Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
CITRIC AC/GLUC/MG 500 IRR
Glendale, CA
See all hospitals reporting HCPCS Q2004 →Price type
Dignity Community Care’s median price of $124 is 18% above the median hospital's median price ($105), higher than 60% of the 975 hospitals reporting HCPCS Q2004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 23 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 2 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 3 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 4 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 5 | Anthem medicaid|all plans fee schedule · inpatient | $104 | $104 | — | — | — | $104 – $104 |
| 6 | Anthem medicaid|all plans fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 7 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 8 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 9 | Cigna commercial|all other plans fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 10 | Cigna commercial|ppo fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 11 | Kaiser commercial|all plans fee schedule · inpatient | $232 | $232 | — | — | — | $232 – $232 |
| 12 | Kaiser commercial|all plans fee schedule · outpatient | $232 | $232 | — | — | — | $232 – $232 |
| 13 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $248 | $248 | — | — | — | $248 – $248 |
| 14 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $248 | $248 | — | — | — | $248 – $248 |
| 15 | Aetna commercial|all other plans fee schedule · outpatient | $259 | $259 | — | — | — | $259 – $259 |
| 16 | Aetna commercial|hmo fee schedule · outpatient | $259 | $259 | — | — | — | $259 – $259 |
| 17 | Aetna commercial|ppo fee schedule · outpatient | $259 | $259 | — | — | — | $259 – $259 |
| 18 | First Health commercial|all plans fee schedule · inpatient | $269 | $269 | — | — | — | $269 – $269 |
| 19 | First Health commercial|all plans fee schedule · outpatient | $269 | $269 | — | — | — | $269 – $269 |
| 20 | MultiPlan commercial|all plans fee schedule · inpatient | $331 | $331 | — | — | — | $331 – $331 |
| 21 | MultiPlan commercial|all plans fee schedule · outpatient | $331 | $331 | — | — | — | $331 – $331 |
| 22 | Anthem commercial|non-mcs fee schedule · outpatient | $381 | $381 | — | — | — | $381 – $381 |
| 23 | Anthem commercial|mcs fee schedule · outpatient | $414 | $414 | — | — | — | $414 – $414 |
Last updated: Feb 28, 2026
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