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Service Code NDC 16571-813-20
Hospital Charge Code 1711506
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 23155-531-02
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
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: 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 68084-479-11
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.34
Max. Negotiated Rate $1.51
Rate for Payer: Aetna of CA HMO/PPO $1.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.43
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.92
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.92
Rate for Payer: Anthem Blue Cross of CA Exchange $0.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.99
Rate for Payer: BCBS Transplant Transplant $1.01
Rate for Payer: Blue Shield of California Commercial $1.06
Rate for Payer: Blue Shield of California EPN $0.82
Rate for Payer: Cash Price $0.76
Rate for Payer: Central Health Plan Commercial $1.34
Rate for Payer: Cigna of CA HMO $1.18
Rate for Payer: Cigna of CA PPO $1.18
Rate for Payer: Dignity Health Commercial/Exchange $1.43
Rate for Payer: EPIC Health Plan Commercial $0.67
Rate for Payer: EPIC Health Plan Transplant $0.67
Rate for Payer: Galaxy Health WC $1.43
Rate for Payer: Global Benefits Group Commercial $1.01
Rate for Payer: Health Management Network EPO/PPO $1.51
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.26
Rate for Payer: IEHP medi-cal $0.59
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.12
Rate for Payer: LLUH Dept of Risk Management WC $0.34
Rate for Payer: Multiplan Commercial $1.26
Rate for Payer: Networks By Design Commercial $1.09
Rate for Payer: Prime Health Services Commercial $1.43
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.01
Rate for Payer: Riverside University Health MISP $0.67
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.01
Rate for Payer: TriValley Medical Group Commercial/Senior $1.01
Rate for Payer: United Healthcare All Other Commercial $0.84
Rate for Payer: United Healthcare All Other HMO $0.84
Rate for Payer: United Healthcare HMO Rider $0.84
Rate for Payer: United Healthcare Select/Navigate/Core $0.84
Rate for Payer: Vantage Medical Group Medi-Cal $1.43
Rate for Payer: Vantage Medical Group Senior $1.43
Service Code NDC 68084-479-11
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.34
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $1.26
Rate for Payer: Blue Shield of California EPN $0.90
Rate for Payer: Cash Price $0.76
Rate for Payer: Cash Price $0.76
Rate for Payer: Central Health Plan Commercial $1.34
Rate for Payer: Cigna of CA HMO $1.18
Rate for Payer: Cigna of CA PPO $1.18
Rate for Payer: EPIC Health Plan Commercial $0.67
Rate for Payer: Galaxy Health WC $1.43
Rate for Payer: Global Benefits Group Commercial $1.01
Rate for Payer: Health Management Network EPO/PPO $1.51
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.12
Rate for Payer: LLUH Dept of Risk Management WC $0.34
Rate for Payer: Multiplan Commercial $1.26
Rate for Payer: Networks By Design Commercial $1.09
Rate for Payer: Prime Health Services Commercial $1.43
Service Code NDC 0781-2081-02
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.15
Max. Negotiated Rate $0.68
Rate for Payer: Aetna of CA HMO/PPO $0.46
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.65
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.42
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.42
Rate for Payer: Anthem Blue Cross of CA Exchange $0.37
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.45
Rate for Payer: BCBS Transplant Transplant $0.46
Rate for Payer: Blue Shield of California Commercial $0.48
Rate for Payer: Blue Shield of California EPN $0.37
Rate for Payer: Cash Price $0.34
Rate for Payer: Central Health Plan Commercial $0.61
Rate for Payer: Cigna of CA HMO $0.53
Rate for Payer: Cigna of CA PPO $0.53
Rate for Payer: Dignity Health Commercial/Exchange $0.65
Rate for Payer: EPIC Health Plan Commercial $0.30
Rate for Payer: EPIC Health Plan Transplant $0.30
Rate for Payer: Galaxy Health WC $0.65
Rate for Payer: Global Benefits Group Commercial $0.46
Rate for Payer: Health Management Network EPO/PPO $0.68
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.57
Rate for Payer: IEHP medi-cal $0.27
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.51
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Multiplan Commercial $0.57
Rate for Payer: Networks By Design Commercial $0.49
Rate for Payer: Prime Health Services Commercial $0.65
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.46
Rate for Payer: Riverside University Health MISP $0.30
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.46
Rate for Payer: TriValley Medical Group Commercial/Senior $0.46
Rate for Payer: United Healthcare All Other Commercial $0.38
Rate for Payer: United Healthcare All Other HMO $0.38
Rate for Payer: United Healthcare HMO Rider $0.38
Rate for Payer: United Healthcare Select/Navigate/Core $0.38
Rate for Payer: Vantage Medical Group Medi-Cal $0.65
Rate for Payer: Vantage Medical Group Senior $0.65
Service Code NDC 0781-2081-02
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.15
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.57
Rate for Payer: Blue Shield of California EPN $0.41
Rate for Payer: Cash Price $0.34
Rate for Payer: Cash Price $0.34
Rate for Payer: Central Health Plan Commercial $0.61
Rate for Payer: Cigna of CA HMO $0.53
Rate for Payer: Cigna of CA PPO $0.53
Rate for Payer: EPIC Health Plan Commercial $0.30
Rate for Payer: Galaxy Health WC $0.65
Rate for Payer: Global Benefits Group Commercial $0.46
Rate for Payer: Health Management Network EPO/PPO $0.68
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.51
Rate for Payer: LLUH Dept of Risk Management WC $0.15
Rate for Payer: Multiplan Commercial $0.57
Rate for Payer: Networks By Design Commercial $0.49
Rate for Payer: Prime Health Services Commercial $0.65
Service Code NDC 23155-531-02
Hospital Charge Code 1711506
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 68084-479-01
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.34
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $1.26
Rate for Payer: Blue Shield of California EPN $0.90
Rate for Payer: Cash Price $0.76
Rate for Payer: Cash Price $0.76
Rate for Payer: Central Health Plan Commercial $1.34
Rate for Payer: Cigna of CA HMO $1.18
Rate for Payer: Cigna of CA PPO $1.18
Rate for Payer: EPIC Health Plan Commercial $0.67
Rate for Payer: Galaxy Health WC $1.43
Rate for Payer: Global Benefits Group Commercial $1.01
Rate for Payer: Health Management Network EPO/PPO $1.51
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.12
Rate for Payer: LLUH Dept of Risk Management WC $0.34
Rate for Payer: Multiplan Commercial $1.26
Rate for Payer: Networks By Design Commercial $1.09
Rate for Payer: Prime Health Services Commercial $1.43
Service Code NDC 68084-479-01
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.34
Max. Negotiated Rate $1.51
Rate for Payer: Aetna of CA HMO/PPO $1.02
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $1.43
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.92
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.92
Rate for Payer: Anthem Blue Cross of CA Exchange $0.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.99
Rate for Payer: BCBS Transplant Transplant $1.01
Rate for Payer: Blue Shield of California Commercial $1.06
Rate for Payer: Blue Shield of California EPN $0.82
Rate for Payer: Cash Price $0.76
Rate for Payer: Central Health Plan Commercial $1.34
Rate for Payer: Cigna of CA HMO $1.18
Rate for Payer: Cigna of CA PPO $1.18
Rate for Payer: Dignity Health Commercial/Exchange $1.43
Rate for Payer: EPIC Health Plan Commercial $0.67
Rate for Payer: EPIC Health Plan Transplant $0.67
Rate for Payer: Galaxy Health WC $1.43
Rate for Payer: Global Benefits Group Commercial $1.01
Rate for Payer: Health Management Network EPO/PPO $1.51
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $1.26
Rate for Payer: IEHP medi-cal $0.59
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1.12
Rate for Payer: LLUH Dept of Risk Management WC $0.34
Rate for Payer: Multiplan Commercial $1.26
Rate for Payer: Networks By Design Commercial $1.09
Rate for Payer: Prime Health Services Commercial $1.43
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $1.01
Rate for Payer: Riverside University Health MISP $0.67
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $1.01
Rate for Payer: TriValley Medical Group Commercial/Senior $1.01
Rate for Payer: United Healthcare All Other Commercial $0.84
Rate for Payer: United Healthcare All Other HMO $0.84
Rate for Payer: United Healthcare HMO Rider $0.84
Rate for Payer: United Healthcare Select/Navigate/Core $0.84
Rate for Payer: Vantage Medical Group Medi-Cal $1.43
Rate for Payer: Vantage Medical Group Senior $1.43
Service Code NDC 16571-813-20
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.06
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
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: 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 29033-026-02
Hospital Charge Code 1711506
Hospital Revenue Code 259
Min. Negotiated Rate $0.17
Max. Negotiated Rate $0.76
Rate for Payer: Aetna of CA HMO/PPO $0.51
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.71
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.46
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.46
Rate for Payer: Anthem Blue Cross of CA Exchange $0.41
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.50
Rate for Payer: BCBS Transplant Transplant $0.50
Rate for Payer: Blue Shield of California Commercial $0.53
Rate for Payer: Blue Shield of California EPN $0.41
Rate for Payer: Cash Price $0.38
Rate for Payer: Central Health Plan Commercial $0.67
Rate for Payer: Cigna of CA HMO $0.59
Rate for Payer: Cigna of CA PPO $0.59
Rate for Payer: Dignity Health Commercial/Exchange $0.71
Rate for Payer: EPIC Health Plan Commercial $0.34
Rate for Payer: EPIC Health Plan Transplant $0.34
Rate for Payer: Galaxy Health WC $0.71
Rate for Payer: Global Benefits Group Commercial $0.50
Rate for Payer: Health Management Network EPO/PPO $0.76
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.63
Rate for Payer: IEHP medi-cal $0.29
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.56
Rate for Payer: LLUH Dept of Risk Management WC $0.17
Rate for Payer: Multiplan Commercial $0.63
Rate for Payer: Networks By Design Commercial $0.55
Rate for Payer: Prime Health Services Commercial $0.71
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.50
Rate for Payer: Riverside University Health MISP $0.34
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.50
Rate for Payer: TriValley Medical Group Commercial/Senior $0.50
Rate for Payer: United Healthcare All Other Commercial $0.42
Rate for Payer: United Healthcare All Other HMO $0.42
Rate for Payer: United Healthcare HMO Rider $0.42
Rate for Payer: United Healthcare Select/Navigate/Core $0.42
Rate for Payer: Vantage Medical Group Medi-Cal $0.71
Rate for Payer: Vantage Medical Group Senior $0.71
Service Code NDC 8770190081
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 0904-6412-92
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 0904-6412-92
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Service Code NDC 0536-1007-15
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 68084-988-32
Hospital Charge Code 1712416
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.79
Rate for Payer: Aetna of CA HMO/PPO $0.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.48
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.48
Rate for Payer: Anthem Blue Cross of CA Exchange $0.43
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.52
Rate for Payer: BCBS Transplant Transplant $0.53
Rate for Payer: Blue Shield of California Commercial $0.55
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.40
Rate for Payer: Central Health Plan Commercial $0.70
Rate for Payer: Cigna of CA HMO $0.62
Rate for Payer: Cigna of CA PPO $0.62
Rate for Payer: Dignity Health Commercial/Exchange $0.75
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: EPIC Health Plan Transplant $0.35
Rate for Payer: Galaxy Health WC $0.75
Rate for Payer: Global Benefits Group Commercial $0.53
Rate for Payer: Health Management Network EPO/PPO $0.79
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.66
Rate for Payer: IEHP medi-cal $0.31
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.59
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.66
Rate for Payer: Networks By Design Commercial $0.57
Rate for Payer: Prime Health Services Commercial $0.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.53
Rate for Payer: Riverside University Health MISP $0.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.53
Rate for Payer: TriValley Medical Group Commercial/Senior $0.53
Rate for Payer: United Healthcare All Other Commercial $0.44
Rate for Payer: United Healthcare All Other HMO $0.44
Rate for Payer: United Healthcare HMO Rider $0.44
Rate for Payer: United Healthcare Select/Navigate/Core $0.44
Rate for Payer: Vantage Medical Group Medi-Cal $0.75
Rate for Payer: Vantage Medical Group Senior $0.75
Service Code NDC 24385-478-47
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $0.02
Rate for Payer: Aetna of CA HMO/PPO $0.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.01
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.01
Rate for Payer: Anthem Blue Cross of CA Exchange $0.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.01
Rate for Payer: BCBS Transplant Transplant $0.01
Rate for Payer: Blue Shield of California Commercial $0.01
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: Dignity Health Commercial/Exchange $0.02
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: EPIC Health Plan Transplant $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.02
Rate for Payer: IEHP medi-cal $0.01
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.01
Rate for Payer: Riverside University Health MISP $0.01
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.01
Rate for Payer: TriValley Medical Group Commercial/Senior $0.01
Rate for Payer: United Healthcare All Other Commercial $0.01
Rate for Payer: United Healthcare All Other HMO $0.01
Rate for Payer: United Healthcare HMO Rider $0.01
Rate for Payer: United Healthcare Select/Navigate/Core $0.01
Rate for Payer: Vantage Medical Group Medi-Cal $0.02
Rate for Payer: Vantage Medical Group Senior $0.02
Service Code NDC 24385-478-47
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Service Code NDC 66553-004-01
Hospital Charge Code 1712416
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
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: 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 66553-004-01
Hospital Charge Code 1712416
Hospital Revenue Code 259
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Aetna of CA HMO/PPO $0.04
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.06
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.04
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.04
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 $0.06
Rate for Payer: Cigna of CA HMO $0.05
Rate for Payer: Cigna of CA PPO $0.05
Rate for Payer: Dignity Health Commercial/Exchange $0.06
Rate for Payer: EPIC Health Plan Commercial $0.03
Rate for Payer: EPIC Health Plan Transplant $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: 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 $0.05
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
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.04
Rate for Payer: Riverside University Health MISP $0.03
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 $0.04
Rate for Payer: United Healthcare All Other HMO $0.04
Rate for Payer: United Healthcare HMO Rider $0.04
Rate for Payer: United Healthcare Select/Navigate/Core $0.04
Rate for Payer: Vantage Medical Group Medi-Cal $0.06
Rate for Payer: Vantage Medical Group Senior $0.06
Service Code NDC 68084-988-32
Hospital Charge Code 1712416
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.47
Rate for Payer: Cash Price $0.40
Rate for Payer: Cash Price $0.40
Rate for Payer: Central Health Plan Commercial $0.70
Rate for Payer: Cigna of CA HMO $0.62
Rate for Payer: Cigna of CA PPO $0.62
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: Galaxy Health WC $0.75
Rate for Payer: Global Benefits Group Commercial $0.53
Rate for Payer: Health Management Network EPO/PPO $0.79
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.59
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.66
Rate for Payer: Networks By Design Commercial $0.57
Rate for Payer: Prime Health Services Commercial $0.75
Service Code NDC 68084-988-33
Hospital Charge Code 1712416
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.66
Rate for Payer: Blue Shield of California EPN $0.47
Rate for Payer: Cash Price $0.40
Rate for Payer: Cash Price $0.40
Rate for Payer: Central Health Plan Commercial $0.70
Rate for Payer: Cigna of CA HMO $0.62
Rate for Payer: Cigna of CA PPO $0.62
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: Galaxy Health WC $0.75
Rate for Payer: Global Benefits Group Commercial $0.53
Rate for Payer: Health Management Network EPO/PPO $0.79
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.59
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.66
Rate for Payer: Networks By Design Commercial $0.57
Rate for Payer: Prime Health Services Commercial $0.75
Service Code NDC 8770190081
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02
Service Code NDC 68084-988-33
Hospital Charge Code 1712416
Hospital Revenue Code 259
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.79
Rate for Payer: Aetna of CA HMO/PPO $0.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $0.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $0.48
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $0.48
Rate for Payer: Anthem Blue Cross of CA Exchange $0.43
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $0.52
Rate for Payer: BCBS Transplant Transplant $0.53
Rate for Payer: Blue Shield of California Commercial $0.55
Rate for Payer: Blue Shield of California EPN $0.43
Rate for Payer: Cash Price $0.40
Rate for Payer: Central Health Plan Commercial $0.70
Rate for Payer: Cigna of CA HMO $0.62
Rate for Payer: Cigna of CA PPO $0.62
Rate for Payer: Dignity Health Commercial/Exchange $0.75
Rate for Payer: EPIC Health Plan Commercial $0.35
Rate for Payer: EPIC Health Plan Transplant $0.35
Rate for Payer: Galaxy Health WC $0.75
Rate for Payer: Global Benefits Group Commercial $0.53
Rate for Payer: Health Management Network EPO/PPO $0.79
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $0.66
Rate for Payer: IEHP medi-cal $0.31
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.59
Rate for Payer: LLUH Dept of Risk Management WC $0.18
Rate for Payer: Multiplan Commercial $0.66
Rate for Payer: Networks By Design Commercial $0.57
Rate for Payer: Prime Health Services Commercial $0.75
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $0.53
Rate for Payer: Riverside University Health MISP $0.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $0.53
Rate for Payer: TriValley Medical Group Commercial/Senior $0.53
Rate for Payer: United Healthcare All Other Commercial $0.44
Rate for Payer: United Healthcare All Other HMO $0.44
Rate for Payer: United Healthcare HMO Rider $0.44
Rate for Payer: United Healthcare Select/Navigate/Core $0.44
Rate for Payer: Vantage Medical Group Medi-Cal $0.75
Rate for Payer: Vantage Medical Group Senior $0.75
Service Code NDC 0536-1007-15
Hospital Charge Code 1712416
Hospital Revenue Code 259
Max. Negotiated Rate $34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $34,005.88
Rate for Payer: Blue Shield of California Commercial $0.02
Rate for Payer: Blue Shield of California EPN $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Cash Price $0.01
Rate for Payer: Central Health Plan Commercial $0.02
Rate for Payer: Cigna of CA HMO $0.01
Rate for Payer: Cigna of CA PPO $0.01
Rate for Payer: EPIC Health Plan Commercial $0.01
Rate for Payer: Galaxy Health WC $0.02
Rate for Payer: Global Benefits Group Commercial $0.01
Rate for Payer: Health Management Network EPO/PPO $0.02
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $0.01
Rate for Payer: LLUH Dept of Risk Management WC $0.00
Rate for Payer: Multiplan Commercial $0.02
Rate for Payer: Networks By Design Commercial $0.01
Rate for Payer: Prime Health Services Commercial $0.02