Mountains Community Hospital
Mountains Community Hospital in Lake Arrowhead, CA publishes cash prices for 235 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the California median for 228 of 232 procedures and above it for 4. By typical cash price it ranks #13 of 168 California hospitals and #4 of 20 hospitals in the Riverside, CA area, cheapest first. Click a procedure to compare it with other hospitals nearby.
29101 Hospital Road, Lake Arrowhead CA 92352 Collected Sep 27, 2026 Source price file (909) 336-3651
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 051312 · CMS hospital register
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 Mountains Community Hospital in Lake Arrowhead, CA:
- Sep 21, 2023 Warning notice
- Mar 11, 2024 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-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL INDEX | $129.60 | $324.00 | $145.80–$275.40 | 77% below | 60% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGRAM | $342.00 | $855.00 | $384.75–$726.75 | 36% below | 60% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE RT | $220.00 | $550.00 | $247.50–$467.50 | 60% below | 60% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE LT | $220.00 | $550.00 | $247.50–$467.50 | 60% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORACIC AORTA | $1,806.00 | $4,515.00 | $2,031.75–$3,837.75 | 42% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PE PROTOCOL | $1,806.00 | $4,515.00 | $2,031.75–$3,837.75 | 42% below | 60% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENAL STONE PROTOCOL | $1,935.20 | $4,838.00 | $2,177.10–$4,112.30 | 31% below | 60% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST | $1,935.20 | $4,838.00 | $2,177.10–$4,112.30 | 31% below | 60% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS WITH CONTRAST | $2,258.80 | $5,647.00 | $2,541.15–$4,799.95 | 44% below | 60% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS WO/W CONTRAST | $2,387.20 | $5,968.00 | $2,685.60–$5,072.80 | 46% below | 60% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $2,387.20 | $5,968.00 | $2,685.60–$5,072.80 | 46% below | 60% |
| CT scan of the abdomen with contrast CPT 74160 CT PANCREATIC PROTOCOL | $1,696.80 | $4,242.00 | $1,908.90–$3,605.70 | 24% below | 60% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONTRAST | $1,696.80 | $4,242.00 | $1,908.90–$3,605.70 | 24% below | 60% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST | $1,484.00 | $3,710.00 | $1,669.50–$3,153.50 | 21% below | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES WO CONTRAST | $742.00 | $1,855.00 | $834.75–$1,576.75 | 66% below | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SOFT TISSUE FACIAL WO CON | $742.00 | $1,855.00 | $834.75–$1,576.75 | 66% below | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST | $742.00 | $1,855.00 | $834.75–$1,576.75 | 66% below | 60% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST | $1,168.00 | $2,920.00 | $1,314.00–$2,482.00 | 49% below | 60% |
| CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAST | $1,245.20 | $3,113.00 | $1,400.85–$2,646.05 | 54% below | 60% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST | $1,600.00 | $4,000.00 | $1,800.00–$3,400.00 | 43% below | 60% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTRAST | $1,303.60 | $3,259.00 | $1,466.55–$2,770.15 | 54% below | 60% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTRAST | $1,478.00 | $3,695.00 | $1,662.75–$3,140.75 | 49% below | 60% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST | $1,504.40 | $3,761.00 | $1,692.45–$3,196.85 | 41% below | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTIDS | $490.80 | $1,227.00 | $552.15–$1,042.95 | 60% below | 60% |
| Chest X-ray, 2 views CPT 71046 XR CHEST PT & LAT | $168.40 | $421.00 | $189.45–$357.85 | 56% below | 60% |
| Chest X-ray, single view CPT 71045 XR CHEST AP / PA | $129.60 | $324.00 | $145.80–$275.40 | 62% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US KIDNEY | $432.80 | $1,082.00 | $486.90–$919.70 | 49% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERIT COMPLETE | $432.80 | $1,082.00 | $486.90–$919.70 | 49% below | 60% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DX DEXA BONE DENSITY | $161.60 | $404.00 | $181.80–$343.40 | 66% below | 60% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST | $1,504.40 | $3,761.00 | $1,692.45–$3,196.85 | 17% below | 60% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST | $1,594.00 | $3,985.00 | $1,793.25–$3,387.25 | 32% below | 60% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG MAMMO CONE DOWN BILAT | $211.60 | $529.00 | $238.05–$449.65 | — | 60% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG MAMMOGRAM BILATERAL | $228.40 | $571.00 | $256.95–$485.35 | — | 60% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US FEMORAL ARTERY BILATERAL | $581.20 | $1,453.00 | $653.85–$1,235.05 | — | 60% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LOWER EXT ARTERY BILATERAL | $1,032.80 | $2,582.00 | $1,161.90–$2,194.70 | — | 60% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UPPER EXT VENOUS BILATERAL | $1,032.80 | $2,582.00 | $1,161.90–$2,194.70 | — | 60% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LOWER EXT VENOUS BILATERAL | $1,032.80 | $2,582.00 | $1,161.90–$2,194.70 | — | 60% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US DOPP ECHO W COLOR FLOW | $407.60 | $1,019.00 | $458.55–$866.15 | 83% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN | $387.60 | $969.00 | $436.05–$823.65 | 53% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS | $387.60 | $969.00 | $436.05–$823.65 | 53% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER | $387.60 | $969.00 | $436.05–$823.65 | 53% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN SINGLE ORGAN | $387.60 | $969.00 | $436.05–$823.65 | 53% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN PARACENTESIS LTD | $387.60 | $969.00 | $436.05–$823.65 | 53% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE ABDOMEN | $387.60 | $969.00 | $436.05–$823.65 | 53% below | 60% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LDCT CHEST WITHOUT | $1,504.40 | $3,761.00 | $1,692.45–$3,196.85 | 278% above | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED | $355.20 | $888.00 | $399.60–$754.80 | 32% below | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US SOFT TISSUE PELVIS | $355.20 | $888.00 | $399.60–$754.80 | 32% below | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US URINARY BLADDER COMPLETE | $387.60 | $969.00 | $436.05–$823.65 | 59% below | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON OB COMPLETE | $387.60 | $969.00 | $436.05–$823.65 | 59% below | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US IUD COMPLETE | $387.60 | $969.00 | $436.05–$823.65 | 59% below | 60% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS >14 WEEKS | $239.20 | $598.00 | $269.10–$508.30 | 67% below | 60% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS <14 WEEKS | $329.60 | $824.00 | $370.80–$700.40 | 53% below | 60% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $218.40 | $546.00 | $245.70–$464.10 | — | 60% |
| Screening mammogram, both breasts CPT 77067 MG MAMMOGRAM SCREENING | $218.40 | $546.00 | $245.70–$464.10 | 16% below | 60% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $226.80 | $567.00 | $255.15–$481.95 | 60% below | 60% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANS VAGINAL | $407.60 | $1,019.00 | $458.55–$866.15 | 29% below | 60% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $496.80 | $1,242.00 | $558.90–$1,055.70 | 50% below | 60% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICLE | $452.40 | $1,131.00 | $508.95–$961.35 | 49% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK | $337.20 | $843.00 | $379.35–$716.55 | 59% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK | $337.20 | $843.00 | $379.35–$716.55 | 59% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $337.20 | $843.00 | $379.35–$716.55 | 59% below | 60% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GIS W/O KUB | $394.00 | $985.00 | $443.25–$837.25 | 35% below | 60% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN / KUB 1 VIEW | $174.80 | $437.00 | $196.65–$371.45 | 42% below | 60% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBAR 2 OR 3 VIEWS | $207.60 | $519.00 | $233.55–$441.15 | 55% below | 60% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $342.00 | $855.00 | $384.75–$726.75 | 42% below | 60% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS | $252.80 | $632.00 | $284.40–$537.20 | 29% below | 60% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES | $200.40 | $501.00 | $225.45–$425.85 | 47% below | 60% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS | $136.80 | $342.00 | $153.90–$290.70 | 68% below | 60% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS | $188.00 | $470.00 | $211.50–$399.50 | 48% below | 60% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM AND COCCYX | $232.80 | $582.00 | $261.90–$494.70 | 45% below | 60% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT | $4.75 | $11.88 | $5.35–$10.10 | 89% below | 60% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $4.75 | $11.88 | $5.35–$10.10 | 89% below | 60% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL | $43.46 | $108.65 | $48.89–$92.35 | 82% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ CURVULARIA LUNATA I | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/BOTRYTIS CINEREA | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ AUREOBASIDIUM PULLU | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE-FACED HORNET ALLERG | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/FUSARIUM MONOLIFORME | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ PENICILLIN NOTATUM | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET ALLERGEN, I | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ C. GLOBOSUM IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ T. RUBUM IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW HORNET ALLERGEN, I | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN, IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ C. ACREMONIUM IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ RHIZOPUS NIGROCANS | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ HELMINTHOSPORIUM HA | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/EPICOCCUM PURPURASCE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/PHOMA BETAE IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER ALLERGEN | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT EPITHELIA ALLERGEN | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST ALLERGEN | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST MITE ALLERGEN | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEY BEE ALLERGEN, IGE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ TRICHODERMA VIRIDE | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/STEMPHYLIUM BOTYROSU | $4.00 | $10.00 | $4.50–$8.50 | 52% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SO CALIF ALLERGY PROFILE | $5.00 | $12.50 | $5.63–$10.63 | 40% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHEDDAR CHEESE (f81) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM (F207) LGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEEF (F27) LGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE (F5) LGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK (F26) IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINEAPPLES (f210) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MELONS (f87) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMON (f208) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT (f209) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT (f36) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE(f1) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY(f44)IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO (f25) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCOA IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILE IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO(f96) IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BUCKWHEAT(f11)IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHOLE EGG (f245) IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE(f33)IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO FRUIT(F91)IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND,IgE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEACH, IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN MEAT (F83) LGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE, IGE | $6.03 | $15.08 | $6.79–$12.82 | 28% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NECTARINE, IGE | $15.80 | $39.51 | $17.78–$33.58 | 90% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD/ P. ORBICULARE IGE | $15.80 | $39.51 | $17.78–$33.58 | 90% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HYPERSENSIT PNEUMONITIS | $17.68 | $44.20 | $19.89–$37.57 | 112% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IgE MILK | $22.55 | $56.37 | $25.37–$47.91 | 171% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL, SEAFOOD GR | $24.00 | $60.00 | $27.00–$51.00 | 188% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 12 ANIMAL | $30.16 | $75.40 | $33.93–$64.09 | 262% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 18,NUT MIX | $30.16 | $75.40 | $33.93–$64.09 | 262% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE, ADU | $72.38 | $180.96 | $81.43–$153.82 | 770% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RESP ALLERGY PRO1 CPT2 | $81.16 | $202.90 | $91.31–$172.47 | 875% above | 60% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 RA DIAGNOSTIC IDENTRA PANEL 2 | $26.24 | $65.59 | $29.52–$55.75 | 29% above | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANACHOICE SPECIFIC AB CAS | $8.94 | $22.34 | $10.05–$18.99 | 74% below | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SLE COMP DIAG PANEL | $90.93 | $227.33 | $102.30–$193.23 | 161% above | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA COMPREHENSIVE PANEL1 | $153.34 | $383.35 | $172.51–$325.85 | 340% above | 60% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP ll OUTPATIENT ONLY | $76.00 | $190.00 | $85.50–$161.50 | 57% below | 60% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP II | $76.00 | $190.00 | $85.50–$161.50 | 57% below | 60% |
| Basic metabolic panel (blood test) CPT 80048 BMP | $9.60 | $24.00 | $10.80–$20.40 | 95% below | 60% |
| Basic metabolic panel (blood test) CPT 80048 BMP, PLASMA | $9.60 | $24.00 | $10.80–$20.40 | 95% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LAB LEVEL IV [I] | $26.00 | $65.00 | $29.25–$55.25 | 83% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LAB LEVEL IV X 2 [I] | $52.80 | $132.00 | $59.40–$112.20 | 65% below | 60% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LAB LEVEL IV X 3 [I] | $78.80 | $197.00 | $88.65–$167.45 | 48% below | 60% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $26.94 | $67.34 | $30.30–$57.24 | 89% below | 60% |
| Blood culture for bacteria CPT 87040 PEDS BLOOD CULTURE | $68.80 | $172.00 | $77.40–$146.20 | 71% below | 60% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE 1 | $68.80 | $172.00 | $77.40–$146.20 | 71% below | 60% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE 2 | $68.80 | $172.00 | $77.40–$146.20 | 71% below | 60% |
| Blood culture for bacteria CPT 87040 PEDIATRIC BLOOD CULTURE | $68.80 | $172.00 | $77.40–$146.20 | 71% below | 60% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE BLOOD CULT | $13.20 | $33.00 | $14.85–$28.05 | 46% below | 60% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ADULT | $13.20 | $33.00 | $14.85–$28.05 | 46% below | 60% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE MONITORING | $9.60 | $24.00 | $10.80–$20.40 | 74% below | 60% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $9.60 | $24.00 | $10.80–$20.40 | 74% below | 60% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $22.00 | $55.00 | $24.75–$46.75 | 41% below | 60% |
| Blood lead test CPT 83655 LEAD, BLOOD | $5.60 | $14.00 | $6.30–$11.90 | 61% below | 60% |
| Blood lead test CPT 83655 HVY MTLS W/CAD CPT3 | $19.08 | $47.69 | $21.46–$40.54 | 34% above | 60% |
| Blood lead test CPT 83655 HEAVY METAL CPT6 | $19.74 | $49.34 | $22.20–$41.94 | 39% above | 60% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 SERUM HCG URINE QUALITATIVE | $31.20 | $78.00 | $35.10–$66.30 | 80% below | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPING | $8.40 | $21.00 | $9.45–$17.85 | 89% below | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO | $27.20 | $68.00 | $30.60–$57.80 | 65% below | 60% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $11.97 | $29.93 | $13.47–$25.44 | 76% below | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PROBE | $38.00 | $95.00 | $42.75–$80.75 | 46% below | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2.1 RP SARS-COV-2 COVID-19 | $122.80 | $307.00 | $138.15–$260.95 | 75% above | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $122.80 | $307.00 | $138.15–$260.95 | 75% above | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 ANA SCREEN IFA W/REFLEX | $276.40 | $691.00 | $310.95–$587.35 | 295% above | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AND GC APTIMA | $20.00 | $50.00 | $22.50–$42.50 | 63% below | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMDIA TRACHOMATIS DNA | $24.00 | $60.00 | $27.00–$51.00 | 56% below | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE | $41.40 | $103.49 | $46.57–$87.97 | 24% below | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/ CHLAMYDIA RNA,TMA,THROAT | $48.00 | $120.00 | $54.00–$102.00 | 12% below | 60% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $10.60 | $26.50 | $11.93–$22.53 | 90% below | 60% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/ DIFF | $27.60 | $69.00 | $31.05–$58.65 | 75% below | 60% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $18.40 | $46.00 | $20.70–$39.10 | 76% below | 60% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP | $113.60 | $284.00 | $127.80–$241.40 | 56% below | 60% |
| D-dimer blood test (blood clot marker) CPT 85379 QUANT D-DIMER | $31.20 | $78.00 | $35.10–$66.30 | 74% below | 60% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER | $39.28 | $98.20 | $44.19–$83.47 | 67% below | 60% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANT STAT | $40.46 | $101.15 | $45.52–$85.98 | 66% below | 60% |
| D-dimer blood test (blood clot marker) CPT 85379 FDP (D-DIMER RATE) | $57.50 | $143.74 | $64.68–$122.18 | 52% below | 60% |
| Estradiol blood test CPT 82670 CAH PANEL 4 CPT4 | $13.01 | $32.52 | $14.63–$27.64 | 79% below | 60% |
| Estradiol blood test CPT 82670 ESTRADIOL, FREE | $14.00 | $35.00 | $15.75–$29.75 | 78% below | 60% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH AND LH, PEDIATRIC | $32.83 | $82.07 | $36.93–$69.76 | 63% below | 60% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN,STOOL | $56.00 | $140.00 | $63.00–$119.00 | 23% below | 60% |
| Ferritin blood test (iron stores) CPT 82728 THAL AND HEMOGL CO CPT2 | $21.59 | $53.97 | $24.29–$45.87 | 74% below | 60% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL | $48.40 | $121.00 | $54.45–$102.85 | 42% below | 60% |
| Folate (folic acid) blood test CPT 82746 VITB12/FOLATE CPT2 | $10.02 | $25.06 | $11.28–$21.30 | 88% below | 60% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID, SERUM | $15.48 | $38.69 | $17.41–$32.89 | 82% below | 60% |
| Folate (folic acid) blood test CPT 82746 FOLATE III | $41.60 | $104.00 | $46.80–$88.40 | 52% below | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE DIRECT DIALYSIS | $10.99 | $27.47 | $12.36–$23.35 | 84% below | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE DIRECT DIALY | $15.54 | $38.85 | $17.48–$33.02 | 77% below | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE | $18.22 | $45.56 | $20.50–$38.73 | 73% below | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $30.40 | $76.00 | $34.20–$64.60 | 55% below | 60% |
| Free testosterone test CPT 84402 TESTOSTERONE,FREE/TOTAL | $12.00 | $30.00 | $13.50–$25.50 | 71% below | 60% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 I HOUR PGL | $17.60 | $44.00 | $19.80–$37.40 | 60% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 2HR PP | $28.00 | $70.00 | $31.50–$59.50 | 76% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 4HR GLUCOSE TOLERANCE | $28.00 | $70.00 | $31.50–$59.50 | 76% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2HOUR | $34.40 | $86.00 | $38.70–$73.10 | 71% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3HR | $66.00 | $165.00 | $74.25–$140.25 | 44% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 5HR | $82.00 | $205.00 | $92.25–$174.25 | 30% below | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $41.40 | $103.49 | $46.57–$87.97 | 22% below | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA RNA,TMA,THOAT | $48.00 | $120.00 | $54.00–$102.00 | 10% below | 60% |
| H. pylori antibody blood test CPT 86677 H PYL ANTI IGG IGA IGM #2 | $33.63 | $84.08 | $37.84–$71.47 | 70% below | 60% |
| H. pylori antibody blood test CPT 86677 H PYLO ANTI IGG IGA IGM#3 | $33.63 | $84.08 | $37.84–$71.47 | 70% below | 60% |
| H. pylori antibody blood test CPT 86677 H. PYLORI AB, IGG,IGA,IGM | $33.63 | $84.08 | $37.84–$71.47 | 70% below | 60% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI, FECA | $42.00 | $105.00 | $47.25–$89.25 | 43% below | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QT PCR VIRAL LO | $60.00 | $150.00 | $67.50–$127.50 | 29% below | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN PCR | $116.40 | $291.00 | $130.95–$247.35 | 37% above | 60% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV II, REFLEX | $35.28 | $88.20 | $39.69–$74.97 | 15% below | 60% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 AG & AB | $38.80 | $97.00 | $43.65–$82.45 | 7% below | 60% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV -1/2 AG W/REFLEX | $43.20 | $108.00 | $48.60–$91.80 | 29% below | 60% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 ACUTE HEP PNL CPT2 | $10.28 | $25.69 | $11.56–$21.84 | 83% below | 60% |
| Hepatitis C antibody blood test (screening) CPT 86803 ACUTE HEP PNL CPT4 | $10.28 | $25.69 | $11.56–$21.84 | 80% below | 60% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QNT, VIRAL LOAD,PCR | $52.00 | $130.00 | $58.50–$110.50 | 34% below | 60% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA, QT W/REF | $106.40 | $266.00 | $119.70–$226.10 | 36% above | 60% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IGM AB,IFA CPT2 | $8.06 | $20.16 | $9.07–$17.14 | 57% below | 60% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX VIRUS I & | $9.60 | $24.00 | $10.80–$20.40 | 49% below | 60% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 AB IgM,W RFX TITE | $16.13 | $40.33 | $18.15–$34.28 | 14% below | 60% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP HIGH SENSITIVE | $10.00 | $25.00 | $11.25–$21.25 | 79% below | 60% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO IQ HS-CRP | $10.00 | $25.00 | $11.25–$21.25 | 79% below | 60% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HS C-REACTIVE PROTEIN | $27.20 | $68.00 | $30.60–$57.80 | 42% below | 60% |
| Homocysteine blood test CPT 83090 METHYLMALONIC ACID AND HO | $44.99 | $112.48 | $50.62–$95.61 | 9% above | 60% |
| Insulin blood test CPT 83525 INSULIN | $7.68 | $19.19 | $8.64–$16.31 | 77% below | 60% |
| Insulin blood test CPT 83525 INSULIN RESP TO GLU,4 SPE | $30.70 | $76.76 | $34.54–$65.25 | 8% below | 60% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $19.20 | $48.00 | $21.60–$40.80 | 57% below | 60% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Bind Cap | $22.00 | $55.00 | $24.75–$46.75 | 60% below | 60% |
| Kidney function blood test panel CPT 80069 RENAL PANEL | $42.40 | $106.00 | $47.70–$90.10 | 70% below | 60% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE,PERITONEAL FLUID | $10.69 | $26.72 | $12.02–$22.71 | 86% below | 60% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $88.80 | $222.00 | $99.90–$188.70 | 34% below | 60% |
| Lyme disease antibody test CPT 86618 LYME DIS Ab IgG WEST BLOT | $14.41 | $36.03 | $16.21–$30.63 | 40% below | 60% |
| Lyme disease antibody test CPT 86618 LYME AB, REF. WB | $16.55 | $41.38 | $18.62–$35.17 | 31% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM 24HR UR W/O CRE | $9.16 | $22.89 | $10.30–$19.46 | 84% below | 60% |
| Magnesium blood test CPT 83735 RBC-MAGNESIUM | $14.27 | $35.67 | $16.05–$30.32 | 75% below | 60% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB | $5.60 | $14.00 | $6.30–$11.90 | 94% below | 60% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO | $27.20 | $68.00 | $30.60–$57.80 | 71% below | 60% |
| Obstetric blood test panel CPT 80055 PRENATAL PANEL 1 | $74.40 | $186.00 | $83.70–$158.10 | 70% below | 60% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL & FREE CPT2 | $9.50 | $23.75 | $10.69–$20.19 | 73% below | 60% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA | $42.80 | $107.00 | $48.15–$90.95 | 23% above | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL/FREE | $9.50 | $23.75 | $10.69–$20.19 | 80% below | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $14.60 | $36.51 | $16.43–$31.03 | 69% below | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA PANEL | $75.20 | $188.00 | $84.60–$159.80 | 61% above | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN-PREP PAP, CYTOLOGY | $12.00 | $30.00 | $13.50–$25.50 | 87% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN-PREP W REFLEX TO HPV | $12.00 | $30.00 | $13.50–$25.50 | 87% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH AND HPV CPT2 | $12.00 | $30.00 | $13.50–$25.50 | 87% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP | $26.46 | $66.15 | $29.77–$56.23 | 71% below | 60% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP W/HR HPV,GC-CHL | $56.00 | $140.00 | $63.00–$119.00 | 38% below | 60% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $6.45 | $16.12 | $7.25–$13.70 | 83% below | 60% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS EVAL W/ REFLEX | $11.67 | $29.17 | $13.13–$24.79 | 69% below | 60% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 VAN WILLIBRANDS CPT5 | $29.59 | $73.97 | $33.29–$62.87 | 22% below | 60% |
| Progesterone blood test CPT 84144 CAH PANEL 4 CPT6 | $13.01 | $32.52 | $14.63–$27.64 | 76% below | 60% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $21.27 | $53.17 | $23.93–$45.19 | 55% below | 60% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $26.80 | $67.00 | $30.15–$56.95 | 44% below | 60% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A&B ANTIGEN DET | $59.20 | $148.00 | $66.60–$125.80 | 21% below | 60% |
| Rheumatoid factor (RF) test CPT 86431 RA SCRN W/REFX TITER CPT2 | $9.00 | $22.50 | $10.13–$19.13 | 31% below | 60% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR | $11.51 | $28.77 | $12.95–$24.45 | 11% below | 60% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER IGG/IGM 376 | $68.00 | $170.00 | $76.50–$144.50 | 70% above | 60% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE AUTOMATED | $24.40 | $61.00 | $27.45–$51.85 | 46% below | 60% |
| Stool ova and parasites exam CPT 87177 O AND P W/ GIARDIA ANTIGE | $11.51 | $28.77 | $12.95–$24.45 | 36% below | 60% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITE | $17.26 | $43.16 | $19.42–$36.69 | 4% below | 60% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL SCREENING | $15.60 | $39.00 | $17.55–$33.15 | 60% below | 60% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN BY IMMUNOCHE | $24.00 | $60.00 | $27.00–$51.00 | 33% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $5.40 | $13.50 | $6.08–$11.48 | 64% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SERUM | $7.67 | $19.17 | $8.63–$16.29 | 49% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (DX) W/ REFLEX TO TITER | $9.85 | $24.62 | $11.08–$20.93 | 34% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR(DX)REFLEXTOTITER/CONFIRM | $12.00 | $30.00 | $13.50–$25.50 | 19% below | 60% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON(TB ANTIGEN) | $22.00 | $55.00 | $24.75–$46.75 | 69% below | 60% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD + 1 TUBE | $22.00 | $55.00 | $24.75–$46.75 | 69% below | 60% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE B&T 3 | $10.66 | $26.66 | $12.00–$22.66 | 73% below | 60% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,FREE & WEAKL | $32.00 | $80.00 | $36.00–$68.00 | 20% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBO | $7.20 | $18.00 | $8.10–$15.30 | 69% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LKM MICROSOME AB | $24.00 | $60.00 | $27.00–$51.00 | 5% above | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIV/KID MICROSOMAL | $35.20 | $88.00 | $39.60–$74.80 | 54% above | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER CYTOSOL (LC-1) AUTOANTI | $55.20 | $138.00 | $62.10–$117.30 | 141% above | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/ REFLEX TO FT4 | $12.95 | $32.37 | $14.57–$27.51 | 85% below | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $16.92 | $42.31 | $19.04–$35.96 | 80% below | 60% |
| Uric acid blood test CPT 84550 URIC ACID | $10.40 | $26.00 | $11.70–$22.10 | 83% below | 60% |
| Urinalysis with microscope exam, automated CPT 81001 UA MICRO REFLEX | $24.00 | $60.00 | $27.00–$51.00 | 71% below | 60% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE | $2.90 | $7.25 | $3.26–$6.16 | 95% below | 60% |
| Urinalysis without microscope exam, automated CPT 81003 RHC UA DIPSTICK | $12.00 | $30.00 | $13.50–$25.50 | 79% below | 60% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS NO MICRO AUTOMATED | $15.60 | $39.00 | $17.55–$33.15 | 72% below | 60% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE,URINE,ROUTINE | $12.66 | $31.65 | $14.24–$26.90 | 91% below | 60% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE | $73.60 | $184.00 | $82.80–$156.40 | 47% below | 60% |
| Urine pregnancy test, read by color change CPT 81025 RHC PREGNANCY URINE | $30.00 | $75.00 | $33.75–$63.75 | 65% below | 60% |
| Urine pregnancy test, read by color change CPT 81025 URINE HCG MANUAL QUANT | $31.20 | $78.00 | $35.10–$66.30 | 64% below | 60% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITB12/FOLATE PANEL | $10.02 | $25.06 | $11.28–$21.30 | 84% below | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D PANEL | $14.00 | $35.00 | $15.75–$29.75 | 78% below | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY | $14.00 | $35.00 | $15.75–$29.75 | 78% below | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 1, 25-DIHYDROXY VITAMIN D | $56.40 | $141.00 | $63.45–$119.85 | 12% below | 60% |
| Zinc blood test CPT 84630 ZINC, PLASMA | $11.60 | $29.00 | $13.05–$24.65 | 17% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHOR. GONADOTROPIN | $12.44 | $31.10 | $14.00–$26.44 | 91% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QHCG | $19.62 | $49.06 | $22.08–$41.70 | 86% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 SERUM QUANTITATIVE HCG | $75.20 | $188.00 | $84.60–$159.80 | 46% below | 60% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY | $777.20 | $1,943.00 | $874.35–$1,651.55 | 64% below | 60% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX W/O | $184.80 | $462.00 | $207.90–$392.70 | 65% below | 60% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLTX METATAR FX W/O MANIP | $184.80 | $462.00 | $207.90–$392.70 | 65% below | 60% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $456.00 | $1,140.00 | $513.00–$969.00 | 75% below | 60% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $136.40 | $341.00 | $153.45–$289.85 | 93% below | 60% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX W/O M | $184.80 | $462.00 | $207.90–$392.70 | 68% below | 60% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL | $222.00 | $555.00 | $249.75–$471.75 | 90% below | 60% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $302.40 | $756.00 | $340.20–$642.60 | 85% below | 60% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $160.80 | $402.00 | $180.90–$341.70 | 92% below | 60% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $117.60 | $294.00 | $132.30–$249.90 | 88% below | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $19.86 | $49.65 | $22.34–$42.20 | 89% below | 60% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $85.20 | $213.00 | $95.85–$181.05 | 51% below | 60% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $88.40 | $221.00 | $99.45–$187.85 | 84% below | 60% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC | $492.40 | $1,231.00 | $553.95–$1,046.35 | 93% below | 60% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC | $661.20 | $1,653.00 | $743.85–$1,405.05 | 91% below | 60% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC | $294.40 | $736.00 | $331.20–$625.60 | 94% below | 60% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $586.40 | $1,466.00 | $659.70–$1,246.10 | 96% below | 60% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY | $946.40 | $2,366.00 | $1,064.70–$2,011.10 | 55% below | 60% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) | $173.60 | $434.00 | $195.30–$368.90 | 91% below | 60% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HMRDECTOMY INTRN RBR BND | $936.80 | $2,342.00 | $1,053.90–$1,990.70 | 50% below | 60% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP | $318.40 | $796.00 | $358.20–$676.60 | 93% below | 60% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT OF IUD DEVICE | $60.00 | $150.00 | $67.50–$127.50 | 90% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC SMPL/SNGL | $98.80 | $247.00 | $111.15–$209.95 | 79% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGL | $106.80 | $267.00 | $120.15–$226.95 | 77% below | 60% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR | $758.00 | $1,895.00 | $852.75–$1,610.75 | 89% below | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHCNT ASP/INJ MJR JT/BR | $312.00 | $780.00 | $351.00–$663.00 | 57% below | 60% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 IMPLANT INSERTION | $60.00 | $150.00 | $67.50–$127.50 | 79% below | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHCNT ASP/INJ INTERM JT | $198.40 | $496.00 | $223.20–$421.60 | 65% below | 60% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHCNT ASP/INJ SML JT/BR | $142.00 | $355.00 | $159.75–$301.75 | 77% below | 60% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY | $534.80 | $1,337.00 | $601.65–$1,136.45 | 93% below | 60% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT | $384.80 | $962.00 | $432.90–$817.70 | 98% below | 60% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR | $384.80 | $962.00 | $432.90–$817.70 | 93% below | 60% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER TREATMENT | $362.00 | $905.00 | $407.25–$769.25 | 78% below | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $132.40 | $331.00 | $148.95–$281.35 | 85% below | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR INT EXTREM 2.5CM/< | $702.40 | $1,756.00 | $790.20–$1,492.60 | 19% below | 60% |
| Lower-back epidural injection, without imaging guidance CPT 62322 CHRONIC PAIN TX ROOM/HR | $846.80 | $2,117.00 | $952.65–$1,799.45 | 49% below | 60% |
| Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE | $342.80 | $857.00 | $385.65–$728.45 | 92% below | 60% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $111.20 | $278.00 | $125.10–$236.30 | 92% below | 60% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $124.40 | $311.00 | $139.95–$264.35 | 92% below | 60% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PRTL | $234.40 | $586.00 | $263.70–$498.10 | 48% below | 60% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $702.40 | $1,756.00 | $790.20–$1,492.60 | 61% below | 60% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL REMOVAL | $80.00 | $200.00 | $90.00–$170.00 | 94% below | 60% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $370.00 | $925.00 | $416.25–$786.25 | 93% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY SUBQ TIS | $91.20 | $228.00 | $102.60–$193.80 | 88% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $188.00 | $470.00 | $211.50–$399.50 | 75% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 I&R FB SUBQ TISS SMPL | $468.80 | $1,172.00 | $527.40–$996.20 | 38% below | 60% |
| Short arm cast (elbow to hand) CPT 29075 APP CAST ELBOW FINGER SHT | $297.20 | $743.00 | $334.35–$631.55 | 40% below | 60% |
| Short arm splint (forearm and hand) CPT 29125 SPLINT APPLY FOREARM | $46.00 | $115.00 | $51.75–$97.75 | 89% below | 60% |
| Short arm splint (forearm and hand) CPT 29125 APP SHT ARM SPLINT STATIC | $131.20 | $328.00 | $147.60–$278.80 | 68% below | 60% |
| Short leg cast (below the knee) CPT 29405 APP SHT LEG CAST BELOW KN | $297.20 | $743.00 | $334.35–$631.55 | 40% below | 60% |
| Short leg splint (calf to foot) CPT 29515 SPLINT APPLY SHORT LEG | $50.00 | $125.00 | $56.25–$106.25 | 90% below | 60% |
| Short leg splint (calf to foot) CPT 29515 APP SHT LEG SPLINT CALF | $131.20 | $328.00 | $147.60–$278.80 | 73% below | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR SMPL TRNK 2.5CM/< | $56.80 | $142.00 | $63.90–$120.70 | 87% below | 60% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $110.40 | $276.00 | $124.20–$234.60 | 85% below | 60% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <W/15 | $77.20 | $193.00 | $86.85–$164.05 | 80% below | 60% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $458.80 | $1,147.00 | $516.15–$974.95 | 63% below | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR SMPL TRNK 2.6-7.5CM | $56.80 | $142.00 | $63.90–$120.70 | 92% below | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $48.00 | $120.00 | $54.00–$102.00 | 93% below | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR SMPL FACE 2.5CM/< | $56.80 | $142.00 | $63.90–$120.70 | 91% below | 60% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $88.80 | $222.00 | $99.90–$188.70 | 84% below | 60% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMG | $647.60 | $1,619.00 | $728.55–$1,376.15 | 68% below | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $43.67 | $109.17 | $49.13–$92.79 | 93% below | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< | $52.80 | $132.00 | $59.40–$112.20 | 92% below | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBID SUBQ TIS 20SQ CM/< | $936.80 | $2,342.00 | $1,053.90–$1,990.70 | 38% above | 60% |
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 BLD/BLD COMP | $396.00 | $990.00 | $445.50–$841.50 | 55% below | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT | $30.00 | $75.00 | $33.75–$63.75 | 90% below | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TX SUB | $42.40 | $106.00 | $47.70–$90.10 | 86% below | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ PAP TX | $42.40 | $106.00 | $47.70–$90.10 | 86% below | 60% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $2,632.40 | $6,581.00 | $1,190.00–$5,593.85 | 47% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $86.80 | $217.00 | $97.65–$184.45 | 74% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG RESP | $86.80 | $217.00 | $97.65–$184.45 | 74% below | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL ONLY ED | $22.00 | $55.00 | $24.75–$46.75 | 94% below | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST LIMITED/MINOR PROB | $211.20 | $528.00 | $237.60–$448.80 | 45% below | 60% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM | $452.00 | $1,130.00 | $508.50–$960.50 | 40% below | 60% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $684.40 | $1,711.00 | $769.95–$1,454.35 | 43% below | 60% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM | $1,158.80 | $2,897.00 | $1,190.00–$2,462.45 | 41% below | 60% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $1,684.40 | $4,211.00 | $1,190.00–$3,579.35 | 49% below | 60% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $542.80 | $1,357.00 | $610.65–$1,153.45 | 55% below | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB-Q/ IM | $74.40 | $186.00 | $83.70–$158.10 | 52% below | 60% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEURO REED 15MIN | $36.00 | $90.00 | $40.50–$76.50 | 72% below | 60% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT OUTPT VISIT LEVEL 3 | $80.00 | $200.00 | $90.00–$170.00 | 55% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT OUTPT VISIT LEVEL 4 | $88.00 | $220.00 | $99.00–$187.00 | 63% below | 60% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT OUTPT VISIT LEVEL 5 | $96.00 | $240.00 | $108.00–$204.00 | 66% below | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT OUTPT VISIT LEVEL 2 | $72.00 | $180.00 | $81.00–$153.00 | 46% below | 60% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION CONSULT INDIV IN 15M | $34.00 | $85.00 | $38.25–$72.25 | 66% below | 60% |
| Preventive checkup, new patient aged 18–39 CPT 99385 NEW PT YOUNG ADULT 18-39 | $90.00 | $225.00 | $101.25–$191.25 | 46% below | 60% |
| Preventive checkup, new patient aged 40–64 CPT 99386 NEW PT ADULT 40-64 YRS | $100.00 | $250.00 | $112.50–$212.50 | 46% below | 60% |
| Preventive checkup, new patient aged 65 or older CPT 99387 NEW PT ADULT 65YR AND UP | $110.00 | $275.00 | $123.75–$233.75 | 39% below | 60% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 ESTAB YOUNG ADULT 18-39YR | $84.00 | $210.00 | $94.50–$178.50 | 46% below | 60% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 ESTAB ADULT 40-64 YRS | $104.00 | $260.00 | $117.00–$221.00 | 34% below | 60% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 ADULT PHYSICAL 65YRS> | $104.00 | $260.00 | $117.00–$221.00 | 34% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT OUTPT VISIT LEVEL 5 | $90.00 | $225.00 | $101.25–$191.25 | 59% below | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OUTPT VISIT LEVEL 3 | $74.00 | $185.00 | $83.25–$157.25 | 49% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT OUTPT VISIT LEVEL 4 | $82.00 | $205.00 | $92.25–$174.25 | 53% below | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OUTPT VISIT LEVEL 2 | $66.00 | $165.00 | $74.25–$140.25 | 42% below | 60% |
| Speech and language evaluation CPT 92523 SPEECH EVAL-REC/EXP 45MIN | $144.00 | $360.00 | $162.00–$306.00 | 68% below | 60% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY W/GRAPHIC RECORD | $54.40 | $136.00 | $61.20–$115.60 | 83% below | 60% |
| Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING | $89.60 | $224.00 | $100.80–$190.40 | 88% below | 60% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $105.20 | $263.00 | $118.35–$223.55 | 65% below | 60% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $170.16 | $425.40 | $191.43–$361.59 | 30% below | 60% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $170.16 | $425.40 | $191.43–$361.59 | 30% below | 60% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $170.16 | $425.40 | — | — | 60% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $170.16 | $425.40 | $191.43–$361.59 | — | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $157.55 | $393.87 | $177.24–$334.79 | 32% below | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $157.55 | $393.87 | $177.24–$334.79 | 32% below | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $157.55 | $393.87 | — | — | 60% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $157.55 | $393.87 | $177.24–$334.79 | — | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA INJECTION | $68.00 | $170.00 | $76.50–$144.50 | 78% below | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA INJECTION | $68.00 | $170.00 | $76.50–$144.50 | 78% below | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX VACCINE (VARICELL | $108.70 | $271.75 | $122.29–$230.99 | 65% below | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX VACCINE (VARICELL | $108.70 | $271.75 | $122.29–$230.99 | 65% below | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA INJECTION | $68.00 | $170.00 | — | — | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA INJECTION | $68.00 | $170.00 | $76.50–$144.50 | — | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX VACCINE (VARICELL | $108.70 | $271.75 | $122.29–$230.99 | — | 60% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX VACCINE (VARICELL | $108.70 | $271.75 | — | — | 60% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $22.13 | $55.32 | $24.89–$47.02 | 34% below | 60% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $22.13 | $55.32 | $24.89–$47.02 | 34% below | 60% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $22.13 | $55.32 | $24.89–$47.02 | — | 60% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $22.13 | $55.32 | — | — | 60% |
| Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE ADULT | $48.00 | $120.00 | $54.00–$102.00 | 66% below | 60% |
| Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE ADULT | $48.00 | $120.00 | $54.00–$102.00 | 66% below | 60% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE ADULT | $48.00 | $120.00 | — | — | 60% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE ADULT | $48.00 | $120.00 | $54.00–$102.00 | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE | $50.30 | $125.75 | $56.59–$106.89 | 41% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE | $50.30 | $125.75 | $56.59–$106.89 | 41% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B (20+YRS) INJECTION | $54.00 | $135.00 | $60.75–$114.75 | 36% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B (20+YRS) INJECTION | $54.00 | $135.00 | $60.75–$114.75 | 36% below | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE | $50.30 | $125.75 | — | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE | $50.30 | $125.75 | $56.59–$106.89 | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B (20+YRS) INJECTION | $54.00 | $135.00 | — | — | 60% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B (20+YRS) INJECTION | $54.00 | $135.00 | $60.75–$114.75 | — | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $78.95 | $197.37 | $88.82–$167.76 | 37% below | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $78.95 | $197.37 | $88.82–$167.76 | 37% below | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV NO PRSV INCREASED AG IM | $78.95 | $197.37 | $88.82–$167.76 | — | 60% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV NO PRSV INCREASED AG IM | $78.95 | $197.37 | — | — | 60% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR INJECTION | $46.00 | $115.00 | $51.75–$97.75 | 61% below | 60% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR INJECTION | $46.00 | $115.00 | $51.75–$97.75 | 61% below | 60% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR INJECTION | $46.00 | $115.00 | — | — | 60% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR INJECTION | $46.00 | $115.00 | $51.75–$97.75 | — | 60% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A/C/Y/W-135 VACC | $69.20 | $173.00 | $77.85–$147.05 | 74% below | 60% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A/C/Y/W-135 VACC | $69.20 | $173.00 | $77.85–$147.05 | 74% below | 60% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A/C/Y/W-135 VACC | $69.20 | $173.00 | — | — | 60% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A/C/Y/W-135 VACC | $69.20 | $173.00 | $77.85–$147.05 | — | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL: PREVNAR | $194.40 | $486.00 | $218.70–$413.10 | 61% below | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL: PREVNAR | $194.40 | $486.00 | $218.70–$413.10 | 61% below | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL: PREVNAR | $194.40 | $486.00 | — | — | 60% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL: PREVNAR | $194.40 | $486.00 | $218.70–$413.10 | — | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $60.00 | $150.00 | $67.50–$127.50 | 63% below | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $60.00 | $150.00 | $67.50–$127.50 | 63% below | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $60.00 | $150.00 | $67.50–$127.50 | — | 60% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $60.00 | $150.00 | — | — | 60% |
| Rabies vaccine, one dose CPT 90675 RAVAVERT (RABIES) VACCINE | $273.00 | $682.50 | $307.13–$580.13 | 61% below | 60% |
| Rabies vaccine, one dose CPT 90675 RAVAVERT (RABIES) VACCINE | $273.00 | $682.50 | $307.13–$580.13 | 61% below | 60% |
| Rabies vaccine, one dose inpatient CPT 90675 RAVAVERT (RABIES) VACCINE | $273.00 | $682.50 | — | — | 60% |
| Rabies vaccine, one dose inpatient CPT 90675 RAVAVERT (RABIES) VACCINE | $273.00 | $682.50 | $307.13–$580.13 | — | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA/TETANUS TOXOID PF | $54.30 | $135.75 | $61.09–$115.39 | 32% below | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA/TETANUS TOXOID PF | $54.30 | $135.75 | $61.09–$115.39 | 32% below | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA/TETANUS TOXOID PF | $54.30 | $135.75 | $61.09–$115.39 | — | 60% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA/TETANUS TOXOID PF | $54.30 | $135.75 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YEARS OR OLDER | $32.00 | $80.00 | $36.00–$68.00 | 62% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YEARS OR OLDER | $32.00 | $80.00 | $36.00–$68.00 | 62% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/PERTUSS(ACELL)/TETANUS | $42.70 | $106.75 | $48.04–$90.74 | 49% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/PERTUSS(ACELL)/TETANUS | $42.70 | $106.75 | $48.04–$90.74 | 49% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 RCH Boostrix | $53.60 | $134.00 | $60.30–$113.90 | 36% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 RCH Boostrix | $53.60 | $134.00 | $60.30–$113.90 | 36% below | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YEARS OR OLDER | $32.00 | $80.00 | $36.00–$68.00 | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YEARS OR OLDER | $32.00 | $80.00 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH/PERTUSS(ACELL)/TETANUS | $42.70 | $106.75 | $48.04–$90.74 | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH/PERTUSS(ACELL)/TETANUS | $42.70 | $106.75 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 RCH Boostrix | $53.60 | $134.00 | — | — | 60% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 RCH Boostrix | $53.60 | $134.00 | $60.30–$113.90 | — | 60% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE | $83.80 | $209.50 | $94.28–$178.08 | 52% below | 60% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE | $83.80 | $209.50 | $94.28–$178.08 | 52% below | 60% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE | $83.80 | $209.50 | $94.28–$178.08 | — | 60% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE | $83.80 | $209.50 | — | — | 60% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $28.80 | $72.00 | $32.40–$61.20 | 71% below | 60% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACC | $40.00 | $100.00 | $45.00–$85.00 | 60% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 2ND DOSE IMMUN ADMIN VACC | $8.00 | $20.00 | $9.00–$17.00 | 88% below | 60% |
Dental
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant one side CDT D4341 SCALING & RT PLANING >4 TTH/QD | $55.20 | $138.00 | $62.10–$117.30 | 93% below | 60% |
| Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 IMPACTED TOOTH REMOVAL - BONY | $100.00 | $250.00 | $112.50–$212.50 | 98% below | 60% |
| Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 PROPHYLAXIS - ADULT | $80.00 | $200.00 | $90.00–$170.00 | 17% below | 60% |
Source file: https://mountains.pt.panaceainc.com/MRFDownload/mountains/mountainscommunityhospital