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Service Code CPT A7520
Hospital Charge Code 901698509
Hospital Revenue Code 272
Min. Negotiated Rate $70.00
Max. Negotiated Rate $315.00
Rate for Payer: Cash Price $157.50
Rate for Payer: Central Health Plan Commercial $280.00
Rate for Payer: EPIC Health Plan Commercial $140.00
Rate for Payer: Galaxy Health WC $297.50
Rate for Payer: Global Benefits Group Commercial $210.00
Rate for Payer: Health Management Network EPO/PPO $315.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $233.45
Rate for Payer: LLUH Dept of Risk Management WC $70.00
Rate for Payer: Multiplan Commercial $262.50
Rate for Payer: Networks By Design Commercial $227.50
Rate for Payer: Prime Health Services Commercial $297.50
Service Code CPT A7520
Hospital Charge Code 901698510
Hospital Revenue Code 272
Min. Negotiated Rate $70.00
Max. Negotiated Rate $315.00
Rate for Payer: Aetna of CA HMO/PPO $124.68
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $297.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $192.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $192.50
Rate for Payer: Anthem Blue Cross of CA Exchange $169.47
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $206.78
Rate for Payer: BCBS Transplant Transplant $210.00
Rate for Payer: Blue Shield of California Commercial $220.15
Rate for Payer: Blue Shield of California EPN $171.15
Rate for Payer: Cash Price $157.50
Rate for Payer: Cash Price $157.50
Rate for Payer: Central Health Plan Commercial $280.00
Rate for Payer: Cigna of CA HMO $224.00
Rate for Payer: Cigna of CA PPO $259.00
Rate for Payer: Dignity Health Commercial/Exchange $297.50
Rate for Payer: EPIC Health Plan Commercial $140.00
Rate for Payer: EPIC Health Plan Transplant $140.00
Rate for Payer: Galaxy Health WC $297.50
Rate for Payer: Global Benefits Group Commercial $210.00
Rate for Payer: Health Management Network EPO/PPO $315.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $262.50
Rate for Payer: IEHP medi-cal $122.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $233.45
Rate for Payer: LLUH Dept of Risk Management WC $70.00
Rate for Payer: Multiplan Commercial $262.50
Rate for Payer: Networks By Design Commercial $227.50
Rate for Payer: Prime Health Services Commercial $297.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $210.00
Rate for Payer: Riverside University Health MISP $140.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $210.00
Rate for Payer: TriValley Medical Group Commercial/Senior $210.00
Rate for Payer: United Healthcare All Other Commercial $175.00
Rate for Payer: United Healthcare All Other HMO $175.00
Rate for Payer: United Healthcare HMO Rider $175.00
Rate for Payer: United Healthcare Select/Navigate/Core $175.00
Rate for Payer: Vantage Medical Group Medi-Cal $297.50
Rate for Payer: Vantage Medical Group Senior $297.50
Service Code CPT A7520
Hospital Charge Code 901698510
Hospital Revenue Code 272
Min. Negotiated Rate $70.00
Max. Negotiated Rate $315.00
Rate for Payer: Cash Price $157.50
Rate for Payer: Central Health Plan Commercial $280.00
Rate for Payer: EPIC Health Plan Commercial $140.00
Rate for Payer: Galaxy Health WC $297.50
Rate for Payer: Global Benefits Group Commercial $210.00
Rate for Payer: Health Management Network EPO/PPO $315.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $233.45
Rate for Payer: LLUH Dept of Risk Management WC $70.00
Rate for Payer: Multiplan Commercial $262.50
Rate for Payer: Networks By Design Commercial $227.50
Rate for Payer: Prime Health Services Commercial $297.50
Service Code CPT A7520
Hospital Charge Code 901698511
Hospital Revenue Code 272
Min. Negotiated Rate $66.33
Max. Negotiated Rate $298.49
Rate for Payer: Aetna of CA HMO/PPO $124.68
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $281.91
Rate for Payer: AlphaCare Medical Group Medi-Cal $182.41
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $182.41
Rate for Payer: Anthem Blue Cross of CA Exchange $160.59
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $195.94
Rate for Payer: BCBS Transplant Transplant $199.00
Rate for Payer: Blue Shield of California Commercial $208.61
Rate for Payer: Blue Shield of California EPN $162.18
Rate for Payer: Cash Price $149.25
Rate for Payer: Cash Price $149.25
Rate for Payer: Central Health Plan Commercial $265.33
Rate for Payer: Cigna of CA HMO $212.26
Rate for Payer: Cigna of CA PPO $245.43
Rate for Payer: Dignity Health Commercial/Exchange $281.91
Rate for Payer: EPIC Health Plan Commercial $132.66
Rate for Payer: EPIC Health Plan Transplant $132.66
Rate for Payer: Galaxy Health WC $281.91
Rate for Payer: Global Benefits Group Commercial $199.00
Rate for Payer: Health Management Network EPO/PPO $298.49
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $248.74
Rate for Payer: IEHP medi-cal $116.08
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $221.22
Rate for Payer: LLUH Dept of Risk Management WC $66.33
Rate for Payer: Multiplan Commercial $248.74
Rate for Payer: Networks By Design Commercial $215.58
Rate for Payer: Prime Health Services Commercial $281.91
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $199.00
Rate for Payer: Riverside University Health MISP $132.66
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $199.00
Rate for Payer: TriValley Medical Group Commercial/Senior $199.00
Rate for Payer: United Healthcare All Other Commercial $165.83
Rate for Payer: United Healthcare All Other HMO $165.83
Rate for Payer: United Healthcare HMO Rider $165.83
Rate for Payer: United Healthcare Select/Navigate/Core $165.83
Rate for Payer: Vantage Medical Group Medi-Cal $281.91
Rate for Payer: Vantage Medical Group Senior $281.91
Service Code CPT A7520
Hospital Charge Code 901698511
Hospital Revenue Code 272
Min. Negotiated Rate $66.33
Max. Negotiated Rate $298.49
Rate for Payer: Cash Price $149.25
Rate for Payer: Central Health Plan Commercial $265.33
Rate for Payer: EPIC Health Plan Commercial $132.66
Rate for Payer: Galaxy Health WC $281.91
Rate for Payer: Global Benefits Group Commercial $199.00
Rate for Payer: Health Management Network EPO/PPO $298.49
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $221.22
Rate for Payer: LLUH Dept of Risk Management WC $66.33
Rate for Payer: Multiplan Commercial $248.74
Rate for Payer: Networks By Design Commercial $215.58
Rate for Payer: Prime Health Services Commercial $281.91
Hospital Charge Code 900800839
Hospital Revenue Code 272
Min. Negotiated Rate $42.00
Max. Negotiated Rate $189.00
Rate for Payer: Aetna of CA HMO/PPO $127.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $178.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $115.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $115.50
Rate for Payer: Anthem Blue Cross of CA Exchange $101.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $124.07
Rate for Payer: BCBS Transplant Transplant $126.00
Rate for Payer: Blue Shield of California Commercial $132.09
Rate for Payer: Blue Shield of California EPN $102.69
Rate for Payer: Cash Price $94.50
Rate for Payer: Central Health Plan Commercial $168.00
Rate for Payer: Cigna of CA HMO $134.40
Rate for Payer: Cigna of CA PPO $155.40
Rate for Payer: Dignity Health Commercial/Exchange $178.50
Rate for Payer: EPIC Health Plan Commercial $84.00
Rate for Payer: EPIC Health Plan Transplant $84.00
Rate for Payer: Galaxy Health WC $178.50
Rate for Payer: Global Benefits Group Commercial $126.00
Rate for Payer: Health Management Network EPO/PPO $189.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $157.50
Rate for Payer: IEHP medi-cal $73.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $140.07
Rate for Payer: LLUH Dept of Risk Management WC $42.00
Rate for Payer: Multiplan Commercial $157.50
Rate for Payer: Networks By Design Commercial $136.50
Rate for Payer: Prime Health Services Commercial $178.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $126.00
Rate for Payer: Riverside University Health MISP $84.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $126.00
Rate for Payer: TriValley Medical Group Commercial/Senior $126.00
Rate for Payer: United Healthcare All Other Commercial $105.00
Rate for Payer: United Healthcare All Other HMO $105.00
Rate for Payer: United Healthcare HMO Rider $105.00
Rate for Payer: United Healthcare Select/Navigate/Core $105.00
Rate for Payer: Vantage Medical Group Medi-Cal $178.50
Rate for Payer: Vantage Medical Group Senior $178.50
Hospital Charge Code 900800839
Hospital Revenue Code 272
Min. Negotiated Rate $42.00
Max. Negotiated Rate $189.00
Rate for Payer: Cash Price $94.50
Rate for Payer: Central Health Plan Commercial $168.00
Rate for Payer: EPIC Health Plan Commercial $84.00
Rate for Payer: Galaxy Health WC $178.50
Rate for Payer: Global Benefits Group Commercial $126.00
Rate for Payer: Health Management Network EPO/PPO $189.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $140.07
Rate for Payer: LLUH Dept of Risk Management WC $42.00
Rate for Payer: Multiplan Commercial $157.50
Rate for Payer: Networks By Design Commercial $136.50
Rate for Payer: Prime Health Services Commercial $178.50
Hospital Charge Code 900800834
Hospital Revenue Code 272
Min. Negotiated Rate $39.52
Max. Negotiated Rate $177.85
Rate for Payer: Cash Price $88.92
Rate for Payer: Central Health Plan Commercial $158.09
Rate for Payer: EPIC Health Plan Commercial $79.04
Rate for Payer: Galaxy Health WC $167.97
Rate for Payer: Global Benefits Group Commercial $118.57
Rate for Payer: Health Management Network EPO/PPO $177.85
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $131.81
Rate for Payer: LLUH Dept of Risk Management WC $39.52
Rate for Payer: Multiplan Commercial $148.21
Rate for Payer: Networks By Design Commercial $128.45
Rate for Payer: Prime Health Services Commercial $167.97
Hospital Charge Code 900800834
Hospital Revenue Code 272
Min. Negotiated Rate $39.52
Max. Negotiated Rate $177.85
Rate for Payer: Aetna of CA HMO/PPO $120.01
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $167.97
Rate for Payer: AlphaCare Medical Group Medi-Cal $108.69
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $108.69
Rate for Payer: Anthem Blue Cross of CA Exchange $95.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $116.75
Rate for Payer: BCBS Transplant Transplant $118.57
Rate for Payer: Blue Shield of California Commercial $124.30
Rate for Payer: Blue Shield of California EPN $96.63
Rate for Payer: Cash Price $88.92
Rate for Payer: Central Health Plan Commercial $158.09
Rate for Payer: Cigna of CA HMO $126.47
Rate for Payer: Cigna of CA PPO $146.23
Rate for Payer: Dignity Health Commercial/Exchange $167.97
Rate for Payer: EPIC Health Plan Commercial $79.04
Rate for Payer: EPIC Health Plan Transplant $79.04
Rate for Payer: Galaxy Health WC $167.97
Rate for Payer: Global Benefits Group Commercial $118.57
Rate for Payer: Health Management Network EPO/PPO $177.85
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $148.21
Rate for Payer: IEHP medi-cal $69.16
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $131.81
Rate for Payer: LLUH Dept of Risk Management WC $39.52
Rate for Payer: Multiplan Commercial $148.21
Rate for Payer: Networks By Design Commercial $128.45
Rate for Payer: Prime Health Services Commercial $167.97
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $118.57
Rate for Payer: Riverside University Health MISP $79.04
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $118.57
Rate for Payer: TriValley Medical Group Commercial/Senior $118.57
Rate for Payer: United Healthcare All Other Commercial $98.80
Rate for Payer: United Healthcare All Other HMO $98.80
Rate for Payer: United Healthcare HMO Rider $98.80
Rate for Payer: United Healthcare Select/Navigate/Core $98.80
Rate for Payer: Vantage Medical Group Medi-Cal $167.97
Rate for Payer: Vantage Medical Group Senior $167.97
Hospital Charge Code 900800835
Hospital Revenue Code 272
Min. Negotiated Rate $41.51
Max. Negotiated Rate $186.80
Rate for Payer: Cash Price $93.40
Rate for Payer: Central Health Plan Commercial $166.04
Rate for Payer: EPIC Health Plan Commercial $83.02
Rate for Payer: Galaxy Health WC $176.42
Rate for Payer: Global Benefits Group Commercial $124.53
Rate for Payer: Health Management Network EPO/PPO $186.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $138.44
Rate for Payer: LLUH Dept of Risk Management WC $41.51
Rate for Payer: Multiplan Commercial $155.66
Rate for Payer: Networks By Design Commercial $134.91
Rate for Payer: Prime Health Services Commercial $176.42
Hospital Charge Code 900800835
Hospital Revenue Code 272
Min. Negotiated Rate $41.51
Max. Negotiated Rate $186.80
Rate for Payer: Aetna of CA HMO/PPO $126.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $176.42
Rate for Payer: AlphaCare Medical Group Medi-Cal $114.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $114.15
Rate for Payer: Anthem Blue Cross of CA Exchange $100.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $122.62
Rate for Payer: BCBS Transplant Transplant $124.53
Rate for Payer: Blue Shield of California Commercial $130.55
Rate for Payer: Blue Shield of California EPN $101.49
Rate for Payer: Cash Price $93.40
Rate for Payer: Central Health Plan Commercial $166.04
Rate for Payer: Cigna of CA HMO $132.83
Rate for Payer: Cigna of CA PPO $153.59
Rate for Payer: Dignity Health Commercial/Exchange $176.42
Rate for Payer: EPIC Health Plan Commercial $83.02
Rate for Payer: EPIC Health Plan Transplant $83.02
Rate for Payer: Galaxy Health WC $176.42
Rate for Payer: Global Benefits Group Commercial $124.53
Rate for Payer: Health Management Network EPO/PPO $186.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $155.66
Rate for Payer: IEHP medi-cal $72.64
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $138.44
Rate for Payer: LLUH Dept of Risk Management WC $41.51
Rate for Payer: Multiplan Commercial $155.66
Rate for Payer: Networks By Design Commercial $134.91
Rate for Payer: Prime Health Services Commercial $176.42
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $124.53
Rate for Payer: Riverside University Health MISP $83.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $124.53
Rate for Payer: TriValley Medical Group Commercial/Senior $124.53
Rate for Payer: United Healthcare All Other Commercial $103.78
Rate for Payer: United Healthcare All Other HMO $103.78
Rate for Payer: United Healthcare HMO Rider $103.78
Rate for Payer: United Healthcare Select/Navigate/Core $103.78
Rate for Payer: Vantage Medical Group Medi-Cal $176.42
Rate for Payer: Vantage Medical Group Senior $176.42
Hospital Charge Code 900800836
Hospital Revenue Code 272
Min. Negotiated Rate $41.51
Max. Negotiated Rate $186.80
Rate for Payer: Cash Price $93.40
Rate for Payer: Central Health Plan Commercial $166.04
Rate for Payer: EPIC Health Plan Commercial $83.02
Rate for Payer: Galaxy Health WC $176.42
Rate for Payer: Global Benefits Group Commercial $124.53
Rate for Payer: Health Management Network EPO/PPO $186.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $138.44
Rate for Payer: LLUH Dept of Risk Management WC $41.51
Rate for Payer: Multiplan Commercial $155.66
Rate for Payer: Networks By Design Commercial $134.91
Rate for Payer: Prime Health Services Commercial $176.42
Hospital Charge Code 900800836
Hospital Revenue Code 272
Min. Negotiated Rate $41.51
Max. Negotiated Rate $186.80
Rate for Payer: Aetna of CA HMO/PPO $126.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $176.42
Rate for Payer: AlphaCare Medical Group Medi-Cal $114.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $114.15
Rate for Payer: Anthem Blue Cross of CA Exchange $100.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $122.62
Rate for Payer: BCBS Transplant Transplant $124.53
Rate for Payer: Blue Shield of California Commercial $130.55
Rate for Payer: Blue Shield of California EPN $101.49
Rate for Payer: Cash Price $93.40
Rate for Payer: Central Health Plan Commercial $166.04
Rate for Payer: Cigna of CA HMO $132.83
Rate for Payer: Cigna of CA PPO $153.59
Rate for Payer: Dignity Health Commercial/Exchange $176.42
Rate for Payer: EPIC Health Plan Commercial $83.02
Rate for Payer: EPIC Health Plan Transplant $83.02
Rate for Payer: Galaxy Health WC $176.42
Rate for Payer: Global Benefits Group Commercial $124.53
Rate for Payer: Health Management Network EPO/PPO $186.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $155.66
Rate for Payer: IEHP medi-cal $72.64
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $138.44
Rate for Payer: LLUH Dept of Risk Management WC $41.51
Rate for Payer: Multiplan Commercial $155.66
Rate for Payer: Networks By Design Commercial $134.91
Rate for Payer: Prime Health Services Commercial $176.42
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $124.53
Rate for Payer: Riverside University Health MISP $83.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $124.53
Rate for Payer: TriValley Medical Group Commercial/Senior $124.53
Rate for Payer: United Healthcare All Other Commercial $103.78
Rate for Payer: United Healthcare All Other HMO $103.78
Rate for Payer: United Healthcare HMO Rider $103.78
Rate for Payer: United Healthcare Select/Navigate/Core $103.78
Rate for Payer: Vantage Medical Group Medi-Cal $176.42
Rate for Payer: Vantage Medical Group Senior $176.42
Hospital Charge Code 900800837
Hospital Revenue Code 272
Min. Negotiated Rate $41.51
Max. Negotiated Rate $186.80
Rate for Payer: Aetna of CA HMO/PPO $126.05
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $176.42
Rate for Payer: AlphaCare Medical Group Medi-Cal $114.15
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $114.15
Rate for Payer: Anthem Blue Cross of CA Exchange $100.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $122.62
Rate for Payer: BCBS Transplant Transplant $124.53
Rate for Payer: Blue Shield of California Commercial $130.55
Rate for Payer: Blue Shield of California EPN $101.49
Rate for Payer: Cash Price $93.40
Rate for Payer: Central Health Plan Commercial $166.04
Rate for Payer: Cigna of CA HMO $132.83
Rate for Payer: Cigna of CA PPO $153.59
Rate for Payer: Dignity Health Commercial/Exchange $176.42
Rate for Payer: EPIC Health Plan Commercial $83.02
Rate for Payer: EPIC Health Plan Transplant $83.02
Rate for Payer: Galaxy Health WC $176.42
Rate for Payer: Global Benefits Group Commercial $124.53
Rate for Payer: Health Management Network EPO/PPO $186.80
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $155.66
Rate for Payer: IEHP medi-cal $72.64
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $138.44
Rate for Payer: LLUH Dept of Risk Management WC $41.51
Rate for Payer: Multiplan Commercial $155.66
Rate for Payer: Networks By Design Commercial $134.91
Rate for Payer: Prime Health Services Commercial $176.42
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $124.53
Rate for Payer: Riverside University Health MISP $83.02
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $124.53
Rate for Payer: TriValley Medical Group Commercial/Senior $124.53
Rate for Payer: United Healthcare All Other Commercial $103.78
Rate for Payer: United Healthcare All Other HMO $103.78
Rate for Payer: United Healthcare HMO Rider $103.78
Rate for Payer: United Healthcare Select/Navigate/Core $103.78
Rate for Payer: Vantage Medical Group Medi-Cal $176.42
Rate for Payer: Vantage Medical Group Senior $176.42
Hospital Charge Code 900800837
Hospital Revenue Code 272
Min. Negotiated Rate $41.51
Max. Negotiated Rate $186.80
Rate for Payer: Cash Price $93.40
Rate for Payer: Central Health Plan Commercial $166.04
Rate for Payer: EPIC Health Plan Commercial $83.02
Rate for Payer: Galaxy Health WC $176.42
Rate for Payer: Global Benefits Group Commercial $124.53
Rate for Payer: Health Management Network EPO/PPO $186.80
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $138.44
Rate for Payer: LLUH Dept of Risk Management WC $41.51
Rate for Payer: Multiplan Commercial $155.66
Rate for Payer: Networks By Design Commercial $134.91
Rate for Payer: Prime Health Services Commercial $176.42
Hospital Charge Code 900800838
Hospital Revenue Code 272
Min. Negotiated Rate $42.00
Max. Negotiated Rate $189.00
Rate for Payer: Aetna of CA HMO/PPO $127.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $178.50
Rate for Payer: AlphaCare Medical Group Medi-Cal $115.50
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $115.50
Rate for Payer: Anthem Blue Cross of CA Exchange $101.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $124.07
Rate for Payer: BCBS Transplant Transplant $126.00
Rate for Payer: Blue Shield of California Commercial $132.09
Rate for Payer: Blue Shield of California EPN $102.69
Rate for Payer: Cash Price $94.50
Rate for Payer: Central Health Plan Commercial $168.00
Rate for Payer: Cigna of CA HMO $134.40
Rate for Payer: Cigna of CA PPO $155.40
Rate for Payer: Dignity Health Commercial/Exchange $178.50
Rate for Payer: EPIC Health Plan Commercial $84.00
Rate for Payer: EPIC Health Plan Transplant $84.00
Rate for Payer: Galaxy Health WC $178.50
Rate for Payer: Global Benefits Group Commercial $126.00
Rate for Payer: Health Management Network EPO/PPO $189.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $157.50
Rate for Payer: IEHP medi-cal $73.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $140.07
Rate for Payer: LLUH Dept of Risk Management WC $42.00
Rate for Payer: Multiplan Commercial $157.50
Rate for Payer: Networks By Design Commercial $136.50
Rate for Payer: Prime Health Services Commercial $178.50
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $126.00
Rate for Payer: Riverside University Health MISP $84.00
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $126.00
Rate for Payer: TriValley Medical Group Commercial/Senior $126.00
Rate for Payer: United Healthcare All Other Commercial $105.00
Rate for Payer: United Healthcare All Other HMO $105.00
Rate for Payer: United Healthcare HMO Rider $105.00
Rate for Payer: United Healthcare Select/Navigate/Core $105.00
Rate for Payer: Vantage Medical Group Medi-Cal $178.50
Rate for Payer: Vantage Medical Group Senior $178.50
Hospital Charge Code 900800838
Hospital Revenue Code 272
Min. Negotiated Rate $42.00
Max. Negotiated Rate $189.00
Rate for Payer: Cash Price $94.50
Rate for Payer: Central Health Plan Commercial $168.00
Rate for Payer: EPIC Health Plan Commercial $84.00
Rate for Payer: Galaxy Health WC $178.50
Rate for Payer: Global Benefits Group Commercial $126.00
Rate for Payer: Health Management Network EPO/PPO $189.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $140.07
Rate for Payer: LLUH Dept of Risk Management WC $42.00
Rate for Payer: Multiplan Commercial $157.50
Rate for Payer: Networks By Design Commercial $136.50
Rate for Payer: Prime Health Services Commercial $178.50
Hospital Charge Code 900800706
Hospital Revenue Code 272
Min. Negotiated Rate $7.20
Max. Negotiated Rate $32.40
Rate for Payer: Cash Price $16.20
Rate for Payer: Central Health Plan Commercial $28.80
Rate for Payer: EPIC Health Plan Commercial $14.40
Rate for Payer: Galaxy Health WC $30.60
Rate for Payer: Global Benefits Group Commercial $21.60
Rate for Payer: Health Management Network EPO/PPO $32.40
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $24.01
Rate for Payer: LLUH Dept of Risk Management WC $7.20
Rate for Payer: Multiplan Commercial $27.00
Rate for Payer: Networks By Design Commercial $23.40
Rate for Payer: Prime Health Services Commercial $30.60
Hospital Charge Code 900800706
Hospital Revenue Code 272
Min. Negotiated Rate $7.20
Max. Negotiated Rate $32.40
Rate for Payer: Aetna of CA HMO/PPO $21.86
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $30.60
Rate for Payer: AlphaCare Medical Group Medi-Cal $19.80
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $19.80
Rate for Payer: Anthem Blue Cross of CA Exchange $17.43
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $21.27
Rate for Payer: BCBS Transplant Transplant $21.60
Rate for Payer: Blue Shield of California Commercial $22.64
Rate for Payer: Blue Shield of California EPN $17.60
Rate for Payer: Cash Price $16.20
Rate for Payer: Central Health Plan Commercial $28.80
Rate for Payer: Cigna of CA HMO $23.04
Rate for Payer: Cigna of CA PPO $26.64
Rate for Payer: Dignity Health Commercial/Exchange $30.60
Rate for Payer: EPIC Health Plan Commercial $14.40
Rate for Payer: EPIC Health Plan Transplant $14.40
Rate for Payer: Galaxy Health WC $30.60
Rate for Payer: Global Benefits Group Commercial $21.60
Rate for Payer: Health Management Network EPO/PPO $32.40
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $27.00
Rate for Payer: IEHP medi-cal $12.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $24.01
Rate for Payer: LLUH Dept of Risk Management WC $7.20
Rate for Payer: Multiplan Commercial $27.00
Rate for Payer: Networks By Design Commercial $23.40
Rate for Payer: Prime Health Services Commercial $30.60
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $21.60
Rate for Payer: Riverside University Health MISP $14.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $21.60
Rate for Payer: TriValley Medical Group Commercial/Senior $21.60
Rate for Payer: United Healthcare All Other Commercial $18.00
Rate for Payer: United Healthcare All Other HMO $18.00
Rate for Payer: United Healthcare HMO Rider $18.00
Rate for Payer: United Healthcare Select/Navigate/Core $18.00
Rate for Payer: Vantage Medical Group Medi-Cal $30.60
Rate for Payer: Vantage Medical Group Senior $30.60
Service Code CPT A7521
Hospital Charge Code 900800840
Hospital Revenue Code 272
Min. Negotiated Rate $81.18
Max. Negotiated Rate $365.29
Rate for Payer: Cash Price $182.65
Rate for Payer: Central Health Plan Commercial $324.70
Rate for Payer: EPIC Health Plan Commercial $162.35
Rate for Payer: Galaxy Health WC $345.00
Rate for Payer: Global Benefits Group Commercial $243.53
Rate for Payer: Health Management Network EPO/PPO $365.29
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $270.72
Rate for Payer: LLUH Dept of Risk Management WC $81.18
Rate for Payer: Multiplan Commercial $304.41
Rate for Payer: Networks By Design Commercial $263.82
Rate for Payer: Prime Health Services Commercial $345.00
Service Code CPT A7521
Hospital Charge Code 900800840
Hospital Revenue Code 272
Min. Negotiated Rate $81.18
Max. Negotiated Rate $365.29
Rate for Payer: Aetna of CA HMO/PPO $123.57
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $345.00
Rate for Payer: AlphaCare Medical Group Medi-Cal $223.23
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $223.23
Rate for Payer: Anthem Blue Cross of CA Exchange $196.53
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $239.79
Rate for Payer: BCBS Transplant Transplant $243.53
Rate for Payer: Blue Shield of California Commercial $255.30
Rate for Payer: Blue Shield of California EPN $198.48
Rate for Payer: Cash Price $182.65
Rate for Payer: Cash Price $182.65
Rate for Payer: Central Health Plan Commercial $324.70
Rate for Payer: Cigna of CA HMO $259.76
Rate for Payer: Cigna of CA PPO $300.35
Rate for Payer: Dignity Health Commercial/Exchange $345.00
Rate for Payer: EPIC Health Plan Commercial $162.35
Rate for Payer: EPIC Health Plan Transplant $162.35
Rate for Payer: Galaxy Health WC $345.00
Rate for Payer: Global Benefits Group Commercial $243.53
Rate for Payer: Health Management Network EPO/PPO $365.29
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $304.41
Rate for Payer: IEHP medi-cal $142.06
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $270.72
Rate for Payer: LLUH Dept of Risk Management WC $81.18
Rate for Payer: Multiplan Commercial $304.41
Rate for Payer: Networks By Design Commercial $263.82
Rate for Payer: Prime Health Services Commercial $345.00
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $243.53
Rate for Payer: Riverside University Health MISP $162.35
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $243.53
Rate for Payer: TriValley Medical Group Commercial/Senior $243.53
Rate for Payer: United Healthcare All Other Commercial $202.94
Rate for Payer: United Healthcare All Other HMO $202.94
Rate for Payer: United Healthcare HMO Rider $202.94
Rate for Payer: United Healthcare Select/Navigate/Core $202.94
Rate for Payer: Vantage Medical Group Medi-Cal $345.00
Rate for Payer: Vantage Medical Group Senior $345.00
Service Code CPT A7521
Hospital Charge Code 900800841
Hospital Revenue Code 272
Min. Negotiated Rate $77.56
Max. Negotiated Rate $349.00
Rate for Payer: Aetna of CA HMO/PPO $123.57
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $329.61
Rate for Payer: AlphaCare Medical Group Medi-Cal $213.28
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $213.28
Rate for Payer: Anthem Blue Cross of CA Exchange $187.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $229.10
Rate for Payer: BCBS Transplant Transplant $232.67
Rate for Payer: Blue Shield of California Commercial $243.91
Rate for Payer: Blue Shield of California EPN $189.62
Rate for Payer: Cash Price $174.50
Rate for Payer: Cash Price $174.50
Rate for Payer: Central Health Plan Commercial $310.22
Rate for Payer: Cigna of CA HMO $248.18
Rate for Payer: Cigna of CA PPO $286.96
Rate for Payer: Dignity Health Commercial/Exchange $329.61
Rate for Payer: EPIC Health Plan Commercial $155.11
Rate for Payer: EPIC Health Plan Transplant $155.11
Rate for Payer: Galaxy Health WC $329.61
Rate for Payer: Global Benefits Group Commercial $232.67
Rate for Payer: Health Management Network EPO/PPO $349.00
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $290.84
Rate for Payer: IEHP medi-cal $135.72
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $258.65
Rate for Payer: LLUH Dept of Risk Management WC $77.56
Rate for Payer: Multiplan Commercial $290.84
Rate for Payer: Networks By Design Commercial $252.06
Rate for Payer: Prime Health Services Commercial $329.61
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $232.67
Rate for Payer: Riverside University Health MISP $155.11
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $232.67
Rate for Payer: TriValley Medical Group Commercial/Senior $232.67
Rate for Payer: United Healthcare All Other Commercial $193.89
Rate for Payer: United Healthcare All Other HMO $193.89
Rate for Payer: United Healthcare HMO Rider $193.89
Rate for Payer: United Healthcare Select/Navigate/Core $193.89
Rate for Payer: Vantage Medical Group Medi-Cal $329.61
Rate for Payer: Vantage Medical Group Senior $329.61
Service Code CPT A7521
Hospital Charge Code 900800841
Hospital Revenue Code 272
Min. Negotiated Rate $77.56
Max. Negotiated Rate $349.00
Rate for Payer: Cash Price $174.50
Rate for Payer: Central Health Plan Commercial $310.22
Rate for Payer: EPIC Health Plan Commercial $155.11
Rate for Payer: Galaxy Health WC $329.61
Rate for Payer: Global Benefits Group Commercial $232.67
Rate for Payer: Health Management Network EPO/PPO $349.00
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $258.65
Rate for Payer: LLUH Dept of Risk Management WC $77.56
Rate for Payer: Multiplan Commercial $290.84
Rate for Payer: Networks By Design Commercial $252.06
Rate for Payer: Prime Health Services Commercial $329.61
Service Code CPT A7521
Hospital Charge Code 900800842
Hospital Revenue Code 272
Min. Negotiated Rate $75.52
Max. Negotiated Rate $339.82
Rate for Payer: Cash Price $169.91
Rate for Payer: Central Health Plan Commercial $302.06
Rate for Payer: EPIC Health Plan Commercial $151.03
Rate for Payer: Galaxy Health WC $320.94
Rate for Payer: Global Benefits Group Commercial $226.55
Rate for Payer: Health Management Network EPO/PPO $339.82
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $251.85
Rate for Payer: LLUH Dept of Risk Management WC $75.52
Rate for Payer: Multiplan Commercial $283.18
Rate for Payer: Networks By Design Commercial $245.43
Rate for Payer: Prime Health Services Commercial $320.94
Service Code CPT A7521
Hospital Charge Code 900800842
Hospital Revenue Code 272
Min. Negotiated Rate $75.52
Max. Negotiated Rate $339.82
Rate for Payer: Aetna of CA HMO/PPO $123.57
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $320.94
Rate for Payer: AlphaCare Medical Group Medi-Cal $207.67
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $207.67
Rate for Payer: Anthem Blue Cross of CA Exchange $182.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $223.07
Rate for Payer: BCBS Transplant Transplant $226.55
Rate for Payer: Blue Shield of California Commercial $237.50
Rate for Payer: Blue Shield of California EPN $184.64
Rate for Payer: Cash Price $169.91
Rate for Payer: Cash Price $169.91
Rate for Payer: Central Health Plan Commercial $302.06
Rate for Payer: Cigna of CA HMO $241.65
Rate for Payer: Cigna of CA PPO $279.41
Rate for Payer: Dignity Health Commercial/Exchange $320.94
Rate for Payer: EPIC Health Plan Commercial $151.03
Rate for Payer: EPIC Health Plan Transplant $151.03
Rate for Payer: Galaxy Health WC $320.94
Rate for Payer: Global Benefits Group Commercial $226.55
Rate for Payer: Health Management Network EPO/PPO $339.82
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $283.18
Rate for Payer: IEHP medi-cal $132.15
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $251.85
Rate for Payer: LLUH Dept of Risk Management WC $75.52
Rate for Payer: Multiplan Commercial $283.18
Rate for Payer: Networks By Design Commercial $245.43
Rate for Payer: Prime Health Services Commercial $320.94
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $226.55
Rate for Payer: Riverside University Health MISP $151.03
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $226.55
Rate for Payer: TriValley Medical Group Commercial/Senior $226.55
Rate for Payer: United Healthcare All Other Commercial $188.79
Rate for Payer: United Healthcare All Other HMO $188.79
Rate for Payer: United Healthcare HMO Rider $188.79
Rate for Payer: United Healthcare Select/Navigate/Core $188.79
Rate for Payer: Vantage Medical Group Medi-Cal $320.94
Rate for Payer: Vantage Medical Group Senior $320.94