Anthem Indemnity: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Anthem Indemnity appears in disclosed negotiated rates across 1 hospital and 110 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

110 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
"Silver Nitrate Applicator 6""" Inpatient	UCLA West Valley Medical Center	12165010001 NDC	$165	$90.75	$34.65 – $165	—
Abacavir 300 MG Tablet Inpatient	UCLA West Valley Medical Center	00378410591 NDC	$116	$63.80	$24.36 – $116	—
ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Inpatient	UCLA West Valley Medical Center	770 MS-DRG	—	—	$10,059 – $20,719	—
ABORTION WITHOUT D&C Inpatient	UCLA West Valley Medical Center	779 MS-DRG	—	—	$8,517 – $17,384	—
Abraxane 100 MG Vial Inpatient	UCLA West Valley Medical Center	68817013450 NDC	$10,759	$5,917	$0.47 – $10,759	—
Acamprosate Calc Dr 333 MG Tab Inpatient	UCLA West Valley Medical Center	00378633380 NDC	$15.27	$8.40	$3.21 – $15.27	—
Accupril 10 MG Tablet Inpatient	UCLA West Valley Medical Center	00071053023 NDC	$93.64	$51.50	$19.66 – $93.64	—
Accupril 20 MG Tablet Inpatient	UCLA West Valley Medical Center	00071053223 NDC	$92.40	$50.82	$19.40 – $92.40	—
Acd-A Solution Inpatient	UCLA West Valley Medical Center	00942064103 NDC	$66.72	$36.70	$14.01 – $66.72	—
Acetadote 200 MG/Ml Vial Inpatient	UCLA West Valley Medical Center	66220020730 NDC	$1,835	$1,009	$0.47 – $1,835	—
Acetaminophen 1 000 MG/100 Ml Vl Inpatient	UCLA West Valley Medical Center	00781315606 NDC	$366	$201	$0.47 – $366	—
Acetaminophen 160 MG/5 Ml Solution Cup Inpatient	UCLA West Valley Medical Center	00121065705 NDC	$10.51	$5.78	$2.21 – $10.51	—
Acetaminophen 325 MG Tablet Inpatient	UCLA West Valley Medical Center	10135012301 NDC	$3.36	$1.85	$0.71 – $3.36	—
Acetaminophen 325 MG/10.15 Ml Cup Inpatient	UCLA West Valley Medical Center	00121131400 NDC	$3.56	$1.96	$0.75 – $3.56	—
Acetaminophen 650 MG Suppos Inpatient	UCLA West Valley Medical Center	45802073030 NDC	$3.56	$1.96	$0.75 – $3.56	—
Acetaminophen-Cod #3 Tablet Inpatient	UCLA West Valley Medical Center	00406048401 NDC	$36.15	$19.88	$7.59 – $36.15	—
Acetaminophen-Codeine 300-30 MG/12.5 Ml Cup Inpatient	UCLA West Valley Medical Center	00121100800 NDC	$15.68	$8.62	$3.29 – $15.68	—
Acetazolamide 250 MG Tablet Inpatient	UCLA West Valley Medical Center	51672402301 NDC	$63.09	$34.70	$13.25 – $63.09	—
Acetazolamide Sod 500 MG Vial Inpatient	UCLA West Valley Medical Center	00143950301 NDC	$452	$249	$0.47 – $452	—
Acetic Acid 0.25% Irrig Soln Inpatient	UCLA West Valley Medical Center	00338065604 NDC	$74.98	$41.24	$15.75 – $74.98	—
Acetylcysteine 10% Vial (Not For Injection) Inpatient	UCLA West Valley Medical Center	63323069504 NDC	$72.08	$39.64	$0.47 – $72.08	—
Acetylcysteine 20% Vial (Not For Injection) Inpatient	UCLA West Valley Medical Center	00517760425 NDC	$32.94	$18.12	$6.92 – $32.94	—
Actemra 200 MG/10 Ml Vial Inpatient	UCLA West Valley Medical Center	50242013601 NDC	$3,859	$2,122	$0.47 – $3,859	—
Actemra 400 MG/20 Ml Vial Inpatient	UCLA West Valley Medical Center	50242013701 NDC	$7,718	$4,245	$0.47 – $7,718	—
Acthib Vaccine With Diluent Inpatient	UCLA West Valley Medical Center	49281054503 NDC	$1,100	$605	$0.47 – $1,100	—