CMS Price Transparency Data

Review of medical records for care

Facility: Casa Colina Hospital

Billing Code: 90889 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90889
Insurance Median: $60
Cash Discount Price: Unavailable
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Review of medical records for care at Casa Colina Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Heritage Prvdr Ntwrk Comm - All Other Plans	$40	N/A
Heritage Prvdr Ntwrk Mcr	$40	N/A
Healthnet Comm - All Other Plans	$41	N/A
Corvel - All Plans	$50	N/A
Coventry - All Plans	$50	N/A
Humana	$50	N/A
Multiplan - All Plans	$50	N/A
Three Rivers - All Plans	$50	N/A
UnitedHealthcare	$50	N/A
Cigna	$56	N/A
Blue Cross Blue Shield	$59	N/A
Brand New Day Mcr Adv - All Plans	$60	N/A
Galaxy Provdr Ntwrk - All Plans	$70	N/A
Blue Shield Comm - All Other Plans	$74	N/A
Healthcare Partners - All Other Plans	$80	N/A
Healthcare Partners Mcr	$80	N/A
Primecare Comm - All Other Plans	$80	N/A
Primecare Mcr Adv	$80	N/A
Prospect Med Grp Alta - All Plans	$85	N/A
Medi-Cal	$100	N/A
Kaiser Mcal	$110	N/A
Aetna	$115	N/A
Iehp Mcal	$250	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90889.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Casa Colina Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90889.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.