Seneca Healthcare District
Seneca Healthcare District in Chester, CA publishes cash prices for 269 common procedures listed here, from its own machine-readable price file updated Jun 9, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 174 of 269 procedures and above it for 94. By typical cash price it ranks #93 of 213 California hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
130 Brentwood Dr Chester CA 96020 Collected Sep 27, 2026 Source price file (530) 258-2151
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 051327 · CMS hospital register NPI 1396848677
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT scan of abdomen before and after contrast | $3,416.80 | $4,271.00 | $340.87–$4,228.29 | 21% above | 20% |
| Abdominal X-ray, 2 views CPT 74019 X-ray of abdomen, 2 views | $480.00 | $600.00 | $43.18–$594.00 | 11% above | 20% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-ray of ankle, minimum of 3 views | $552.00 | $690.00 | $36.06–$683.10 | 2% above | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ultrasound study of arm and leg arteries | $320.00 | $400.00 | $74.73–$396.00 | 43% below | 20% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT scan of arm without contrast | $2,277.60 | $2,847.00 | $232.06–$2,818.53 | at median | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Single contrast X-ray of esophagus | $558.40 | $698.00 | $54.64–$691.02 | 7% below | 20% |
| Breast ultrasound, complete, one breast CPT 76641 Complete ultrasound scan of 1 breast | $836.80 | $1,046.00 | $140.05–$1,035.54 | 16% above | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Limited ultrasound scan of 1 breast | $836.80 | $1,046.00 | $114.74–$1,035.54 | 55% above | 20% |
| CT angiography (CTA) of the neck CPT 70498 CT scan of blood vessels of neck with contrast | $2,620.00 | $3,275.00 | $522.23–$3,242.25 | 12% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT scan of blood vessels of chest with contrast | $1,280.00 | $1,600.00 | $388.59–$1,584.00 | 62% below | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT scan of abdomen and pelvis without contrast | $2,277.60 | $2,847.00 | $256.82–$2,818.53 | 25% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $2,784.00 | $3,480.00 | $404.21–$3,445.20 | 32% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT scan of abdomen and pelvis before and after contrast | $3,416.80 | $4,271.00 | $457.92–$4,228.29 | 24% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT scan of abdomen with contrast | $2,784.00 | $3,480.00 | $299.45–$3,445.20 | 10% above | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT scan of abdomen without contrast | $2,277.60 | $2,847.00 | $208.42–$2,818.53 | 19% above | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT scan of face without contrast | $2,277.60 | $2,847.00 | $208.72–$2,818.53 | 4% above | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $2,277.60 | $2,847.00 | $165.86–$2,818.53 | at median | 20% |
| CT scan of the head with contrast CPT 70460 CT scan head or brain with contrast | $2,784.00 | $3,480.00 | $216.71–$3,445.20 | 3% above | 20% |
| CT scan of the head without and with contrast CPT 70470 CT scan of head or brain before and after contrast | $3,416.80 | $4,271.00 | $247.72–$4,228.29 | 12% above | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT scan of lower spine without contrast | $3,137.60 | $3,922.00 | $232.06–$3,882.78 | 10% above | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT scan of upper spine without contrast | $3,172.80 | $3,966.00 | $238.84–$3,926.34 | 9% above | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,784.00 | $3,480.00 | $293.26–$3,445.20 | 9% above | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of both sides of head and neck blood flow | $1,275.20 | $1,594.00 | $224.68–$1,578.06 | 8% above | 20% |
| Chest CT scan without and with contrast CPT 71270 CT scan of chest before and after contrast | $3,416.80 | $4,271.00 | $357.58–$4,228.29 | 10% above | 20% |
| Chest X-ray, 2 views CPT 71046 X-ray of chest, 2 views | $380.80 | $476.00 | $39.42–$471.24 | 7% below | 20% |
| Chest X-ray, single view CPT 71045 X-ray of chest, 1 view | $380.80 | $476.00 | $25.35–$471.24 | 5% above | 20% |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-ray of collar bone | $328.80 | $411.00 | $29.81–$406.89 | 32% below | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete ultrasound scan behind abdominal cavity | $709.60 | $887.00 | $115.78–$878.13 | 17% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density measurement of hip, pelvis, spine | $636.80 | $796.00 | $53.59–$788.04 | 26% above | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA bone density measurement of forearm, finger, hand, or foot | $206.40 | $258.00 | $36.00–$255.42 | 25% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT scan of chest without contrast | $2,277.60 | $2,847.00 | $233.36–$2,818.53 | 13% above | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT scan of chest with contrast | $2,784.00 | $3,480.00 | $297.64–$3,445.20 | 4% below | 20% |
| Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts | $416.00 | $520.00 | $197.60–$520.00 | 17% below | 20% |
| Diagnostic mammogram, one breast CPT 77065 Diagnostic mammography of 1 breast | $360.80 | $451.00 | $171.38–$451.00 | 4% below | 20% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Ultrasound of leg arteries or artery grafts | $680.00 | $850.00 | $138.95–$841.50 | 34% below | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Ultrasound study of arm or leg veins with compression and maneuvers | $680.00 | $850.00 | $241.32–$844.63 | 40% below | 20% |
| Elbow X-ray, 2 views CPT 73070 X-ray of elbow, 2 views | $458.40 | $573.00 | $29.81–$567.27 | 16% above | 20% |
| Elbow X-ray, complete, 3 or more views CPT 73080 X-ray of elbow, minimum of 3 views | $571.20 | $714.00 | $37.27–$706.86 | 19% above | 20% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT scan of cranial cavity without contrast | $2,277.60 | $2,847.00 | $302.69–$2,818.53 | at median | 20% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 X-ray of face bones, minimum of 3 views | $580.00 | $725.00 | $53.47–$717.75 | 17% above | 20% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-ray of forearm, 2 views | $486.40 | $608.00 | $29.81–$601.92 | 22% above | 20% |
| Hand X-ray, 2 views CPT 73120 X-ray of hand, 2 views | $282.40 | $353.00 | $24.82–$349.47 | 31% below | 20% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-ray of heel, minimum of 2 views | $445.60 | $557.00 | $27.28–$551.43 | 27% above | 20% |
| Knee X-ray, 3 views CPT 73562 X-ray of knee, 3 views | $559.20 | $699.00 | $33.54–$692.01 | 22% above | 20% |
| Knee X-ray, complete, 4 or more views CPT 73564 X-ray of knee, 4 or more views | $427.20 | $534.00 | $39.73–$528.66 | 27% below | 20% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT scan of leg without contrast | $2,277.60 | $2,847.00 | $232.06–$2,818.53 | 7% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited ultrasound scan of abdomen | $729.60 | $912.00 | $87.13–$902.88 | 12% below | 20% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Limited ultrasound scan of joint or other extremity structure except blood vessels | $434.40 | $543.00 | $37.65–$537.57 | 14% below | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low dose CT scan of chest for lung cancer screening | $2,640.00 | $3,300.00 | $193.59–$3,267.00 | 698% above | 20% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-ray of lower leg, 2 views | $572.00 | $715.00 | $29.81–$707.85 | 32% above | 20% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI scan of blood vessels of head without contrast | $2,660.00 | $3,325.00 | $514.85–$3,291.75 | 9% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $2,819.20 | $3,524.00 | $560.10–$3,488.76 | 13% below | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast | $3,628.00 | $4,535.00 | $822.18–$4,489.65 | 23% below | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI scan of abdomen without contrast | $2,868.00 | $3,585.00 | $434.02–$3,549.15 | 4% above | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI scan of abdomen before and after contrast | $4,014.40 | $5,018.00 | $661.42–$4,967.82 | 8% below | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $2,945.60 | $3,682.00 | $439.07–$3,645.18 | at median | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $4,302.40 | $5,378.00 | $594.39–$5,324.22 | 2% below | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $2,848.00 | $3,560.00 | $390.06–$3,524.40 | 8% below | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI scan of lower spinal canal before and after contrast | $3,969.60 | $4,962.00 | $583.81–$4,912.38 | 13% below | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI scan of middle spinal canal without contrast | $2,850.40 | $3,563.00 | $394.99–$3,527.37 | 6% below | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI scan of upper spinal canal before and after contrast | $3,969.60 | $4,962.00 | $592.86–$4,912.38 | 10% below | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI scan of upper spinal canal without contrast | $2,843.20 | $3,554.00 | $391.86–$3,518.46 | 7% below | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI scan of pelvis before and after contrast | $3,737.60 | $4,672.00 | $660.00–$4,625.28 | 12% below | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI scan of pelvis without contrast | $2,659.20 | $3,324.00 | $491.22–$3,290.76 | 3% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI scan of arm joint without contrast | $2,648.80 | $3,311.00 | $390.48–$3,277.89 | 1% below | 20% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-ray of upper spine, 4-5 views | $548.80 | $686.00 | $57.38–$679.14 | 10% below | 20% |
| Neck soft tissue CT scan with contrast CPT 70491 CT scan of soft tissue of neck with contrast | $2,784.00 | $3,480.00 | $305.43–$3,445.20 | 8% above | 20% |
| Neck soft tissue CT scan without contrast CPT 70490 CT scan of soft tissue of neck without contrast | $2,277.60 | $2,847.00 | $249.10–$2,818.53 | 11% above | 20% |
| Neck soft tissue X-ray CPT 70360 X-ray of soft tissue of neck | $296.80 | $371.00 | $24.82–$367.29 | 8% below | 20% |
| Pelvic CT scan without contrast CPT 72192 CT scan of pelvis without contrast | $2,277.60 | $2,847.00 | $204.64–$2,818.53 | 16% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited ultrasound scan of pelvis | $733.60 | $917.00 | $60.49–$907.83 | 29% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete ultrasound scan of pelvis | $836.80 | $1,046.00 | $97.04–$1,035.54 | 11% below | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $360.00 | $450.00 | $135.29–$450.00 | 60% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus | $360.00 | $450.00 | $112.49–$445.50 | 56% below | 20% |
| Rib X-ray, one side, 2 views CPT 71100 X-ray of ribs on side of body, 2 views | $367.20 | $459.00 | $38.96–$454.41 | 21% below | 20% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-ray of ribs on side of body, minimum of 3 views | $427.20 | $534.00 | $46.36–$528.66 | 31% below | 20% |
| Screening mammogram, both breasts CPT 77067 Screening mammography | $250.40 | $313.00 | $118.94–$313.00 | 19% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray of shoulder, minimum of 2 views | $380.80 | $476.00 | $37.09–$471.24 | 32% below | 20% |
| Sinus X-ray, complete, 3 or more views CPT 70220 X-ray of paranasal sinus, minimum of 3 views | $580.00 | $725.00 | $47.84–$717.75 | 27% above | 20% |
| Skull X-ray, fewer than 4 views CPT 70250 X-ray of skull, 1-3 views | $380.80 | $476.00 | $37.27–$471.24 | 10% below | 20% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-ray of thigh bone, minimum 2 views | $440.00 | $550.00 | $41.81–$544.50 | 13% above | 20% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT scan of middle spine without contrast | $2,277.60 | $2,847.00 | $233.48–$2,818.53 | 19% below | 20% |
| Toe X-ray, 2 or more views CPT 73660 X-ray of toe, minimum of 2 views | $282.40 | $353.00 | $22.36–$349.47 | 15% below | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $295.20 | $369.00 | $97.04–$365.31 | 59% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 Vaginal ultrasound of pregnant uterus | $295.20 | $369.00 | $117.86–$369.00 | 56% below | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $950.40 | $1,188.00 | $119.34–$1,176.12 | 16% below | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scan of scrotum | $733.60 | $917.00 | $85.75–$907.83 | 18% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound scan of head and neck soft tissue | $837.60 | $1,047.00 | $85.69–$1,036.53 | at median | 20% |
| Upper arm X-ray (humerus), 2 views CPT 73060 X-ray of upper arm, minimum of 2 views | $328.80 | $411.00 | $29.81–$406.89 | 23% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Ultrasound study of one arm or leg veins with compression and maneuvers | $480.00 | $600.00 | $121.29–$594.00 | 46% below | 20% |
| Wrist X-ray, 2 views CPT 73100 X-ray of wrist, 2 views | $424.00 | $530.00 | $24.82–$524.70 | 9% above | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-ray of wrist, minimum of 3 views | $652.00 | $815.00 | $36.06–$806.85 | 30% above | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray of hip, 2-3 views | $427.20 | $534.00 | $53.47–$528.66 | 1% above | 20% |
| X-ray of the abdomen, 1 view CPT 74018 X-ray of abdomen, 1 view | $328.80 | $411.00 | $35.33–$406.89 | 9% above | 20% |
| X-ray of the ankle, 2 views CPT 73600 X-ray of ankle, 2 views | $445.60 | $557.00 | $27.28–$551.43 | 14% above | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-ray of finger, minimum of 2 views | $282.40 | $353.00 | $22.36–$349.47 | 25% below | 20% |
| X-ray of the foot, 2 views CPT 73620 X-ray of foot, 2 views | $445.60 | $557.00 | $24.82–$551.43 | 10% above | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-ray of foot, minimum of 3 views | $552.00 | $690.00 | $34.74–$683.10 | 7% above | 20% |
| X-ray of the hand, 3 or more views CPT 73130 X-ray of hand, minimum of 3 views | $367.20 | $459.00 | $36.06–$454.41 | 28% below | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-ray of knee, 1-2 views | $493.60 | $617.00 | $27.28–$610.83 | 29% above | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray of lower and sacral spine, 2-3 views | $457.60 | $572.00 | $43.45–$566.28 | 8% below | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $655.20 | $819.00 | $62.90–$810.81 | 3% below | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray of middle spine, 2 views | $457.60 | $572.00 | $40.22–$566.28 | 1% below | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-ray of nose bones, minimum of 3 views | $580.00 | $725.00 | $35.56–$717.75 | 28% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray of upper spine, 2-3 views | $380.80 | $476.00 | $37.27–$471.24 | 16% below | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray of pelvis, 1-2 views | $328.80 | $411.00 | $31.01–$406.89 | 17% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray of sacrum and tailbone, minimum of 2 views | $427.20 | $534.00 | $35.89–$528.66 | 12% below | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH) level | $16.00 | $20.00 | $7.60–$20.00 | 76% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver enzyme (SGPT), level | $48.40 | $60.50 | $6.08–$59.90 | 12% above | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Liver enzyme (SGOT), level | $16.00 | $20.00 | $5.94–$19.80 | 65% below | 20% |
| Albumin blood test CPT 82040 Albumin (protein) level | $69.60 | $87.00 | $5.68–$86.13 | 179% above | 20% |
| Aldosterone blood test CPT 82088 Aldosterone hormone level | $37.56 | $46.95 | $17.84–$46.95 | 6% below | 20% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Phosphatase (enzyme) level, alkaline | $71.60 | $89.50 | $5.92–$88.61 | 94% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Measurement of antibody (IgE) to allergic substance, crude allergen extract, each | $17.71 | $22.14 | $5.98–$21.92 | 113% above | 20% |
| Amylase blood test CPT 82150 Amylase (enzyme) level | $86.40 | $108.00 | $7.43–$106.92 | 30% above | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Measurement of antibody for rheumatoid arthritis assessment | $16.00 | $20.00 | $7.60–$19.80 | 33% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Screening test for autoimmune disorder | $328.80 | $411.00 | $13.87–$406.89 | 533% above | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide (heart and blood vessel protein) level | $125.20 | $156.50 | $43.25–$154.94 | 40% below | 20% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bacterial culture, any other source except urine, blood or stool, aerobic | $114.00 | $142.50 | $9.88–$141.08 | 14% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total) | $100.00 | $125.00 | $9.70–$123.75 | 48% below | 20% |
| Bilirubin blood test, total CPT 82247 Bilirubin level, total | $48.40 | $60.50 | $5.75–$59.90 | 7% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology examination of tissue using a microscope, intermediate complexity | $23.56 | $29.45 | $11.19–$29.45 | 82% below | 20% |
| Blood culture for bacteria CPT 87040 Bacterial blood culture | $122.80 | $153.50 | $11.83–$151.97 | 55% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Insertion of needle into vein for collection of blood sample | $32.00 | $40.00 | $15.20–$140.00 | 60% above | 20% |
| Blood glucose (sugar) test CPT 82947 Blood glucose (sugar) level | $16.00 | $20.00 | $4.50–$19.80 | 57% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin (reproductive hormone) analysis | $82.80 | $103.50 | $8.62–$102.47 | 52% below | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood group typing (ABO) | $64.00 | $80.00 | $3.41–$79.20 | 39% below | 20% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea nitrogen level to assess kidney function, quantitative | $65.60 | $82.00 | $4.52–$81.18 | 79% above | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Measurement C-reactive protein for detection of infection or inflammation | $62.40 | $78.00 | $5.94–$77.22 | 9% below | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9 | $20.00 | $25.00 | $9.50–$25.00 | 64% below | 20% |
| Calcium blood test, total CPT 82310 Calcium level, total | $25.00 | $31.25 | $5.88–$30.94 | 60% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | $96.86 | $121.07 | $40.26–$119.86 | 77% above | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $135.20 | $169.00 | $15.36–$167.31 | 18% above | 20% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $118.40 | $148.00 | $8.91–$146.52 | 7% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $70.00 | $87.50 | $7.42–$86.63 | 19% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $140.00 | $175.00 | $12.11–$173.25 | 45% below | 20% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine kinase (cardiac enzyme) level, total | $76.40 | $95.50 | $7.46–$94.55 | 13% below | 20% |
| Creatinine blood test CPT 82565 Blood creatinine level | $71.60 | $89.50 | $5.87–$88.61 | 50% above | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 Coagulation function measurement, D-dimer; quantitative | $124.00 | $155.00 | $11.68–$153.45 | 14% below | 20% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) | $76.80 | $96.00 | $8.03–$95.04 | 12% below | 20% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid | $9.58 | $11.97 | $4.55–$11.97 | 65% below | 20% |
| Estradiol blood test CPT 82670 Measurement of total estradiol (hormone) | $13.42 | $16.77 | $6.37–$16.77 | 85% below | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Stool calprotectin (protein) level | $154.97 | $193.71 | $22.52–$191.77 | 113% above | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (thyroid chemical), free | $140.00 | $175.00 | $10.34–$173.25 | 106% above | 20% |
| Free testosterone test CPT 84402 Testosterone (hormone) level, free | $18.59 | $23.24 | $8.83–$23.24 | 38% below | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel | $300.00 | $375.00 | $142.50–$457.50 | 8% above | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Blood glucose (sugar) level after receiving dose of glucose | $92.80 | $116.00 | $5.45–$114.84 | 88% above | 20% |
| Glucose tolerance test, 3 samples CPT 82951 Blood glucose (sugar) tolerance test, 3 specimens | $141.60 | $177.00 | $14.76–$175.23 | 3% above | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | $12.80 | $16.00 | $6.08–$16.00 | 81% below | 20% |
| H. pylori antibody blood test CPT 86677 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) | $9.78 | $12.22 | $4.64–$12.22 | 91% below | 20% |
| H. pylori stool antigen test CPT 87338 Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool | $30.00 | $37.50 | $14.25–$37.13 | 64% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Detection test by nucleic acid for HIV-1 virus, quantification | $340.54 | $425.67 | $97.65–$421.41 | 210% above | 20% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types | $21.22 | $26.52 | $10.08–$26.52 | 84% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C level | $117.20 | $146.50 | $11.13–$145.04 | 80% above | 20% |
| Hemoglobin blood test CPT 85018 Blood count, hemoglobin | $18.80 | $23.50 | $2.71–$23.27 | 53% below | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Detection test by nucleic acid for Hepatitis C virus, quantification | $91.94 | $114.92 | $43.67–$113.77 | 5% above | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 Analysis for antibody to Herpes simplex virus, type 1 | $11.20 | $14.00 | $5.32–$14.00 | 42% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 Analysis for antibody to Herpes simplex virus, type 2 | $11.18 | $13.98 | $5.31–$13.98 | 53% below | 20% |
| Homocysteine blood test CPT 83090 Homocysteine (amino acid) level | $20.14 | $25.18 | $9.57–$25.08 | 72% below | 20% |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $124.00 | $155.00 | $9.95–$153.45 | 13% below | 20% |
| Lactate (lactic acid) blood test CPT 83605 Lactic acid level | $86.40 | $108.00 | $13.27–$106.92 | 39% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase (fat enzyme) level | $96.40 | $120.50 | $7.90–$119.30 | 13% below | 20% |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $93.20 | $116.50 | $9.15–$115.34 | 38% below | 20% |
| Lyme disease antibody test CPT 86618 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) | $13.43 | $16.79 | $6.38–$16.79 | 42% below | 20% |
| Magnesium blood test CPT 83735 Magnesium level | $77.60 | $97.00 | $7.69–$96.03 | 2% below | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Screening test for mononucleosis (mono) | $68.00 | $85.00 | $5.94–$84.15 | 35% below | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pap test, automated thin layer preparation; automated system and manual rescreening | $15.50 | $19.37 | $7.36–$19.37 | 81% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $86.80 | $108.50 | $6.89–$107.42 | 30% above | 20% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphate level | $47.60 | $59.50 | $5.44–$58.91 | 37% below | 20% |
| Potassium blood test CPT 84132 Blood potassium level | $61.60 | $77.00 | $4.93–$76.23 | 16% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $84.00 | $105.00 | $4.92–$103.95 | 27% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Testing for presence of drug, read by direct observation | $200.80 | $251.00 | $14.32–$248.49 | 137% above | 20% |
| Renin blood test CPT 84244 Renin (kidney enzyme) level | $9.74 | $12.18 | $4.63–$12.18 | 61% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Red blood cell sedimentation rate, to detect inflammation, automated | $60.80 | $76.00 | $3.10–$75.24 | 9% above | 20% |
| Sodium blood test CPT 84295 Blood sodium level | $16.00 | $20.00 | $5.03–$19.80 | 76% below | 20% |
| Stool ova and parasites exam CPT 87177 Smear for parasites | $7.53 | $9.41 | $3.58–$9.41 | 64% below | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool analysis for blood to screen for colon tumors | $42.40 | $53.00 | $3.56–$52.47 | 9% above | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay | $57.60 | $72.00 | $18.26–$71.28 | 47% above | 20% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Analysis for antibody, Treponema pallidum | $8.45 | $10.56 | $4.01–$10.56 | 63% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, gamma interferon | $44.00 | $55.00 | $20.90–$55.00 | 55% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibodies (autoantibody) measurement | $10.48 | $13.10 | $4.98–$13.10 | 54% below | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $166.40 | $208.00 | $19.28–$205.92 | 53% above | 20% |
| Total cholesterol blood test CPT 82465 Cholesterol level | $46.80 | $58.50 | $4.99–$57.92 | 6% above | 20% |
| Trichomonas test (NAAT) CPT 87661 Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique | $103.24 | $129.05 | $40.26–$127.76 | 4% above | 20% |
| Triglycerides blood test CPT 84478 Triglycerides level | $112.00 | $140.00 | $6.58–$138.60 | 172% above | 20% |
| Troponin test, quantitative CPT 84484 Troponin (protein) analysis, quantitative | $174.40 | $218.00 | $12.15–$215.82 | 4% below | 20% |
| Uric acid blood test CPT 84550 Uric acid level, blood | $46.80 | $58.50 | $5.18–$57.92 | 28% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $76.80 | $96.00 | $3.63–$95.04 | 7% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $44.00 | $55.00 | $2.58–$54.45 | 21% below | 20% |
| Urine culture for bacteria, with colony count CPT 87086 Bacterial colony count, urine | $46.07 | $57.59 | $9.25–$57.01 | 67% below | 20% |
| Urine microalbumin (albumin) test CPT 82043 Urine microalbumin (protein) level | $5.34 | $6.67 | $2.53–$6.67 | 85% below | 20% |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test | $36.00 | $45.00 | $4.02–$44.55 | 59% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D-3 level | $156.00 | $195.00 | $33.97–$193.05 | 138% above | 20% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Dihydroxyvitamin D, 1, 25 level | $14.40 | $18.00 | $6.84–$18.00 | 79% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (reproductive hormone) level | $177.60 | $222.00 | $17.27–$219.78 | 1% below | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face | $1,039.20 | $1,299.00 | $103.87–$1,286.01 | 18% above | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 External shock to heart to regulate heart beat | $561.60 | $702.00 | $175.66–$694.98 | 70% below | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 External shock to heart to regulate heart beat | $561.60 | $702.00 | $175.66–$694.98 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation | $964.00 | $1,205.00 | $157.38–$1,192.95 | 63% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation | $964.00 | $1,205.00 | $157.38–$1,192.95 | — | 20% |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare | $2,580.80 | $3,226.00 | $400.22–$3,193.74 | 13% above | 20% |
| Colonoscopy with tissue sample CPT 45380 Biopsy of large bowel using a flexible endoscope | $2,574.40 | $3,218.00 | $330.23–$3,185.82 | 24% above | 20% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using a flexible endoscope | $2,376.00 | $2,970.00 | $295.23–$2,940.30 | 14% above | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal of impacted ear wax by washing | $44.00 | $55.00 | $11.54–$54.45 | 75% below | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal of impacted ear wax by washing | $44.00 | $55.00 | $11.54–$54.45 | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 Removal of impacted ear wax | $127.20 | $159.00 | $30.53–$157.41 | 28% below | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Removal of impacted ear wax | $127.20 | $159.00 | $30.53–$157.41 | — | 20% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection of lower or sacral spine facet joint using imaging guidance, single level | $1,931.20 | $2,414.00 | $144.45–$2,389.86 | 6% below | 20% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic exam of lower portion of large bowel using a flexible endoscope | $435.20 | $544.00 | $54.73–$538.56 | 73% below | 20% |
| Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope | $12,267.00 | $15,333.75 | $668.60–$15,180.41 | 7% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess | $249.60 | $312.00 | $60.88–$308.88 | 47% below | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Simple or single drainage of skin abscess | $249.60 | $312.00 | $60.88–$308.88 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection into tendon or ligament | $148.00 | $185.00 | $65.68–$185.00 | 78% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection into tendon or ligament | $148.00 | $185.00 | $65.68–$185.00 | 78% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection into tendon or ligament | $148.00 | $185.00 | $65.68–$185.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $228.00 | $285.00 | $45.79–$282.15 | 76% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $254.40 | $318.00 | $45.79–$314.82 | 73% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration and/or injection of fluid from large joint | $228.00 | $285.00 | $45.79–$282.15 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium joint | $140.80 | $176.00 | $54.46–$176.00 | 77% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Aspiration and/or injection of fluid from medium joint | $140.80 | $176.00 | $54.46–$176.00 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration and/or injection of fluid from small joint | $378.40 | $473.00 | $46.46–$468.27 | 48% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Aspiration and/or injection of fluid from small joint | $378.40 | $473.00 | $46.46–$468.27 | — | 20% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Removal of appendix using an endoscope | $1,903.60 | $2,379.50 | $273.27–$2,355.71 | 76% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $384.00 | $480.00 | $84.51–$475.20 | 56% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $384.00 | $480.00 | $84.51–$475.20 | — | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | $2,352.00 | $2,940.00 | $143.34–$2,910.60 | 21% above | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $140.80 | $176.00 | $45.93–$174.24 | 71% below | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $140.80 | $176.00 | $45.93–$174.24 | — | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $267.20 | $334.00 | $62.92–$330.66 | 70% below | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $625.60 | $782.00 | $62.92–$774.18 | 29% below | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $267.20 | $334.00 | $62.92–$330.66 | — | 20% |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $494.40 | $618.00 | $89.85–$611.82 | 73% below | 20% |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $560.00 | $700.00 | $89.85–$693.00 | 69% below | 20% |
| Paracentesis with imaging guidance inpatient CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $560.00 | $700.00 | $89.85–$693.00 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Permanent removal fingernail or toenail | $422.40 | $528.00 | $120.69–$522.72 | 67% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Permanent removal fingernail or toenail | $422.40 | $528.00 | $120.69–$522.72 | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $275.20 | $344.00 | $74.23–$340.56 | 72% below | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $275.20 | $344.00 | $74.23–$340.56 | — | 20% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $3,286.40 | $4,108.00 | $1,561.04–$14,378.00 | 93% above | 20% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $3,291.20 | $4,114.00 | $1,563.32–$14,399.00 | 76% above | 20% |
| Short arm cast (elbow to hand) CPT 29075 Application of elbow to finger cast | $620.00 | $775.00 | $82.65–$767.25 | 24% above | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Application of elbow to finger cast | $620.00 | $775.00 | $82.65–$767.25 | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint | $170.40 | $213.00 | $52.87–$210.87 | 58% below | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Application of nonmoveable forearm to hand splint | $170.40 | $213.00 | $52.87–$210.87 | — | 20% |
| Short leg cast (below the knee) CPT 29405 Application of short leg cast | $269.60 | $337.00 | $122.30–$337.00 | 46% below | 20% |
| Short leg cast (below the knee) inpatient CPT 29405 Application of short leg cast | $269.60 | $337.00 | $122.30–$337.00 | — | 20% |
| Short leg splint (calf to foot) CPT 29515 Application of short leg splint from calf to foot | $160.80 | $201.00 | $76.38–$201.00 | 67% below | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 Application of short leg splint from calf to foot | $160.80 | $201.00 | $76.38–$201.00 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $361.60 | $452.00 | $100.39–$447.48 | 34% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $361.60 | $452.00 | $100.39–$447.48 | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 Removal of skin tag, 1-15 skin tags | $129.60 | $162.00 | $45.40–$160.38 | 67% below | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tag, 1-15 skin tags | $129.60 | $162.00 | $45.40–$160.38 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $426.40 | $533.00 | $81.91–$527.67 | 68% below | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $426.40 | $533.00 | $81.91–$527.67 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $436.80 | $546.00 | $106.81–$540.54 | 42% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $436.80 | $546.00 | $106.81–$540.54 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $436.80 | $546.00 | $72.97–$540.54 | 34% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $436.80 | $546.00 | $72.97–$540.54 | — | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection of trigger points, 1-2 muscles | $435.20 | $544.00 | $75.29–$538.56 | 30% below | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection of trigger points, 1-2 muscles | $435.20 | $544.00 | $75.29–$538.56 | — | 20% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | $1,919.20 | $2,399.00 | $319.89–$2,375.01 | 19% below | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $2,097.60 | $2,622.00 | $234.18–$2,595.78 | 19% above | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $1,933.60 | $2,417.00 | $224.12–$2,392.83 | 3% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $366.40 | $458.00 | $148.99–$458.00 | 46% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $366.40 | $458.00 | $148.99–$458.00 | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products | $186.40 | $233.00 | $88.54–$815.50 | 79% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production | $178.40 | $223.00 | $16.78–$220.77 | 45% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production | $182.40 | $228.00 | $16.78–$225.72 | 44% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation treatment for airway obstruction or sputum production | $182.40 | $228.00 | $16.78–$225.72 | — | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes | $2,380.00 | $2,975.00 | $174.42–$2,945.25 | 49% below | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes | $2,380.00 | $2,975.00 | $174.42–$2,945.25 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $164.00 | $205.00 | $23.52–$202.95 | 51% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $351.20 | $439.00 | $23.52–$434.61 | 4% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $164.00 | $205.00 | $23.52–$202.95 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional | $224.00 | $280.00 | $21.77–$277.20 | 47% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional | $224.00 | $280.00 | $21.77–$277.20 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making | $312.00 | $390.00 | $34.97–$386.10 | 64% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making | $312.00 | $390.00 | $34.97–$386.10 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making | $717.60 | $897.00 | $63.97–$888.03 | 53% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making | $717.60 | $897.00 | $63.97–$888.03 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making | $1,589.60 | $1,987.00 | $98.04–$1,967.13 | 41% below | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making | $1,589.60 | $1,987.00 | $98.04–$1,967.13 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making | $1,888.80 | $2,361.00 | $155.03–$2,337.39 | 47% below | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making | $1,888.80 | $2,361.00 | $155.03–$2,337.39 | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise or drug-induced heart stress test with electrocardiogram (ECG) | $666.40 | $833.00 | $75.31–$824.67 | 51% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $381.60 | $477.00 | $73.58–$472.23 | 23% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $640.00 | $800.00 | $73.58–$792.00 | 29% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $640.00 | $800.00 | $73.58–$792.00 | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $381.60 | $477.00 | $89.79–$472.23 | 35% below | 20% |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $381.60 | $477.00 | $89.79–$472.23 | 35% below | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $381.60 | $477.00 | $89.79–$472.23 | — | 20% |
| IV push of a medicine, first drug CPT 96374 Injection of drug or substance into vein | $192.80 | $241.00 | $71.46–$241.00 | 45% below | 20% |
| IV push of a medicine, first drug CPT 96374 Injection of drug or substance into vein | $262.40 | $328.00 | $71.46–$324.72 | 26% below | 20% |
| IV push of a medicine, first drug inpatient CPT 96374 Injection of drug or substance into vein | $262.40 | $328.00 | $71.46–$324.72 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $160.00 | $200.00 | $26.90–$198.00 | 11% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $160.00 | $200.00 | $26.90–$198.00 | 11% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection of drug or substance under skin or into muscle | $160.00 | $200.00 | $26.90–$198.00 | — | 20% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction, 7-8 studies | $478.40 | $598.00 | $227.24–$598.00 | 48% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $72.80 | $91.00 | $17.53–$90.09 | 43% below | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 Evaluation for occupational therapy, typically 30 minutes | $171.20 | $214.00 | $81.32–$749.00 | 34% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Evaluation for physical therapy, typically 45 minutes | $171.20 | $214.00 | $81.32–$214.00 | 60% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Evaluation for physical therapy, typically 30 minutes | $171.20 | $214.00 | $81.32–$749.00 | 52% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy procedure using manual technique, each 15 minutes | $59.20 | $74.00 | $28.12–$74.00 | 51% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $73.60 | $92.00 | $15.72–$91.08 | 43% below | 20% |
| Spirometry (breathing test) CPT 94010 Test to measure expiratory airflow and volume | $152.80 | $191.00 | $35.29–$189.09 | 57% below | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration | $590.40 | $738.00 | $64.59–$730.62 | 26% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy procedure using functional activities | $59.20 | $74.00 | $15.98–$73.26 | 57% below | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of blood for a medical problem | $255.20 | $319.00 | $23.52–$315.81 | 21% below | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use | $1,422.22 | $1,777.78 | $675.56–$6,222.23 | 488% above | 20% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine | $151.20 | $189.00 | $71.82–$661.50 | 27% below | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage | $35.20 | $44.00 | $16.72–$154.00 | 14% below | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use | $614.67 | $768.34 | $291.97–$2,689.19 | 22% above | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal vaccine, 23-valent | $672.14 | $840.17 | $319.26–$2,940.60 | 316% above | 20% |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle | $2,081.39 | $2,601.74 | $462.62–$2,575.72 | 195% above | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older) | $133.29 | $166.61 | $63.31–$583.14 | 15% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine | $194.40 | $243.00 | $6.40–$240.57 | 87% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of vaccine, each additional vaccine | $25.60 | $32.00 | $12.16–$32.00 | 67% below | 20% |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSDHCHESTERCA&type=CDMWithoutLabel&fileType=CSV