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Charge Type Price  
Hospital Charge Code 901607899
Hospital Revenue Code 272
Min. Negotiated Rate $25.84
Max. Negotiated Rate $116.28
Rate for Payer: Cash Price $58.14
Rate for Payer: Central Health Plan Commercial $103.36
Rate for Payer: EPIC Health Plan Commercial $51.68
Rate for Payer: Galaxy Health WC $109.82
Rate for Payer: Global Benefits Group Commercial $77.52
Rate for Payer: Health Management Network EPO/PPO $116.28
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $86.18
Rate for Payer: LLUH Dept of Risk Management WC $25.84
Rate for Payer: Multiplan Commercial $96.90
Rate for Payer: Networks By Design Commercial $83.98
Rate for Payer: Prime Health Services Commercial $109.82
Service Code CPT A4369
Hospital Charge Code 901607709
Hospital Revenue Code 272
Min. Negotiated Rate $2.13
Max. Negotiated Rate $9.59
Rate for Payer: Cash Price $4.80
Rate for Payer: Central Health Plan Commercial $8.53
Rate for Payer: EPIC Health Plan Commercial $4.26
Rate for Payer: Galaxy Health WC $9.06
Rate for Payer: Global Benefits Group Commercial $6.40
Rate for Payer: Health Management Network EPO/PPO $9.59
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $7.11
Rate for Payer: LLUH Dept of Risk Management WC $2.13
Rate for Payer: Multiplan Commercial $8.00
Rate for Payer: Networks By Design Commercial $6.93
Rate for Payer: Prime Health Services Commercial $9.06
Service Code CPT A4369
Hospital Charge Code 901607709
Hospital Revenue Code 272
Min. Negotiated Rate $2.13
Max. Negotiated Rate $9.59
Rate for Payer: Aetna of CA HMO/PPO $6.38
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $9.06
Rate for Payer: AlphaCare Medical Group Medi-Cal $5.86
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $5.86
Rate for Payer: Anthem Blue Cross of CA Exchange $5.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $6.30
Rate for Payer: BCBS Transplant Transplant $6.40
Rate for Payer: Blue Shield of California Commercial $6.71
Rate for Payer: Blue Shield of California EPN $5.21
Rate for Payer: Cash Price $4.80
Rate for Payer: Cash Price $4.80
Rate for Payer: Central Health Plan Commercial $8.53
Rate for Payer: Cigna of CA HMO $6.82
Rate for Payer: Cigna of CA PPO $7.89
Rate for Payer: Dignity Health Commercial/Exchange $9.06
Rate for Payer: EPIC Health Plan Commercial $4.26
Rate for Payer: EPIC Health Plan Transplant $4.26
Rate for Payer: Galaxy Health WC $9.06
Rate for Payer: Global Benefits Group Commercial $6.40
Rate for Payer: Health Management Network EPO/PPO $9.59
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $8.00
Rate for Payer: IEHP medi-cal $3.73
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $7.11
Rate for Payer: LLUH Dept of Risk Management WC $2.13
Rate for Payer: Multiplan Commercial $8.00
Rate for Payer: Networks By Design Commercial $6.93
Rate for Payer: Prime Health Services Commercial $9.06
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $6.40
Rate for Payer: Riverside University Health MISP $4.26
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $6.40
Rate for Payer: TriValley Medical Group Commercial/Senior $6.40
Rate for Payer: United Healthcare All Other Commercial $5.33
Rate for Payer: United Healthcare All Other HMO $5.33
Rate for Payer: United Healthcare HMO Rider $5.33
Rate for Payer: United Healthcare Select/Navigate/Core $5.33
Rate for Payer: Vantage Medical Group Medi-Cal $9.06
Rate for Payer: Vantage Medical Group Senior $9.06
Service Code CPT A5120
Hospital Charge Code 901698767
Hospital Revenue Code 272
Min. Negotiated Rate $0.67
Max. Negotiated Rate $11.66
Rate for Payer: Aetna of CA HMO/PPO $0.67
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $11.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $7.13
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $7.13
Rate for Payer: Anthem Blue Cross of CA Exchange $6.28
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $7.66
Rate for Payer: BCBS Transplant Transplant $7.78
Rate for Payer: Blue Shield of California Commercial $8.15
Rate for Payer: Blue Shield of California EPN $6.34
Rate for Payer: Cash Price $5.83
Rate for Payer: Cash Price $5.83
Rate for Payer: Central Health Plan Commercial $10.37
Rate for Payer: Cigna of CA HMO $8.29
Rate for Payer: Cigna of CA PPO $9.59
Rate for Payer: Dignity Health Commercial/Exchange $11.02
Rate for Payer: EPIC Health Plan Commercial $5.18
Rate for Payer: EPIC Health Plan Transplant $5.18
Rate for Payer: Galaxy Health WC $11.02
Rate for Payer: Global Benefits Group Commercial $7.78
Rate for Payer: Health Management Network EPO/PPO $11.66
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $9.72
Rate for Payer: IEHP medi-cal $4.54
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $8.64
Rate for Payer: LLUH Dept of Risk Management WC $2.59
Rate for Payer: Multiplan Commercial $9.72
Rate for Payer: Networks By Design Commercial $8.42
Rate for Payer: Prime Health Services Commercial $11.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $7.78
Rate for Payer: Riverside University Health MISP $5.18
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $7.78
Rate for Payer: TriValley Medical Group Commercial/Senior $7.78
Rate for Payer: United Healthcare All Other Commercial $6.48
Rate for Payer: United Healthcare All Other HMO $6.48
Rate for Payer: United Healthcare HMO Rider $6.48
Rate for Payer: United Healthcare Select/Navigate/Core $6.48
Rate for Payer: Vantage Medical Group Medi-Cal $11.02
Rate for Payer: Vantage Medical Group Senior $11.02
Service Code CPT A5120
Hospital Charge Code 901698767
Hospital Revenue Code 272
Min. Negotiated Rate $2.59
Max. Negotiated Rate $11.66
Rate for Payer: Cash Price $5.83
Rate for Payer: Central Health Plan Commercial $10.37
Rate for Payer: EPIC Health Plan Commercial $5.18
Rate for Payer: Galaxy Health WC $11.02
Rate for Payer: Global Benefits Group Commercial $7.78
Rate for Payer: Health Management Network EPO/PPO $11.66
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $8.64
Rate for Payer: LLUH Dept of Risk Management WC $2.59
Rate for Payer: Multiplan Commercial $9.72
Rate for Payer: Networks By Design Commercial $8.42
Rate for Payer: Prime Health Services Commercial $11.02
Hospital Charge Code 901605433
Hospital Revenue Code 272
Min. Negotiated Rate $5.90
Max. Negotiated Rate $26.57
Rate for Payer: Aetna of CA HMO/PPO $17.93
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $25.09
Rate for Payer: AlphaCare Medical Group Medi-Cal $16.24
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $16.24
Rate for Payer: Anthem Blue Cross of CA Exchange $14.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $17.44
Rate for Payer: BCBS Transplant Transplant $17.71
Rate for Payer: Blue Shield of California Commercial $18.57
Rate for Payer: Blue Shield of California EPN $14.44
Rate for Payer: Cash Price $13.28
Rate for Payer: Central Health Plan Commercial $23.62
Rate for Payer: Cigna of CA HMO $18.89
Rate for Payer: Cigna of CA PPO $21.84
Rate for Payer: Dignity Health Commercial/Exchange $25.09
Rate for Payer: EPIC Health Plan Commercial $11.81
Rate for Payer: EPIC Health Plan Transplant $11.81
Rate for Payer: Galaxy Health WC $25.09
Rate for Payer: Global Benefits Group Commercial $17.71
Rate for Payer: Health Management Network EPO/PPO $26.57
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $22.14
Rate for Payer: IEHP medi-cal $10.33
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.69
Rate for Payer: LLUH Dept of Risk Management WC $5.90
Rate for Payer: Multiplan Commercial $22.14
Rate for Payer: Networks By Design Commercial $19.19
Rate for Payer: Prime Health Services Commercial $25.09
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $17.71
Rate for Payer: Riverside University Health MISP $11.81
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $17.71
Rate for Payer: TriValley Medical Group Commercial/Senior $17.71
Rate for Payer: United Healthcare All Other Commercial $14.76
Rate for Payer: United Healthcare All Other HMO $14.76
Rate for Payer: United Healthcare HMO Rider $14.76
Rate for Payer: United Healthcare Select/Navigate/Core $14.76
Rate for Payer: Vantage Medical Group Medi-Cal $25.09
Rate for Payer: Vantage Medical Group Senior $25.09
Hospital Charge Code 901605433
Hospital Revenue Code 272
Min. Negotiated Rate $5.90
Max. Negotiated Rate $26.57
Rate for Payer: Cash Price $13.28
Rate for Payer: Central Health Plan Commercial $23.62
Rate for Payer: EPIC Health Plan Commercial $11.81
Rate for Payer: Galaxy Health WC $25.09
Rate for Payer: Global Benefits Group Commercial $17.71
Rate for Payer: Health Management Network EPO/PPO $26.57
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.69
Rate for Payer: LLUH Dept of Risk Management WC $5.90
Rate for Payer: Multiplan Commercial $22.14
Rate for Payer: Networks By Design Commercial $19.19
Rate for Payer: Prime Health Services Commercial $25.09
Hospital Charge Code 901605431
Hospital Revenue Code 272
Min. Negotiated Rate $5.89
Max. Negotiated Rate $26.50
Rate for Payer: Cash Price $13.25
Rate for Payer: Central Health Plan Commercial $23.55
Rate for Payer: EPIC Health Plan Commercial $11.78
Rate for Payer: Galaxy Health WC $25.02
Rate for Payer: Global Benefits Group Commercial $17.66
Rate for Payer: Health Management Network EPO/PPO $26.50
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.64
Rate for Payer: LLUH Dept of Risk Management WC $5.89
Rate for Payer: Multiplan Commercial $22.08
Rate for Payer: Networks By Design Commercial $19.14
Rate for Payer: Prime Health Services Commercial $25.02
Hospital Charge Code 901605431
Hospital Revenue Code 272
Min. Negotiated Rate $5.89
Max. Negotiated Rate $26.50
Rate for Payer: Aetna of CA HMO/PPO $17.88
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $25.02
Rate for Payer: AlphaCare Medical Group Medi-Cal $16.19
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $16.19
Rate for Payer: Anthem Blue Cross of CA Exchange $14.25
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $17.39
Rate for Payer: BCBS Transplant Transplant $17.66
Rate for Payer: Blue Shield of California Commercial $18.52
Rate for Payer: Blue Shield of California EPN $14.40
Rate for Payer: Cash Price $13.25
Rate for Payer: Central Health Plan Commercial $23.55
Rate for Payer: Cigna of CA HMO $18.84
Rate for Payer: Cigna of CA PPO $21.79
Rate for Payer: Dignity Health Commercial/Exchange $25.02
Rate for Payer: EPIC Health Plan Commercial $11.78
Rate for Payer: EPIC Health Plan Transplant $11.78
Rate for Payer: Galaxy Health WC $25.02
Rate for Payer: Global Benefits Group Commercial $17.66
Rate for Payer: Health Management Network EPO/PPO $26.50
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $22.08
Rate for Payer: IEHP medi-cal $10.30
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.64
Rate for Payer: LLUH Dept of Risk Management WC $5.89
Rate for Payer: Multiplan Commercial $22.08
Rate for Payer: Networks By Design Commercial $19.14
Rate for Payer: Prime Health Services Commercial $25.02
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $17.66
Rate for Payer: Riverside University Health MISP $11.78
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $17.66
Rate for Payer: TriValley Medical Group Commercial/Senior $17.66
Rate for Payer: United Healthcare All Other Commercial $14.72
Rate for Payer: United Healthcare All Other HMO $14.72
Rate for Payer: United Healthcare HMO Rider $14.72
Rate for Payer: United Healthcare Select/Navigate/Core $14.72
Rate for Payer: Vantage Medical Group Medi-Cal $25.02
Rate for Payer: Vantage Medical Group Senior $25.02
Hospital Charge Code 901605432
Hospital Revenue Code 272
Min. Negotiated Rate $5.95
Max. Negotiated Rate $26.79
Rate for Payer: Aetna of CA HMO/PPO $18.08
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $25.30
Rate for Payer: AlphaCare Medical Group Medi-Cal $16.37
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $16.37
Rate for Payer: Anthem Blue Cross of CA Exchange $14.41
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $17.59
Rate for Payer: BCBS Transplant Transplant $17.86
Rate for Payer: Blue Shield of California Commercial $18.73
Rate for Payer: Blue Shield of California EPN $14.56
Rate for Payer: Cash Price $13.40
Rate for Payer: Central Health Plan Commercial $23.82
Rate for Payer: Cigna of CA HMO $19.05
Rate for Payer: Cigna of CA PPO $22.03
Rate for Payer: Dignity Health Commercial/Exchange $25.30
Rate for Payer: EPIC Health Plan Commercial $11.91
Rate for Payer: EPIC Health Plan Transplant $11.91
Rate for Payer: Galaxy Health WC $25.30
Rate for Payer: Global Benefits Group Commercial $17.86
Rate for Payer: Health Management Network EPO/PPO $26.79
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $22.33
Rate for Payer: IEHP medi-cal $10.42
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.86
Rate for Payer: LLUH Dept of Risk Management WC $5.95
Rate for Payer: Multiplan Commercial $22.33
Rate for Payer: Networks By Design Commercial $19.35
Rate for Payer: Prime Health Services Commercial $25.30
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $17.86
Rate for Payer: Riverside University Health MISP $11.91
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $17.86
Rate for Payer: TriValley Medical Group Commercial/Senior $17.86
Rate for Payer: United Healthcare All Other Commercial $14.88
Rate for Payer: United Healthcare All Other HMO $14.88
Rate for Payer: United Healthcare HMO Rider $14.88
Rate for Payer: United Healthcare Select/Navigate/Core $14.88
Rate for Payer: Vantage Medical Group Medi-Cal $25.30
Rate for Payer: Vantage Medical Group Senior $25.30
Hospital Charge Code 901605432
Hospital Revenue Code 272
Min. Negotiated Rate $5.95
Max. Negotiated Rate $26.79
Rate for Payer: Cash Price $13.40
Rate for Payer: Central Health Plan Commercial $23.82
Rate for Payer: EPIC Health Plan Commercial $11.91
Rate for Payer: Galaxy Health WC $25.30
Rate for Payer: Global Benefits Group Commercial $17.86
Rate for Payer: Health Management Network EPO/PPO $26.79
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.86
Rate for Payer: LLUH Dept of Risk Management WC $5.95
Rate for Payer: Multiplan Commercial $22.33
Rate for Payer: Networks By Design Commercial $19.35
Rate for Payer: Prime Health Services Commercial $25.30
Hospital Charge Code 901605430
Hospital Revenue Code 272
Min. Negotiated Rate $1.82
Max. Negotiated Rate $8.19
Rate for Payer: Cash Price $4.10
Rate for Payer: Central Health Plan Commercial $7.28
Rate for Payer: EPIC Health Plan Commercial $3.64
Rate for Payer: Galaxy Health WC $7.74
Rate for Payer: Global Benefits Group Commercial $5.46
Rate for Payer: Health Management Network EPO/PPO $8.19
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6.07
Rate for Payer: LLUH Dept of Risk Management WC $1.82
Rate for Payer: Multiplan Commercial $6.82
Rate for Payer: Networks By Design Commercial $5.92
Rate for Payer: Prime Health Services Commercial $7.74
Hospital Charge Code 901605430
Hospital Revenue Code 272
Min. Negotiated Rate $1.82
Max. Negotiated Rate $8.19
Rate for Payer: Aetna of CA HMO/PPO $5.53
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $7.74
Rate for Payer: AlphaCare Medical Group Medi-Cal $5.00
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $5.00
Rate for Payer: Anthem Blue Cross of CA Exchange $4.41
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $5.38
Rate for Payer: BCBS Transplant Transplant $5.46
Rate for Payer: Blue Shield of California Commercial $5.72
Rate for Payer: Blue Shield of California EPN $4.45
Rate for Payer: Cash Price $4.10
Rate for Payer: Central Health Plan Commercial $7.28
Rate for Payer: Cigna of CA HMO $5.82
Rate for Payer: Cigna of CA PPO $6.73
Rate for Payer: Dignity Health Commercial/Exchange $7.74
Rate for Payer: EPIC Health Plan Commercial $3.64
Rate for Payer: EPIC Health Plan Transplant $3.64
Rate for Payer: Galaxy Health WC $7.74
Rate for Payer: Global Benefits Group Commercial $5.46
Rate for Payer: Health Management Network EPO/PPO $8.19
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $6.82
Rate for Payer: IEHP medi-cal $3.18
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6.07
Rate for Payer: LLUH Dept of Risk Management WC $1.82
Rate for Payer: Multiplan Commercial $6.82
Rate for Payer: Networks By Design Commercial $5.92
Rate for Payer: Prime Health Services Commercial $7.74
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $5.46
Rate for Payer: Riverside University Health MISP $3.64
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $5.46
Rate for Payer: TriValley Medical Group Commercial/Senior $5.46
Rate for Payer: United Healthcare All Other Commercial $4.55
Rate for Payer: United Healthcare All Other HMO $4.55
Rate for Payer: United Healthcare HMO Rider $4.55
Rate for Payer: United Healthcare Select/Navigate/Core $4.55
Rate for Payer: Vantage Medical Group Medi-Cal $7.74
Rate for Payer: Vantage Medical Group Senior $7.74
Hospital Charge Code 901605434
Hospital Revenue Code 272
Min. Negotiated Rate $24.97
Max. Negotiated Rate $112.38
Rate for Payer: Aetna of CA HMO/PPO $75.83
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $106.14
Rate for Payer: AlphaCare Medical Group Medi-Cal $68.68
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $68.68
Rate for Payer: Anthem Blue Cross of CA Exchange $60.46
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $73.77
Rate for Payer: BCBS Transplant Transplant $74.92
Rate for Payer: Blue Shield of California Commercial $78.54
Rate for Payer: Blue Shield of California EPN $61.06
Rate for Payer: Cash Price $56.19
Rate for Payer: Central Health Plan Commercial $99.90
Rate for Payer: Cigna of CA HMO $79.92
Rate for Payer: Cigna of CA PPO $92.40
Rate for Payer: Dignity Health Commercial/Exchange $106.14
Rate for Payer: EPIC Health Plan Commercial $49.95
Rate for Payer: EPIC Health Plan Transplant $49.95
Rate for Payer: Galaxy Health WC $106.14
Rate for Payer: Global Benefits Group Commercial $74.92
Rate for Payer: Health Management Network EPO/PPO $112.38
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $93.65
Rate for Payer: IEHP medi-cal $43.70
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $83.29
Rate for Payer: LLUH Dept of Risk Management WC $24.97
Rate for Payer: Multiplan Commercial $93.65
Rate for Payer: Networks By Design Commercial $81.17
Rate for Payer: Prime Health Services Commercial $106.14
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $74.92
Rate for Payer: Riverside University Health MISP $49.95
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $74.92
Rate for Payer: TriValley Medical Group Commercial/Senior $74.92
Rate for Payer: United Healthcare All Other Commercial $62.44
Rate for Payer: United Healthcare All Other HMO $62.44
Rate for Payer: United Healthcare HMO Rider $62.44
Rate for Payer: United Healthcare Select/Navigate/Core $62.44
Rate for Payer: Vantage Medical Group Medi-Cal $106.14
Rate for Payer: Vantage Medical Group Senior $106.14
Hospital Charge Code 901605434
Hospital Revenue Code 272
Min. Negotiated Rate $24.97
Max. Negotiated Rate $112.38
Rate for Payer: Cash Price $56.19
Rate for Payer: Central Health Plan Commercial $99.90
Rate for Payer: EPIC Health Plan Commercial $49.95
Rate for Payer: Galaxy Health WC $106.14
Rate for Payer: Global Benefits Group Commercial $74.92
Rate for Payer: Health Management Network EPO/PPO $112.38
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $83.29
Rate for Payer: LLUH Dept of Risk Management WC $24.97
Rate for Payer: Multiplan Commercial $93.65
Rate for Payer: Networks By Design Commercial $81.17
Rate for Payer: Prime Health Services Commercial $106.14
Hospital Charge Code 901604398
Hospital Revenue Code 272
Min. Negotiated Rate $4.28
Max. Negotiated Rate $19.26
Rate for Payer: Cash Price $9.63
Rate for Payer: Central Health Plan Commercial $17.12
Rate for Payer: EPIC Health Plan Commercial $8.56
Rate for Payer: Galaxy Health WC $18.19
Rate for Payer: Global Benefits Group Commercial $12.84
Rate for Payer: Health Management Network EPO/PPO $19.26
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.27
Rate for Payer: LLUH Dept of Risk Management WC $4.28
Rate for Payer: Multiplan Commercial $16.05
Rate for Payer: Networks By Design Commercial $13.91
Rate for Payer: Prime Health Services Commercial $18.19
Hospital Charge Code 901604398
Hospital Revenue Code 272
Min. Negotiated Rate $4.28
Max. Negotiated Rate $19.26
Rate for Payer: Aetna of CA HMO/PPO $13.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $18.19
Rate for Payer: AlphaCare Medical Group Medi-Cal $11.77
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $11.77
Rate for Payer: Anthem Blue Cross of CA Exchange $10.36
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $12.64
Rate for Payer: BCBS Transplant Transplant $12.84
Rate for Payer: Blue Shield of California Commercial $13.46
Rate for Payer: Blue Shield of California EPN $10.46
Rate for Payer: Cash Price $9.63
Rate for Payer: Central Health Plan Commercial $17.12
Rate for Payer: Cigna of CA HMO $13.70
Rate for Payer: Cigna of CA PPO $15.84
Rate for Payer: Dignity Health Commercial/Exchange $18.19
Rate for Payer: EPIC Health Plan Commercial $8.56
Rate for Payer: EPIC Health Plan Transplant $8.56
Rate for Payer: Galaxy Health WC $18.19
Rate for Payer: Global Benefits Group Commercial $12.84
Rate for Payer: Health Management Network EPO/PPO $19.26
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $16.05
Rate for Payer: IEHP medi-cal $7.49
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $14.27
Rate for Payer: LLUH Dept of Risk Management WC $4.28
Rate for Payer: Multiplan Commercial $16.05
Rate for Payer: Networks By Design Commercial $13.91
Rate for Payer: Prime Health Services Commercial $18.19
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $12.84
Rate for Payer: Riverside University Health MISP $8.56
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $12.84
Rate for Payer: TriValley Medical Group Commercial/Senior $12.84
Rate for Payer: United Healthcare All Other Commercial $10.70
Rate for Payer: United Healthcare All Other HMO $10.70
Rate for Payer: United Healthcare HMO Rider $10.70
Rate for Payer: United Healthcare Select/Navigate/Core $10.70
Rate for Payer: Vantage Medical Group Medi-Cal $18.19
Rate for Payer: Vantage Medical Group Senior $18.19
Hospital Charge Code 901698704
Hospital Revenue Code 271
Min. Negotiated Rate $4.05
Max. Negotiated Rate $18.22
Rate for Payer: Cash Price $9.11
Rate for Payer: Central Health Plan Commercial $16.20
Rate for Payer: EPIC Health Plan Commercial $8.10
Rate for Payer: Galaxy Health WC $17.21
Rate for Payer: Global Benefits Group Commercial $12.15
Rate for Payer: Health Management Network EPO/PPO $18.22
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $13.51
Rate for Payer: LLUH Dept of Risk Management WC $4.05
Rate for Payer: Multiplan Commercial $15.19
Rate for Payer: Networks By Design Commercial $13.16
Rate for Payer: Prime Health Services Commercial $17.21
Hospital Charge Code 901698704
Hospital Revenue Code 271
Min. Negotiated Rate $4.05
Max. Negotiated Rate $18.22
Rate for Payer: Aetna of CA HMO/PPO $12.30
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $17.21
Rate for Payer: AlphaCare Medical Group Medi-Cal $11.14
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $11.14
Rate for Payer: Anthem Blue Cross of CA Exchange $9.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11.96
Rate for Payer: BCBS Transplant Transplant $12.15
Rate for Payer: Blue Shield of California Commercial $12.74
Rate for Payer: Blue Shield of California EPN $9.90
Rate for Payer: Cash Price $9.11
Rate for Payer: Central Health Plan Commercial $16.20
Rate for Payer: Cigna of CA HMO $12.96
Rate for Payer: Cigna of CA PPO $14.98
Rate for Payer: Dignity Health Commercial/Exchange $17.21
Rate for Payer: EPIC Health Plan Commercial $8.10
Rate for Payer: EPIC Health Plan Transplant $8.10
Rate for Payer: Galaxy Health WC $17.21
Rate for Payer: Global Benefits Group Commercial $12.15
Rate for Payer: Health Management Network EPO/PPO $18.22
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $15.19
Rate for Payer: IEHP medi-cal $7.09
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $13.51
Rate for Payer: LLUH Dept of Risk Management WC $4.05
Rate for Payer: Multiplan Commercial $15.19
Rate for Payer: Networks By Design Commercial $13.16
Rate for Payer: Prime Health Services Commercial $17.21
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $12.15
Rate for Payer: Riverside University Health MISP $8.10
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $12.15
Rate for Payer: TriValley Medical Group Commercial/Senior $12.15
Rate for Payer: United Healthcare All Other Commercial $10.12
Rate for Payer: United Healthcare All Other HMO $10.12
Rate for Payer: United Healthcare HMO Rider $10.12
Rate for Payer: United Healthcare Select/Navigate/Core $10.12
Rate for Payer: Vantage Medical Group Medi-Cal $17.21
Rate for Payer: Vantage Medical Group Senior $17.21
Hospital Charge Code 901698453
Hospital Revenue Code 272
Min. Negotiated Rate $9.18
Max. Negotiated Rate $41.33
Rate for Payer: Aetna of CA HMO/PPO $27.89
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $39.03
Rate for Payer: AlphaCare Medical Group Medi-Cal $25.26
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $25.26
Rate for Payer: Anthem Blue Cross of CA Exchange $22.23
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $27.13
Rate for Payer: BCBS Transplant Transplant $27.55
Rate for Payer: Blue Shield of California Commercial $28.88
Rate for Payer: Blue Shield of California EPN $22.45
Rate for Payer: Cash Price $20.66
Rate for Payer: Central Health Plan Commercial $36.74
Rate for Payer: Cigna of CA HMO $29.39
Rate for Payer: Cigna of CA PPO $33.98
Rate for Payer: Dignity Health Commercial/Exchange $39.03
Rate for Payer: EPIC Health Plan Commercial $18.37
Rate for Payer: EPIC Health Plan Transplant $18.37
Rate for Payer: Galaxy Health WC $39.03
Rate for Payer: Global Benefits Group Commercial $27.55
Rate for Payer: Health Management Network EPO/PPO $41.33
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $34.44
Rate for Payer: IEHP medi-cal $16.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $30.63
Rate for Payer: LLUH Dept of Risk Management WC $9.18
Rate for Payer: Multiplan Commercial $34.44
Rate for Payer: Networks By Design Commercial $29.85
Rate for Payer: Prime Health Services Commercial $39.03
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $27.55
Rate for Payer: Riverside University Health MISP $18.37
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $27.55
Rate for Payer: TriValley Medical Group Commercial/Senior $27.55
Rate for Payer: United Healthcare All Other Commercial $22.96
Rate for Payer: United Healthcare All Other HMO $22.96
Rate for Payer: United Healthcare HMO Rider $22.96
Rate for Payer: United Healthcare Select/Navigate/Core $22.96
Rate for Payer: Vantage Medical Group Medi-Cal $39.03
Rate for Payer: Vantage Medical Group Senior $39.03
Hospital Charge Code 901698453
Hospital Revenue Code 272
Min. Negotiated Rate $9.18
Max. Negotiated Rate $41.33
Rate for Payer: Cash Price $20.66
Rate for Payer: Central Health Plan Commercial $36.74
Rate for Payer: EPIC Health Plan Commercial $18.37
Rate for Payer: Galaxy Health WC $39.03
Rate for Payer: Global Benefits Group Commercial $27.55
Rate for Payer: Health Management Network EPO/PPO $41.33
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $30.63
Rate for Payer: LLUH Dept of Risk Management WC $9.18
Rate for Payer: Multiplan Commercial $34.44
Rate for Payer: Networks By Design Commercial $29.85
Rate for Payer: Prime Health Services Commercial $39.03
Hospital Charge Code 901698680
Hospital Revenue Code 271
Min. Negotiated Rate $5.92
Max. Negotiated Rate $26.64
Rate for Payer: Cash Price $13.32
Rate for Payer: Central Health Plan Commercial $23.68
Rate for Payer: EPIC Health Plan Commercial $11.84
Rate for Payer: Galaxy Health WC $25.16
Rate for Payer: Global Benefits Group Commercial $17.76
Rate for Payer: Health Management Network EPO/PPO $26.64
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.74
Rate for Payer: LLUH Dept of Risk Management WC $5.92
Rate for Payer: Multiplan Commercial $22.20
Rate for Payer: Networks By Design Commercial $19.24
Rate for Payer: Prime Health Services Commercial $25.16
Hospital Charge Code 901698680
Hospital Revenue Code 271
Min. Negotiated Rate $5.92
Max. Negotiated Rate $26.64
Rate for Payer: Aetna of CA HMO/PPO $17.98
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $25.16
Rate for Payer: AlphaCare Medical Group Medi-Cal $16.28
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $16.28
Rate for Payer: Anthem Blue Cross of CA Exchange $14.33
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $17.49
Rate for Payer: BCBS Transplant Transplant $17.76
Rate for Payer: Blue Shield of California Commercial $18.62
Rate for Payer: Blue Shield of California EPN $14.47
Rate for Payer: Cash Price $13.32
Rate for Payer: Central Health Plan Commercial $23.68
Rate for Payer: Cigna of CA HMO $18.94
Rate for Payer: Cigna of CA PPO $21.90
Rate for Payer: Dignity Health Commercial/Exchange $25.16
Rate for Payer: EPIC Health Plan Commercial $11.84
Rate for Payer: EPIC Health Plan Transplant $11.84
Rate for Payer: Galaxy Health WC $25.16
Rate for Payer: Global Benefits Group Commercial $17.76
Rate for Payer: Health Management Network EPO/PPO $26.64
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $22.20
Rate for Payer: IEHP medi-cal $10.36
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $19.74
Rate for Payer: LLUH Dept of Risk Management WC $5.92
Rate for Payer: Multiplan Commercial $22.20
Rate for Payer: Networks By Design Commercial $19.24
Rate for Payer: Prime Health Services Commercial $25.16
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $17.76
Rate for Payer: Riverside University Health MISP $11.84
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $17.76
Rate for Payer: TriValley Medical Group Commercial/Senior $17.76
Rate for Payer: United Healthcare All Other Commercial $14.80
Rate for Payer: United Healthcare All Other HMO $14.80
Rate for Payer: United Healthcare HMO Rider $14.80
Rate for Payer: United Healthcare Select/Navigate/Core $14.80
Rate for Payer: Vantage Medical Group Medi-Cal $25.16
Rate for Payer: Vantage Medical Group Senior $25.16
Service Code CPT 15273
Hospital Charge Code 900101500
Hospital Revenue Code 761
Min. Negotiated Rate $1,984.80
Max. Negotiated Rate $8,931.60
Rate for Payer: Cash Price $4,465.80
Rate for Payer: Central Health Plan Commercial $7,939.20
Rate for Payer: EPIC Health Plan Commercial $3,969.60
Rate for Payer: Galaxy Health WC $8,435.40
Rate for Payer: Global Benefits Group Commercial $5,954.40
Rate for Payer: Health Management Network EPO/PPO $8,931.60
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,619.31
Rate for Payer: LLUH Dept of Risk Management WC $1,984.80
Rate for Payer: Multiplan Commercial $7,443.00
Rate for Payer: Networks By Design Commercial $6,450.60
Rate for Payer: Prime Health Services Commercial $8,435.40
Service Code CPT 15273
Hospital Charge Code 900101500
Hospital Revenue Code 761
Min. Negotiated Rate $1,984.80
Max. Negotiated Rate $397,400.00
Rate for Payer: Adventist Health Medi-Cal $4,482.50
Rate for Payer: Aetna of CA HMO/PPO $6,248.00
Rate for Payer: AlphaCare Medical Group Commercial/Exchange $6,723.75
Rate for Payer: AlphaCare Medical Group Medi-Cal $4,930.75
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product $4,482.50
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 $5,954.40
Rate for Payer: Blue Shield of California Commercial $6,242.20
Rate for Payer: Blue Shield of California EPN $4,852.84
Rate for Payer: Caremore Medicare Advantage $4,482.50
Rate for Payer: Cash Price $4,465.80
Rate for Payer: Cash Price $4,465.80
Rate for Payer: Cash Price $4,465.80
Rate for Payer: Central Health Plan Commercial $7,939.20
Rate for Payer: Cigna of CA HMO $6,351.36
Rate for Payer: Cigna of CA PPO $7,343.76
Rate for Payer: Dignity Health Commercial/Exchange $6,723.75
Rate for Payer: EPIC Health Plan Commercial $6,051.38
Rate for Payer: EPIC Health Plan Medicare/Senior $4,482.50
Rate for Payer: EPIC Health Plan Transplant $4,482.50
Rate for Payer: Galaxy Health WC $8,435.40
Rate for Payer: Global Benefits Group Commercial $5,954.40
Rate for Payer: Health Management Network EPO/PPO $8,931.60
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other $7,443.00
Rate for Payer: Heritage Provider Network Commercial/Senior $7,351.30
Rate for Payer: IEHP medi-cal $7,396.12
Rate for Payer: IEHP Medicare Advantage $4,482.50
Rate for Payer: Innovage PACE Commercial $6,723.75
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded $6,619.31
Rate for Payer: Kaiser Permanente of CA Medicare Advantage $4,482.50
Rate for Payer: LLUH Dept of Risk Management WC $1,984.80
Rate for Payer: Molina Healthcare of CA Medi-Cal $6,006.55
Rate for Payer: Molina Healthcare of CA Medicare $6,006.55
Rate for Payer: Multiplan Commercial $7,443.00
Rate for Payer: Networks By Design Commercial $6,450.60
Rate for Payer: Prime Health Services Commercial $8,435.40
Rate for Payer: Prime Health Services Medicare $4,751.45
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior $5,954.40
Rate for Payer: Riverside University Health MISP $4,930.75
Rate for Payer: Temecula Valley Physicians Medical Group Commercial $5,954.40
Rate for Payer: TriValley Medical Group Commercial/Senior $5,954.40
Rate for Payer: United Healthcare All Other Commercial $4,962.00
Rate for Payer: United Healthcare All Other HMO $4,962.00
Rate for Payer: United Healthcare HMO Rider $4,962.00
Rate for Payer: United Healthcare Select/Navigate/Core $4,962.00
Rate for Payer: Vantage Medical Group Commercial/Exchange $6,723.75
Rate for Payer: Vantage Medical Group Medi-Cal $4,930.75
Rate for Payer: Vantage Medical Group Senior $4,482.50