Hospital San Diego-Chula Vista-Carlsbad, CA

Scripps Memorial Hospital La Jolla

Scripps Memorial Hospital La Jolla in La Jolla, CA publishes cash prices for 306 common procedures listed here, from its own machine-readable price file updated Mar 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 259 of 301 procedures and above it for 39. By typical cash price it ranks #12 of 106 California hospitals and #2 of 12 hospitals in the San Diego, CA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

9888 Genesee Avenue, La Jolla, CA, 92037-1205 Collected Sep 27, 2026 Source price file

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Scripps Memorial Hospital La Jolla in La Jolla, CA:

Oct 31, 2024 Warning notice
Feb 13, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 HC Ankle Min 3vw Bilateral	$341.26	$1,365.04	$34.14–$1,092.03	—	75%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Ankle Min 3vw Unilateral	$227.51	$910.03	$34.14–$728.02	46% below	75%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 HC Ankle Min 3vw Bilateral	$341.26	$1,365.04	$34.14–$1,092.03	—	75%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Ankle Min 3vw Unilateral	$227.51	$910.03	$34.14–$728.02	—	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC Ltd Bilat Up/Low Ext Artery 1-2 Level	$70.89	$283.56	$22.68–$427.81	—	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC Ltd Bilat Up/Low Ext Artery 1-2 Level	$70.89	$283.56	$22.68–$427.81	—	75%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esoph Swallow Barium	$233.85	$935.42	$74.83–$748.34	57% below	75%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Esoph Swallow Barium	$233.85	$935.42	$74.83–$748.34	—	75%
Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Image Whole Body	$1,123.85	$4,495.40	$262.78–$3,596.32	47% below	75%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone Image Whole Body	$1,123.85	$4,495.40	$262.78–$3,596.32	—	75%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US Breast Bilat Comp	$846.50	$3,386.00	$79.28–$2,708.80	—	75%
Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Unilat Comp	$564.33	$2,257.34	$79.28–$1,805.87	1% above	75%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US Breast Bilat Comp	$846.50	$3,386.00	$79.28–$2,708.80	—	75%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Unilat Comp	$564.33	$2,257.34	$79.28–$1,805.87	—	75%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US Breast Bilat Limited	$414.07	$1,656.27	$62.10–$1,325.02	—	75%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US Breast Unilat Limited	$276.04	$1,104.18	$62.10–$883.34	24% below	75%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US Breast Bilat Limited	$414.07	$1,656.27	$62.10–$1,325.02	—	75%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US Breast Unilat Limited	$276.04	$1,104.18	$62.10–$883.34	—	75%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio Chst Noncor W/WO	$1,664.74	$6,658.96	$183.32–$5,327.17	47% below	75%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio Chst Noncor W/WO	$1,664.74	$6,658.96	$183.32–$5,327.17	—	75%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Cta Hrt W/3d Art/Grft/Ca	$771.55	$3,086.21	$185.17–$2,468.97	71% below	75%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Cta Hrt W/3d Art/Grft/Ca	$771.55	$3,086.21	$185.17–$2,468.97	—	75%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Hrt W/O Dye W/Ca Test	$235.29	$941.18	$56.47–$752.94	30% below	75%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT Hrt W/O Dye W/Ca Test	$235.29	$941.18	$56.47–$752.94	—	75%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abdomen & Pelvis WO	$1,456.80	$5,827.20	$95.94–$4,661.76	48% below	75%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abdomen & Pelvis WO	$1,456.80	$5,827.20	$95.94–$4,661.76	—	75%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W	$2,250.00	$9,000.00	$201.57–$7,200.00	44% below	75%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W	$2,250.00	$9,000.00	$201.57–$7,200.00	—	75%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen & Pelvis W/WO	$2,362.50	$9,450.00	$207.00–$7,560.00	47% below	75%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abdomen & Pelvis W/WO	$2,362.50	$9,450.00	$207.00–$7,560.00	—	75%
CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen Upper W	$607.66	$2,430.66	$145.84–$1,944.53	73% below	75%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen Upper W	$607.66	$2,430.66	$145.84–$1,944.53	—	75%
CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen Upper W/O	$317.66	$1,270.66	$75.86–$1,016.53	83% below	75%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen Upper W/O	$317.66	$1,270.66	$75.86–$1,016.53	—	75%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial WO	$1,832.54	$7,330.18	$82.40–$5,864.14	16% below	75%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Maxillofacial WO	$1,832.54	$7,330.18	$82.40–$5,864.14	—	75%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head WO	$864.40	$3,457.62	$62.46–$2,766.10	62% below	75%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head WO	$864.40	$3,457.62	$62.46–$2,766.10	—	75%
CT scan of the head with contrast CPT 70460 HC CT Head W	$940.40	$3,761.61	$89.40–$3,009.29	65% below	75%
CT scan of the head with contrast inpatient CPT 70460 HC CT Head W	$940.40	$3,761.61	$89.40–$3,009.29	—	75%
CT scan of the head without and with contrast CPT 70470 HC CT Head W/WO	$1,016.40	$4,065.60	$106.53–$3,252.48	64% below	75%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head W/WO	$1,016.40	$4,065.60	$106.53–$3,252.48	—	75%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar WO	$479.81	$1,919.23	$77.73–$1,535.38	83% below	75%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Lumbar WO	$479.81	$1,919.23	$77.73–$1,535.38	—	75%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical WO	$1,725.00	$6,900.00	$78.35–$5,520.00	41% below	75%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Cervical WO	$1,725.00	$6,900.00	$78.35–$5,520.00	—	75%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W	$730.05	$2,920.22	$160.44–$2,336.18	71% below	75%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W	$730.05	$2,920.22	$160.44–$2,336.18	—	75%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Extracranl Art Duplex Bi	$176.40	$705.60	$56.45–$767.21	—	75%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Extracranl Art Duplex Bi	$176.40	$705.60	$56.45–$767.21	—	75%
Chest X-ray, 2 views CPT 71046 HC Chest 2 Views	$243.65	$974.59	$27.35–$779.67	37% below	75%
Chest X-ray, 2 views inpatient CPT 71046 HC Chest 2 Views	$243.65	$974.59	$27.35–$779.67	—	75%
Chest X-ray, single view CPT 71045 HC Chest X-Ray Special Views	$54.14	$216.58	$17.33–$279.82	85% below	75%
Chest X-ray, single view CPT 71045 HC Chest Single Vw	$75.74	$302.98	$20.15–$279.82	79% below	75%
Chest X-ray, single view inpatient CPT 71045 HC Chest X-Ray Special Views	$54.14	$216.58	$17.33–$279.82	—	75%
Chest X-ray, single view inpatient CPT 71045 HC Chest Single Vw	$75.74	$302.98	$20.15–$279.82	—	75%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitoneal Comp	$97.35	$389.40	$31.15–$336.16	89% below	75%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Retroperitoneal Comp	$97.35	$389.40	$31.15–$336.16	—	75%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Bone Density Spine/Hip/Pelvis	$127.15	$508.61	$35.73–$406.89	75% below	75%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC Bone Density Spine/Hip/Pelvis	$127.15	$508.61	$35.73–$406.89	—	75%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC Bone Density Extrm-Dexa	$70.41	$281.66	$22.53–$279.82	75% below	75%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC Bone Density Extrm-Dexa	$70.41	$281.66	$22.53–$279.82	—	75%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US Preg Sgl Ges Det Fetus	$136.71	$546.84	$43.75–$767.21	85% below	75%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US Preg Sgl Ges Det Fetus	$136.71	$546.84	$43.75–$767.21	—	75%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest WO	$524.73	$2,098.94	$77.42–$1,679.15	71% below	75%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Chest WO	$524.73	$2,098.94	$77.42–$1,679.15	—	75%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Chest W	$2,133.65	$8,534.59	$104.98–$6,827.67	9% below	75%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Chest W	$2,133.65	$8,534.59	$104.98–$6,827.67	—	75%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Dx Bilat Mammo Incl Cad	$224.45	$897.82	$71.83–$718.26	—	75%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Dx Bilat Mammo Incl Cad	$224.45	$897.82	$71.83–$718.26	—	75%
Diagnostic mammogram, one breast CPT 77065 HC Dx Uni Mammo Incl Cad	$168.00	$671.99	$53.76–$537.59	54% below	75%
Diagnostic mammogram, one breast inpatient CPT 77065 HC Dx Uni Mammo Incl Cad	$168.00	$671.99	$53.76–$537.59	—	75%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Dplx Low Ext Art Bi Comp	$153.36	$613.43	$49.07–$767.21	—	75%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC Dplx Low Ext Art Bi Comp	$153.36	$613.43	$49.07–$767.21	—	75%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Scan Ext Bilat/Complt	$275.62	$1,102.50	$88.20–$882.00	—	75%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Dplx Up&Lo Ext Ven Bilat/Complt	$275.62	$1,102.50	$88.20–$882.00	—	75%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Venous Mapping	$183.75	$735.00	$58.80–$767.21	84% below	75%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Dplx Up&Lo Ext Ven Bilat/Complt	$275.62	$1,102.50	$88.20–$882.00	—	75%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Scan Ext Bilat/Complt	$275.62	$1,102.50	$88.20–$882.00	—	75%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Venous Mapping	$183.75	$735.00	$58.80–$767.21	—	75%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo 2dcomp W/ Doppler	$391.72	$1,566.87	$125.35–$1,756.95	85% below	75%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo 2dcomp W/Con W/ Dop	$460.51	$1,842.06	$147.36–$2,520.63	83% below	75%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo 2dcomp W/ Doppler	$391.72	$1,566.87	$125.35–$1,756.95	—	75%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo 2dcomp W/Con W/ Dop	$460.51	$1,842.06	$147.36–$2,520.63	—	75%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobil Sys W/O Pharm	$230.75	$923.01	$73.84–$1,285.43	87% below	75%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC Hepatobil Sys W/O Pharm	$230.75	$923.01	$73.84–$1,285.43	—	75%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Stdy Unattended	$103.30	$413.22	$33.06–$694.28	87% below	75%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Sleep Stdy Unattended	$103.30	$413.22	$33.06–$694.28	—	75%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Poly 4 or More Para W/Bin	$578.37	$2,313.49	$185.08–$2,761.21	84% below	75%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Poly 4 or More Para W/Bin	$578.37	$2,313.49	$185.08–$2,761.21	—	75%
Knee X-ray, 3 views both sides CPT 73562 HC Knee 3vw Bilateral	$340.04	$1,360.17	$39.33–$1,088.14	—	75%
Knee X-ray, 3 views one side CPT 73562 HC Knee 3vw Unilateral	$226.69	$906.78	$39.33–$725.42	44% below	75%
Knee X-ray, 3 views inpatient both sides CPT 73562 HC Knee 3vw Bilateral	$340.04	$1,360.17	$39.33–$1,088.14	—	75%
Knee X-ray, 3 views inpatient one side CPT 73562 HC Knee 3vw Unilateral	$226.69	$906.78	$39.33–$725.42	—	75%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Ltd Pyloric	$365.80	$1,463.20	$70.09–$1,170.56	56% below	75%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Ltd	$447.64	$1,790.56	$70.09–$1,432.45	46% below	75%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Ltd Pyloric	$365.80	$1,463.20	$70.09–$1,170.56	—	75%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Ltd	$447.64	$1,790.56	$70.09–$1,432.45	—	75%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thorax Lw Dose Lng Ca Scr C-	$229.70	$918.82	$55.13–$735.06	42% below	75%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Thorax Lw Dose Lng Ca Scr C-	$229.70	$918.82	$55.13–$735.06	—	75%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MR Breast WO/W Bilat	$1,160.19	$4,640.78	$217.60–$3,712.62	—	75%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MR Breast WO/W Bilat	$1,160.19	$4,640.78	$217.60–$3,712.62	—	75%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 HC MRI Any Jt Lower Extrem W/O Contrast Matrl Bilateral	$1,657.11	$6,628.43	$131.77–$5,302.74	—	75%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MR Jnt Low Ext WO Unilat	$945.23	$3,780.92	$131.77–$3,024.74	60% below	75%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 HC MRI Any Jt Lower Extrem W/O Contrast Matrl Bilateral	$1,657.11	$6,628.43	$131.77–$5,302.74	—	75%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MR Jnt Low Ext WO Unilat	$945.23	$3,780.92	$131.77–$3,024.74	—	75%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 HC MR Jnt Low Ext W/WO Bilateral	$1,533.63	$6,134.54	$262.78–$4,907.63	—	75%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MR Jnt Low Ext W/WO Unilat	$1,196.75	$4,787.00	$262.78–$3,829.60	67% below	75%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 HC MR Jnt Low Ext W/WO Bilateral	$1,533.63	$6,134.54	$262.78–$4,907.63	—	75%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MR Jnt Low Ext W/WO Unilat	$1,196.75	$4,787.00	$262.78–$3,829.60	—	75%
MRI of the abdomen without contrast CPT 74181 HC MR Abdomen WO	$549.07	$2,196.29	$118.37–$1,757.03	79% below	75%
MRI of the abdomen without contrast inpatient CPT 74181 HC MR Abdomen WO	$549.07	$2,196.29	$118.37–$1,757.03	—	75%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MR Abdomen W/WO	$860.11	$3,440.45	$218.23–$2,752.36	80% below	75%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MR Abdomen W/WO	$860.11	$3,440.45	$218.23–$2,752.36	—	75%
MRI of the brain, no contrast dye CPT 70551 HC MR Brain WO	$913.03	$3,652.13	$118.68–$2,921.70	65% below	75%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MR Brain WO	$913.03	$3,652.13	$118.68–$2,921.70	—	75%
MRI of the brain, with and without contrast dye CPT 70553 HC MR Brain W/WO	$1,475.74	$5,902.98	$197.04–$4,722.38	62% below	75%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR Brain W/WO	$1,475.74	$5,902.98	$197.04–$4,722.38	—	75%
MRI of the lower back, no contrast dye CPT 72148 HC MR Lumbar WO	$753.25	$3,013.00	$114.64–$2,410.40	71% below	75%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR Lumbar WO	$753.25	$3,013.00	$114.64–$2,410.40	—	75%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MR Lumbar W/WO	$846.45	$3,385.80	$197.97–$2,708.64	77% below	75%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MR Lumbar W/WO	$846.45	$3,385.80	$197.97–$2,708.64	—	75%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MR Thoracic WO	$1,026.21	$4,104.86	$113.70–$3,283.89	59% below	75%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MR Thoracic WO	$1,026.21	$4,104.86	$113.70–$3,283.89	—	75%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MR Cervical W/WO	$1,662.00	$6,648.00	$197.66–$5,318.40	58% below	75%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MR Cervical W/WO	$1,662.00	$6,648.00	$197.66–$5,318.40	—	75%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MR Cervical WO	$1,257.12	$5,028.48	$114.01–$4,022.78	51% below	75%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MR Cervical WO	$1,257.12	$5,028.48	$114.01–$4,022.78	—	75%
MRI of the pelvis without and with contrast CPT 72197 HC MR Pelvis Wwo	$946.08	$3,784.32	$216.67–$3,027.46	76% below	75%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MR Pelvis Wwo	$946.08	$3,784.32	$216.67–$3,027.46	—	75%
MRI of the pelvis, no contrast dye CPT 72195 HC MR Pelvis WO	$567.91	$2,271.63	$149.53–$1,817.30	76% below	75%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MR Pelvis WO	$567.91	$2,271.63	$149.53–$1,817.30	—	75%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 HC MR Jnt Upp Ext WO Bilateral	$867.21	$3,468.86	$132.09–$2,775.09	—	75%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MR Jnt Upp Ext WO Unilateral	$578.14	$2,312.57	$132.09–$1,850.06	76% below	75%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 HC MR Jnt Upp Ext WO Bilateral	$867.21	$3,468.86	$132.09–$2,775.09	—	75%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MR Jnt Upp Ext WO Unilateral	$578.14	$2,312.57	$132.09–$1,850.06	—	75%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocard Spect Mul/Rst/Str	$842.53	$3,370.12	$269.61–$4,162.84	77% below	75%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC Myocard Spect Mul/Rst/Str	$842.53	$3,370.12	$269.61–$4,162.84	—	75%
OCT scan of the retina (optical coherence tomography) CPT 92134 HC Computr Ophth Img Retina	$35.39	$141.56	$11.32–$189.68	86% below	75%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HC Computr Ophth Img Retina	$35.39	$141.56	$11.32–$189.68	—	75%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull Base-Midthih	$1,098.20	$4,392.80	$351.42–$4,597.88	82% below	75%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull Base-Midthih	$1,098.20	$4,392.80	$351.42–$4,597.88	—	75%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Ltd or F/Up	$538.81	$2,155.26	$32.54–$1,724.21	4% above	75%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvic Ltd or F/Up	$538.81	$2,155.26	$32.54–$1,724.21	—	75%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic Complete Non-OB	$577.81	$2,311.24	$86.87–$1,848.99	39% below	75%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US Pelvic Complete Non-OB	$577.81	$2,311.24	$86.87–$1,848.99	—	75%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg>14 Wks Sgl Ges	$227.26	$909.04	$72.72–$727.23	69% below	75%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Preg>14 Wks Sgl Ges	$227.26	$909.04	$72.72–$727.23	—	75%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg<14 Wks Sgl Ges	$735.44	$2,941.78	$84.07–$2,353.42	6% above	75%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US Preg<14 Wks Sgl Ges	$735.44	$2,941.78	$84.07–$2,353.42	—	75%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Uterus Preg Limited	$97.35	$389.40	$31.15–$336.16	81% below	75%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US Uterus Preg Limited	$97.35	$389.40	$31.15–$336.16	—	75%
Screening mammogram, both breasts both sides CPT 77067 HC Scrn Bi Mammo Ximgs W/Cad	$180.87	$723.47	$57.88–$578.78	—	75%
Screening mammogram, both breasts both sides CPT 77067 HC Scrn Bilat Mammo Incl Cad	$180.87	$723.47	$57.88–$578.78	—	75%
Screening mammogram, both breasts CPT 77067 HC Scrn Uni Mammo Ximg W/Cad	$180.87	$723.47	$57.88–$578.78	36% below	75%
Screening mammogram, both breasts CPT 77067 HC Scrn Uni Mammo Incl Cad	$180.87	$723.47	$57.88–$578.78	36% below	75%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Scrn Bilat Mammo Incl Cad	$180.87	$723.47	$57.88–$578.78	—	75%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Scrn Bi Mammo Ximgs W/Cad	$180.87	$723.47	$57.88–$578.78	—	75%
Screening mammogram, both breasts inpatient CPT 77067 HC Scrn Uni Mammo Ximg W/Cad	$180.87	$723.47	$57.88–$578.78	—	75%
Screening mammogram, both breasts inpatient CPT 77067 HC Scrn Uni Mammo Incl Cad	$180.87	$723.47	$57.88–$578.78	—	75%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Min 2vw Bilaterl	$364.61	$1,458.43	$31.74–$1,166.74	28% below	75%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Shoulder Min 2vw Unilateral	$243.07	$972.29	$31.74–$777.83	52% below	75%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder Min 2vw Bilaterl	$364.61	$1,458.43	$31.74–$1,166.74	—	75%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Shoulder Min 2vw Unilateral	$243.07	$972.29	$31.74–$777.83	—	75%
Sleep study in a lab (polysomnography) CPT 95810 HC Poly 4 or More Para Atted	$578.37	$2,313.49	$185.08–$2,761.21	88% below	75%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Poly 4 or More Para Atted	$578.37	$2,313.49	$185.08–$2,761.21	—	75%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Swallow Funct (Mbs)	$127.15	$508.61	$40.69–$563.99	78% below	75%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Swallow Funct (Mbs)	$127.15	$508.61	$40.69–$563.99	—	75%
Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal	$403.95	$1,615.79	$101.43–$1,292.63	33% below	75%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal	$403.95	$1,615.79	$101.43–$1,292.63	—	75%
Transvaginal ultrasound during pregnancy CPT 76817 HC US Pregnant Transvaginal	$558.59	$2,234.35	$68.49–$1,787.48	3% below	75%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US Pregnant Transvaginal	$558.59	$2,234.35	$68.49–$1,787.48	—	75%
Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete	$342.36	$1,369.44	$91.44–$1,095.55	65% below	75%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete	$342.36	$1,369.44	$91.44–$1,095.55	—	75%
Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum & Contents	$538.81	$2,155.26	$82.07–$1,724.21	39% below	75%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Scrotum & Contents	$538.81	$2,155.26	$82.07–$1,724.21	—	75%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Head/Neck Soft Tissue	$522.34	$2,089.35	$98.05–$1,671.48	37% below	75%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Head/Neck Soft Tissue	$522.34	$2,089.35	$98.05–$1,671.48	—	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Ugi W/O Kub	$192.96	$771.84	$61.75–$617.47	69% below	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Ugi W/O Kub	$192.96	$771.84	$61.75–$617.47	—	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study both sides CPT 93971 HC Dplx Ext Vein Bilat/Ltd	$539.64	$2,158.55	$114.21–$1,726.84	—	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Scan Up&Lo Ext Veins Uni/Limtd	$359.76	$1,439.03	$114.21–$1,151.22	59% below	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Dplx Ext Vein Unilat/Ltd	$359.76	$1,439.03	$114.21–$1,151.22	59% below	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient both sides CPT 93971 HC Dplx Ext Vein Bilat/Ltd	$539.64	$2,158.55	$114.21–$1,726.84	—	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Duplex Scan Up&Lo Ext Veins Uni/Limtd	$359.76	$1,439.03	$114.21–$1,151.22	—	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Dplx Ext Vein Unilat/Ltd	$359.76	$1,439.03	$114.21–$1,151.22	—	75%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 HC Wrist Min 3vw Bilateral	$363.53	$1,454.13	$40.53–$1,163.30	—	75%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Wrist Min 3vw Unilateral	$242.35	$969.42	$40.53–$775.54	44% below	75%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 HC Wrist Min 3vw Bilateral	$363.53	$1,454.13	$40.53–$1,163.30	—	75%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Wrist Min 3vw Unilateral	$242.35	$969.42	$40.53–$775.54	—	75%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Hip Wwo Pelvis 2-3vw Unilat	$70.41	$281.66	$22.53–$279.82	82% below	75%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Hip Wwo Pelvis 2-3vw Unilat	$70.41	$281.66	$22.53–$279.82	—	75%
X-ray of the abdomen, 1 view CPT 74018 HC Abdomen 1vw	$67.68	$270.72	$21.66–$279.82	78% below	75%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Abdomen 1vw	$67.68	$270.72	$21.66–$279.82	—	75%
X-ray of the ankle, 2 views both sides CPT 73600 HC Radiologic Examination Ankle 2 Views Bilateral	$341.24	$1,364.95	$28.94–$1,091.96	—	75%
X-ray of the ankle, 2 views one side CPT 73600 HC Ankle Up to 2vw Unilateral	$227.49	$909.97	$28.94–$727.98	25% below	75%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC Radiologic Examination Ankle 2 Views Bilateral	$341.24	$1,364.95	$28.94–$1,091.96	—	75%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Ankle Up to 2vw Unilateral	$227.49	$909.97	$28.94–$727.98	—	75%
X-ray of the finger(s), 2 or more views both sides CPT 73140 HC Finger Min 2vw Bilateral	$316.98	$1,267.92	$38.93–$1,014.34	—	75%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger Min 2vw Unilateral	$211.32	$845.28	$38.93–$676.22	20% below	75%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 HC Finger Min 2vw Bilateral	$316.98	$1,267.92	$38.93–$1,014.34	—	75%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger Min 2vw Unilateral	$211.32	$845.28	$38.93–$676.22	—	75%
X-ray of the foot, 2 views both sides CPT 73620 HC Foot 2vw Bilateral	$132.30	$529.20	$24.95–$423.36	—	75%
X-ray of the foot, 2 views one side CPT 73620 HC Foot Up to 2vw Unilateral	$88.20	$352.80	$24.95–$282.24	71% below	75%
X-ray of the foot, 2 views inpatient both sides CPT 73620 HC Foot 2vw Bilateral	$132.30	$529.20	$24.95–$423.36	—	75%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Foot Up to 2vw Unilateral	$88.20	$352.80	$24.95–$282.24	—	75%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 HC Foot Min 3vw Bilateral	$340.22	$1,360.87	$30.94–$1,088.70	—	75%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Foot Min 3vw Unilateral	$226.81	$907.25	$30.94–$725.80	43% below	75%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 HC Foot Min 3vw Bilateral	$340.22	$1,360.87	$30.94–$1,088.70	—	75%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Foot Min 3vw Unilateral	$226.81	$907.25	$30.94–$725.80	—	75%
X-ray of the hand, 3 or more views both sides CPT 73130 HC Hand Ap/OB/Lat Min 3vw Bi	$409.54	$1,638.18	$34.94–$1,310.54	—	75%
X-ray of the hand, 3 or more views one side CPT 73130 HC Hand Ap/OB/Lat Min 3vw Unilat	$273.03	$1,092.12	$34.94–$873.70	35% below	75%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HC Hand Ap/OB/Lat Min 3vw Bi	$409.54	$1,638.18	$34.94–$1,310.54	—	75%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Hand Ap/OB/Lat Min 3vw Unilat	$273.03	$1,092.12	$34.94–$873.70	—	75%
X-ray of the knee, 1 or 2 views both sides CPT 73560 HC Knee Up to 2vw Bilateral	$105.79	$423.18	$31.34–$338.54	—	75%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Knee Up to 2vw Unilateral	$70.53	$282.12	$22.57–$279.82	79% below	75%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 HC Knee Up to 2vw Bilateral	$105.79	$423.18	$31.34–$338.54	—	75%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Knee Up to 2vw Unilateral	$70.53	$282.12	$22.57–$279.82	—	75%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbar Up to 3vw	$322.70	$1,290.82	$35.33–$1,032.66	29% below	75%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Spine Lumbar Up to 3vw	$322.70	$1,290.82	$35.33–$1,032.66	—	75%
X-ray of the lower back, 4 or more views CPT 72110 HC Spine L-S Min 4vw	$292.03	$1,168.13	$48.52–$934.50	50% below	75%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spine L-S Min 4vw	$292.03	$1,168.13	$48.52–$934.50	—	75%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic 2vw Ap/Lat	$195.55	$782.21	$27.74–$625.77	44% below	75%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Spine Thoracic 2vw Ap/Lat	$195.55	$782.21	$27.74–$625.77	—	75%
X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bone Min 3vw	$211.25	$844.99	$34.54–$675.99	45% below	75%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Nasal Bone Min 3vw	$211.25	$844.99	$34.54–$675.99	—	75%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 1-3 Vw	$243.65	$974.59	$34.94–$779.67	44% below	75%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine Cervical 1-3 Vw	$243.65	$974.59	$34.94–$779.67	—	75%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 1-2 Views	$107.57	$430.27	$23.35–$344.22	70% below	75%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 1vw	$130.37	$521.47	$23.35–$417.18	64% below	75%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis 1-2 Views	$107.57	$430.27	$23.35–$344.22	—	75%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis 1vw	$130.37	$521.47	$23.35–$417.18	—	75%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Coccyx/Sacrum Min 2vw	$243.65	$974.59	$28.14–$779.67	47% below	75%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Coccyx/Sacrum Min 2vw	$243.65	$974.59	$28.14–$779.67	—	75%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Alt (Sgpt)	$11.52	$46.08	$3.69–$36.86	73% below	75%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Alt (Sgpt)	$11.52	$46.08	$3.69–$36.86	—	75%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Ast(Sgot)	$11.52	$46.08	$3.69–$36.86	75% below	75%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Ast(Sgot)	$11.52	$46.08	$3.69–$36.86	—	75%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide (Bnp)	$42.19	$168.77	$13.50–$135.02	80% below	75%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Natriuretic Peptide (Bnp)	$42.19	$168.77	$13.50–$135.02	—	75%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel	$61.00	$244.00	$8.46–$195.20	68% below	75%
Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel	$61.00	$244.00	$8.46–$195.20	—	75%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Surg Pth;G&M;Mult.Uncom	$47.69	$190.77	$15.26–$167.56	76% below	75%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC G&M Level IV	$63.65	$254.59	$20.37–$203.67	68% below	75%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Surg Pth;G&M;Mult.Uncom	$47.69	$190.77	$15.26–$167.56	—	75%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC G&M Level IV	$63.65	$254.59	$20.37–$203.67	—	75%
Blood culture for bacteria CPT 87040 HC Cultureblood	$184.55	$738.19	$10.32–$590.55	32% below	75%
Blood culture for bacteria inpatient CPT 87040 HC Cultureblood	$184.55	$738.19	$10.32–$590.55	—	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture	$5.04	$20.16	$1.61–$23.35	81% below	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Venipuncture	$5.04	$20.16	$1.61–$23.35	—	75%
Blood glucose (sugar) test CPT 82947 HC Glucose 1hr	$5.76	$23.04	$1.84–$18.43	85% below	75%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose 1hr	$5.76	$23.04	$1.84–$18.43	—	75%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Preg Screen Blood	$115.77	$463.10	$7.52–$370.48	34% below	75%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Preg Screen Blood	$115.77	$463.10	$7.52–$370.48	—	75%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing;Abo	$230.68	$922.74	$2.99–$738.19	36% above	75%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Type Abo	$230.68	$922.74	$2.99–$738.19	36% above	75%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing;Abo	$230.68	$922.74	$2.99–$738.19	—	75%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Type Abo	$230.68	$922.74	$2.99–$738.19	—	75%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C Reactive Protein	$8.21	$32.83	$2.63–$26.26	83% below	75%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C Reactive Protein	$8.21	$32.83	$2.63–$26.26	—	75%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq	$55.15	$220.62	$17.65–$176.50	42% below	75%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq	$55.15	$220.62	$17.65–$176.50	—	75%
Complete blood count (CBC) with differential CPT 85025 HC Cbc	$27.50	$110.00	$7.77–$88.00	75% below	75%
Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc	$27.50	$110.00	$7.77–$88.00	—	75%
Complete blood count (CBC), no differential CPT 85027 HC Hemogram	$37.91	$151.63	$6.47–$121.30	50% below	75%
Complete blood count (CBC), no differential inpatient CPT 85027 HC Hemogram	$37.91	$151.63	$6.47–$121.30	—	75%
Comprehensive metabolic panel (blood test) CPT 80053 HC Metabolic Pnl,Comp, Wb	$98.00	$391.99	$10.56–$313.59	62% below	75%
Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Panel	$98.00	$391.99	$10.56–$313.59	62% below	75%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Panel	$98.00	$391.99	$10.56–$313.59	—	75%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Metabolic Pnl,Comp, Wb	$98.00	$391.99	$10.56–$313.59	—	75%
D-dimer blood test (blood clot marker) CPT 85379 HC D-Dimer,Quant	$97.20	$388.80	$10.18–$311.04	32% below	75%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-Dimer,Quant	$97.20	$388.80	$10.18–$311.04	—	75%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin, Fecal	$14.84	$59.36	$4.75–$49.08	80% below	75%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Calprotectin, Fecal	$14.84	$59.36	$4.75–$49.08	—	75%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel	$113.61	$454.46	$36.36–$363.57	59% below	75%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC General Health Panel	$113.61	$454.46	$36.36–$363.57	—	75%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucosewhole Blood	$4.16	$16.63	$1.33–$13.30	91% below	75%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Whole Blood/1hr	$4.16	$16.63	$1.33–$13.30	91% below	75%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Post Dose	$4.53	$18.14	$1.45–$14.51	90% below	75%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose 1hr 50g/Post Dose	$5.67	$22.68	$1.81–$18.14	87% below	75%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucosewhole Blood	$4.16	$16.63	$1.33–$13.30	—	75%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose Whole Blood/1hr	$4.16	$16.63	$1.33–$13.30	—	75%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose Post Dose	$4.53	$18.14	$1.45–$14.51	—	75%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose 1hr 50g/Post Dose	$5.67	$22.68	$1.81–$18.14	—	75%
Glucose tolerance test, 3 samples CPT 82951 HC Glucose Gtt 3 Spec	$81.21	$324.86	$12.87–$259.89	41% below	75%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Gtt 3 Spec	$81.21	$324.86	$12.87–$259.89	—	75%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin; Glycated	$12.96	$51.84	$4.15–$41.47	80% below	75%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin; Glycated	$12.96	$51.84	$4.15–$41.47	—	75%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$22.00	$88.00	$7.04–$70.40	84% below	75%
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel	$22.00	$88.00	$7.04–$70.40	—	75%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase, Body Fluid	$86.40	$345.60	$6.89–$276.48	40% below	75%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase, Body Fluid	$86.40	$345.60	$6.89–$276.48	—	75%
Liver function blood test panel CPT 80076 HC Hepatic Fx Panel	$71.21	$284.84	$8.17–$227.87	47% below	75%
Liver function blood test panel inpatient CPT 80076 HC Hepatic Fx Panel	$71.21	$284.84	$8.17–$227.87	—	75%
Magnesium blood test CPT 83735 HC Magnesium	$16.41	$65.66	$5.25–$52.53	85% below	75%
Magnesium blood test CPT 83735 HC Magnesiumurine	$16.41	$65.66	$5.25–$52.53	85% below	75%
Magnesium blood test inpatient CPT 83735 HC Magnesium	$16.41	$65.66	$5.25–$52.53	—	75%
Magnesium blood test inpatient CPT 83735 HC Magnesiumurine	$16.41	$65.66	$5.25–$52.53	—	75%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Mono Screen	$86.40	$345.60	$5.18–$276.48	2% below	75%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Mono Screen	$86.40	$345.60	$5.18–$276.48	—	75%
Obstetric blood test panel CPT 80055 HC Obstetric Panel	$87.02	$348.08	$27.85–$278.46	65% below	75%
Obstetric blood test panel inpatient CPT 80055 HC Obstetric Panel	$87.02	$348.08	$27.85–$278.46	—	75%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa Antigen (Psa Screen)	$31.50	$126.00	$10.08–$100.80	33% below	75%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Psa Antigen (Psa Screen)	$31.50	$126.00	$10.08–$100.80	—	75%
Pap test (liquid-based, automated screening with review) CPT 88175 HC Cyto Patp,Cer/Vag,Thin Layer,Auto	$33.67	$134.70	$10.78–$107.76	63% below	75%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Cyto Patp,Cer/Vag,Thin Layer,Auto	$33.67	$134.70	$10.78–$107.76	—	75%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cyto Patp,Cer/Vag,Thin Layer,Manual	$25.64	$102.57	$8.21–$82.06	72% below	75%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cyto Patp,Cer/Vag,Thin Layer,Manual	$25.64	$102.57	$8.21–$82.06	—	75%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Aptt	$33.75	$135.00	$6.01–$108.00	69% below	75%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Aptt	$33.75	$135.00	$6.01–$108.00	—	75%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time	$25.75	$103.00	$4.29–$82.40	69% below	75%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time	$25.75	$103.00	$4.29–$82.40	—	75%
Rapid flu test (influenza antigen) CPT 87804 HC Influenza Assay W/Optic	$29.30	$117.20	$9.38–$93.76	61% below	75%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC Influenza Assay W/Optic	$29.30	$117.20	$9.38–$93.76	—	75%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Strep a Ag Screen	$27.65	$110.60	$8.85–$88.48	75% below	75%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Strep a Ag Screen	$27.65	$110.60	$8.85–$88.48	—	75%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sed Rate,Automated	$9.36	$37.44	$2.70–$29.95	78% below	75%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Sed Rate,Automated	$9.36	$37.44	$2.70–$29.95	—	75%
Stool ova and parasites exam CPT 87177 HC Ova and Parasite,Dir Lhe	$20.88	$83.52	$6.68–$66.82	25% below	75%
Stool ova and parasites exam inpatient CPT 87177 HC Ova and Parasite,Dir Lhe	$20.88	$83.52	$6.68–$66.82	—	75%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Occult Bloodbf	$7.38	$29.51	$2.36–$23.61	81% below	75%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Occult Bloodbf	$7.38	$29.51	$2.36–$23.61	—	75%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Blood,Immunoassay	$19.15	$76.61	$6.13–$61.29	60% below	75%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Occult Blood,Immunoassay	$19.15	$76.61	$6.13–$61.29	—	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rpr	$5.04	$20.16	$1.61–$16.13	88% below	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rpr	$5.04	$20.16	$1.61–$16.13	—	75%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Tsh	$33.58	$134.32	$10.75–$107.46	67% below	75%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Tsh	$33.58	$134.32	$10.75–$107.46	—	75%
Trichomonas test (NAAT) CPT 87661 HC Infect Agt Det by Nucl Acid (Dna or Rna); Trichomonas Vag, Amp Prb	$79.58	$318.32	$25.47–$254.66	20% below	75%
Trichomonas test (NAAT) inpatient CPT 87661 HC Infect Agt Det by Nucl Acid (Dna or Rna); Trichomonas Vag, Amp Prb	$79.58	$318.32	$25.47–$254.66	—	75%
Uric acid blood test CPT 84550 HC Uric Acid	$9.36	$37.44	$3.00–$29.95	84% below	75%
Uric acid blood test inpatient CPT 84550 HC Uric Acid	$9.36	$37.44	$3.00–$29.95	—	75%
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis-Complete	$35.36	$141.43	$3.17–$113.14	57% below	75%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis-Complete	$35.36	$141.43	$3.17–$113.14	—	75%
Urinalysis without microscope exam, automated CPT 81003 HC Sp Gravity	$16.26	$65.03	$2.25–$52.02	71% below	75%
Urinalysis without microscope exam, automated CPT 81003 HC Urine Screen	$16.26	$65.03	$2.25–$52.02	71% below	75%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Macro/Sp Gravity	$21.19	$84.77	$2.25–$67.82	62% below	75%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Sp Gravity	$16.26	$65.03	$2.25–$52.02	—	75%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urine Screen	$16.26	$65.03	$2.25–$52.02	—	75%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Macro/Sp Gravity	$21.19	$84.77	$2.25–$67.82	—	75%
Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Dipstick/Reducing/Sub/Ph	$4.77	$19.08	$1.53–$15.26	87% below	75%
Urinalysis without microscope exam, manual CPT 81002 HC Phurine	$4.77	$19.08	$1.53–$15.26	87% below	75%
Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis;Dipstick	$4.77	$19.08	$1.53–$15.26	87% below	75%
Urinalysis without microscope exam, manual CPT 81002 HC Dipstick Urine	$5.27	$21.09	$1.69–$16.87	86% below	75%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC Phurine	$4.77	$19.08	$1.53–$15.26	—	75%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC Urinalysis Dipstick/Reducing/Sub/Ph	$4.77	$19.08	$1.53–$15.26	—	75%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC Urinalysis;Dipstick	$4.77	$19.08	$1.53–$15.26	—	75%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC Dipstick Urine	$5.27	$21.09	$1.69–$16.87	—	75%
Urine pregnancy test, read by color change CPT 81025 HC Pregnancy Test	$13.15	$52.62	$4.21–$42.10	85% below	75%
Urine pregnancy test, read by color change CPT 81025 HC Preg Screenurine	$25.92	$103.68	$8.29–$82.94	71% below	75%
Urine pregnancy test, read by color change inpatient CPT 81025 HC Pregnancy Test	$13.15	$52.62	$4.21–$42.10	—	75%
Urine pregnancy test, read by color change inpatient CPT 81025 HC Preg Screenurine	$25.92	$103.68	$8.29–$82.94	—	75%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcgquantblood	$208.22	$832.90	$15.05–$666.32	14% above	75%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcgquantblood	$208.22	$832.90	$15.05–$666.32	—	75%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC Repair Acl Arthroscop	$4,833.36	$19,333.44	$926.66–$23,331.76	48% below	75%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 HC Repair Acl Arthroscop	$4,833.36	$19,333.44	$926.66–$23,331.76	—	75%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC Arthroscopy Shld Rtr Cuff	$3,296.03	$13,184.14	$1,016.76–$23,331.76	48% below	75%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 HC Arthroscopy Shld Rtr Cuff	$3,296.03	$13,184.14	$1,016.76–$23,331.76	—	75%
Balloon dilation of the maxillary sinus opening, one side both sides CPT 31295 HC Sinus Endo Bln Dil Max Bi	$7,204.40	$28,817.60	$138.29–$23,054.08	—	75%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC Sinus Endo Bln Dil Max Un	$4,755.38	$19,021.53	$138.29–$22,692.68	14% below	75%
Balloon dilation of the maxillary sinus opening, one side inpatient both sides CPT 31295 HC Sinus Endo Bln Dil Max Bi	$7,204.40	$28,817.60	$138.29–$23,054.08	—	75%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC Sinus Endo Bln Dil Max Un	$4,755.38	$19,021.53	$138.29–$22,692.68	—	75%
Botox injections for chronic migraine CPT 64615 HC Chemodervate Facial/Trigem/Cerv Musc Migraine	$315.28	$1,261.14	$100.89–$1,008.91	64% below	75%
Botox injections for chronic migraine inpatient CPT 64615 HC Chemodervate Facial/Trigem/Cerv Musc Migraine	$315.28	$1,261.14	$100.89–$1,008.91	—	75%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC Breast Bx 1st Les Stereo	$1,842.75	$7,371.00	$139.94–$5,896.80	58% below	75%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC Breast Bx 1st Les Stereo	$1,842.75	$7,371.00	$139.94–$5,896.80	—	75%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Tx Distal Fibula Fx	$183.88	$735.51	$58.84–$793.14	66% below	75%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC Tx Distal Fibula Fx	$183.88	$735.51	$58.84–$793.14	—	75%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Closed Tx Metatarsal Fracture W/O Manipulation, Ea	$331.47	$1,325.88	$106.07–$1,193.29	38% below	75%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC Closed Tx Metatarsal Fracture W/O Manipulation, Ea	$331.47	$1,325.88	$106.07–$1,193.29	—	75%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC Correction Hallux Valgus W/Bunion W/Sesmdc W/Dist Metar Osteot	$1,829.60	$7,318.40	$516.75–$10,520.85	56% below	75%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC Correction Hallux Valgus W/Bunion W/Sesmdc W/Dist Metar Osteot	$1,829.60	$7,318.40	$516.75–$10,520.85	—	75%
Bunion correction with removal of part of the big toe joint CPT 28292 HC Correction Hallux Valgus W/Bunion W/Sesmdc W/Rescj Prox Phal	$5,006.49	$20,025.98	$492.84–$16,020.78	43% below	75%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 HC Correction Hallux Valgus W/Bunion W/Sesmdc W/Rescj Prox Phal	$5,006.49	$20,025.98	$492.84–$16,020.78	—	75%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Elec Ext	$1,744.97	$6,979.87	$99.36–$6,281.88	2% below	75%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion Elec Ext	$1,744.97	$6,979.87	$99.36–$6,281.88	—	75%
Carpal tunnel release, open surgery CPT 64721 HC Neuroplasty Med Nrv Carp	$1,063.91	$4,255.65	$340.45–$6,278.83	71% below	75%
Carpal tunnel release, open surgery inpatient CPT 64721 HC Neuroplasty Med Nrv Carp	$1,063.91	$4,255.65	$340.45–$6,278.83	—	75%
Cataract surgery with lens implant CPT 66984 HC Cataract Rml W/Iol 1 Stg	$1,943.50	$7,774.02	$501.72–$7,420.62	61% below	75%
Cataract surgery with lens implant inpatient CPT 66984 HC Cataract Rml W/Iol 1 Stg	$1,943.50	$7,774.02	$501.72–$7,420.62	—	75%
Cervical biopsy CPT 57500 HC Biops Local Excis Wwo Fug	$1,291.54	$5,166.16	$70.82–$4,132.93	34% below	75%
Cervical biopsy inpatient CPT 57500 HC Biops Local Excis Wwo Fug	$1,291.54	$5,166.16	$70.82–$4,132.93	—	75%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circum 28 Days or Older	$4,646.89	$18,587.56	$189.38–$14,870.05	2% below	75%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC Circum 28 Days or Older	$4,646.89	$18,587.56	$189.38–$14,870.05	—	75%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision W/Clamp/Oth Dev W/Block	$3,999.82	$15,999.30	$85.17–$14,399.37	50% above	75%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC Circumcision W/Clamp/Oth Dev W/Block	$3,999.82	$15,999.30	$85.17–$14,399.37	—	75%
Circumcision, surgical, older than a newborn CPT 54160 HC Circumci Surg Excision Nb	$163.13	$652.51	$52.20–$2,242.10	78% below	75%
Circumcision, surgical, older than a newborn inpatient CPT 54160 HC Circumci Surg Excision Nb	$163.13	$652.51	$52.20–$2,242.10	—	75%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Clsd Tx Fx Distal Radius	$516.76	$2,067.04	$165.36–$1,860.34	7% below	75%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Clsd Tx Fx Distal Radius	$516.76	$2,067.04	$165.36–$1,860.34	—	75%
Colonoscopy with endoscopic ultrasound CPT 45391 HC Colonscopy Endo US Exam	$922.99	$3,691.96	$234.68–$3,847.70	63% below	75%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC Colonscopy Endo US Exam	$922.99	$3,691.96	$234.68–$3,847.70	—	75%
Colonoscopy with polyp removal CPT 45385 HC Colonoscpy Tum/Pol/Les Sr	$846.33	$3,385.34	$231.38–$3,847.70	65% below	75%
Colonoscopy with polyp removal inpatient CPT 45385 HC Colonoscpy Tum/Pol/Les Sr	$846.33	$3,385.34	$231.38–$3,847.70	—	75%
Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy	$971.85	$3,887.40	$184.11–$3,847.70	59% below	75%
Colonoscopy with tissue sample inpatient CPT 45380 HC Colonoscopy W/Biopsy	$971.85	$3,887.40	$184.11–$3,847.70	—	75%
Colonoscopy, diagnostic CPT 45378 HC Colonoscpy	$749.49	$2,997.98	$170.35–$2,990.20	64% below	75%
Colonoscopy, diagnostic CPT 45378 HC Diagnostic Colonoscopy	$749.49	$2,997.98	$170.35–$2,990.20	64% below	75%
Colonoscopy, diagnostic CPT 45378 HC Colonoscopy W/Fmt	$749.49	$2,997.98	$170.35–$2,990.20	64% below	75%
Colonoscopy, diagnostic inpatient CPT 45378 HC Colonoscopy W/Fmt	$749.49	$2,997.98	$170.35–$2,990.20	—	75%
Colonoscopy, diagnostic inpatient CPT 45378 HC Colonoscpy	$749.49	$2,997.98	$170.35–$2,990.20	—	75%
Colonoscopy, diagnostic inpatient CPT 45378 HC Diagnostic Colonoscopy	$749.49	$2,997.98	$170.35–$2,990.20	—	75%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC Colposcopy Cervix Biopsy	$3,688.13	$14,752.52	$143.59–$11,802.02	21% below	75%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC Colposcopy Cervix Biopsy	$3,688.13	$14,752.52	$143.59–$11,802.02	—	75%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC Bx Curett of Cervix+Scope	$247.20	$988.81	$79.10–$979.83	74% below	75%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC Bx Curett of Cervix+Scope	$247.20	$988.81	$79.10–$979.83	—	75%
Complex cataract surgery with lens implant CPT 66982 HC Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp	$1,861.71	$7,446.85	$595.75–$7,420.62	59% below	75%
Complex cataract surgery with lens implant inpatient CPT 66982 HC Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp	$1,861.71	$7,446.85	$595.75–$7,420.62	—	75%
Cystoscopy with ureteral stent placement CPT 52332 HC Cystourethroscopy Stent	$1,732.77	$6,931.07	$143.87–$11,334.29	70% below	75%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC Cystourethroscopy Stent	$1,732.77	$6,931.07	$143.87–$11,334.29	—	75%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy Sep	$694.92	$2,779.69	$72.46–$2,501.72	57% below	75%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystourethroscopy Sep	$694.92	$2,779.69	$72.46–$2,501.72	—	75%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC Dilation and Curettage	$3,813.10	$15,252.42	$217.27–$12,201.94	10% below	75%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC Dilation and Curettage	$3,813.10	$15,252.42	$217.27–$12,201.94	—	75%
Ear tube placement (tympanostomy) under general anesthesia, one ear both sides CPT 69436 HC Tympanostomy Bilateral	$2,208.68	$8,834.73	$155.99–$7,067.78	—	75%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 HC Tympanostomy Unilateral	$1,472.45	$5,889.82	$155.99–$4,988.99	71% below	75%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient both sides CPT 69436 HC Tympanostomy Bilateral	$2,208.68	$8,834.73	$155.99–$7,067.78	—	75%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient one side CPT 69436 HC Tympanostomy Unilateral	$1,472.45	$5,889.82	$155.99–$4,988.99	—	75%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC Tympanostomy Local/Topical Anesthesia	$409.41	$1,637.64	$129.94–$1,734.17	60% below	75%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC Tympanostomy Local/Topical Anesthesia	$409.41	$1,637.64	$129.94–$1,734.17	—	75%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Removal Impacted Cerumen	$69.00	$276.00	$20.15–$248.40	61% below	75%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC Removal Impacted Cerumen	$69.00	$276.00	$20.15–$248.40	—	75%
Earwax removal with instruments, one ear CPT 69210 HC Remv Impacted Ear Wax Uni	$291.10	$1,164.41	$27.56–$931.53	66% above	75%
Earwax removal with instruments, one ear CPT 69210 HC Remvl Cerumen Req Instr	$291.10	$1,164.41	$27.56–$1,047.97	66% above	75%
Earwax removal with instruments, one ear inpatient CPT 69210 HC Remv Impacted Ear Wax Uni	$291.10	$1,164.41	$27.56–$931.53	—	75%
Earwax removal with instruments, one ear inpatient CPT 69210 HC Remvl Cerumen Req Instr	$291.10	$1,164.41	$27.56–$1,047.97	—	75%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Biopsy of Uterus Lining	$145.30	$581.21	$46.50–$650.06	73% below	75%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC Biopsy of Uterus Lining	$145.30	$581.21	$46.50–$650.06	—	75%
Endoscopic sinus surgery: full ethmoid sinus opening both sides CPT 31255 HC Nasal/Sns Endo Eth Tot Bi	$3,569.94	$14,279.75	$277.75–$22,692.68	—	75%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC Nasal/Sns Endo Eth Tot Un	$2,379.96	$9,519.83	$277.75–$22,692.68	78% below	75%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient both sides CPT 31255 HC Nasal/Sns Endo Eth Tot Bi	$3,569.94	$14,279.75	$277.75–$22,692.68	—	75%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 HC Nasal/Sns Endo Eth Tot Un	$2,379.96	$9,519.83	$277.75–$22,692.68	—	75%
Endoscopic sinus surgery: opening the frontal sinus both sides CPT 31276 HC Nasal/Sinus Endo Front Bi	$3,511.46	$14,045.84	$322.85–$22,692.68	—	75%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC Nasal/Sinus Endo Front Un	$2,340.97	$9,363.89	$322.85–$22,692.68	76% below	75%
Endoscopic sinus surgery: opening the frontal sinus inpatient both sides CPT 31276 HC Nasal/Sinus Endo Front Bi	$3,511.46	$14,045.84	$322.85–$22,692.68	—	75%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 HC Nasal/Sinus Endo Front Un	$2,340.97	$9,363.89	$322.85–$22,692.68	—	75%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus both sides CPT 31256 HC Nasal/Sns Endo Maxllry Bi	$2,281.51	$9,126.05	$156.37–$11,988.19	—	75%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC Nasal/Sns Endo Maxllry Un	$1,521.01	$6,084.04	$156.37–$11,988.19	77% below	75%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient both sides CPT 31256 HC Nasal/Sns Endo Maxllry Bi	$2,281.51	$9,126.05	$156.37–$11,988.19	—	75%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 HC Nasal/Sns Endo Maxllry Un	$1,521.01	$6,084.04	$156.37–$11,988.19	—	75%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue both sides CPT 31267 HC Nasal/Sns Endo Max Rml Bi	$3,568.71	$14,274.85	$228.35–$22,692.68	—	75%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC Nasal/Sns Endo Max Rml Un	$2,379.14	$9,516.56	$228.35–$22,692.68	76% below	75%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient both sides CPT 31267 HC Nasal/Sns Endo Max Rml Bi	$3,568.71	$14,274.85	$228.35–$22,692.68	—	75%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 HC Nasal/Sns Endo Max Rml Un	$2,379.14	$9,516.56	$228.35–$22,692.68	—	75%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Inj Cerv/Thora W Image	$379.48	$1,517.92	$99.78–$2,269.70	80% below	75%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Inj Cerv/Thora W Image	$379.48	$1,517.92	$99.78–$2,269.70	—	75%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Pvert Nerv L/S 1stlev	$1,326.22	$5,304.87	$86.21–$4,243.90	36% below	75%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Pvert Nerve L/S 1st Level	$1,745.56	$6,982.25	$86.21–$5,585.80	15% below	75%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Pvert Nerv L/S 1stlev	$1,326.22	$5,304.87	$86.21–$4,243.90	—	75%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Pvert Nerve L/S 1st Level	$1,745.56	$6,982.25	$86.21–$5,585.80	—	75%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC Rpr Aa Hernia 1st 3-10 Cm Reducible	$2,346.60	$9,386.42	$515.52–$20,816.04	69% below	75%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 HC Rpr Aa Hernia 1st 3-10 Cm Reducible	$2,346.60	$9,386.42	$515.52–$20,816.04	—	75%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC Rpr Aa Hernia 1st < 3 Cm Reducible	$6,744.49	$26,977.98	$312.74–$21,582.38	47% above	75%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HC Rpr Aa Hernia 1st < 3 Cm Reducible	$6,744.49	$26,977.98	$312.74–$21,582.38	—	75%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC Sigmoid W/WO Specimen	$495.57	$1,982.30	$57.15–$2,990.20	74% below	75%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC Sigmoid W/WO Specimen	$495.57	$1,982.30	$57.15–$2,990.20	—	75%
Gallbladder removal, laparoscopic CPT 47562 HC Laparoscopy Surg Cholecystectomy	$12,438.63	$49,754.53	$640.87–$39,803.62	6% below	75%
Gallbladder removal, laparoscopic inpatient CPT 47562 HC Laparoscopy Surg Cholecystectomy	$12,438.63	$49,754.53	$640.87–$39,803.62	—	75%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC Cholecystectomy/Graph Lap	$12,563.07	$50,252.29	$692.31–$40,201.83	51% above	75%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC Cholecystectomy/Graph Lap	$12,563.07	$50,252.29	$692.31–$40,201.83	—	75%
Hammertoe correction surgery CPT 28285 HC Repair of Hammertoe	$1,210.65	$4,842.62	$387.41–$10,520.85	71% below	75%
Hammertoe correction surgery inpatient CPT 28285 HC Repair of Hammertoe	$1,210.65	$4,842.62	$387.41–$10,520.85	—	75%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC Hemorrhoidectomy Lig Band	$1,114.45	$4,457.81	$215.07–$3,566.25	40% below	75%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC Hemorrhoidectomy Lig Band	$1,114.45	$4,457.81	$215.07–$3,566.25	—	75%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC Hemorrhoidec Sgl Colu/Grp	$3,404.08	$13,616.33	$372.73–$10,893.06	25% below	75%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC Hemorrhoidec Sgl Colu/Grp	$3,404.08	$13,616.33	$372.73–$10,893.06	—	75%
Hysteroscopy with endometrial ablation CPT 58563 HC Hysteroscopy Ablation	$10,839.45	$43,357.80	$218.45–$34,686.24	69% above	75%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HC Hysteroscopy Ablation	$10,839.45	$43,357.80	$218.45–$34,686.24	—	75%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC Hysteroscopy Biopsy	$7,081.48	$28,325.92	$206.18–$22,660.74	at median	75%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC Hysteroscopy Biopsy	$7,081.48	$28,325.92	$206.18–$22,660.74	—	75%
IUD insertion (the device itself billed separately) CPT 58300 HC Insertion of Iud	$991.40	$3,965.59	$317.25–$3,172.47	69% above	75%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC Insertion of Iud	$991.40	$3,965.59	$317.25–$3,172.47	—	75%
Incision and drainage of a simple or single skin abscess CPT 10060 HC Drg Skin Abscess Simple	$714.02	$2,856.10	$110.80–$2,570.49	38% above	75%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Drg Skin Abscess Simple	$714.02	$2,856.10	$110.80–$2,570.49	—	75%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Prp I/Hern Init Reduc>5 R	$3,332.45	$13,329.79	$519.79–$19,520.47	55% below	75%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Rpr I/Hern Init Redc >5yr	$3,909.17	$15,636.67	$519.79–$19,520.47	47% below	75%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC Prp I/Hern Init Reduc>5 R	$3,332.45	$13,329.79	$519.79–$19,520.47	—	75%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC Rpr I/Hern Init Redc >5yr	$3,909.17	$15,636.67	$519.79–$19,520.47	—	75%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Tendon/Ligament	$226.20	$904.82	$33.93–$986.98	66% below	75%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Injection 1 Tendon Sheath/Ligament Aponeurosis	$286.65	$1,146.60	$33.93–$986.98	57% below	75%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inj Tendon/Ligament	$226.20	$904.82	$33.93–$986.98	—	75%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Injection 1 Tendon Sheath/Ligament Aponeurosis	$286.65	$1,146.60	$33.93–$986.98	—	75%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Inj Maj Jt/Bursa WO US	$955.69	$3,822.78	$40.43–$3,440.50	at median	75%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Inj Maj Jt/Bursa WO US	$955.69	$3,822.78	$40.43–$3,440.50	—	75%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Drug Delivery Imp	$284.26	$1,137.05	$54.77–$909.64	at median	75%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC Insert Drug Delivery Imp	$284.26	$1,137.05	$54.77–$909.64	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Inj Interm Jt/Bursa WO US	$441.55	$1,766.22	$32.94–$1,589.60	27% below	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$515.79	$2,063.15	$32.94–$1,650.52	15% below	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Inj Interm Jt/Bursa WO US	$441.55	$1,766.22	$32.94–$1,589.60	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$515.79	$2,063.15	$32.94–$1,650.52	—	75%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Inj Sml Jt/Bursa WO US	$164.60	$658.41	$32.25–$986.98	77% below	75%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Drain/Inj Jnt/Bursa WO US	$191.94	$767.78	$32.25–$986.98	74% below	75%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Inj Sml Jt/Bursa WO US	$164.60	$658.41	$32.25–$986.98	—	75%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Drain/Inj Jnt/Bursa WO US	$191.94	$767.78	$32.25–$986.98	—	75%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC Arthroscopy Knee+Meniscus	$3,397.83	$13,591.31	$675.26–$10,873.05	19% below	75%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 HC Arthroscopy Knee+Meniscus	$3,397.83	$13,591.31	$675.26–$10,873.05	—	75%
Knee arthroscopy with meniscus trim CPT 29881 HC Knee Meniscec Med or Lat	$2,963.99	$11,855.97	$548.23–$10,520.85	42% below	75%
Knee arthroscopy with meniscus trim inpatient CPT 29881 HC Knee Meniscec Med or Lat	$2,963.99	$11,855.97	$548.23–$10,520.85	—	75%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC Knee Meniscec Med and Lat	$1,829.60	$7,318.40	$565.47–$10,520.85	56% below	75%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 HC Knee Meniscec Med and Lat	$1,829.60	$7,318.40	$565.47–$10,520.85	—	75%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC Arthroscopy Knee Surg	$2,639.85	$10,559.40	$620.76–$10,520.85	49% below	75%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 HC Arthroscopy Knee Surg	$2,639.85	$10,559.40	$620.76–$10,520.85	—	75%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC Laparoscopy Appendectomy	$13,922.35	$55,689.42	$588.44–$44,551.54	74% above	75%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 HC Laparoscopy Appendectomy	$13,922.35	$55,689.42	$588.44–$44,551.54	—	75%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HC Hysterectomy Total 250g<	$14,140.44	$56,561.77	$845.10–$45,249.42	4% above	75%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 HC Hysterectomy Total 250g<	$14,140.44	$56,561.77	$845.10–$45,249.42	—	75%
Laparoscopic inguinal (groin) hernia repair, first repair on that side both sides CPT 49650 HC Repair Ingu Hernia Int Bi	$4,104.36	$16,417.44	$437.35–$19,438.90	—	75%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC Repair Ingu Hernia Int Un	$2,736.24	$10,944.96	$437.35–$19,438.90	83% below	75%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient both sides CPT 49650 HC Repair Ingu Hernia Int Bi	$4,104.36	$16,417.44	$437.35–$19,438.90	—	75%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HC Repair Ingu Hernia Int Un	$2,736.24	$10,944.96	$437.35–$19,438.90	—	75%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC Repair Ingu Hernia Recurr	$13,731.78	$54,927.12	$565.67–$43,941.70	77% above	75%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 HC Repair Ingu Hernia Recurr	$13,731.78	$54,927.12	$565.67–$43,941.70	—	75%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC Removal Adnexal Lap	$14,281.05	$57,124.20	$593.17–$45,699.36	63% above	75%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 HC Removal Adnexal Lap	$14,281.05	$57,124.20	$593.17–$45,699.36	—	75%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 HC Lap Sleeve Gastrectomy	$2,896.87	$11,587.48	$463.50–$9,269.98	55% below	75%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 HC Lap Sleeve Gastrectomy	$2,896.87	$11,587.48	$463.50–$9,269.98	—	75%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC Discisn 2nd Cataract Lasr V	$251.55	$1,006.20	$80.50–$1,768.47	91% below	75%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC Discisn 2nd Cataract Lasr	$251.55	$1,006.20	$80.50–$1,768.47	91% below	75%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC Discisn 2nd Cataract Lasr	$251.55	$1,006.20	$80.50–$1,768.47	—	75%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC Discisn 2nd Cataract Lasr V	$251.55	$1,006.20	$80.50–$1,768.47	—	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Rep Intmd S/a/T/E <2.5cm	$452.70	$1,810.81	$143.55–$1,448.65	58% below	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Rep Interm Scalp/Axil/Trunk/Extremities <= 2.5cm	$640.59	$2,562.38	$143.55–$2,306.14	41% below	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Rep Intmd S/a/T/E <2.5cm	$452.70	$1,810.81	$143.55–$1,448.65	—	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Rep Interm Scalp/Axil/Trunk/Extremities <= 2.5cm	$640.59	$2,562.38	$143.55–$2,306.14	—	75%
Lower-back epidural injection, with imaging guidance CPT 62323 HC Inj Lumbr/Sacrl W Image	$517.93	$2,071.74	$93.19–$2,269.70	77% below	75%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Inj Lumbr/Sacrl W Image	$517.93	$2,071.74	$93.19–$2,269.70	—	75%
Lower-back epidural injection, without imaging guidance CPT 62322 HC Inj Lumbr/Sacrl WO Image	$320.10	$1,280.41	$77.03–$2,843.95	81% below	75%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC Inj Lumbr/Sacrl WO Image	$320.10	$1,280.41	$77.03–$2,843.95	—	75%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC Inj Foramen Epi L/S 1 Lev, Bilateral	$1,138.64	$4,554.55	$105.07–$3,643.64	—	75%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$569.32	$2,277.28	$105.07–$2,843.95	71% below	75%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Foramn Epi L/S 1lev	$569.32	$2,277.28	$105.07–$2,843.95	71% below	75%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 HC Inj Foramen Epi L/S 1 Lev, Bilateral	$1,138.64	$4,554.55	$105.07–$3,643.64	—	75%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$569.32	$2,277.28	$105.07–$2,843.95	—	75%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj Foramn Epi L/S 1lev	$569.32	$2,277.28	$105.07–$2,843.95	—	75%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 HC Lamnotmy Incl W/Dcmprsn Nrv Root 1 Intrspc Lumbr	$4,907.95	$19,631.79	$925.43–$23,331.76	47% below	75%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 HC Lamnotmy Incl W/Dcmprsn Nrv Root 1 Intrspc Lumbr	$4,907.95	$19,631.79	$925.43–$23,331.76	—	75%
Lumpectomy (partial mastectomy) CPT 19301 HC Mastectomy Partial Uni	$3,103.39	$12,413.57	$646.34–$21,350.91	54% below	75%
Lumpectomy (partial mastectomy) CPT 19301 HC Mastectomy Partial Bil	$4,655.09	$18,620.36	$646.34–$21,350.91	30% below	75%
Lumpectomy (partial mastectomy) inpatient CPT 19301 HC Mastectomy Partial Uni	$3,103.39	$12,413.57	$646.34–$21,350.91	—	75%
Lumpectomy (partial mastectomy) inpatient CPT 19301 HC Mastectomy Partial Bil	$4,655.09	$18,620.36	$646.34–$21,350.91	—	75%
Mastectomy (total removal of the breast) CPT 19303 HC Mastectomy Simp Comp Uni	$14,128.02	$56,512.10	$932.33–$45,209.68	66% above	75%
Mastectomy (total removal of the breast) CPT 19303 HC Mastectomy Simp Comp Bil	$21,192.04	$84,768.15	$932.33–$67,814.52	149% above	75%
Mastectomy (total removal of the breast) inpatient CPT 19303 HC Mastectomy Simp Comp Uni	$14,128.02	$56,512.10	$932.33–$45,209.68	—	75%
Mastectomy (total removal of the breast) inpatient CPT 19303 HC Mastectomy Simp Comp Bil	$21,192.04	$84,768.15	$932.33–$67,814.52	—	75%
Miscarriage treatment with D&C, first trimester CPT 59820 HC Care of Miscarriage	$6,036.26	$24,145.03	$361.31–$21,730.53	34% above	75%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC Care of Miscarriage	$6,036.26	$24,145.03	$361.31–$21,730.53	—	75%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs <=0.5 Cm	$530.30	$2,121.21	$84.20–$2,276.94	60% below	75%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs <=0.5 Cm	$530.30	$2,121.21	$84.20–$2,276.94	—	75%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Benign Les S/N/H <0.5cm	$1,803.69	$7,214.78	$108.99–$5,771.82	22% above	75%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC Benign Les S/N/H <0.5cm	$1,803.69	$7,214.78	$108.99–$5,771.82	—	75%
Nail removal (partial or complete), one nail CPT 11730 HC Removal of Nail Plate	$584.95	$2,339.81	$50.92–$2,105.83	2% above	75%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC Removal of Nail Plate	$584.95	$2,339.81	$50.92–$2,105.83	—	75%
Occipital nerve block (injection for headaches) CPT 64405 HC Inject Great Occip Nerve	$441.55	$1,766.22	$45.44–$1,589.60	50% below	75%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Inject Great Occip Nerve	$441.55	$1,766.22	$45.44–$1,589.60	—	75%
Paracentesis with imaging guidance CPT 49083 HC Paracentesis W/ Guidance	$1,747.63	$6,990.52	$47.83–$6,291.47	5% below	75%
Paracentesis with imaging guidance inpatient CPT 49083 HC Paracentesis W/ Guidance	$1,747.63	$6,990.52	$47.83–$6,291.47	—	75%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Removal Nail Bed	$443.49	$1,773.95	$101.06–$1,596.56	69% below	75%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Removal Nail Bed	$443.49	$1,773.95	$101.06–$1,596.56	—	75%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Destr Pvert Nerv L/S 1jnt	$1,454.87	$5,819.48	$182.63–$6,278.83	62% below	75%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC Destr Pvert Nerv L/S 1jnt	$1,454.87	$5,819.48	$182.63–$6,278.83	—	75%
Removal of a breast lump, open surgery CPT 19120 HC Excise Brst Les =>1 Uni	$3,983.94	$15,935.77	$424.09–$12,748.62	20% below	75%
Removal of a breast lump, open surgery CPT 19120 HC Excise Brst Les =>1 Bil	$5,989.53	$23,958.14	$424.09–$19,166.51	20% above	75%
Removal of a breast lump, open surgery inpatient CPT 19120 HC Excise Brst Les =>1 Uni	$3,983.94	$15,935.77	$424.09–$12,748.62	—	75%
Removal of a breast lump, open surgery inpatient CPT 19120 HC Excise Brst Les =>1 Bil	$5,989.53	$23,958.14	$424.09–$19,166.51	—	75%
Removal of a foreign object under the skin, simple CPT 10120 HC Remove FB/Subq Simple	$1,189.67	$4,758.70	$112.58–$4,282.83	11% above	75%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Remove FB/Subq Simple	$1,189.67	$4,758.70	$112.58–$4,282.83	—	75%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 HC Thyroid Lobectomy Total	$5,971.74	$23,886.95	$658.77–$19,438.90	13% below	75%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 HC Thyroid Lobectomy Total	$5,971.74	$23,886.95	$658.77–$19,438.90	—	75%
Septoplasty to straighten the nasal septum CPT 30520 HC Repair Nasal Septum	$1,284.19	$5,136.77	$410.94–$10,660.59	74% below	75%
Septoplasty to straighten the nasal septum inpatient CPT 30520 HC Repair Nasal Septum	$1,284.19	$5,136.77	$410.94–$10,660.59	—	75%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC Lithotripsy Urol	$8,235.84	$32,943.36	$543.47–$26,354.69	16% above	75%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC Lithotripsy Urol	$8,235.84	$32,943.36	$543.47–$26,354.69	—	75%
Short arm cast (elbow to hand) CPT 29075 HC Elbow Finger Cast(Short )	$202.06	$808.26	$63.09–$899.33	60% below	75%
Short arm cast (elbow to hand) inpatient CPT 29075 HC Elbow Finger Cast(Short )	$202.06	$808.26	$63.09–$899.33	—	75%
Short arm splint (forearm and hand) both sides CPT 29125 HC Apply Forearm Splint Bilat	$720.70	$2,882.80	$44.45–$2,594.52	—	75%
Short arm splint (forearm and hand) CPT 29125 HC Apply Forearm Splint	$480.47	$1,921.87	$44.45–$1,729.68	18% above	75%
Short arm splint (forearm and hand) inpatient both sides CPT 29125 HC Apply Forearm Splint Bilat	$720.70	$2,882.80	$44.45–$2,594.52	—	75%
Short arm splint (forearm and hand) inpatient CPT 29125 HC Apply Forearm Splint	$480.47	$1,921.87	$44.45–$1,729.68	—	75%
Short leg cast (below the knee) CPT 29405 HC Apply Short Leg Cast	$332.84	$1,331.38	$59.55–$1,198.24	33% below	75%
Short leg cast (below the knee) inpatient CPT 29405 HC Apply Short Leg Cast	$332.84	$1,331.38	$59.55–$1,198.24	—	75%
Short leg splint (calf to foot) CPT 29515 HC Appl Lower Leg Splint	$604.17	$2,416.70	$52.96–$2,175.03	22% above	75%
Short leg splint (calf to foot) inpatient CPT 29515 HC Appl Lower Leg Splint	$604.17	$2,416.70	$52.96–$2,175.03	—	75%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC Arthroscopy Shld Clavicul	$1,829.60	$7,318.40	$585.47–$10,520.85	56% below	75%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 HC Arthroscopy Shld Clavicul	$1,829.60	$7,318.40	$585.47–$10,520.85	—	75%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC Arthroscopy Shldr Decomp	$4,313.25	$17,253.00	$147.65–$13,802.40	at median	75%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC Arthroscopy Shldr Decomp	$4,313.25	$17,253.00	$147.65–$13,802.40	—	75%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Simple Rep <=2.5 Cm	$851.34	$3,405.35	$44.25–$3,064.82	54% above	75%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Simple Rep <=2.5 Cm	$851.34	$3,405.35	$44.25–$3,064.82	—	75%
Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy Skin Single Lesion	$890.53	$3,562.13	$39.08–$3,205.92	23% above	75%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Biopsy Skin Single Lesion	$890.53	$3,562.13	$39.08–$3,205.92	—	75%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC Malig Les T/a/L <0.5cm	$2,578.32	$10,313.29	$116.43–$8,250.63	31% above	75%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC Malig Les T/a/L <0.5cm	$2,578.32	$10,313.29	$116.43–$8,250.63	—	75%
Skin tag removal, up to 15 tags CPT 11200 HC Rem Skin Tags Up to 15les	$660.20	$2,640.79	$76.51–$2,112.63	67% above	75%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC Rem Skin Tags Up to 15les	$660.20	$2,640.79	$76.51–$2,112.63	—	75%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture	$1,984.99	$7,939.96	$57.37–$7,145.96	50% above	75%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Puncture	$1,984.99	$7,939.96	$57.37–$7,145.96	—	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Rpr S/N/a/Gn/Tr 2.6-7.5cm	$851.34	$3,405.35	$57.31–$2,724.28	14% above	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Simple Rep 2.6 to 7.5cm	$851.34	$3,405.35	$57.31–$3,064.82	14% above	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Simple Rep 2.6 to 7.5cm	$851.34	$3,405.35	$57.31–$3,064.82	—	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Rpr S/N/a/Gn/Tr 2.6-7.5cm	$851.34	$3,405.35	$57.31–$2,724.28	—	75%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Rep Simple Face/Ears/Eyelids/Nose/Lips/Muc Mem <=2.5 Cm	$851.34	$3,405.35	$54.32–$3,064.82	21% above	75%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Repair F/E/E/N/L/M<=2.5cm	$851.34	$3,405.35	$54.32–$2,724.28	21% above	75%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Rep Simple Face/Ears/Eyelids/Nose/Lips/Muc Mem <=2.5 Cm	$851.34	$3,405.35	$54.32–$3,064.82	—	75%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Repair F/E/E/N/L/M<=2.5cm	$851.34	$3,405.35	$54.32–$2,724.28	—	75%
TURP (transurethral resection of the prostate) CPT 52601 HC Prostatectomy (Turp)	$4,440.97	$17,763.89	$547.59–$17,240.42	58% below	75%
TURP (transurethral resection of the prostate) inpatient CPT 52601 HC Prostatectomy (Turp)	$4,440.97	$17,763.89	$547.59–$17,240.42	—	75%
Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis W/Imaging	$412.55	$1,650.22	$95.19–$2,017.04	80% below	75%
Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Image	$1,957.53	$7,830.11	$95.19–$7,047.10	4% below	75%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis W/Imaging	$412.55	$1,650.22	$95.19–$2,017.04	—	75%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Aspirate Pleura W/ Image	$1,957.53	$7,830.11	$95.19–$7,047.10	—	75%
Tonsil and adenoid removal, age 12 or older CPT 42821 HC Rmvl Tonsils and Adenoids	$1,284.19	$5,136.77	$288.68–$10,660.59	82% below	75%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 HC Rmvl Tonsils and Adenoids	$1,284.19	$5,136.77	$288.68–$10,660.59	—	75%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC Removal of Tonsils	$1,854.94	$7,419.78	$247.72–$10,660.59	70% below	75%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 HC Removal of Tonsils	$1,854.94	$7,419.78	$247.72–$10,660.59	—	75%
Total shoulder replacement CPT 23472 HC Reconstruct Shouldr Joint	$4,490.00	$17,960.02	$1,340.26–$56,378.55	60% below	75%
Total shoulder replacement inpatient CPT 23472 HC Reconstruct Shouldr Joint	$4,490.00	$17,960.02	$1,340.26–$56,378.55	—	75%
Total thyroid removal (thyroidectomy) CPT 60240 HC Thyroidectomy Total	$3,911.39	$15,645.56	$844.82–$19,438.90	88% below	75%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 HC Thyroidectomy Total	$3,911.39	$15,645.56	$844.82–$19,438.90	—	75%
Trigger finger release surgery CPT 26055 HC Tendon Sheath Incision	$1,111.65	$4,446.60	$314.48–$5,170.37	64% below	75%
Trigger finger release surgery inpatient CPT 26055 HC Tendon Sheath Incision	$1,111.65	$4,446.60	$314.48–$5,170.37	—	75%
Trigger point injections, 1 or 2 muscles CPT 20552 HC Inj Triggr Point 1-2 Musc	$820.03	$3,280.12	$37.67–$2,952.11	31% above	75%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inj Triggr Point 1-2 Musc	$820.03	$3,280.12	$37.67–$2,952.11	—	75%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HC Laparoscopy Tubal Cautery	$2,866.61	$11,466.44	$344.06–$19,438.90	34% below	75%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 HC Laparoscopy Tubal Cautery	$2,866.61	$11,466.44	$344.06–$19,438.90	—	75%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC Breast Bx 1st Lesion US	$1,461.69	$5,846.75	$132.02–$5,310.58	55% below	75%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC Breast Bx 1st Lesion US	$1,461.69	$5,846.75	$132.02–$5,310.58	—	75%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Egd W/Blln Dil Esop <30mm	$613.15	$2,452.59	$142.02–$6,170.09	75% below	75%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC Egd W/Blln Dil Esop <30mm	$613.15	$2,452.59	$142.02–$6,170.09	—	75%
Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd W/Biopsy Sgl/Mult	$649.35	$2,597.40	$128.99–$2,916.34	63% below	75%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Egd W/Biopsy Sgl/Mult	$649.35	$2,597.40	$128.99–$2,916.34	—	75%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC Egd W/Submucosal Inject	$358.86	$1,435.46	$114.84–$2,916.34	82% below	75%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC Egd W/Submucosal Inject	$358.86	$1,435.46	$114.84–$2,916.34	—	75%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC Egd Tum/Pol/Les/Snare	$608.09	$2,432.36	$179.67–$6,170.09	81% below	75%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC Egd Tum/Pol/Les/Snare	$608.09	$2,432.36	$179.67–$6,170.09	—	75%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC Egd W/Gwire Insertion	$463.60	$1,854.41	$148.35–$2,916.34	74% below	75%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC Egd W/Gwire Insertion	$463.60	$1,854.41	$148.35–$2,916.34	—	75%
Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diag Brush/Wash	$725.40	$2,901.60	$115.67–$2,916.34	61% below	75%
Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diag W/Fmt	$725.40	$2,901.60	$115.67–$2,916.34	61% below	75%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd Diag W/Fmt	$725.40	$2,901.60	$115.67–$2,916.34	—	75%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd Diag Brush/Wash	$725.40	$2,901.60	$115.67–$2,916.34	—	75%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC Aspirate Pleura W/ Image	$2,256.57	$9,026.29	$353.16–$19,520.47	68% below	75%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC Aspirate Pleura W/ Image	$2,256.57	$9,026.29	$353.16–$19,520.47	—	75%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC Cysto W/Ureteroscopy W/Lithotripsy	$4,440.97	$17,763.89	$350.21–$17,240.42	37% below	75%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 HC Cysto W/Ureteroscopy W/Lithotripsy	$4,440.97	$17,763.89	$350.21–$17,240.42	—	75%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC Cystourethroscopy Lithotr	$2,456.80	$9,827.19	$371.10–$17,240.42	80% below	75%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 HC Cystourethroscopy Lithotr	$2,456.80	$9,827.19	$371.10–$17,240.42	—	75%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC Removal of Sperm Duct(S)	$2,784.11	$11,136.44	$233.44–$8,909.15	2% above	75%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC Removal of Sperm Duct(S)	$2,784.11	$11,136.44	$233.44–$8,909.15	—	75%
Wart removal, up to 14 warts CPT 17110 HC Destruct Benign Lesn 1-14	$199.61	$798.44	$63.88–$718.60	44% below	75%
Wart removal, up to 14 warts CPT 17110 HC Destruction Benign Lesions Up to 14	$326.70	$1,306.80	$69.40–$1,045.44	9% below	75%
Wart removal, up to 14 warts inpatient CPT 17110 HC Destruct Benign Lesn 1-14	$199.61	$798.44	$63.88–$718.60	—	75%
Wart removal, up to 14 warts inpatient CPT 17110 HC Destruction Benign Lesions Up to 14	$326.70	$1,306.80	$69.40–$1,045.44	—	75%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Subq 1st 20 Sqcm	$640.59	$2,562.38	$58.44–$2,306.14	6% below	75%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debride Subq 1st 20 Sqcm	$640.59	$2,562.38	$58.44–$2,306.14	—	75%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC Treat Fx Rad Extraarticul	$6,094.96	$24,379.84	$741.36–$23,331.76	23% above	75%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC Treat Fx Rad Extraarticul	$6,094.96	$24,379.84	$741.36–$23,331.76	—	75%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC Transfusion Serv Ea Addhr	$169.92	$679.68	$54.37–$1,418.56	81% below	75%
Blood transfusion (giving blood or blood components) CPT 36430 HC Transfusion Serv 1-4hrs	$338.40	$1,353.60	$56.07–$1,418.56	62% below	75%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Transfusion Serv Ea Addhr	$169.92	$679.68	$54.37–$1,418.56	—	75%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Transfusion Serv 1-4hrs	$338.40	$1,353.60	$56.07–$1,418.56	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Heliox Therapy	$62.40	$249.60	$10.17–$704.10	80% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Press/Nonpress Subseq Enc	$94.75	$379.01	$10.17–$704.10	69% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Press/Nonpress Intl Enc	$97.49	$389.95	$10.17–$704.10	68% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Heliox Therapy	$62.40	$249.60	$10.17–$704.10	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Press/Nonpress Subseq Enc	$94.75	$379.01	$10.17–$704.10	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Press/Nonpress Intl Enc	$97.49	$389.95	$10.17–$704.10	—	75%
Chemotherapy IV infusion, first hour CPT 96413 HC Chemo IV Inf 1hr Initl	$467.31	$1,869.24	$149.54–$1,495.39	47% below	75%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo IV Inf 1hr Initl	$467.31	$1,869.24	$149.54–$1,495.39	—	75%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Aud Eval & Speech Recogn	$73.41	$293.66	$23.49–$413.74	87% below	75%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC Aud Eval & Speech Recogn	$73.41	$293.66	$23.49–$413.74	—	75%
Critical care, first 30 to 74 minutes CPT 99291 HC Critcl Care 1st 30-74min	$3,149.70	$12,598.80	$203.09–$11,338.92	43% below	75%
Critical care, first 30 to 74 minutes CPT 99291 HC Critcl Care 1st 30-74min Trauma	$7,086.82	$28,347.30	$203.09–$25,512.57	29% above	75%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC Critcl Care 1st 30-74min	$3,149.70	$12,598.80	$203.09–$11,338.92	—	75%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC Critcl Care 1st 30-74min Trauma	$7,086.82	$28,347.30	$203.09–$25,512.57	—	75%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake and Drowsy	$219.31	$877.25	$70.18–$701.80	77% below	75%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Eeg Awake and Drowsy	$219.31	$877.25	$70.18–$701.80	—	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ekg Routine 12 Lead Trace	$103.60	$414.41	$8.17–$331.53	69% below	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Ekg Routine 12 Lead Trace	$103.60	$414.41	$8.17–$331.53	—	75%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Level I	$209.98	$839.92	$11.14–$755.93	50% below	75%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER Level I	$209.98	$839.92	$11.14–$755.93	—	75%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Level II	$328.09	$1,312.38	$40.78–$1,181.14	56% below	75%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER Level II	$328.09	$1,312.38	$40.78–$1,181.14	—	75%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Level III	$603.69	$2,414.77	$69.85–$2,173.29	51% below	75%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER Level III	$603.69	$2,414.77	$69.85–$2,173.29	—	75%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level IV	$971.16	$3,884.63	$118.58–$3,496.17	50% below	75%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level IV Trauma	$4,908.28	$19,633.13	$118.58–$17,669.82	151% above	75%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER Level IV	$971.16	$3,884.63	$118.58–$3,496.17	—	75%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER Level IV Trauma	$4,908.28	$19,633.13	$118.58–$17,669.82	—	75%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level V	$1,968.56	$7,874.25	$172.27–$7,086.83	40% below	75%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level V Trauma	$5,905.69	$23,622.75	$172.27–$21,260.48	80% above	75%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER Level V	$1,968.56	$7,874.25	$172.27–$7,086.83	—	75%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER Level V Trauma	$5,905.69	$23,622.75	$172.27–$21,260.48	—	75%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiovas Stress Test	$277.09	$1,108.38	$46.30–$886.70	80% below	75%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiovas Stress Test	$277.09	$1,108.38	$46.30–$886.70	—	75%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Inf Hyd 31min to 1hr	$494.32	$1,977.30	$38.79–$1,581.84	8% above	75%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Inf Hyd 31min to 1hr	$494.32	$1,977.30	$38.79–$1,581.84	—	75%
IV infusion of a medicine, first hour CPT 96365 HC IV Inf Therapy Upto 1hr	$467.31	$1,869.24	$78.26–$1,495.39	8% below	75%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Inf Therapy Upto 1hr	$467.31	$1,869.24	$78.26–$1,495.39	—	75%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Inject Ther/Prop/Dx Sq/Im	$186.74	$746.98	$17.21–$597.58	8% above	75%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Inject Ther/Prop/Dx Sq/Im	$186.74	$746.98	$17.21–$597.58	—	75%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nrv Motor/Sens 7-8 Nrv	$256.54	$1,026.18	$82.09–$1,199.86	76% below	75%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC Nrv Motor/Sens 7-8 Nrv	$256.54	$1,026.18	$82.09–$1,199.86	—	75%
Neuromuscular re-education, 15 minutes CPT 97112 HC Neuro ED 15 Min	$27.65	$110.59	$8.85–$90.40	78% below	75%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuro ED 15 Min	$27.65	$110.59	$8.85–$90.40	—	75%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Low Complexity	$55.01	$220.03	$17.60–$278.70	79% below	75%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Eval Low Complexity	$55.01	$220.03	$17.60–$278.70	—	75%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval High Complexity	$69.84	$279.36	$22.35–$295.00	85% below	75%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Eval High Complexity	$69.84	$279.36	$22.35–$295.00	—	75%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Low Complexity	$54.72	$218.88	$17.51–$295.00	75% below	75%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Eval Low Complexity	$54.72	$218.88	$17.51–$295.00	—	75%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Mod Complexity	$62.06	$248.26	$19.86–$295.00	83% below	75%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Eval Mod Complexity	$62.06	$248.26	$19.86–$295.00	—	75%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Treatment 15 Min	$38.59	$154.37	$12.35–$123.50	68% below	75%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Jt Mobil per Proc	$62.78	$251.14	$20.09–$200.91	48% below	75%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Manual Treatment 15 Min	$38.59	$154.37	$12.35–$123.50	—	75%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Jt Mobil per Proc	$62.78	$251.14	$20.09–$200.91	—	75%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ther Ex 15 Min	$43.20	$172.80	$13.82–$138.24	67% below	75%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ther Ex 15 Min	$43.20	$172.80	$13.82–$138.24	—	75%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC G-Tube Removal Only	$73.43	$293.71	$23.50–$428.09	52% below	75%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC G-Tube Removal Only	$73.43	$293.71	$23.50–$428.09	—	75%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Nasal Gastric Tube Insert	$38.37	$153.47	$12.28–$428.09	69% below	75%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Fecal Disimpaction	$60.53	$242.11	$19.37–$428.09	52% below	75%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Nasal Gastric Tube Insert	$38.37	$153.47	$12.28–$428.09	—	75%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Fecal Disimpaction	$60.53	$242.11	$19.37–$428.09	—	75%
Speech and language evaluation CPT 92523 HC Eval Language Comp/Expres	$119.66	$478.66	$38.29–$623.33	74% below	75%
Speech and language evaluation inpatient CPT 92523 HC Eval Language Comp/Expres	$119.66	$478.66	$38.29–$623.33	—	75%
Speech therapy session, individual CPT 92507 HC Speech Tx Individual	$64.32	$257.28	$20.58–$209.13	77% below	75%
Speech therapy session, individual inpatient CPT 92507 HC Speech Tx Individual	$64.32	$257.28	$20.58–$209.13	—	75%
Spirometry (breathing test) CPT 94010 HC Spirometry Simple	$142.70	$570.82	$25.35–$694.28	56% below	75%
Spirometry (breathing test) inpatient CPT 94010 HC Spirometry Simple	$142.70	$570.82	$25.35–$694.28	—	75%
Spirometry before and after a bronchodilator CPT 94060 HC Spirometry II W & W/O Bd	$208.80	$835.20	$39.33–$1,199.86	74% below	75%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spirometry II W & W/O Bd	$208.80	$835.20	$39.33–$1,199.86	—	75%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ther Act 15 Min	$25.20	$100.80	$8.06–$98.23	82% below	75%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ther Act 15 Min	$25.20	$100.80	$8.06–$98.23	—	75%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Therapeutic Phlebotomy	$224.64	$898.56	$71.88–$718.85	33% below	75%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Therapeutic Phlebotomy Fresenius	$375.81	$1,503.26	$116.35–$1,202.61	11% above	75%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Therapeutic Phlebotomy	$224.64	$898.56	$71.88–$718.85	—	75%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Therapeutic Phlebotomy Fresenius	$375.81	$1,503.26	$116.35–$1,202.61	—	75%
Visual field test, extended CPT 92083 HC Visual Field (Humphrey)	$336.14	$1,344.56	$44.52–$1,075.65	12% above	75%
Visual field test, extended inpatient CPT 92083 HC Visual Field (Humphrey)	$336.14	$1,344.56	$44.52–$1,075.65	—	75%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Sarscov2 (Moderna) 50mcg/0.5ml Im Use, (12yr+) Sdv	$102.60	$410.40	$32.83–$328.32	58% below	75%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE	$159.52	$638.10	$51.05–$510.48	34% below	75%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Sarscov2 (Moderna) 50mcg/0.5ml Im Use, (12yr+) Prefilled Syringe	$159.52	$638.10	$51.05–$510.48	34% below	75%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC Sarscov2 (Moderna) 50mcg/0.5ml Im Use, (12yr+) Sdv	$102.60	$410.40	$32.83–$328.32	—	75%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC Sarscov2 (Moderna) 50mcg/0.5ml Im Use, (12yr+) Prefilled Syringe	$159.52	$638.10	$51.05–$510.48	—	75%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE	$159.52	$638.10	$51.05–$510.48	—	75%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TRIV (6 MOS UP) 45 MCG (15 MCG X3)/0.5 ML IM WRAPPER	$13.44	$53.78	$4.30–$43.02	60% below	75%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TRIV (6 MOS UP) 45 MCG (15 MCG X3)/0.5 ML IM WRAPPER	$13.44	$53.78	$4.30–$43.02	—	75%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$50.73	$202.92	$16.23–$162.34	60% below	75%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$50.73	$202.92	$16.23–$162.34	—	75%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$79.36	$317.45	$25.40–$253.96	15% below	75%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$79.36	$317.45	$25.40–$253.96	—	75%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$180.70	$722.82	$57.83–$578.26	29% below	75%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$180.70	$722.82	$57.83–$578.26	—	75%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$279.98	$1,119.94	$89.60–$895.95	44% below	75%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$279.98	$1,119.94	$89.60–$895.95	—	75%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$556.87	$2,227.50	$178.20–$1,782.00	42% below	75%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$556.87	$2,227.50	$178.20–$1,782.00	—	75%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR INJ WRAPPER	$426.42	$1,705.69	$136.46–$1,364.55	40% below	75%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR INJ WRAPPER	$426.42	$1,705.69	$136.46–$1,364.55	—	75%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$73.44	$293.76	$23.50–$235.01	at median	75%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$73.44	$293.76	$23.50–$235.01	—	75%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$53.73	$214.92	$17.19–$171.94	10% below	75%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH, PERTUS (AC) TETANUS (PF) (2.5-5-3-5 MCG) 0.5 ML IM (ASAP)	$112.74	$450.98	$36.08–$360.78	88% above	75%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$53.73	$214.92	$17.19–$171.94	—	75%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH, PERTUS (AC) TETANUS (PF) (2.5-5-3-5 MCG) 0.5 ML IM (ASAP)	$112.74	$450.98	$36.08–$360.78	—	75%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Admin	$148.17	$592.70	$25.20–$474.16	42% above	75%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Admin	$148.17	$592.70	$25.20–$474.16	—	75%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Admin Ea Add	$56.25	$225.00	$18.00–$180.00	13% below	75%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Immunization Admin Ea Add	$56.25	$225.00	$18.00–$180.00	—	75%

Source file: https://apps.scripps.org/pricetransparency/951684089_Scripps-Memorial-Hospital-La-Jolla_standardcharges.csv