11994001601 — Samarium Sm 153 Lexidronam 1850 Mbq/ml IV Soln
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SAMARIUM SM 153 LEXIDRONAM 1850 MBQ/ML IV SOLN (NDC 11994001601) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/11994001601?code_type=NDC
MLA (9th ed.)
“SAMARIUM SM 153 LEXIDRONAM 1850 MBQ/ML IV SOLN (NDC 11994001601) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/11994001601?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“SAMARIUM SM 153 LEXIDRONAM 1850 MBQ/ML IV SOLN (NDC 11994001601) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/11994001601?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $26,789–$40,300 (25th–75th percentile) across 5 hospitals · 111 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 11994001601 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | Medicare Advantage | $1,725.25 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna Medicare | Medicare | $1,725.25 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community Medicare | Medicare | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | St. Jude | Medicare HMO | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Medicare | Medicare | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | TriWest Healthcare Alliance | Other Government | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | TriWest Healthcare Alliance | Other Government | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna Medicare | Medicare | $3,159.80 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | SCAN | Medicare | $3,180.52 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | HealthSmart | Workers Compensation | $3,791.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Mediare Advantage | Medicare Advantage | $4,314.91 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Monarch | Medicare | $4,314.91 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $4,314.91 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care DSNP | Medicare HMO | $4,314.91 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | Medicare Advantage | $4,314.91 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Anthem Vivity-Anthem HMO | All Products-HMO | $4,314.91 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Memorial Medicare | HMO-Medicare | $4,746.40 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Providence Healthcare | Medicare | $4,746.40 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | SCAN | Medicare | $5,825.13 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Centivo | PPO | $7,583.52 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Plan of Nevada Commercial | All Products | $8,721.05 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Optum | Medicare | $9,068.63 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | EPN | $11,961.00 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | EPN | $11,961.00 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna Medicare | Medicare | $13,433.37 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCLA Health Medicare Advantage Plan | Medicare Advantage | $13,433.37 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Gold Coast Health Plan | HMO | $15,045.37 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Gold Coast Health Plan | HMO | $15,045.37 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Workers Comp | Workers Comp | $15,416.14 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $15,749.28 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | All Products | $15,948.00 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | EPN | $15,948.00 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | All Products | $15,948.00 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $16,287.34 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | All Products | $16,897.00 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-City of LA | $17,474.13 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | BEACON | HEALTH OPTIONS | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | HEALTH PLAN w/o UHRIP | CHIP | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | FIRSTCARE | STAR | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | BEACON | STAR | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | BEACON | CHIP | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | BEACON | ALL PRODUCTS | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | HEALTH PLAN w/o UHRIP | STAR KIDS | $17,585.52 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $17,624.58 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $18,054.45 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $18,054.45 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA MediCal - RMG | Medicaid Advantage | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | CenCal Medi-Cal HMO | Medi-Cal HMO | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Care LA - RMG | All Products | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Providence Healthcare | Medicare | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | CenCal Transplant Medi-Cal HMO | Medi-Cal HMO | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | Medicare Advantage | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Care LA - RMG | All Products | $18,806.72 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $19,687.95 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $19,687.95 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Central Health Plan | Medicare HMO | $20,711.82 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Care - PPO | PPO | $21,009.79 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA care Medi-Cal HMO | Medi-Cal HMO | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Molina Healthcare HMO | MediCal HMO | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Children Hospital of Orange County | Medicaid HMO | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UCI University - RMG | All Products | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UCI University - RMG | All Products | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Children Hospital of Orange County | Medicaid HMO | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Molina Healthcare HMO | MediCal HMO | $21,493.39 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UC Ship | PPO | $21,708.33 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UC Ship | PPO | $21,708.33 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | LA Care Covered CA | HMO | $24,163.79 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | SUPERIOR HEALTH | CHIP | $24,355.95 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | SUPERIOR HEALTH | STAR PLUS | $24,355.95 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | HEALTH PLAN w/o UHRIP | CHIP | $24,355.95 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | HEALTH PLAN w/o UHRIP | STAR KIDS | $24,355.95 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | HEALTH PLAN w. UHRIP | STAR | $24,355.95 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | SUPERIOR HEALTH | STAR | $24,355.95 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | RIGHTCARE | MDC S&W | $24,509.82 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | HEALTH PLAN w/o UHRIP | CHIP | $24,509.82 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | HEALTH PLAN w. UHRIP | STAR | $24,509.82 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | HEALTH PLAN w/o UHRIP | STAR KIDS | $24,509.82 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | RIGHTCARE | STAR | $24,509.82 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | UC Ship | PPO | $25,523.40 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | WELLPOINT | STAR | $25,572.28 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | WELLPOINT | CHIP | $25,572.28 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | WELLPOINT | STAR PLUS | $25,572.28 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | WELLPOINT | STAR PLUS | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | UNITED COMMUNITY | STAR KIDS | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | UNITED COMMUNITY | STAR | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | UNITED COMMUNITY | STAR PLUS | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | WELLPOINT | STAR | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | WELLPOINT | CHIP | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | UNITED COMMUNITY | CHIP | $25,740.80 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | BCBS | CHIP STAR KIDS | $26,305.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | BCBS | BCBS TX STAR | $26,305.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | BCBS | CHIP | $26,305.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | BCBS | CHIP | $26,473.53 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | BCBS | BCBS TX STAR | $26,473.53 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | BCBS | CHIP STAR KIDS | $26,473.53 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | Aetna | BETTER HEALTH STAR UHRIP | $26,788.61 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | Aetna | BETTER HEALTH CHIP | $26,788.61 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | Aetna | BETTER HEALTH STAR Kids | $26,788.61 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | MOLINA | STAR | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER InpatientFacility | UNITED COMMUNITY | CHIP | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER InpatientFacility | UNITED COMMUNITY | STAR | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER InpatientFacility | UNITED COMMUNITY | STAR PLUS | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER InpatientFacility | UNITED COMMUNITY | STAR KIDS | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | MOLINA | STAR KIDS | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | MOLINA | CHIP | $27,111.01 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | Medicare | $27,135.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | All Products | $27,135.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | All Products | $27,135.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | Medicare | $27,135.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | HEALTH PLAN w. UHRIP | STAR | $27,858.39 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | HealthCare Partners HMO | HMO-Medicare | $29,553.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA Care Covered CA | HMO | $29,553.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | LA Care DSNP | Medicare HMO | $29,553.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | HealthCare Partners HMO | HMO-Medicare | $29,553.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Optum | Medicare | $29,553.41 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Net B&G | HMO | $30,037.02 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Kaiser | All Products | $30,090.75 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Kaiser | All Products | $30,090.75 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Kaiser | All Products | $30,628.08 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Redlands Community General Services | HMO | $31,165.42 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Redlands Community General Services | HMO | $31,165.42 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Cigna | HMO | $31,439.46 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Cigna | HMO | $31,439.46 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Cigna | PPO | $31,439.46 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Cigna | PPO | $31,439.46 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | UNITED COMMUNITY | CHIP | $32,166.85 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | UNITED COMMUNITY | STAR | $32,166.85 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | UNITED COMMUNITY | STAR KIDS | $32,166.85 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | UNITED COMMUNITY | STAR PLUS | $32,166.85 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | BEACON | HEALTH OPTIONS | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | TX CHILDREN HEALTH | STAR | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | EL PASO HEALTH FIRST | STAR MEDICAID | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | RIGHTCARE | MDC S&W | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | BEACON | ALL PRODUCTS | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | EL PASO HEALTH FIRST | STAR | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | BEACON | STAR | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | BEACON | CHIP | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | RIGHTCARE | STAR | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | EL PASO HEALTH FIRST | CHIP | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | Optum | ALL PRODUCTS | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | TX CHILDREN HEALTH | CHIP | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | TX CHILDREN HEALTH | STAR KIDS | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | SUPERIOR HEALTH | STAR PLUS | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | SUPERIOR HEALTH | CHIP | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | SUPERIOR HEALTH | STAR | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | Optum | ALL PRODUCTS | $32,240.12 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | EL PASO HEALTH FIRST | STAR MEDICAID | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | BEACON | CHIP | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | EL PASO HEALTH FIRST | CHIP | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | EL PASO HEALTH FIRST | STAR | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | TX CHILDREN HEALTH | STAR | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | TX CHILDREN HEALTH | CHIP | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | BEACON | HEALTH OPTIONS | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | BEACON | STAR | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | BEACON | ALL PRODUCTS | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | TX CHILDREN HEALTH | STAR KIDS | $33,705.58 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER BothFacility | FIRSTCARE | STAR | $33,852.13 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Plan of Nevada Commercial | All Products | $34,389.43 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Access Medical Group - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Valley Care - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Santa Barbara Select IPA - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Access Medical Group - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Monarch | Medicare | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Seaview IPA - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Seoul Medical Group - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Torrance Hospital - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | MemorialCare Medical Foundation - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Primecare Commercial | HMO | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Western Neurological Network - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Monarch | Medicare | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | MemorialCare Medical Foundation - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Western Neurological Network - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Santa Barbara Select IPA - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Seaview IPA - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Seoul Medical Group - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Primecare Commercial | HMO | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Torrance Hospital - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Valley Care - RMG | All Products | $34,926.76 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER BothFacility | FIRSTCARE | STAR | $35,390.86 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | Aetna | BETTER HEALTH STAR Kids | $35,464.13 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | Aetna | BETTER HEALTH CHIP | $35,464.13 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | Aetna | BETTER HEALTH STAR UHRIP | $35,464.13 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna | All Products | $36,431.30 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Aetna | All Products | $36,431.30 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Aetna | All Products | $36,431.30 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER InpatientFacility | BCBS | HMO | $36,636.50 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | BCBS | Blue Cross Blue Shield PAR (BCBSPAR) - Indemnity | $36,636.50 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER InpatientFacility | BCBS | Blue Cross Blue Shield PAR (BCBSPAR) - Indemnity | $36,636.50 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | BCBS | HMO | $36,636.50 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER InpatientFacility | Aetna | EMPLOYEE | $36,636.50 | $73,273.00 | $54,954.75 | 2026-01-01 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Select/SelectPlus | Select-Select Plus | $36,796.69 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UHC Select/SelectPlus | Select-Select Plus | $36,796.69 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | First Health | Workers Compensation | $36,861.17 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | UHC Select/SelectPlus | Select-Select Plus | $37,285.66 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | UHC Select/SelectPlus | Select-Select Plus | $37,285.66 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Health Net B&G | HMO | $37,291.04 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Health Net B&G | HMO | $37,291.04 | $53,733.48 | $29,553.41 | 2026-03-29 | MRF ↗ |
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