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Charge Type Price  
Service Code CPT L3962
Hospital Charge Code 905353962
Hospital Revenue Code 274
Min. Negotiated Rate $326.40
Max. Negotiated Rate $1,468.80
Rate for Payer: Blue Shield of California EPN $871.49
Rate for Payer: Cash Price $734.40
Rate for Payer: Central Health Plan Commercial $1,305.60
Rate for Payer: Cigna of CA HMO $1,142.40
Rate for Payer: Cigna of CA PPO $1,142.40
Rate for Payer: EPIC Health Plan Commercial $652.80
Rate for Payer: EPIC Health Plan Transplant $652.80
Rate for Payer: Galaxy Health WC $1,387.20
Rate for Payer: Global Benefits Group Commercial $979.20
Rate for Payer: Health Management Network EPO/PPO $1,468.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $1,088.54
Rate for Payer: LLUH Dept of Risk Management WC $326.40
Rate for Payer: Multiplan Commercial $1,224.00
Rate for Payer: Networks By Design Commercial $816.00
Rate for Payer: Prime Health Services Commercial $1,387.20
Service Code CPT 11301
Hospital Charge Code 900501790
Hospital Revenue Code 361
Min. Negotiated Rate $98.00
Max. Negotiated Rate $397,400.00
Rate for Payer: Adventist Health Medi-Cal $250.14
Rate for Payer: Aetna of CA HMO/PPO $260.52
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $375.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $275.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $250.14
Rate for Payer: Anthem Blue Cross of CA Exchange $397,400.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,846.00
Rate for Payer: BCBS Transplant Transplant $294.00
Rate for Payer: Blue Shield of California Commercial $951.13
Rate for Payer: Blue Shield of California EPN $683.14
Rate for Payer: Caremore Medicare Advantage $250.14
Rate for Payer: Cash Price $220.50
Rate for Payer: Cash Price $220.50
Rate for Payer: Cash Price $220.50
Rate for Payer: Central Health Plan Commercial $392.00
Rate for Payer: Cigna of CA PPO $362.60
Rate for Payer: Dignity Health Commercial/Exchange $375.21
Rate for Payer: EPIC Health Plan Commercial $337.69
Rate for Payer: EPIC Health Plan Medicare/Senior $250.14
Rate for Payer: EPIC Health Plan Transplant $250.14
Rate for Payer: Galaxy Health WC $416.50
Rate for Payer: Global Benefits Group Commercial $294.00
Rate for Payer: Health Management Network EPO/PPO $441.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $367.50
Rate for Payer: Heritage Provider Network Commercial/Senior $410.23
Rate for Payer: IEHP medi-cal $412.73
Rate for Payer: IEHP Medicare Advantage $250.14
Rate for Payer: Innovage PACE Commercial $375.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $326.83
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $250.14
Rate for Payer: LLUH Dept of Risk Management WC $98.00
Rate for Payer: Molina Healthcare of CA Medi-Cal $335.19
Rate for Payer: Molina Healthcare of CA Medicare $335.19
Rate for Payer: Multiplan Commercial $367.50
Rate for Payer: Networks By Design Commercial $318.50
Rate for Payer: Prime Health Services Commercial $416.50
Rate for Payer: Prime Health Services Medicare $265.15
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $294.00
Rate for Payer: Riverside University Health MISP $275.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $294.00
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 Commercial/Exchange $375.21
Rate for Payer: Vantage Medical Group Medi-Cal $275.15
Rate for Payer: Vantage Medical Group Senior $250.14
Service Code CPT 11301
Hospital Charge Code 900501790
Hospital Revenue Code 361
Min. Negotiated Rate $98.00
Max. Negotiated Rate $441.00
Rate for Payer: Cash Price $220.50
Rate for Payer: Central Health Plan Commercial $392.00
Rate for Payer: EPIC Health Plan Commercial $196.00
Rate for Payer: Galaxy Health WC $416.50
Rate for Payer: Global Benefits Group Commercial $294.00
Rate for Payer: Health Management Network EPO/PPO $441.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $326.83
Rate for Payer: LLUH Dept of Risk Management WC $98.00
Rate for Payer: Multiplan Commercial $367.50
Rate for Payer: Networks By Design Commercial $318.50
Rate for Payer: Prime Health Services Commercial $416.50
Service Code CPT 11305
Hospital Charge Code 902890369
Hospital Revenue Code 516
Min. Negotiated Rate $76.00
Max. Negotiated Rate $2,356.00
Rate for Payer: Adventist Health Medi-Cal $250.14
Rate for Payer: Aetna of CA HMO/PPO $172.84
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $375.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $275.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $250.14
Rate for Payer: Anthem Blue Cross of CA Exchange $1,833.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,356.00
Rate for Payer: BCBS Transplant Transplant $228.00
Rate for Payer: Blue Shield of California Commercial $239.02
Rate for Payer: Blue Shield of California EPN $185.82
Rate for Payer: Caremore Medicare Advantage $250.14
Rate for Payer: Cash Price $171.00
Rate for Payer: Cash Price $171.00
Rate for Payer: Cash Price $171.00
Rate for Payer: Central Health Plan Commercial $304.00
Rate for Payer: Cigna of CA HMO $243.20
Rate for Payer: Cigna of CA PPO $281.20
Rate for Payer: Dignity Health Commercial/Exchange $375.21
Rate for Payer: EPIC Health Plan Commercial $337.69
Rate for Payer: EPIC Health Plan Medicare/Senior $250.14
Rate for Payer: EPIC Health Plan Transplant $250.14
Rate for Payer: Galaxy Health WC $323.00
Rate for Payer: Global Benefits Group Commercial $228.00
Rate for Payer: Health Management Network EPO/PPO $342.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $285.00
Rate for Payer: Heritage Provider Network Commercial/Senior $410.23
Rate for Payer: IEHP medi-cal $412.73
Rate for Payer: IEHP Medicare Advantage $250.14
Rate for Payer: Innovage PACE Commercial $375.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $253.46
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $250.14
Rate for Payer: LLUH Dept of Risk Management WC $76.00
Rate for Payer: Molina Healthcare of CA Medi-Cal $335.19
Rate for Payer: Molina Healthcare of CA Medicare $335.19
Rate for Payer: Multiplan Commercial $285.00
Rate for Payer: Networks By Design Commercial $247.00
Rate for Payer: Prime Health Services Commercial $323.00
Rate for Payer: Prime Health Services Medicare $265.15
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $228.00
Rate for Payer: Riverside University Health MISP $275.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $228.00
Rate for Payer: TriValley Medical Group Commercial/Senior $228.00
Rate for Payer: United Healthcare All Other Commercial $190.00
Rate for Payer: United Healthcare All Other HMO $190.00
Rate for Payer: United Healthcare HMO Rider $190.00
Rate for Payer: United Healthcare Select/Navigate/Core $190.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $375.21
Rate for Payer: Vantage Medical Group Medi-Cal $275.15
Rate for Payer: Vantage Medical Group Senior $250.14
Service Code CPT 11305
Hospital Charge Code 902890369
Hospital Revenue Code 516
Min. Negotiated Rate $76.00
Max. Negotiated Rate $342.00
Rate for Payer: Cash Price $171.00
Rate for Payer: Central Health Plan Commercial $304.00
Rate for Payer: EPIC Health Plan Commercial $152.00
Rate for Payer: Galaxy Health WC $323.00
Rate for Payer: Global Benefits Group Commercial $228.00
Rate for Payer: Health Management Network EPO/PPO $342.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $253.46
Rate for Payer: LLUH Dept of Risk Management WC $76.00
Rate for Payer: Multiplan Commercial $285.00
Rate for Payer: Networks By Design Commercial $247.00
Rate for Payer: Prime Health Services Commercial $323.00
Service Code CPT 11310
Hospital Charge Code 900501338
Hospital Revenue Code 450
Min. Negotiated Rate $113.40
Max. Negotiated Rate $510.30
Rate for Payer: Cash Price $255.15
Rate for Payer: Central Health Plan Commercial $453.60
Rate for Payer: EPIC Health Plan Commercial $226.80
Rate for Payer: Galaxy Health WC $481.95
Rate for Payer: Global Benefits Group Commercial $340.20
Rate for Payer: Health Management Network EPO/PPO $510.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $378.19
Rate for Payer: LLUH Dept of Risk Management WC $113.40
Rate for Payer: Multiplan Commercial $425.25
Rate for Payer: Networks By Design Commercial $368.55
Rate for Payer: Prime Health Services Commercial $481.95
Service Code CPT 11310
Hospital Charge Code 900501338
Hospital Revenue Code 516
Min. Negotiated Rate $113.40
Max. Negotiated Rate $2,356.00
Rate for Payer: Adventist Health Medi-Cal $250.14
Rate for Payer: Aetna of CA HMO/PPO $221.74
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $375.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $275.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $250.14
Rate for Payer: Anthem Blue Cross of CA Exchange $1,833.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,356.00
Rate for Payer: BCBS Transplant Transplant $340.20
Rate for Payer: Blue Shield of California Commercial $356.64
Rate for Payer: Blue Shield of California EPN $277.26
Rate for Payer: Caremore Medicare Advantage $250.14
Rate for Payer: Cash Price $255.15
Rate for Payer: Cash Price $255.15
Rate for Payer: Cash Price $255.15
Rate for Payer: Central Health Plan Commercial $453.60
Rate for Payer: Cigna of CA HMO $362.88
Rate for Payer: Cigna of CA PPO $419.58
Rate for Payer: Dignity Health Commercial/Exchange $375.21
Rate for Payer: EPIC Health Plan Commercial $337.69
Rate for Payer: EPIC Health Plan Medicare/Senior $250.14
Rate for Payer: EPIC Health Plan Transplant $250.14
Rate for Payer: Galaxy Health WC $481.95
Rate for Payer: Global Benefits Group Commercial $340.20
Rate for Payer: Health Management Network EPO/PPO $510.30
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $425.25
Rate for Payer: Heritage Provider Network Commercial/Senior $410.23
Rate for Payer: IEHP medi-cal $412.73
Rate for Payer: IEHP Medicare Advantage $250.14
Rate for Payer: Innovage PACE Commercial $375.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $378.19
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $250.14
Rate for Payer: LLUH Dept of Risk Management WC $113.40
Rate for Payer: Molina Healthcare of CA Medi-Cal $335.19
Rate for Payer: Molina Healthcare of CA Medicare $335.19
Rate for Payer: Multiplan Commercial $425.25
Rate for Payer: Networks By Design Commercial $368.55
Rate for Payer: Prime Health Services Commercial $481.95
Rate for Payer: Prime Health Services Medicare $265.15
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $340.20
Rate for Payer: Riverside University Health MISP $275.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $340.20
Rate for Payer: TriValley Medical Group Commercial/Senior $340.20
Rate for Payer: United Healthcare All Other Commercial $283.50
Rate for Payer: United Healthcare All Other HMO $283.50
Rate for Payer: United Healthcare HMO Rider $283.50
Rate for Payer: United Healthcare Select/Navigate/Core $283.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $375.21
Rate for Payer: Vantage Medical Group Medi-Cal $275.15
Rate for Payer: Vantage Medical Group Senior $250.14
Service Code CPT 11310
Hospital Charge Code 900501338
Hospital Revenue Code 516
Min. Negotiated Rate $113.40
Max. Negotiated Rate $510.30
Rate for Payer: Cash Price $255.15
Rate for Payer: Central Health Plan Commercial $453.60
Rate for Payer: EPIC Health Plan Commercial $226.80
Rate for Payer: Galaxy Health WC $481.95
Rate for Payer: Global Benefits Group Commercial $340.20
Rate for Payer: Health Management Network EPO/PPO $510.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $378.19
Rate for Payer: LLUH Dept of Risk Management WC $113.40
Rate for Payer: Multiplan Commercial $425.25
Rate for Payer: Networks By Design Commercial $368.55
Rate for Payer: Prime Health Services Commercial $481.95
Service Code CPT 11310
Hospital Charge Code 900501338
Hospital Revenue Code 450
Min. Negotiated Rate $113.40
Max. Negotiated Rate $2,696.00
Rate for Payer: Adventist Health Medi-Cal $400.00
Rate for Payer: Aetna of CA HMO/PPO $2,696.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $375.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $275.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $250.14
Rate for Payer: Anthem Blue Cross of CA Exchange $1,833.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $2,356.00
Rate for Payer: BCBS Transplant Transplant $340.20
Rate for Payer: Caremore Medicare Advantage $250.14
Rate for Payer: Cash Price $255.15
Rate for Payer: Cash Price $255.15
Rate for Payer: Cash Price $255.15
Rate for Payer: Cash Price $255.15
Rate for Payer: Central Health Plan Commercial $453.60
Rate for Payer: Cigna of CA PPO $419.58
Rate for Payer: Dignity Health Commercial/Exchange $375.21
Rate for Payer: EPIC Health Plan Commercial $337.69
Rate for Payer: EPIC Health Plan Medicare/Senior $250.14
Rate for Payer: EPIC Health Plan Transplant $250.14
Rate for Payer: Galaxy Health WC $481.95
Rate for Payer: Global Benefits Group Commercial $340.20
Rate for Payer: Health Management Network EPO/PPO $510.30
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $425.25
Rate for Payer: Heritage Provider Network Commercial/Senior $410.23
Rate for Payer: IEHP medi-cal $936.00
Rate for Payer: IEHP Medicare Advantage $250.14
Rate for Payer: Innovage PACE Commercial $375.21
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $378.19
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $250.14
Rate for Payer: LLUH Dept of Risk Management WC $113.40
Rate for Payer: Molina Healthcare of CA Medi-Cal $335.19
Rate for Payer: Molina Healthcare of CA Medicare $335.19
Rate for Payer: Multiplan Commercial $425.25
Rate for Payer: Networks By Design Commercial $368.55
Rate for Payer: Prime Health Services Commercial $481.95
Rate for Payer: Prime Health Services Medicare $265.15
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $340.20
Rate for Payer: Riverside University Health MISP $275.15
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $340.20
Rate for Payer: United Healthcare All Other Commercial $283.50
Rate for Payer: United Healthcare All Other HMO $283.50
Rate for Payer: United Healthcare HMO Rider $283.50
Rate for Payer: United Healthcare Select/Navigate/Core $283.50
Rate for Payer: Vantage Medical Group Commercial/Exchange $375.21
Rate for Payer: Vantage Medical Group Medi-Cal $275.15
Rate for Payer: Vantage Medical Group Senior $250.14
Service Code CPT C1894
Hospital Charge Code 901607733
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $92.89
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Service Code CPT C1894
Hospital Charge Code 901607733
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $235.49
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $87.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $56.77
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $56.77
Rate for Payer: Anthem Blue Cross of CA Exchange $49.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $60.98
Rate for Payer: BCBS Transplant Transplant $61.93
Rate for Payer: Blue Shield of California Commercial $64.92
Rate for Payer: Blue Shield of California EPN $50.47
Rate for Payer: Cash Price $46.44
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: Cigna of CA HMO $66.05
Rate for Payer: Cigna of CA PPO $76.38
Rate for Payer: Dignity Health Commercial/Exchange $87.73
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: EPIC Health Plan Transplant $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $77.41
Rate for Payer: IEHP medi-cal $36.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $61.93
Rate for Payer: Riverside University Health MISP $41.28
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $61.93
Rate for Payer: TriValley Medical Group Commercial/Senior $61.93
Rate for Payer: United Healthcare All Other Commercial $51.60
Rate for Payer: United Healthcare All Other HMO $51.60
Rate for Payer: United Healthcare HMO Rider $51.60
Rate for Payer: United Healthcare Select/Navigate/Core $51.60
Rate for Payer: Vantage Medical Group Medi-Cal $87.73
Rate for Payer: Vantage Medical Group Senior $87.73
Service Code CPT C1894
Hospital Charge Code 901607732
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $235.49
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $87.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $56.77
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $56.77
Rate for Payer: Anthem Blue Cross of CA Exchange $49.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $60.98
Rate for Payer: BCBS Transplant Transplant $61.93
Rate for Payer: Blue Shield of California Commercial $64.92
Rate for Payer: Blue Shield of California EPN $50.47
Rate for Payer: Cash Price $46.44
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: Cigna of CA HMO $66.05
Rate for Payer: Cigna of CA PPO $76.38
Rate for Payer: Dignity Health Commercial/Exchange $87.73
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: EPIC Health Plan Transplant $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $77.41
Rate for Payer: IEHP medi-cal $36.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $61.93
Rate for Payer: Riverside University Health MISP $41.28
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $61.93
Rate for Payer: TriValley Medical Group Commercial/Senior $61.93
Rate for Payer: United Healthcare All Other Commercial $51.60
Rate for Payer: United Healthcare All Other HMO $51.60
Rate for Payer: United Healthcare HMO Rider $51.60
Rate for Payer: United Healthcare Select/Navigate/Core $51.60
Rate for Payer: Vantage Medical Group Medi-Cal $87.73
Rate for Payer: Vantage Medical Group Senior $87.73
Service Code CPT C1894
Hospital Charge Code 901607732
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $92.89
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Service Code CPT C1894
Hospital Charge Code 901607735
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $92.89
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Service Code CPT C1894
Hospital Charge Code 901607735
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $235.49
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $87.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $56.77
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $56.77
Rate for Payer: Anthem Blue Cross of CA Exchange $49.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $60.98
Rate for Payer: BCBS Transplant Transplant $61.93
Rate for Payer: Blue Shield of California Commercial $64.92
Rate for Payer: Blue Shield of California EPN $50.47
Rate for Payer: Cash Price $46.44
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: Cigna of CA HMO $66.05
Rate for Payer: Cigna of CA PPO $76.38
Rate for Payer: Dignity Health Commercial/Exchange $87.73
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: EPIC Health Plan Transplant $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $77.41
Rate for Payer: IEHP medi-cal $36.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $61.93
Rate for Payer: Riverside University Health MISP $41.28
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $61.93
Rate for Payer: TriValley Medical Group Commercial/Senior $61.93
Rate for Payer: United Healthcare All Other Commercial $51.60
Rate for Payer: United Healthcare All Other HMO $51.60
Rate for Payer: United Healthcare HMO Rider $51.60
Rate for Payer: United Healthcare Select/Navigate/Core $51.60
Rate for Payer: Vantage Medical Group Medi-Cal $87.73
Rate for Payer: Vantage Medical Group Senior $87.73
Service Code CPT C1894
Hospital Charge Code 901607734
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $92.89
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Service Code CPT C1894
Hospital Charge Code 901607734
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $235.49
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $87.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $56.77
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $56.77
Rate for Payer: Anthem Blue Cross of CA Exchange $49.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $60.98
Rate for Payer: BCBS Transplant Transplant $61.93
Rate for Payer: Blue Shield of California Commercial $64.92
Rate for Payer: Blue Shield of California EPN $50.47
Rate for Payer: Cash Price $46.44
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: Cigna of CA HMO $66.05
Rate for Payer: Cigna of CA PPO $76.38
Rate for Payer: Dignity Health Commercial/Exchange $87.73
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: EPIC Health Plan Transplant $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $77.41
Rate for Payer: IEHP medi-cal $36.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $61.93
Rate for Payer: Riverside University Health MISP $41.28
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $61.93
Rate for Payer: TriValley Medical Group Commercial/Senior $61.93
Rate for Payer: United Healthcare All Other Commercial $51.60
Rate for Payer: United Healthcare All Other HMO $51.60
Rate for Payer: United Healthcare HMO Rider $51.60
Rate for Payer: United Healthcare Select/Navigate/Core $51.60
Rate for Payer: Vantage Medical Group Medi-Cal $87.73
Rate for Payer: Vantage Medical Group Senior $87.73
Service Code CPT C1894
Hospital Charge Code 901607736
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $235.49
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $87.73
Rate for Payer: AlphaCare Medical Group Medi-Cal $56.77
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $56.77
Rate for Payer: Anthem Blue Cross of CA Exchange $49.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $60.98
Rate for Payer: BCBS Transplant Transplant $61.93
Rate for Payer: Blue Shield of California Commercial $64.92
Rate for Payer: Blue Shield of California EPN $50.47
Rate for Payer: Cash Price $46.44
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: Cigna of CA HMO $66.05
Rate for Payer: Cigna of CA PPO $76.38
Rate for Payer: Dignity Health Commercial/Exchange $87.73
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: EPIC Health Plan Transplant $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $77.41
Rate for Payer: IEHP medi-cal $36.12
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $61.93
Rate for Payer: Riverside University Health MISP $41.28
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $61.93
Rate for Payer: TriValley Medical Group Commercial/Senior $61.93
Rate for Payer: United Healthcare All Other Commercial $51.60
Rate for Payer: United Healthcare All Other HMO $51.60
Rate for Payer: United Healthcare HMO Rider $51.60
Rate for Payer: United Healthcare Select/Navigate/Core $51.60
Rate for Payer: Vantage Medical Group Medi-Cal $87.73
Rate for Payer: Vantage Medical Group Senior $87.73
Service Code CPT C1894
Hospital Charge Code 901607736
Hospital Revenue Code 272
Min. Negotiated Rate $20.64
Max. Negotiated Rate $92.89
Rate for Payer: Cash Price $46.44
Rate for Payer: Central Health Plan Commercial $82.57
Rate for Payer: EPIC Health Plan Commercial $41.28
Rate for Payer: Galaxy Health WC $87.73
Rate for Payer: Global Benefits Group Commercial $61.93
Rate for Payer: Health Management Network EPO/PPO $92.89
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $68.84
Rate for Payer: LLUH Dept of Risk Management WC $20.64
Rate for Payer: Multiplan Commercial $77.41
Rate for Payer: Networks By Design Commercial $67.09
Rate for Payer: Prime Health Services Commercial $87.73
Service Code CPT C1894
Hospital Charge Code 901698534
Hospital Revenue Code 272
Min. Negotiated Rate $127.78
Max. Negotiated Rate $575.00
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $543.06
Rate for Payer: AlphaCare Medical Group Medi-Cal $351.39
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $351.39
Rate for Payer: Anthem Blue Cross of CA Exchange $309.35
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $377.46
Rate for Payer: BCBS Transplant Transplant $383.33
Rate for Payer: Blue Shield of California Commercial $401.86
Rate for Payer: Blue Shield of California EPN $312.42
Rate for Payer: Cash Price $287.50
Rate for Payer: Cash Price $287.50
Rate for Payer: Central Health Plan Commercial $511.11
Rate for Payer: Cigna of CA HMO $408.89
Rate for Payer: Cigna of CA PPO $472.78
Rate for Payer: Dignity Health Commercial/Exchange $543.06
Rate for Payer: EPIC Health Plan Commercial $255.56
Rate for Payer: EPIC Health Plan Transplant $255.56
Rate for Payer: Galaxy Health WC $543.06
Rate for Payer: Global Benefits Group Commercial $383.33
Rate for Payer: Health Management Network EPO/PPO $575.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $479.17
Rate for Payer: IEHP medi-cal $223.61
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $426.14
Rate for Payer: LLUH Dept of Risk Management WC $127.78
Rate for Payer: Multiplan Commercial $479.17
Rate for Payer: Networks By Design Commercial $415.28
Rate for Payer: Prime Health Services Commercial $543.06
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $383.33
Rate for Payer: Riverside University Health MISP $255.56
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $383.33
Rate for Payer: TriValley Medical Group Commercial/Senior $383.33
Rate for Payer: United Healthcare All Other Commercial $319.44
Rate for Payer: United Healthcare All Other HMO $319.44
Rate for Payer: United Healthcare HMO Rider $319.44
Rate for Payer: United Healthcare Select/Navigate/Core $319.44
Rate for Payer: Vantage Medical Group Medi-Cal $543.06
Rate for Payer: Vantage Medical Group Senior $543.06
Service Code CPT C1894
Hospital Charge Code 901698534
Hospital Revenue Code 272
Min. Negotiated Rate $127.78
Max. Negotiated Rate $575.00
Rate for Payer: Cash Price $287.50
Rate for Payer: Central Health Plan Commercial $511.11
Rate for Payer: EPIC Health Plan Commercial $255.56
Rate for Payer: Galaxy Health WC $543.06
Rate for Payer: Global Benefits Group Commercial $383.33
Rate for Payer: Health Management Network EPO/PPO $575.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $426.14
Rate for Payer: LLUH Dept of Risk Management WC $127.78
Rate for Payer: Multiplan Commercial $479.17
Rate for Payer: Networks By Design Commercial $415.28
Rate for Payer: Prime Health Services Commercial $543.06
Service Code CPT C1894
Hospital Charge Code 901698535
Hospital Revenue Code 272
Min. Negotiated Rate $138.08
Max. Negotiated Rate $621.37
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $586.85
Rate for Payer: AlphaCare Medical Group Medi-Cal $379.73
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $379.73
Rate for Payer: Anthem Blue Cross of CA Exchange $334.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $407.89
Rate for Payer: BCBS Transplant Transplant $414.25
Rate for Payer: Blue Shield of California Commercial $434.27
Rate for Payer: Blue Shield of California EPN $337.61
Rate for Payer: Cash Price $310.68
Rate for Payer: Cash Price $310.68
Rate for Payer: Central Health Plan Commercial $552.33
Rate for Payer: Cigna of CA HMO $441.86
Rate for Payer: Cigna of CA PPO $510.90
Rate for Payer: Dignity Health Commercial/Exchange $586.85
Rate for Payer: EPIC Health Plan Commercial $276.16
Rate for Payer: EPIC Health Plan Transplant $276.16
Rate for Payer: Galaxy Health WC $586.85
Rate for Payer: Global Benefits Group Commercial $414.25
Rate for Payer: Health Management Network EPO/PPO $621.37
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $517.81
Rate for Payer: IEHP medi-cal $241.64
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $460.50
Rate for Payer: LLUH Dept of Risk Management WC $138.08
Rate for Payer: Multiplan Commercial $517.81
Rate for Payer: Networks By Design Commercial $448.77
Rate for Payer: Prime Health Services Commercial $586.85
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $414.25
Rate for Payer: Riverside University Health MISP $276.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $414.25
Rate for Payer: TriValley Medical Group Commercial/Senior $414.25
Rate for Payer: United Healthcare All Other Commercial $345.20
Rate for Payer: United Healthcare All Other HMO $345.20
Rate for Payer: United Healthcare HMO Rider $345.20
Rate for Payer: United Healthcare Select/Navigate/Core $345.20
Rate for Payer: Vantage Medical Group Medi-Cal $586.85
Rate for Payer: Vantage Medical Group Senior $586.85
Service Code CPT C1894
Hospital Charge Code 901698535
Hospital Revenue Code 272
Min. Negotiated Rate $138.08
Max. Negotiated Rate $621.37
Rate for Payer: Cash Price $310.68
Rate for Payer: Central Health Plan Commercial $552.33
Rate for Payer: EPIC Health Plan Commercial $276.16
Rate for Payer: Galaxy Health WC $586.85
Rate for Payer: Global Benefits Group Commercial $414.25
Rate for Payer: Health Management Network EPO/PPO $621.37
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $460.50
Rate for Payer: LLUH Dept of Risk Management WC $138.08
Rate for Payer: Multiplan Commercial $517.81
Rate for Payer: Networks By Design Commercial $448.77
Rate for Payer: Prime Health Services Commercial $586.85
Service Code CPT C1894
Hospital Charge Code 909001044
Hospital Revenue Code 272
Min. Negotiated Rate $34.60
Max. Negotiated Rate $155.70
Rate for Payer: Cash Price $77.85
Rate for Payer: Central Health Plan Commercial $138.40
Rate for Payer: EPIC Health Plan Commercial $69.20
Rate for Payer: Galaxy Health WC $147.05
Rate for Payer: Global Benefits Group Commercial $103.80
Rate for Payer: Health Management Network EPO/PPO $155.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $115.39
Rate for Payer: LLUH Dept of Risk Management WC $34.60
Rate for Payer: Multiplan Commercial $129.75
Rate for Payer: Networks By Design Commercial $112.45
Rate for Payer: Prime Health Services Commercial $147.05
Service Code CPT C1894
Hospital Charge Code 909001044
Hospital Revenue Code 272
Min. Negotiated Rate $34.60
Max. Negotiated Rate $235.49
Rate for Payer: Aetna of CA HMO/PPO $235.49
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $147.05
Rate for Payer: AlphaCare Medical Group Medi-Cal $95.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $95.15
Rate for Payer: Anthem Blue Cross of CA Exchange $83.77
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $102.21
Rate for Payer: BCBS Transplant Transplant $103.80
Rate for Payer: Blue Shield of California Commercial $108.82
Rate for Payer: Blue Shield of California EPN $84.60
Rate for Payer: Cash Price $77.85
Rate for Payer: Cash Price $77.85
Rate for Payer: Central Health Plan Commercial $138.40
Rate for Payer: Cigna of CA HMO $110.72
Rate for Payer: Cigna of CA PPO $128.02
Rate for Payer: Dignity Health Commercial/Exchange $147.05
Rate for Payer: EPIC Health Plan Commercial $69.20
Rate for Payer: EPIC Health Plan Transplant $69.20
Rate for Payer: Galaxy Health WC $147.05
Rate for Payer: Global Benefits Group Commercial $103.80
Rate for Payer: Health Management Network EPO/PPO $155.70
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $129.75
Rate for Payer: IEHP medi-cal $60.55
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $115.39
Rate for Payer: LLUH Dept of Risk Management WC $34.60
Rate for Payer: Multiplan Commercial $129.75
Rate for Payer: Networks By Design Commercial $112.45
Rate for Payer: Prime Health Services Commercial $147.05
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $103.80
Rate for Payer: Riverside University Health MISP $69.20
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $103.80
Rate for Payer: TriValley Medical Group Commercial/Senior $103.80
Rate for Payer: United Healthcare All Other Commercial $86.50
Rate for Payer: United Healthcare All Other HMO $86.50
Rate for Payer: United Healthcare HMO Rider $86.50
Rate for Payer: United Healthcare Select/Navigate/Core $86.50
Rate for Payer: Vantage Medical Group Medi-Cal $147.05
Rate for Payer: Vantage Medical Group Senior $147.05