San Antonio Regional Hospital
San Antonio Regional Hospital in Upland, CA publishes cash prices for 41 common procedures listed here, from its own machine-readable price file updated Apr 2, 2026. Click a procedure to compare it with other hospitals nearby.
999 San Bernardino Rd Upland CA 91786 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $1,243.00 | $19,755.00 | 94% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $2,890.50 | $5,781.00 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $1,243.00 | $10,968.00 | 89% |
| Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts | $187.00 | $1,752.00 | 89% |
| Diagnostic mammogram, one breast CPT 77065 Diagnostic mammography of 1 breast | $187.00 | $1,406.00 | 87% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $1,461.00 | $8,907.00 | 84% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast | $1,461.00 | $12,103.00 | 88% |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $1,461.00 | $11,643.00 | 87% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $1,461.00 | $15,539.00 | 91% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $1,461.00 | $11,666.00 | 87% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $312.00 | $3,523.00 | 91% |
| Screening mammogram, both breasts CPT 77067 Screening mammography | $187.00 | $1,058.00 | 82% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $312.00 | $2,902.00 | 89% |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $312.00 | $3,795.00 | 92% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $281.00 | $1,939.00 | 86% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total) | $185.00 | $1,250.00 | 85% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $185.00 | $920.00 | 80% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $185.00 | $347.00 | 47% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $185.00 | $436.00 | 58% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $185.00 | $1,458.00 | 87% |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $185.00 | $778.00 | 76% |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $185.00 | $1,017.00 | 82% |
| Obstetric blood test panel CPT 80055 Obstetric blood test panel | $185.00 | $251.00 | 26% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (prostate specific antigen) measurement, free | $185.00 | $22.00 | -741% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total | $185.00 | $10.00 | -1750% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $185.00 | $30.00 | -517% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $185.00 | $16.50 | -1021% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $185.00 | $851.00 | 78% |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $185.00 | $399.00 | 54% |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $185.00 | $196.00 | 6% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis, manual test | $185.00 | $84.00 | -120% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 Insertion of tube in left heart chambers for diagnosis with review by radiologist | $11,250.50 | $22,501.00 | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection of substance into lower spine canal using imaging guidance | $1,083.00 | $7,415.00 | 85% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection of substance into lower spine canal | $1,083.00 | $12,825.00 | 92% |
| Prostate biopsy CPT 55700 Biopsy of prostate gland | $1,684.00 | $4,325.00 | 61% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $151.50 | $303.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $181.50 | $363.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $218.00 | $436.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $249.00 | $532.00 | 53% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office or other outpatient consultation with low level of medical decision making, if using time, 30 minutes or more | $164.50 | $329.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office or other outpatient consultation with moderate level of medical decision making, if using time, 40 minutes or more | $181.00 | $362.00 | 50% |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSACHUPLANDCA&type=CDMWithoutLabel&fileType=CSV