Centro Medico Del Turabo Inc

Bayamon, PR

417

Beds

6,564

Inpatient discharges a year

$67.3M

Net patient revenue a year

In-network payers

About this hospital

Centro Medico Del Turabo Inc is a 417-bed hospital in Bayamon, PR. Below you'll find publicly disclosed negotiated rates and facility details, including 3 in-network payers and 27 disclosed rate categories.

CCN: 400109
NPI: 1497770697
Teaching: No Medicare-funded residents
County: Bayamón Municipio
Metro area: San Juan-Bayamon-Caguas, PR MSA
Medicare contractor: Jurisdiction N, First Coast Service Options (09001)
In Medicare since: 1976
Last CMS survey: 2025

Negotiated Rates

The data below comes from CMS-mandated price transparency data. Learn more.

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Payer	Category	Code Type & Group	Contract Type	vs. State Average
BCBS	Outpatient	CPT Anesthesia Range: 00100 - 01999	Negotiated	Very Low
BCBS	Outpatient	CPT Category III Codes Range: 0042T - 0810T	Negotiated	Very Low
BCBS	Outpatient	CPT Evaluation and Management Range: 99091 - 99499	Negotiated	Very Low
BCBS	Outpatient	CPT Medicine Services and Procedures Range: 90281 - 99607	Negotiated	Very Low
BCBS	Outpatient	CPT Pathology and Laboratory Procedures Range: 80047 - 89398	Negotiated	Very Low
BCBS	Outpatient	CPT Proprietary Laboratory Analyses Range: 0001U - 0401U	Negotiated	Very Low
BCBS	Outpatient	CPT Radiology Procedures Range: 70010 - 79999	Negotiated	Very Low
BCBS	Outpatient	CPT Surgery Range: 10004 - 69990	Negotiated	Very Low
BCBS	Facility	RC All-inclusive Rate Range: 0100 - 0109	Per Diem	Average
BCBS	Facility	RC Blood and Blood Products Range: 0380 - 0389	Per Diem	Very Low

Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.

Showing 1 - 10 of 27

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Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Kaiser Permanente

More about this hospital

Doctors and services
Accredited by The Joint Commission
- No Medicare-funded residents
- 122 affiliated clinicians
See doctors and services
Finances
$67.3M net patient revenue
- Operating margin on patient care -18.7%
- $1.1M unreimbursed and uncompensated care
- -$9.1M net income
See finances
Ownership and leadership
Owned by Sociedad Espanola De Auxilio Mutuo Y Beneficencia De Puerto Rico
- Private (not for profit)
See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Centro Medico Del Turabo Inc in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)	Plans and networks listing it	Organization NPIs
66-0465905Hospital Hima San Pablo Caguas	9Cigna, Triple-S Salud, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), BCBS, EMI Health and 4 more	1295768232 Centro Medico Del Turabo Inc.1497770697 Centro Medico Del Turabo Inc.1710107883 Centro Medico Del Turabo Incand 56 more

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

Bayamon, PR

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Accreditation and services

The Joint Commission (since 1994)
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
436
Medicare-certified beds
349
Registered nurses (full-time equivalent)
1976
In Medicare since

Source: CMS Provider of Services file, as reported by the hospital and state surveyors.

Size and patient volume

What Centro Medico Del Turabo Inc reported to Medicare in its latest cost report, covering Oct 1, 2024 to Sep 30, 2025.

6,564
Inpatient discharges
Medicare 6%, Medicaid 7%
49,369
Inpatient days
32% of available bed days used
826
Employees (full-time equivalent)

Source: CMS cost report (HCRIS) (report 831095). Figures cover the reporting period, which is not always 12 months, and are self-reported.

Utilization by payer and unit

Inpatient days and discharges Centro Medico Del Turabo Inc reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.

	Medicare	Medicaid	Other	Total
Inpatient days	3,872	3,374	42,123	49,369
Discharges	421	481	5,662	6,564
Average length of stay	9.2 days	7.0 days	7.4 days	7.5 days
Average daily census	10.6	9.2	115.4	135.3

25,854
Medicare Advantage days
3,383 discharges

Beds and days by unit

Unit	Beds	Inpatient days	Medicare days	Occupancy
Adults & pediatrics	351	38,630	3,217	30%
Intensive care unit	39	6,030	643	42%
Coronary care unit	11	2,585		64%

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.

Where patients come from

ZIP codes with the most Medicare inpatient stays at Centro Medico Del Turabo Inc in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 3,587 in 2020 to 4,084 in 2025.

ZIP code	Stays	Of this hospital's stays	Days	Charges	Market share	Share in 2020
00956	727	18%	5,186	$9.6M	38%	40%
00959	472	12%	3,844	$7.1M	34%	42%
00957	405	10%	2,880	$5.3M	33%	39%
00961	381	9%	2,860	$5.3M	41%	43%
00949	380	9%	2,792	$5.4M	24%	36%
00953	290	7%	2,181	$4.3M	22%	31%
00719	183	4%	1,350	$2.8M	24%	31%
00962	171	4%	1,245	$2.2M	34%	42%
00960	102	2%	735	$1.3M	38%	53%
00783	99	2%	792	$1.7M	10%	11%
00952	87	2%	585	$1.1M	29%	37%
00966	78	2%	538	$983,737	20%	18%
00951	67	2%	537	$979,493	24%	34%
00969	59	1%	569	$1.2M	7%	8%
00646	57	1%	454	$915,917	5%	9%
00926	52	1%	419	$819,052	2%	2%
00965	44	1%	294	$564,156	45%	25%
00971	43	1%	265	$578,751	10%	5%
00970	42	1%	349	$692,633	13%	11%
00692	33	1%	280	$643,373	3%	4%
00963	32	1%	273	$571,382	44%	34%
00782	29	1%	198	$355,413	6%	12%
00954	27	1%	303	$679,594	14%	33%
00950	26	1%	247	$452,208	60%	73%
00958	25	1%	208	$470,161	66%	100%

Source: CMS Hospital Service Area file. Shares are of the 4,084 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.

Staff and facilities

Staff by profession and the rooms and units Centro Medico Del Turabo Inc reported at its latest Medicare certification survey (2025). Counts are people, not full-time equivalents.

20
Operating rooms
3
Endoscopy rooms
3
Cardiac catheterization rooms

349
Registered nurses
30
Licensed practical nurses
23
Nurse anesthetists (CRNAs)
17
Pharmacists
12
Respiratory therapists
2
Physical therapists
36
Radiology technicians
3
Nuclear medicine technicians
10
Laboratory technicians
29
Medical technologists
5
Dietitians
10
Social workers
353
Other personnel

Source: CMS Provider of Services file.

Doctors and clinicians

122 clinicians who bill Medicare list Centro Medico Del Turabo Inc as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.

Internal Medicine Physician 20
Cardiovascular Disease Physician 8
Urology Physician 8
Diagnostic Radiology Physician 7
General Practice Physician 7
Surgery Physician 7
Anesthesiology Physician 6
Emergency Medicine Physician 6
Infectious Disease Physician 6
Nephrology Physician 6

Gory Ballester Ortiz, M.D.
Diagnostic Radiology Physician
NPI 1861748618
See commercial rates for Gory Ballester Ortiz, M.D.
Juan Serrano, M.D.
Specialist
NPI 1083793434
See commercial rates for Juan Serrano, M.D.
Jose Pereyo Diaz, M.D.
Cardiovascular Disease Physician
NPI 1770577454
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Jan Rodriguez Ferrer, MD
Internal Medicine Physician
NPI 1407969215
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Daniel Mendez, MD
Body Imaging Physician
NPI 1003008517
See commercial rates for Daniel Mendez, MD
Rainier Ramirez Ramirez, M.D.
Internal Medicine Physician
NPI 1679516363
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Agustin Velazquez Perez
Nephrology Physician
NPI 1942614599
See commercial rates for Agustin Velazquez Perez
Juan Igartua Ponton, M.D.F.A.C.C.
Cardiovascular Disease Physician
NPI 1649275603
See commercial rates for Juan Igartua Ponton, M.D.F.A.C.C.
Rafael Tirado Siragusa
Geriatric Medicine (Internal Medicine) Physician
NPI 1356564264
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Felix Del Rio, MD
Cardiovascular Disease Physician
NPI 1114088747
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Reinaldo Gonzalez Martinez, MD FCCP
Pulmonary Disease Physician
NPI 1437253952
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Jaime Busquets, MD
Internal Medicine Physician
NPI 1598943417
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Rolando Blanco-Cuadra, M.D.
Internal Medicine Physician
NPI 1881626182
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Juan Amador, MD
Diagnostic Radiology Physician
NPI 1811191182
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Jorge Cortes-Ruiz, M.D.
Gastroenterology Physician
NPI 1770586273
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Harry Jimenez, MD
Endocrinology, Diabetes & Metabolism Physician
NPI 1497782551
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Ana Rivera De La Vega, M.D.
Nephrology Physician
NPI 1003934589
See commercial rates for Ana Rivera De La Vega, M.D.
Carlos Rodriguez Olivencia, MD
Internal Medicine Physician
NPI 1245277565
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Ildefonso Rivera Rivera, MD
Cardiovascular Disease Physician
NPI 1740264712
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Hector Lopez-Huertas, MD
Urology Physician
NPI 1467660936
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Jose Maymi Rivera, M.D.
Specialist
NPI 1124085790
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Robert Hunter, MD
Hematology & Oncology Physician
NPI 1588657522
See commercial rates for Robert Hunter, MD
Raul Melendez Ayala
Internal Medicine Physician
NPI 1528155363
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Neisa Torres Reyes, MD
Specialist
NPI 1629016829
See commercial rates for Neisa Torres Reyes, MD

Source: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.

Income statement

Revenue, expenses and income Centro Medico Del Turabo Inc reported to Medicare for Oct 1, 2024 to Sep 30, 2025. Percentages are of net patient revenue.

Line	Amount	Share
Gross patient revenue (charges)	$141.2M	209.8%
Inpatient	$107.3M	159.4%
Outpatient	$33.9M	50.4%
Contractual allowances and discounts	-$73.9M	-109.8%
Net patient revenue	$67.3M	100.0%
Operating expenses	-$79.9M	-118.7%
Operating income from patient care	-$12.6M	-18.7%
Other income	$3.5M	5.2%
Net income	-$9.1M	-13.5%

Gross revenue by payer

Line	Amount	Share
Traditional Medicare	$5.6M	4.0%
Medicaid (including managed care)	$9.8M	7.0%
Other payers and self-pay	$125.1M	89.0%
Total charges	$140.5M	100.0%

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.

Financial ratios

Computed from Centro Medico Del Turabo Inc's latest cost report.

-18.7%
Operating margin
Operating income from patient care / net patient revenue
-12.8%
Total margin
Net income / net patient revenue plus other income
-6.0%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
49% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$20.17
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-11.6%
Return on assets
Net income for a year / total assets
-37.4%
Return on equity
Net income for a year / fund balance
1.31
Current ratio
Current assets / current liabilities
1.13
Quick ratio
Cash, temporary investments and net receivables / current liabilities
14 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
71 days
Days in patient receivables
Net patient receivables / daily net patient revenue
67 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
0.90
Asset turnover
Total revenue for a year / total assets
1.9 years
Average age of plant
Accumulated depreciation / depreciation for a year

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements.

Balance sheet

What Centro Medico Del Turabo Inc owned and owed at the end of its reporting period (Sep 2025), across all fund types: $78.3M in total assets and a $24.2M fund balance.

Show the balance sheet

Line	Amount	Of total assets
Cash and temporary investments	$2.9M	3.8%
Patient receivables, net	$13M	16.6%
Inventory	$598,360	0.8%
Total current assets	$18.5M	23.6%
Property and equipment, net of depreciation	$57.6M	73.5%
Investments and other assets	$2.3M	3.0%
Total assets	$78.3M	100.0%
Current liabilities	$14.1M	18.0%
Total liabilities	$54.1M	69.0%
Fund balance (net assets)	$24.2M	31.0%

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements.

Charity care and uncompensated care

Care Centro Medico Del Turabo Inc provided without full payment, as reported on Worksheet S-10 of its cost report.

$227,533
Bad debt
Patient bills written off as uncollectible, at charges
$1M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$1.1M
Total unreimbursed and uncompensated care
1.4% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements.

Financial trend

Centro Medico Del Turabo Inc's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.

Show 6 years

Fiscal year ending	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Sep 2024	Sep 2025
Net patient revenue	$137.7M	$98.3M	$86.9M	$41.7M	$40.9M	$67.3M
Operating expenses	$119.1M	$115.2M	$104.1M	$94.7M	$54.5M	$79.9M
Operating margin	13.5%	-17.2%	-19.8%	-127.1%	-33.4%	-18.7%
Net income	$39.3M	-$14.6M	-$11.9M	-$52.8M	-$12M	-$9.1M
Total assets	$169.5M	$107.6M	$109.2M	$82.4M	$71.8M	$78.3M
Discharges	9,587	9,669	8,297	4,066	4,123	6,564
Inpatient days	66,021	63,228	57,807	30,338	34,762	49,369
Medicare Advantage days	28,242	31,588	32,023	10,847	10,761	25,854
Beds	426	424	424	424	417	417
Employees (FTE)	1,265	1,103	1,010	1,018	640	826

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements.

Departments

Each cost center Centro Medico Del Turabo Inc reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.

Show all 40 departments

Ancillary and outpatient departments

Department	Salaries	Total cost	Charges	Cost-to-charge	Square feet
Emergency	$2.9M	$7.5M	$6.6M	1.14	17,193
Operating room	$3.7M	$7.4M	$10.5M	0.71	33,021
Drugs charged to patients		$6.7M	$12.9M	0.52
Laboratory	$1.9M	$5.2M	$7.5M	0.69	6,842
Medical supplies charged to patient		$3.7M	$12M	0.30
Radiology-diagnostic	$1.7M	$3.5M	$10.3M	0.34	15,902
Impl. dev. charged to patients		$2.7M	$2.2M	1.22
Cardiac catheterization	$869,799	$2.6M	$4.8M	0.54	6,104
Anesthesiology	$1.7M	$2.5M
Respiratory therapy	$889,156	$2.1M	$20.4M	0.10	1,983
Endoscopy	$389,533	$1.3M	$1.6M	0.81	1,569
Blood storing processing & trans.		$922,455	$2.7M	0.34	504
Womans imaging center	$161,942	$644,460	$113,926	5.66
Physical therapy	$162,508	$396,269	$119,257	3.32	4,674
Nuclear medicine	$64,702	$288,062	$422,249	0.68
Mri	$121,090	$251,629	$1.8M	0.14	563
Electrocardiology		$72,905	$1.4M	0.05
Electroencephalography	$30,016	$59,853	$45,861	1.31	121
I&r services-not apprvd prgm		$53,968
Renal dialysis		$41,287	$206,908	0.20	593
Ambulance services			$23,918

Inpatient units

Department	Salaries	Total cost	Charges	Cost-to-charge	Square feet
Adults & pediatrics	$5.5M	$16.1M	$35.7M	0.45	98,382
Intensive care unit	$2.1M	$4.2M	$4.8M	0.88	13,184
Coronary care unit	$915,042	$2M	$2.1M	0.92	4,034
Stroke unit	$655,414	$1.5M	$2.3M	0.62	4,566

Overhead (general service) departments

Department	Salaries	Direct cost	Paid hours	Average hourly wage	Square feet
Administrative & general	$3.9M	$11.6M	220,010	$17.68	116,626
Pharmacy	$1.9M	$5.4M	58,871	$32.19	2,233
Cap rel costs-mvble equip		$3.8M
Central services & supply		$3M
Housekeeping	$201,626	$2.2M	14,006	$14.40	1,785
Maintenance & repairs	$725,668	$2.1M	43,368	$16.73	4,494
Operation of plant		$1.9M			12,763
Dietary	$218,542	$1.7M	9,001	$24.28	6,418
Nursing administration	$1.4M	$1.7M	62,945	$22.28	2,307
Medical records & library	$1.2M	$1.4M	68,722	$17.26	7,998
Cap rel costs-bldg & fixt		$1.1M			404,223
Employee benefits department	$503,131	$708,162	24,332	$20.68	1,121
Social service	$287,417	$325,575	14,554	$19.75	453
Cafeteria		$325,197			9,720
Laundry & linen service		$13,758			700

Source: CMS cost report (HCRIS, Form 2552-10), report 831095, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.

Medicare payment profile

The factors Medicare uses to set what it pays Centro Medico Del Turabo Inc for an inpatient stay.

1.57
Case mix index
Higher than 36% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
7.6%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
416
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).

Show FY 2021 to FY 2027

IPPS fiscal year	FY 2021	FY 2022	FY 2023	FY 2024	FY 2025	FY 2026	FY 2027
Case mix index	1.53	1.54	1.81	1.61	1.73	1.60	1.57
Wage index	0.624	0.616	0.614	0.613	0.583	0.554	0.526
Medicare inpatient stays	1,035	1,035	556	484	316	262	416

Source: CMS IPPS final rule Impact File (FY 2027).

Frequently asked questions

About Centro Medico Del Turabo Inc's rates and hospital price transparency.

Is Centro Medico Del Turabo Inc a teaching hospital?

CMS reports no Medicare-funded interns or residents at Centro Medico Del Turabo Inc for fiscal year 2027.

What is Centro Medico Del Turabo Inc's case mix index?

Centro Medico Del Turabo Inc's Medicare case mix index is 1.57 for fiscal year 2027, higher than 36% of hospitals paid under the inpatient prospective payment system.

How many patients does Centro Medico Del Turabo Inc admit?

Centro Medico Del Turabo Inc reported 6,564 inpatient discharges and 49,369 inpatient days from Oct 1, 2024 to Sep 30, 2025.

How many employees does Centro Medico Del Turabo Inc have?

Centro Medico Del Turabo Inc reported 826 full-time-equivalent employees on payroll from Oct 1, 2024 to Sep 30, 2025.

How much revenue does Centro Medico Del Turabo Inc make?

Centro Medico Del Turabo Inc reported $67.3M in net patient revenue on $141.2M of gross charges for Oct 1, 2024 to Sep 30, 2025, an operating margin of -18.7%, and net income of -$9.1M.

How much charity and uncompensated care does Centro Medico Del Turabo Inc provide?

Centro Medico Del Turabo Inc reported $1.1M of unreimbursed and uncompensated care for Oct 1, 2024 to Sep 30, 2025.

What is Centro Medico Del Turabo Inc's tax ID (EIN)?

Insurers' price transparency files list Centro Medico Del Turabo Inc under employer identification number 66-0465905 (Hospital Hima San Pablo Caguas). 9 health plans and networks list 66-0465905 for it.

How many doctors are affiliated with Centro Medico Del Turabo Inc?

122 clinicians who bill Medicare list Centro Medico Del Turabo Inc as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are internal medicine physician (20), cardiovascular disease physician (8), urology physician (8).

Is Centro Medico Del Turabo Inc accredited?

Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Centro Medico Del Turabo Inc, effective 1994.

Who owns Centro Medico Del Turabo Inc?

In its Medicare enrollment, Centro Medico Del Turabo Inc reports Sociedad Espanola De Auxilio Mutuo Y Beneficencia De Puerto Rico as 5% or greater direct ownership interest (100%).

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{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
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        "standard_charge_dollar": 400
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Centro Medico Del Turabo Inc

About this hospital

Negotiated Rates

Insurance Accepted

More about this hospital

Tax IDs and NPIs insurers list

Location

Accreditation and services

Size and patient volume

Utilization by payer and unit

Beds and days by unit

Where patients come from

Staff and facilities

Doctors and clinicians

Income statement

Gross revenue by payer

Financial ratios

Balance sheet

Charity care and uncompensated care

Financial trend

Departments

Ancillary and outpatient departments

Inpatient units

Overhead (general service) departments

Medicare payment profile

Ownership

Changes of ownership

Leadership

Officers and directors on the Medicare enrollment

Frequently asked questions

Running price transparency at a hospital like this one?

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About this hospital

Negotiated Rates

Insurance Accepted

More about this hospital

Tax IDs and NPIs insurers list

Location

Accreditation and services

Size and patient volume

Utilization by payer and unit

Beds and days by unit

Where patients come from

Staff and facilities

Doctors and clinicians

Income statement

Gross revenue by payer

Financial ratios

Balance sheet

Charity care and uncompensated care

Financial trend

Departments

Ancillary and outpatient departments

Inpatient units

Overhead (general service) departments

Medicare payment profile

Ownership

Changes of ownership

Leadership

Officers and directors on the Medicare enrollment

Nearby hospitals

Frequently asked questions

Running price transparency at a hospital like this one?

Publish a CMS-compliant machine-readable file

Get your chargemaster right for billing and payer contracts