Central Health Plan: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Central Health Plan appears in disclosed negotiated rates across 1 hospital and 38 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.

38 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
1ST PSYC COLLAB CARE MGMT Outpatient	UCLA Santa Monica Medical Center	99492 HCPCS	—	—	$118 – $375	—
2019-ncov diagnostic p Outpatient	UCLA Santa Monica Medical Center	U0001 HCPCS	—	—	$35.91 – $103	—
2d cephal radio image Outpatient	UCLA Santa Monica Medical Center	D0702 HCPCS	—	—	$112 – $321	—
2d cephalometric image Outpatient	UCLA Santa Monica Medical Center	D0340 HCPCS	—	—	$112 – $321	—
2d oral/facial photo image Outpatient	UCLA Santa Monica Medical Center	D0703 HCPCS	—	—	$112 – $321	—
2d tee w or w/o fol w/con,in Outpatient	UCLA Santa Monica Medical Center	C8925 HCPCS	—	—	$1,004 – $2,894	—
2d tte w or w/o fol w/con,co Outpatient	UCLA Santa Monica Medical Center	C8923 HCPCS	—	—	$1,004 – $2,894	—
3-D RADIOTHERAPY PLAN Outpatient	UCLA Santa Monica Medical Center	77295 HCPCS	—	—	$430 – $5,109	—
ABATACEPT 125 MG/ML SC SOSY Outpatient	UCLA Santa Monica Medical Center	00003218811 NDC	$3,869	$2,128	$43.44 – $3,702	—
ABATACEPT 125 MG/ML SC SOSY\|DISCARDED DRUG NOT ADMINISTERED Outpatient	UCLA Santa Monica Medical Center	00003218811_2 NDC	$3,869	$2,128	$43.44 – $3,702	—
ABATACEPT 250 MG IV SOLR Outpatient	UCLA Santa Monica Medical Center	00003218713 NDC	$3,974	$2,186	$43.44 – $19,878	—
ABD PARACENTESIS Outpatient	UCLA Santa Monica Medical Center	49082 HCPCS	—	—	$1,167 – $3,348	—
ABD PARACENTESIS W/IMAGING Outpatient	UCLA Santa Monica Medical Center	49083 HCPCS	—	—	$1,167 – $3,348	—
ABL1 GENE Outpatient	UCLA Santa Monica Medical Center	81170 HCPCS	—	—	$240 – $861	—
ABLATE BONE TUMOR(S) PERQ Outpatient	UCLA Santa Monica Medical Center	20982 HCPCS	—	—	$9,077 – $64,723	—
ABLATE INF TURBINATE SUBMUC Outpatient	UCLA Santa Monica Medical Center	30802 HCPCS	—	—	$1,882 – $5,727	—
ABLATE INF TURBINATE SUPERF Outpatient	UCLA Santa Monica Medical Center	30801 HCPCS	—	—	$1,882 – $5,727	—
ABLATE PULM TUMOR PERQ CRYBL Outpatient	UCLA Santa Monica Medical Center	32994 HCPCS	—	—	$13,229 – $39,238	—
ABLATE PULM TUMOR PERQ RF Outpatient	UCLA Santa Monica Medical Center	32998 HCPCS	—	—	$7,413 – $22,316	—
ABLTJ B9 THYR NDUL PERQ LASR Outpatient	UCLA Santa Monica Medical Center	0673T HCPCS	—	—	$2,059 – $6,097	—
ABLTJ MAL BRST TUM PERQ CRTX Outpatient	UCLA Santa Monica Medical Center	0581T HCPCS	—	—	$4,865 – $14,453	—
ABLTJ MAL PRST8 TISS HIFU Outpatient	UCLA Santa Monica Medical Center	55880 HCPCS	—	—	$11,749 – $34,944	—
ABLTJ PERC UXTR/PERPH NRV Outpatient	UCLA Santa Monica Medical Center	0440T HCPCS	—	—	$2,481 – $7,208	—
ABO GNOTYP ABO 7 EXONS Outpatient	UCLA Santa Monica Medical Center	0180U HCPCS	—	—	$275 – $789	—
ABO GNOTYP NEXT GNRJ SEQ ABO Outpatient	UCLA Santa Monica Medical Center	0221U HCPCS	—	—	$275 – $789	—