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Comparison of Costs Between TIHN Referral and Normal Charges

UCLA Medical Center – Inpatient Hospital Charge (Heart Surgery)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $123,698.83 $44,079.48 None $100.00
Other Referral Blue Cross $123,698.83 $122,398.83 $300.00 $1,300.00

UCLA Medical Center – Outpatient Hospital Charge (Eye Surgery)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $10,690.28 $6,194.00 None $100.00
Other Referral Blue Cross $10,690.28 $6,194.00 $300.00 $929.10

Cedars Sinai Medical Center – Outpatient Hospital Charge (Hysteroscopy Surgery)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $34,130.80 $14,334.94 None $100
Other Referral Blue Cross $34,130.80 $14,334.94 $300.00 $1,300.00

C V ENT SURGICAL GROUP – Doctor Charge (Nasal Surgery)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $41,260.00 $3,450.93 None $100.00
Other Referral Blue Cross $41,260.00 $3,450.93 $300.00 $772.64

UCLA ORTHOPAEDIC SURGERY – Doctor Charge (Office Consultation)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $945.00 $472.65 None $10.00
Other Referral Blue Cross $945.00 $472.65 $300.00 $325.90

ABEMAYOR, ELLIOTT MD – Doctor Charge (Thyroid Surgery)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $25,381.25 $7,065.68 None $100.00
Other Referral Blue Cross $25,381.25 $7,065.68 $300.00 $1,300.00

UCLA DEPARTMENT OF PEDIATRICS GROUP PRAC – Doctor Charge (Heart Surgery)

Type of Referral Network Billed Amount Allowed Amount Deductible Patient Responsibility
TIHN Referral TIHN $20,432.00 $10,850.38 None $100.00
Other Referral Blue Cross $20,432.00 $10,850.38 $300.00 $1,300.00