Machine Readable Files
Downloads
As pricing may change periodically, patients are encouraged to contact [email protected] to obtain estimates using the most current information.
Thank you for your interest in understanding more about hospital charges. Contained in this file you will find information that complies with the pricing transparency requirements for machine-readable files prescribed by the Centers for Medicare & Medicaid Services (CMS). In those requirements, hospitals must provide several different types of charging elements.
In general, it is useful to create a distinction between two different types of charges that exist in the healthcare industry. The first is "gross charge" which relates to the established prices that are billed to all patients regardless of insurance coverage. The second is the "negotiated charge" that relates to prices insurance companies have agreed to pay for services. All patients will receive the same "gross charge" for items and services at the hospital, however, the "negotiated charge" will vary based on agreements that exist with insurance companies.
If a patient is insured, they will typically be responsible for a portion of the negotiated charge. The portion of the charge that an uninsured or insured patient will pay a hospital for services is referred to as an "out-of-pocket" expense. An insured patient's out-of-pocket expense will be dependent on the type of coverage the patient has with the insurance company. Uninsured patients should contact a hospital representative to assist with options for payment. Individual patient responsibility and pricing estimates can be discussed by contacting [email protected].
Other important notes about the machine-readable files:
- The term “self-pay” signifies discounted facility charges equal to 55% of billed charges.
- Multiple services may be included within each patient encounter represented by a HCPCS/CPT**; we are only displaying the negotiated rate for the fixed primary CPT.
**HCPCS (Healthcare Common Procedure Coding System) and CPT (Current Procedure Terminology) are coding systems used to report services, supplies, and equipment.
Ronald Reagan UCLA Medical Center
UCLA Santa Monica Medical Center