Health Plan of Nevada Commercial: disclosed hospital rates

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Based on the published hospital price files, Health Plan of Nevada Commercial appears in disclosed negotiated rates across 2 hospitals and 181 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.

181 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	—
0.9% SODIUM CHLORIDE--CONTROL FOR ATG Outpatient	UCLA Santa Monica Medical Center	63323018610 NDC	$40.00	$22.00	$1.03 – $200	—
1ST OPN IMPLT BAT MODULJ SYS Outpatient	Ronald Reagan UCLA Medical Center	64654 HCPCS	—	—	$56,651 – $162,589	—
1ST OPN IMPLT BAT MODULJ SYS Outpatient	UCLA Santa Monica Medical Center	64654 HCPCS	—	—	$56,651 – $162,589	—
1ST PSYC COLLAB CARE MGMT Outpatient	Ronald Reagan UCLA Medical Center	99492 HCPCS	—	—	$111 – $375	—
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	Ronald Reagan UCLA Medical Center	D0702 HCPCS	—	—	$112 – $321	—
2d cephal radio image Outpatient	UCLA Santa Monica Medical Center	D0702 HCPCS	—	—	$112 – $321	—
2d cephalometric image Outpatient	Ronald Reagan UCLA Medical Center	D0340 HCPCS	—	—	$112 – $321	—
2d cephalometric image Outpatient	UCLA Santa Monica Medical Center	D0340 HCPCS	—	—	$112 – $321	—
2d oral/facial photo image Outpatient	Ronald Reagan UCLA Medical Center	D0703 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	Ronald Reagan UCLA Medical Center	C8925 HCPCS	—	—	$1,000 – $2,894	—
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	Ronald Reagan UCLA Medical Center	C8923 HCPCS	—	—	$1,000 – $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	Ronald Reagan UCLA Medical Center	77295 HCPCS	—	—	$430 – $5,109	—
3-D RADIOTHERAPY PLAN Outpatient	UCLA Santa Monica Medical Center	77295 HCPCS	—	—	$430 – $5,109	—
361 hct/p skin subs, nos Outpatient	Ronald Reagan UCLA Medical Center	Q4433 HCPCS	—	—	$160 – $459	—
361 hct/p skin subs, nos Outpatient	UCLA Santa Monica Medical Center	Q4433 HCPCS	—	—	$160 – $459	—
3d anat seg imaging preop Outpatient	Ronald Reagan UCLA Medical Center	C8001 HCPCS	—	—	$112 – $475	—
3d anat seg imaging preop Outpatient	UCLA Santa Monica Medical Center	C8001 HCPCS	—	—	$112 – $475	—
3d bn img algor drvd fr mri Outpatient	Ronald Reagan UCLA Medical Center	G0566 HCPCS	—	—	$166 – $475	—
3d bn img algor drvd fr mri Outpatient	UCLA Santa Monica Medical Center	G0566 HCPCS	—	—	$166 – $475	—