.80
Rate for Payer: Galaxy Health WC $137.70
Rate for Payer: Global Benefits Group Commercial $97.20
Rate for Payer: Health Management Network EPO/PPO $145.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $121.50
Rate for Payer: IEHP medi-cal $56.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $108.05
Rate for Payer: LLUH Dept of Risk Management WC $66.42
Rate for Payer: Multiplan Commercial $121.50
Rate for Payer: Networks By Design Commercial $105.30
Rate for Payer: Prime Health Services Commercial $137.70
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $97.20
Rate for Payer: Riverside University Health MISP $64.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $97.20
Rate for Payer: TriValley Medical Group Commercial/Senior $97.20
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $137.70
Rate for Payer: Vantage Medical Group Senior $137.70
Hospital Charge Code 900413922
Hospital Revenue Code 420
Min. Negotiated Rate $32.40
Max. Negotiated Rate $145.80
Rate for Payer: Cash Price $72.90
Rate for Payer: Central Health Plan Commercial $129.60
Rate for Payer: EPIC Health Plan Commercial $64.80
Rate for Payer: Galaxy Health WC $137.70
Rate for Payer: Global Benefits Group Commercial $97.20
Rate for Payer: Health Management Network EPO/PPO $145.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $108.05
Rate for Payer: LLUH Dept of Risk Management WC $32.40
Rate for Payer: Multiplan Commercial $121.50
Rate for Payer: Networks By Design Commercial $105.30
Rate for Payer: Prime Health Services Commercial $137.70
Hospital Charge Code 905103309
Hospital Revenue Code 420
Min. Negotiated Rate $108.85
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $188.87
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $264.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $171.05
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $171.05
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $186.60
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $139.95
Rate for Payer: Cash Price $139.95
Rate for Payer: Cash Price $139.95
Rate for Payer: Central Health Plan Commercial $248.80
Rate for Payer: Cigna of CA HMO $199.04
Rate for Payer: Cigna of CA PPO $230.14
Rate for Payer: Dignity Health Commercial/Exchange $264.35
Rate for Payer: EPIC Health Plan Commercial $124.40
Rate for Payer: EPIC Health Plan Transplant $124.40
Rate for Payer: Galaxy Health WC $264.35
Rate for Payer: Global Benefits Group Commercial $186.60
Rate for Payer: Health Management Network EPO/PPO $279.90
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $233.25
Rate for Payer: IEHP medi-cal $108.85
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $207.44
Rate for Payer: LLUH Dept of Risk Management WC $127.51
Rate for Payer: Multiplan Commercial $233.25
Rate for Payer: Networks By Design Commercial $202.15
Rate for Payer: Prime Health Services Commercial $264.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $186.60
Rate for Payer: Riverside University Health MISP $124.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $186.60
Rate for Payer: TriValley Medical Group Commercial/Senior $186.60
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $264.35
Rate for Payer: Vantage Medical Group Senior $264.35
Hospital Charge Code 905103309
Hospital Revenue Code 420
Min. Negotiated Rate $62.20
Max. Negotiated Rate $279.90
Rate for Payer: Cash Price $139.95
Rate for Payer: Central Health Plan Commercial $248.80
Rate for Payer: EPIC Health Plan Commercial $124.40
Rate for Payer: Galaxy Health WC $264.35
Rate for Payer: Global Benefits Group Commercial $186.60
Rate for Payer: Health Management Network EPO/PPO $279.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $207.44
Rate for Payer: LLUH Dept of Risk Management WC $62.20
Rate for Payer: Multiplan Commercial $233.25
Rate for Payer: Networks By Design Commercial $202.15
Rate for Payer: Prime Health Services Commercial $264.35
Hospital Charge Code 900413920
Hospital Revenue Code 420
Min. Negotiated Rate $108.85
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $188.87
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $264.35
Rate for Payer: AlphaCare Medical Group Medi-Cal $171.05
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $171.05
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $186.60
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $139.95
Rate for Payer: Cash Price $139.95
Rate for Payer: Cash Price $139.95
Rate for Payer: Central Health Plan Commercial $248.80
Rate for Payer: Cigna of CA HMO $199.04
Rate for Payer: Cigna of CA PPO $230.14
Rate for Payer: Dignity Health Commercial/Exchange $264.35
Rate for Payer: EPIC Health Plan Commercial $124.40
Rate for Payer: EPIC Health Plan Transplant $124.40
Rate for Payer: Galaxy Health WC $264.35
Rate for Payer: Global Benefits Group Commercial $186.60
Rate for Payer: Health Management Network EPO/PPO $279.90
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $233.25
Rate for Payer: IEHP medi-cal $108.85
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $207.44
Rate for Payer: LLUH Dept of Risk Management WC $127.51
Rate for Payer: Multiplan Commercial $233.25
Rate for Payer: Networks By Design Commercial $202.15
Rate for Payer: Prime Health Services Commercial $264.35
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $186.60
Rate for Payer: Riverside University Health MISP $124.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $186.60
Rate for Payer: TriValley Medical Group Commercial/Senior $186.60
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $264.35
Rate for Payer: Vantage Medical Group Senior $264.35
Hospital Charge Code 900413920
Hospital Revenue Code 420
Min. Negotiated Rate $62.20
Max. Negotiated Rate $279.90
Rate for Payer: Cash Price $139.95
Rate for Payer: Central Health Plan Commercial $248.80
Rate for Payer: EPIC Health Plan Commercial $124.40
Rate for Payer: Galaxy Health WC $264.35
Rate for Payer: Global Benefits Group Commercial $186.60
Rate for Payer: Health Management Network EPO/PPO $279.90
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $207.44
Rate for Payer: LLUH Dept of Risk Management WC $62.20
Rate for Payer: Multiplan Commercial $233.25
Rate for Payer: Networks By Design Commercial $202.15
Rate for Payer: Prime Health Services Commercial $264.35
Hospital Charge Code 905103307
Hospital Revenue Code 420
Min. Negotiated Rate $32.20
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $55.87
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $78.20
Rate for Payer: AlphaCare Medical Group Medi-Cal $50.60
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $50.60
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $55.20
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $41.40
Rate for Payer: Cash Price $41.40
Rate for Payer: Cash Price $41.40
Rate for Payer: Central Health Plan Commercial $73.60
Rate for Payer: Cigna of CA HMO $58.88
Rate for Payer: Cigna of CA PPO $68.08
Rate for Payer: Dignity Health Commercial/Exchange $78.20
Rate for Payer: EPIC Health Plan Commercial $36.80
Rate for Payer: EPIC Health Plan Transplant $36.80
Rate for Payer: Galaxy Health WC $78.20
Rate for Payer: Global Benefits Group Commercial $55.20
Rate for Payer: Health Management Network EPO/PPO $82.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $69.00
Rate for Payer: IEHP medi-cal $32.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $61.36
Rate for Payer: LLUH Dept of Risk Management WC $37.72
Rate for Payer: Multiplan Commercial $69.00
Rate for Payer: Networks By Design Commercial $59.80
Rate for Payer: Prime Health Services Commercial $78.20
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $55.20
Rate for Payer: Riverside University Health MISP $36.80
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $55.20
Rate for Payer: TriValley Medical Group Commercial/Senior $55.20
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $78.20
Rate for Payer: Vantage Medical Group Senior $78.20
Hospital Charge Code 905103307
Hospital Revenue Code 420
Min. Negotiated Rate $18.40
Max. Negotiated Rate $82.80
Rate for Payer: Cash Price $41.40
Rate for Payer: Central Health Plan Commercial $73.60
Rate for Payer: EPIC Health Plan Commercial $36.80
Rate for Payer: Galaxy Health WC $78.20
Rate for Payer: Global Benefits Group Commercial $55.20
Rate for Payer: Health Management Network EPO/PPO $82.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $61.36
Rate for Payer: LLUH Dept of Risk Management WC $18.40
Rate for Payer: Multiplan Commercial $69.00
Rate for Payer: Networks By Design Commercial $59.80
Rate for Payer: Prime Health Services Commercial $78.20
Hospital Charge Code 900419041
Hospital Revenue Code 420
Min. Negotiated Rate $31.15
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $54.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $75.65
Rate for Payer: AlphaCare Medical Group Medi-Cal $48.95
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $48.95
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $53.40
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $40.05
Rate for Payer: Cash Price $40.05
Rate for Payer: Cash Price $40.05
Rate for Payer: Central Health Plan Commercial $71.20
Rate for Payer: Cigna of CA HMO $56.96
Rate for Payer: Cigna of CA PPO $65.86
Rate for Payer: Dignity Health Commercial/Exchange $75.65
Rate for Payer: EPIC Health Plan Commercial $35.60
Rate for Payer: EPIC Health Plan Transplant $35.60
Rate for Payer: Galaxy Health WC $75.65
Rate for Payer: Global Benefits Group Commercial $53.40
Rate for Payer: Health Management Network EPO/PPO $80.10
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $66.75
Rate for Payer: IEHP medi-cal $31.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $59.36
Rate for Payer: LLUH Dept of Risk Management WC $36.49
Rate for Payer: Multiplan Commercial $66.75
Rate for Payer: Networks By Design Commercial $57.85
Rate for Payer: Prime Health Services Commercial $75.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $53.40
Rate for Payer: Riverside University Health MISP $35.60
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $53.40
Rate for Payer: TriValley Medical Group Commercial/Senior $53.40
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $75.65
Rate for Payer: Vantage Medical Group Senior $75.65
Hospital Charge Code 900419041
Hospital Revenue Code 420
Min. Negotiated Rate $17.80
Max. Negotiated Rate $80.10
Rate for Payer: Cash Price $40.05
Rate for Payer: Central Health Plan Commercial $71.20
Rate for Payer: EPIC Health Plan Commercial $35.60
Rate for Payer: Galaxy Health WC $75.65
Rate for Payer: Global Benefits Group Commercial $53.40
Rate for Payer: Health Management Network EPO/PPO $80.10
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $59.36
Rate for Payer: LLUH Dept of Risk Management WC $17.80
Rate for Payer: Multiplan Commercial $66.75
Rate for Payer: Networks By Design Commercial $57.85
Rate for Payer: Prime Health Services Commercial $75.65
Hospital Charge Code 905103306
Hospital Revenue Code 420
Min. Negotiated Rate $41.30
Max. Negotiated Rate $408.00
Rate for Payer: Aetna of CA HMO/PPO $71.66
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $100.30
Rate for Payer: AlphaCare Medical Group Medi-Cal $64.90
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $64.90
Rate for Payer: Anthem Blue Cross of CA Exchange $336.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $408.00
Rate for Payer: BCBS Transplant Transplant $70.80
Rate for Payer: Blue Shield of California Commercial $400.00
Rate for Payer: Blue Shield of California EPN $287.00
Rate for Payer: Cash Price $53.10
Rate for Payer: Cash Price $53.10
Rate for Payer: Cash Price $53.10
Rate for Payer: Central Health Plan Commercial $94.40
Rate for Payer: Cigna of CA HMO $75.52
Rate for Payer: Cigna of CA PPO $87.32
Rate for Payer: Dignity Health Commercial/Exchange $100.30
Rate for Payer: EPIC Health Plan Commercial $47.20
Rate for Payer: EPIC Health Plan Transplant $47.20
Rate for Payer: Galaxy Health WC $100.30
Rate for Payer: Global Benefits Group Commercial $70.80
Rate for Payer: Health Management Network EPO/PPO $106.20
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $88.50
Rate for Payer: IEHP medi-cal $41.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $78.71
Rate for Payer: LLUH Dept of Risk Management WC $48.38
Rate for Payer: Multiplan Commercial $88.50
Rate for Payer: Networks By Design Commercial $76.70
Rate for Payer: Prime Health Services Commercial $100.30
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $70.80
Rate for Payer: Riverside University Health MISP $47.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $70.80
Rate for Payer: TriValley Medical Group Commercial/Senior $70.80
Rate for Payer: United Healthcare All Other Commercial $396.00
Rate for Payer: United Healthcare All Other HMO $281.00
Rate for Payer: United Healthcare HMO Rider $213.00
Rate for Payer: United Healthcare Select/Navigate/Core $196.00
Rate for Payer: Vantage Medical Group Medi-Cal $100.30
Rate for Payer: Vantage Medical Group Senior $100.30
Hospital Charge Code 905103306
Hospital Revenue Code 420
Min. Negotiated Rate $23.60
Max. Negotiated Rate $106.20
Rate for Payer: Cash Price $53.10
Rate for Payer: Central Health Plan Commercial $94.40
Rate for Payer: EPIC Health Plan Commercial $47.20
Rate for Payer: Galaxy Health WC $100.30
Rate for Payer: Global Benefits Group Commercial $70.80
Rate for Payer: Health Management Network EPO/PPO $106.20
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $78.71
Rate for Payer: LLUH Dept of Risk Management WC $23.60
Rate for Payer: Multiplan Commercial $88.50
Rate for Payer: Networks By Design Commercial $76.70
Rate for Payer: Prime Health Services Commercial $100.30
Hospital Charge Code 900419040
Hospital Revenue Code 420
Min. Negotiated Rate $22.60
Max. Negotiated Rate $101.70
Rate for Payer: Cash Price $50.85
Rate for Payer: Central Health Plan Commercial $90.40
Rate for Payer: EPIC Health Plan Commercial $45.20
Rate for Payer: Galaxy Health WC $96.05
Rate for Payer: Global Benefits Group Commercial $67.80
Rate for Payer: Health Management Network EPO/PPO $101.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $75.37
Rate for Payer: LLUH Dept of Risk Management WC $22.60
Rate for Payer: Multiplan Commercial $84.75
Rate for Payer: Networks By Design Commercial $73.45
Rate for Payer: Prime Health Services Commercial $96.05