{ "hospital_name": "Cedars-Sinai Medical Center", "last_updated_on": "2025-11-26", "version": "2.0.0", "location_name": [ "Cedars-Sinai Medical Center" ], "hospital_address": [ "8700 Beverly Blvd, Los Angeles, CA 90048" ], "license_information": { "license_number": "930000110", "state": "CA" }, "attestation": { "attestation": "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.", "confirm_attestation": true, "attester_name": "David Wrigley" }, "standard_charge_information": [ { "description": "Outpatient Surgery Group 7 Global Rate", "code_information": [ { "code": "22533", "type": "CPT" } ], "standard_charges": [ { "minimum": 36188.0, "maximum": 39001.0, "setting": "outpatient", "payers_information": [ { "payer_name": "Blue Cross of California, dba Anthem Blue Cross and its Affiliates", "plan_name": "PPO", "standard_charge_dollar": 39001.0, "methodology": "fee schedule" } ] }, { "minimum": 36188.0, "maximum": 39001.0, "setting": "outpatient", "payers_information": [ { "payer_name": "Blue Cross of California, dba Anthem Blue Cross and its Affiliates", "plan_name": "HMO", "standard_charge_dollar": 36188.0, "methodology": "fee schedule" } ] } ] }, { "description": "Outpatient Surgery Group 7 Global Rate", "code_information": [ { "code": "22630", "type": "CPT" } ], "standard_charges": [ { "minimum": 36188.0, "maximum": 39001.0, "setting": "outpatient", "payers_information": [ { "payer_name": "Blue Cross of California, dba Anthem Blue Cross and its Affiliates", "plan_name": "PPO", "standard_charge_dollar": 39001.0, "methodology": "fee schedule" } ] }, { "minimum": 36188.0, "maximum": 39001.0, "setting": "outpatient", "payers_information": [ { "payer_name": "Blue Cross of California, dba Anthem Blue Cross and its Affiliates", "plan_name": "HMO", "standard_charge_dollar": 36188.0, 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7503.89, "discounted_cash": 4877.53, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 7503.89, "discounted_cash": 4877.53, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43611", "type": "CPT" }, { "code": "799", "type": "RC" } ], "standard_charges": [ { "minimum": 13030.5, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 13030.5, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 13030.5, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43621", "type": "CPT" }, { "code": "499", "type": "RC" } ], "standard_charges": [ { "minimum": 12162.28, "maximum": 18056.43, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 12162.28, "maximum": 18056.43, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 12162.28, "maximum": 18056.43, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43622", "type": "CPT" }, { "code": "499", "type": "RC" } ], "standard_charges": [ { "minimum": 12162.28, "maximum": 18056.43, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 12162.28, "maximum": 18056.43, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 12162.28, "maximum": 18056.43, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43631", "type": "CPT" }, { "code": "361", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43631", "type": "CPT" }, { "code": "369", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43632", "type": "CPT" }, { "code": "361", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43632", "type": "CPT" }, { "code": "369", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43633", "type": "CPT" }, { "code": "481", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 37207.0, "discounted_cash": 24184.55, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 37207.0, "discounted_cash": 24184.55, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 37207.0, "discounted_cash": 24184.55, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43633", "type": "CPT" }, { "code": "490", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43634", "type": "CPT" }, { "code": "799", "type": "RC" } ], "standard_charges": [ { "minimum": 13030.5, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 13030.5, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 13030.5, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43635", "type": "CPT" }, { "code": "499", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43641", "type": "CPT" }, { "code": "360", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 8681.23, "discounted_cash": 5642.8, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 8681.23, "discounted_cash": 5642.8, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 8681.23, "discounted_cash": 5642.8, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43641", "type": "CPT" }, { "code": "499", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43800", "type": "CPT" }, { "code": "361", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43800", "type": "CPT" }, { "code": "369", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43810", "type": "CPT" }, { "code": "360", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 8681.23, "discounted_cash": 5642.8, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 8681.23, "discounted_cash": 5642.8, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 8681.23, "discounted_cash": 5642.8, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43810", "type": "CPT" }, { "code": "361", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Grouper - Unlisted", "code_information": [ { "code": "43810", "type": "CPT" }, { "code": "499", "type": "RC" } ], "standard_charges": [ { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "PPO", "standard_charge_dollar": 14136.81, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "Select", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] }, { "minimum": 9088.3, "maximum": 14136.81, "setting": "outpatient", "payers_information": [ { "payer_name": "UHC of California, dba UnitedHealthcare of California and fka PacificCare of California", "plan_name": "HMO", "standard_charge_dollar": 13030.5, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Surgical Group 0", "code_information": [ { "code": "361", "type": "RC" }, { "code": "Q4193", "type": "CPT" } ], "standard_charges": [ { "minimum": 2806.68, "maximum": 4166.87, "gross_charge": 6099.75, "discounted_cash": 3964.84, "setting": "outpatient", "payers_information": [ { "payer_name": "California Physicians' Service, dba Blue Shield of California", "plan_name": "HMO", "additional_payer_notes": "Lesser of amount listed and a percentage of billed charges. 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Case rate using payer-specific multiplier and regional factor for LA county.", "standard_charge_dollar": 4166.87, "methodology": "case rate" } ] } ] }, { "description": "Outpatient Surgical Group 0", "code_information": [ { "code": "490", "type": "RC" }, { "code": "0628T", "type": "CPT" } ], "standard_charges": [ { "minimum": 2806.68, "maximum": 9827.82, "gross_charge": 54802.6, "discounted_cash": 35621.69, "setting": "outpatient", "payers_information": [ { "payer_name": "California Physicians' Service, dba Blue Shield of California", "plan_name": "POS", "additional_payer_notes": "Lesser of amount listed and a percentage of billed charges. 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