Montclair Hospital Medical Center
Montclair Hospital Medical Center in Montclair, CA publishes cash prices for 38 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Click a procedure to compare it with other hospitals nearby.
5000 San Bernardino Street Montclair, CA 91763 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Scan Abdomen/Pelvis W Contrast | $446.00 | $9,567.25 | 95% |
| CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Scan,Head/Brain,W/O Contrast Matl | $133.00 | $6,964.38 | 98% |
| CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Scan Of Pelvis Contrast | $224.00 | $4,823.75 | 95% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Hc Mammography; Bilateral | $121.00 | $1,060.00 | 89% |
| Diagnostic mammogram, one breast one side CPT 77065 Hc Mammography; Unilateral | $94.00 | $844.90 | 89% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Lower Extrem Jt, W/O Contrast | $305.00 | $6,378.75 | 95% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Joint Of Leg. Combo | $446.00 | $3,491.88 | 87% |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain | $305.00 | $5,922.50 | 95% |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Combo | $446.00 | $8,453.75 | 95% |
| MRI of the lower back, no contrast dye CPT 72148 Hc Mri, Lumbar Spine | $305.00 | $6,378.75 | 95% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Us, Ob >/= 14 Wks, Sngl Fetus | $133.00 | $1,479.00 | 91% |
| Screening mammogram, both breasts CPT 77067 Hc Mammogram, Screening | $99.00 | $589.51 | 83% |
| Transvaginal pelvic ultrasound CPT 76830 Hc Ultrasound,Transvaginal | $133.00 | $1,535.00 | 91% |
| Ultrasound of the abdomen, complete CPT 76700 Hc Us, Abdom,B-Scan &/Or Real Time,Complete | $133.00 | $2,556.13 | 95% |
| X-ray of the lower back, 4 or more views CPT 72110 Hc X-Ray Lumbar Spine 4 Vw | $133.00 | $1,398.75 | 90% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic Panel Calcium Total | $8.00 | $809.88 | 99% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel | $13.00 | $827.75 | 98% |
| Complete blood count (CBC) with differential CPT 85025 Hc Complete Cbc & Auto Diff Wbc | $7.00 | $301.13 | 98% |
| Complete blood count (CBC), no differential CPT 85027 Hc Complete Cbc | $6.00 | $158.35 | 96% |
| Kidney function blood test panel CPT 80069 Hc Renal Function Panel | $8.00 | $534.88 | 99% |
| Liver function blood test panel CPT 80076 Hc Hepatic Function Panel | $8.00 | $548.63 | 99% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Prostate Specific Antigen,Free | $18.00 | $190.16 | 91% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Assay Of Prostate Specific Antigen Total - 84153 - 30100312 | $18.00 | $251.59 | 93% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial | $6.00 | $249.12 | 98% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time | $4.00 | $181.98 | 98% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Assay Thyroid Stim Hormone | $16.00 | $434.50 | 96% |
| Urinalysis with microscope exam, manual CPT 81000 Hc Urinalysis, Nonauto, W/Scope | $4.00 | $69.26 | 94% |
| Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis Nonauto W/O Scope | $3.00 | $81.03 | 96% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 Colonoscopy W/Lesion Removal | $1,531.00 | $10,781.30 | 86% |
| Colonoscopy with polyp removal CPT 45385 Hc Colonoscopy,Remv Lesn,Snare | $1,531.00 | $8,495.31 | 82% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy And Biopsy | $1,531.00 | $9,591.67 | 84% |
| Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy,Biopsy | $1,531.00 | $7,723.01 | 80% |
| Colonoscopy, diagnostic CPT 45378 Hc Colorectal Cancer Scrn, Colonoscopy Not High Risk - 45378 - 75000071 | $1,190.00 | $6,501.30 | 82% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic Colonoscopy | $1,190.00 | $9,928.60 | 88% |
| Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy,Diagnostic | $1,190.00 | $5,910.28 | 80% |
| Colonoscopy, diagnostic CPT 45378 Hc Colorectal Cancer Screen, Colonoscopy High Risk - 45378 - 75000068 | $1,190.00 | $5,442.56 | 78% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopic Cholecystectomy | $7,737.00 | $17,655.50 | 56% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp I/Hern Init Reduc >5 Yr | $4,582.00 | $33,746.40 | 86% |
| Left heart catheterization, diagnostic one side CPT 93452 Hc Left Heart Cath Inj Vetriculography, Rs/I | $4,149.00 | $14,792.30 | 72% |
| Removal of a breast lump, open surgery CPT 19120 Removal Of Breast Lesion | $5,011.00 | $14,376.50 | 65% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Biopsy Single/Multiple | $1,160.00 | $10,818.70 | 89% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd Transoral Biopsy Single/Multiple | $1,160.00 | $6,026.29 | 81% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash | $1,160.00 | $10,178.70 | 89% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd Transoral Diagnostic | $1,160.00 | $6,026.29 | 81% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Ot Exercise Ota Complex Ea 15 - 97110 - 42000162 | $30.00 | $288.75 | 90% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Therapeutic Exercises, Ea 15 Min | $30.00 | $380.81 | 92% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Therapeutic Exercises Complex, Ea 15 Min | $30.00 | $202.50 | 85% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Pt Exercise Pta Complex Ea 15 | $30.00 | $288.75 | 90% |