CenCal Transplant Medi-Cal HMO: disclosed hospital rates

iDirect answer

Based on the published hospital price files, CenCal Transplant Medi-Cal HMO appears in disclosed negotiated rates across 1 hospital and 41 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.

41 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
0.9% SODIUM CHLORIDE--CONTROL FOR ATG Outpatient	Ronald Reagan UCLA Medical Center	63323018610 NDC	$40.00	$22.00	$10.00 – $200	—
ABACAVIR SULFATE 20 MG/ML PO SOLN Outpatient	Ronald Reagan UCLA Medical Center	64980040524 NDC	$218	$120	$54.51 – $196	—
ABACAVIR SULFATE 300 MG PO TABS Outpatient	Ronald Reagan UCLA Medical Center	68084002121 NDC	$9.05	$4.98	$2.26 – $8.15	—
ABACAVIR SULFATE-LAMIVUDINE 600-300 MG PO TABS Outpatient	Ronald Reagan UCLA Medical Center	65862033530 NDC	$4.00	$2.20	$1.00 – $3.60	—
ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG PO TABS Outpatient	Ronald Reagan UCLA Medical Center	49702023113 NDC	$424	$233	$106 – $382	—
ABATACEPT 125 MG/ML SC SOSY Outpatient	Ronald Reagan UCLA Medical Center	00003218811 NDC	$3,869	$2,128	$967 – $3,482	—
ABATACEPT 125 MG/ML SC SOSY\|DISCARDED DRUG NOT ADMINISTERED Outpatient	Ronald Reagan UCLA Medical Center	00003218811_2 NDC	$3,869	$2,128	$967 – $3,482	—
ABATACEPT 250 MG IV SOLR Outpatient	Ronald Reagan UCLA Medical Center	00003218713 NDC	$3,974	$2,186	$993 – $19,878	—
ABIRATERONE ACETATE 250 MG PO TABS Outpatient	Ronald Reagan UCLA Medical Center	60687079021 NDC	$23.36	$12.85	$5.84 – $117	—
ABOBOTULINUMTOXINA 300 UNITS IM SOLR Outpatient	Ronald Reagan UCLA Medical Center	15054053006 NDC	$2,062	$1,134	$516 – $10,315	—
ABOBOTULINUMTOXINA 500 UNITS IM SOLR Outpatient	Ronald Reagan UCLA Medical Center	15054050001 NDC	$3,436	$1,890	$859 – $17,189	—
ABSORBABLE HEMOSTAT Outpatient	Ronald Reagan UCLA Medical Center	82526100005 NDC	$557	$306	$139 – $2,786	—
ABSORBASE EX OINT Outpatient	Ronald Reagan UCLA Medical Center	46287050716 NDC	$51.43	$28.29	$12.86 – $46.29	—
ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN Outpatient	Ronald Reagan UCLA Medical Center	14537081775 NDC	$40.00	$22.00	$10.00 – $200	—
ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (ADULT CRRT) Outpatient	Ronald Reagan UCLA Medical Center	14537081775_2 NDC	$40.00	$22.00	$10.00 – $200	—
ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (APHERESIS) Outpatient	Ronald Reagan UCLA Medical Center	14537081775_3 NDC	$40.00	$22.00	$10.00 – $200	—
ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (PEDS CRRT NXSTAGE) Outpatient	Ronald Reagan UCLA Medical Center	14537081775_4 NDC	$40.00	$22.00	$10.00 – $200	—
ACD FORMULA A 0.73-2.45-2.2 GM/100ML VI SOLN (PEDS CRRT PRISMAFLEX) Outpatient	Ronald Reagan UCLA Medical Center	14537081775_5 NDC	$40.00	$22.00	$10.00 – $200	—
ACETAMINOPHEN 10 MG/ML 0-50 ML SYRINGE Outpatient	Ronald Reagan UCLA Medical Center	00264410090_2 NDC	$110	$60.50	$27.50 – $550	—
ACETAMINOPHEN 10 MG/ML 0-50 ML SYRINGE (2 DAY MAX DURATION) Outpatient	Ronald Reagan UCLA Medical Center	00264410090_3 NDC	$110	$60.50	$27.50 – $550	—
ACETAMINOPHEN 10 MG/ML 50-100 ML INTRAVIA Outpatient	Ronald Reagan UCLA Medical Center	00264410090_4 NDC	$110	$60.50	$27.50 – $550	—
ACETAMINOPHEN 10 MG/ML 50-100 ML INTRAVIA (2 DAY MAX DURATION) Outpatient	Ronald Reagan UCLA Medical Center	00264410090_5 NDC	$110	$60.50	$27.50 – $550	—
ACETAMINOPHEN 10 MG/ML IV SOLN Outpatient	Ronald Reagan UCLA Medical Center	00264410090_6 NDC	$110	$60.50	$27.50 – $550	—
ACETAMINOPHEN 10 MG/ML IV SOLN (2 DAY MAX DURATION) Outpatient	Ronald Reagan UCLA Medical Center	00264410090_7 NDC	$110	$60.50	$27.50 – $550	—
ACETAMINOPHEN 10 MG/ML SYRINGE (NICU) Outpatient	Ronald Reagan UCLA Medical Center	00264410090 NDC	$40.00	$22.00	$10.00 – $200	—