Hospital Los Angeles-Long Beach-Anaheim, CA

San Dimas Community Hospital

San Dimas Community Hospital in San Dimas, CA publishes cash prices for 293 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 259 of 289 procedures and above it for 15. By typical cash price it ranks #21 of 168 California hospitals and #9 of 49 hospitals in the Los Angeles, CA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1350 West Covina Boulevard San Dimas, CA 91773 Collected Sep 27, 2026 Source price file (909) 599-6811

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 050588 · 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 1 action for a hospital named San Dimas Community Hospital in San Dimas, CA:

  • Jul 21, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

ProcedureCash price List priceInsurers payvs CaliforniaOff list
Ankle X-ray, complete, 3 or more views CPT 73610 Hc X-Ray Ankle 3+ Vw $111.00 $948.44 $26.32–$948.44 73% below 88%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Hc Non-Inv Physiologic Std Extrem Art 1-2 Lvl, Lmt $170.00 $1,395.75 $50.82–$1,395.75 70% below 88%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Hc Esophagram $224.00 $1,376.34 $40.98–$1,376.34 58% below 84%
Bone scan, whole body (nuclear medicine) CPT 78306 Hc Nm Bone Imaging, Whole Body $511.00 $3,378.00 $171.95–$3,378.00 76% below 85%
Breast ultrasound, complete, one breast one side CPT 76641 Hc Us, Breast Unilat Complete $133.00 $2,117.50 $65.44–$2,117.50 76% below 94%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Hc Ultrasound Breast Unilat Limited $111.00 $856.00 $49.43–$856.00 73% below 87%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Hc Ct Angio, Chest, Combo, Incl Image Proc $224.00 $6,227.38 $192.35–$6,227.38 93% below 96%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Hc Ct Scan Abdomen/Pelvis Wo Contrast $305.00 $7,926.11 $101.10–$7,926.11 89% below 96%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Scan Abdomen/Pelvis W Contrast $446.00 $9,567.25 $202.90–$9,567.25 89% below 95%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Hc Ct Scan Abdomen/Pelvis Combo $446.00 $10,297.50 $233.05–$10,297.50 90% below 96%
CT scan of the abdomen with contrast CPT 74160 Hc Ct Scan Of Abdomen Contrast $224.00 $5,759.30 $213.26–$5,759.30 90% below 96%
CT scan of the abdomen without contrast CPT 74150 Hc Ct Scan,Abdomen,W/O Contrast $133.00 $6,743.00 $116.66–$6,743.00 93% below 98%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Ct Scan,Maxillofacial Area,W/O Contrast $133.00 $6,183.38 $125.62–$6,183.38 94% below 98%
CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Scan,Head/Brain,W/O Contrast Matl $133.00 $6,964.38 $94.42–$6,964.38 94% below 98%
CT scan of the head with contrast CPT 70460 Hc Ct Scan Head Contrast $224.00 $3,855.50 $137.27–$3,855.50 92% below 94%
CT scan of the head without and with contrast CPT 70470 Hc Ct Scan Head Combo $224.00 $5,598.75 $163.90–$5,598.75 92% below 96%
CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Scan Of Pelvis Contrast $224.00 $4,823.75 $213.26–$4,823.75 91% below 95%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Hc Duplex Scan Extracranial,Bilat $305.00 $2,928.75 $168.51–$2,928.75 — 90%
Chest X-ray, 2 views CPT 71046 Hc Chest X-Ray 2 Vw $111.00 $1,036.75 $18.13–$1,036.75 71% below 89%
Chest X-ray, single view CPT 71045 Hc Chest X-Ray 1 Vw $111.00 $745.25 $9.71–$745.25 67% below 85%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Hc Us,Retroperit, B-Scan/Real Time,Complete $133.00 $2,103.49 $79.89–$2,103.49 84% below 94%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Hc Diagnostic Computed Tomography Thorax W/O Cntrst $133.00 $6,179.25 $127.11–$6,179.25 93% below 98%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Hc Diagnostic Computed Tomography Thorax W/Contrast $224.00 $5,910.70 $170.83–$5,910.70 90% below 96%
Diagnostic mammogram, both breasts both sides CPT 77066 Hc Mammography; Bilateral $130.00 $1,060.00 $108.06–$1,060.00 — 88%
Diagnostic mammogram, one breast one side CPT 77065 Hc Mammography; Unilateral $101.00 $844.90 $84.30–$844.90 71% below 88%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Hc Duplex Lo Extrem Art Bilat $305.00 $2,905.09 $104.21–$2,905.09 — 90%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Hc Duplex Extrem Venous,Bilat $305.00 $3,356.38 $173.75–$3,356.38 — 91%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Hc Echo Heart Xthoracic,Complete W Doppler $699.00 $4,329.67 $177.42–$4,329.67 71% below 84%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hc Nm Hepatobiliary Syst Imaging Including Gallbladdr $511.00 $3,725.56 $261.91–$3,725.56 67% below 86%
Knee X-ray, 3 views CPT 73562 Hc X-Ray Knee 3 View $111.00 $1,113.75 $25.15–$1,113.75 73% below 90%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hc Us, Abdomen Limited $133.00 $2,051.09 $60.12–$2,051.09 84% below 94%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Hc Computed Tomography Thorax Lw Dose Lng Ca Scr C- $133.00 $531.70 $86.98–$531.70 67% below 75%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Lower Extrem Jt, W/O Contrast $305.00 $6,378.75 $206.20–$6,378.75 88% below 95%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Joint Of Leg. Combo $446.00 $3,491.88 $300.20–$3,491.88 88% below 87%
MRI of the abdomen without contrast CPT 74181 Hc Mri Abdomen Wo Contrast $305.00 $5,095.00 $216.39–$5,095.00 88% below 94%
MRI of the abdomen, without and then with contrast dye CPT 74183 Hc Mri Abdomen Wo/W Contrast $446.00 $6,358.26 $263.48–$6,358.26 90% below 93%
MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain $305.00 $5,922.50 $188.21–$5,922.50 88% below 95%
MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Combo $446.00 $8,453.75 $316.79–$8,453.75 88% below 95%
MRI of the lower back, no contrast dye CPT 72148 Hc Mri, Lumbar Spine $305.00 $6,378.75 $181.42–$6,378.75 88% below 95%
MRI of the lower back, without and then with contrast dye CPT 72158 Hc Mri, Lumbar Spine Combo $446.00 $8,359.59 $318.04–$8,359.59 89% below 95%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Hc Mri, Dorsal Spine $305.00 $6,197.50 $183.45–$6,197.50 87% below 95%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Hc Mri, Cerv Spine Combo $446.00 $6,821.37 $319.01–$6,821.37 89% below 93%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Hc Mri, Cerv Spine $305.00 $6,197.50 $181.08–$6,197.50 88% below 95%
MRI of the pelvis without and with contrast CPT 72197 Hc Mri, Pelvis, Combo $446.00 $8,270.40 $263.00–$8,270.40 87% below 95%
MRI of the pelvis, no contrast dye CPT 72195 Hc Mri, Pelvis, W/O Contrast $305.00 $4,611.95 $185.60–$4,611.95 86% below 93%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Hc Mri Joint Upper Extrem Wo Contrast $305.00 $6,378.75 $206.55–$6,378.75 88% below 95%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Hc Nm Myocardial Spect Multiple Studies $1,656.00 $10,855.60 $295.90–$10,855.60 55% below 85%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hc Us Pelvis Nonobst Limited/Fu $133.00 $2,051.09 $30.24–$2,051.09 74% below 94%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Hc Ultrasound,Pelvic (Nonobstetric) $133.00 $2,142.15 $67.93–$2,142.15 86% below 94%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Us, Ob >/= 14 Wks, Sngl Fetus $133.00 $1,479.00 $90.65–$1,479.00 82% below 91%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Hc Us, Ob < 14 Wks, Single Fetus $133.00 $1,235.00 $47.84–$1,235.00 81% below 89%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Hc Us,Pregnant Uterus,Limited, 1/> Fetuses $133.00 $984.00 $56.89–$984.00 74% below 86%
Screening mammogram, both breasts CPT 77067 Hc Mammogram, Screening $107.00 $589.51 $73.10–$589.51 59% below 82%
Shoulder X-ray, complete, 2 or more views CPT 73030 Hc X-Ray Shoulder 2+ Vw $111.00 $1,068.38 $25.59–$1,068.38 78% below 90%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Hc Swallowing Fcn,W/Cine &/Or Video $224.00 $1,984.13 $59.57–$1,984.13 61% below 89%
Transvaginal pelvic ultrasound CPT 76830 Hc Ultrasound,Transvaginal $133.00 $1,535.00 $70.84–$1,535.00 76% below 91%
Transvaginal ultrasound during pregnancy CPT 76817 Hc Us,Pregnant Uterus,Transvaginal $133.00 $1,173.21 $51.77–$1,173.21 77% below 89%
Ultrasound of the abdomen, complete CPT 76700 Hc Us, Abdom,B-Scan &/Or Real Time,Complete $133.00 $2,556.13 $82.35–$2,556.13 87% below 95%
Ultrasound of the scrotum and testicles CPT 76870 Hc Ultrasound,Scrotum & Contents $133.00 $1,599.75 $47.16–$1,599.75 85% below 92%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Hc Us, Head/Neck Tissues,Real Time $133.00 $1,690.39 $65.98–$1,690.39 84% below 92%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Hc Xray Upper Gi Tract $224.00 $1,722.50 $103.91–$1,722.50 63% below 87%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hc Duplex Extrem Venous,Uni Or Ltd $133.00 $2,302.48 $101.89–$2,302.48 84% below 94%
Wrist X-ray, complete, 3 or more views CPT 73110 Hc X-Ray Wrist 3+ Vw $111.00 $1,123.53 $27.41–$1,123.53 74% below 90%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hc Xray Hip W Pelvis, Unilat 2-3 Vw $111.00 $934.02 $27.59–$934.02 71% below 88%
X-ray of the abdomen, 1 view CPT 74018 Hc Radiologic Exam Abdomen 1 View $111.00 $771.31 $16.73–$771.31 63% below 86%
X-ray of the ankle, 2 views CPT 73600 Hc X-Ray Ankle 2 Vw $111.00 $799.59 $19.92–$799.59 63% below 86%
X-ray of the finger(s), 2 or more views CPT 73140 Hc X-Ray Exam Of Finger(S) $111.00 $782.86 $17.67–$782.86 58% below 86%
X-ray of the foot, 2 views CPT 73620 Hc X-Ray Foot 2 Vw $111.00 $832.50 $17.87–$832.50 63% below 87%
X-ray of the foot, complete, 3 or more views CPT 73630 Hc X-Ray Foot 3+ Vw $111.00 $1,914.38 $25.01–$1,914.38 72% below 94%
X-ray of the hand, 3 or more views CPT 73130 Hc X-Ray Hand 3+ Vw $111.00 $1,092.15 $26.32–$1,092.15 74% below 90%
X-ray of the knee, 1 or 2 views CPT 73560 Hc X-Ray Knee 1 Or 2 View $111.00 $838.24 $20.19–$838.24 67% below 87%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hc X-Ray Lumbar Spine 2/3 Vw $133.00 $1,105.02 $29.98–$1,105.02 71% below 88%
X-ray of the lower back, 4 or more views CPT 72110 Hc X-Ray Lumbar Spine 4 Vw $133.00 $1,398.75 $43.40–$1,398.75 77% below 90%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Hc X-Ray Thoracic Spine 2 Vw $133.00 $615.01 $27.35–$615.01 63% below 78%
X-ray of the nasal bones, 3 or more views CPT 70160 Hc X-Ray Nasal Bones $111.00 $821.25 $26.31–$821.25 71% below 86%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Hc Radex Spine Cervical 2 Or 3 Views $111.00 $983.90 $24.97–$983.90 74% below 89%
X-ray of the pelvis, 1 or 2 views CPT 72170 Hc X-Ray Pelvis 1/2 Vw $133.00 $917.13 $22.95–$917.13 63% below 85%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Hc X-Ray Sacrum/Coccyx 2+ Vw $111.00 $926.75 $25.12–$926.75 74% below 88%

Lab tests

ProcedureCash price List priceInsurers payvs CaliforniaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Hc Transferase Alanine Amino (Alt) (Sgpt) $5.00 $201.25 $5.04–$201.25 88% below 98%
AST (aspartate aminotransferase) enzyme test CPT 84450 Hc Transferase Aspartate Amino (Ast) (Sgot) $5.00 $149.00 $4.92–$149.00 89% below 97%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hc Hepatitis Panel,Acute $47.00 $994.68 $40.00–$994.68 81% below 95%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Allergen Spec Ige Quant,Each $5.00 $74.59 $4.96–$74.59 40% below 93%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Hc Cyclic Cirullinated Peptide Antibody $12.00 $101.51 $5.68–$101.51 41% below 88%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Hc Antinuclear Antibodies $12.00 $178.00 $11.49–$178.00 66% below 93%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc Natriuretic Peptide $39.00 $590.84 $24.12–$590.84 78% below 93%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Surg Path,Level Iv $66.00 $757.23 $11.76–$757.23 57% below 91%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Collection Venous Blood,Venipuncture - 36415 - 30000001 $9.00 $67.62 $1.08–$67.62 63% below 87%
Blood lead test CPT 83655 Hc Assay Of Lead $12.00 $88.35 $11.50–$88.35 16% below 86%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Blood Typing, Abo $170.00 $923.78 $2.73–$923.78 121% above 82%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Arc Blood Typing, Abo $170.00 $839.80 $2.73–$923.78 121% above 80%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Hc C-Reactive Protein $5.00 $216.50 $4.92–$216.50 89% below 98%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc Cytomed, Dna, Amp Probe $37.00 $447.95 $22.91–$447.95 76% below 92%
CA 19-9 blood test (tumor marker) CPT 86301 Hc Immunoassay, Tumor Antigen, Ca 19-9 $20.00 $250.00 $14.80–$250.00 60% below 92%
CA-125 blood test (ovarian cancer marker) CPT 86304 Hc Immunoassay, Tumor Antigen, Ca 125 $20.00 $489.38 $14.80–$489.38 79% below 96%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Sars-Cov-2 Covid-19 Amp Prb $51.00 $256.55 $48.74–$256.55 27% below 80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Chylmd Trach, Dna, Amp Probe $35.00 $356.06 $29.37–$356.06 36% below 90%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel $13.00 $827.75 $12.72–$827.75 87% below 98%
Complete blood count (CBC) with differential CPT 85025 Hc Complete Cbc & Auto Diff Wbc $7.00 $301.13 $7.38–$301.13 94% below 98%
Complete blood count (CBC), no differential CPT 85027 Hc Complete Cbc $6.00 $158.35 $6.15–$158.35 92% below 96%
D-dimer blood test (blood clot marker) CPT 85379 Hc Fibrin Degradproducts,D-Dimer, Quant $10.00 $397.19 $9.67–$397.19 92% below 97%
DHEA sulfate (DHEA-S) blood test CPT 82627 Hc Dehydroepiandrosterone-Sulfate $22.00 $181.62 $21.12–$181.62 71% below 88%
Estradiol blood test CPT 82670 Hc Assay Of Total Estradiol $27.00 $295.00 $26.54–$295.00 57% below 91%
FSH (follicle-stimulating hormone) test CPT 83001 Hc Gonadotropin (Fsh) $18.00 $367.61 $17.65–$367.61 80% below 95%
Fecal calprotectin (stool inflammation test) CPT 83993 Hc Assay For Calprotectin Fecal $19.00 $366.28 $13.96–$366.28 74% below 95%
Ferritin blood test (iron stores) CPT 82728 Hc Assay Of Ferritin $13.00 $365.75 $12.95–$365.75 84% below 96%
Folate (folic acid) blood test CPT 82746 Hc Blood Folic Acid Serum $14.00 $350.63 $13.97–$350.63 84% below 96%
Free T3 thyroid hormone test CPT 84481 Hc Triiodothyronine Free Assay (Ft-3) $16.00 $137.92 $13.69–$137.92 75% below 88%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Hc Assay Of Free Thyroxine $9.00 $341.48 $8.57–$341.48 87% below 97%
Free testosterone test CPT 84402 Hc Assay Of Testosterone $25.00 $234.75 $24.20–$234.75 40% below 89%
Glucose tolerance test, 3 samples CPT 82951 Hc Glucose Tolerance Test (Gtt) $12.00 $615.00 $12.23–$615.00 90% below 98%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc N.Gonorrhoeae, Dna, Amp Prob $35.00 $267.46 $29.10–$267.46 34% below 87%
H. pylori antibody blood test CPT 86677 Hc Helicobacter Pylori $16.00 $388.56 $14.86–$388.56 86% below 96%
H. pylori stool antigen test CPT 87338 Hc Hpylori Stool Eia $14.00 $165.25 $10.23–$165.25 81% below 92%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hc Iadna Hiv-1 Quant & Reverse Transcription $85.00 $652.00 $80.85–$652.00 at median 87%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Hiv-1/Hiv-2, Single Assay $13.00 $347.50 $13.02–$347.50 69% below 96%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab $24.00 $120.40 $16.21–$120.40 60% below 80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hc Glycosylated Hemoglobin Test $9.00 $215.88 $9.22–$215.88 86% below 96%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hc Hepatitis B Surface Ab Test $10.00 $269.90 $10.20–$269.90 74% below 96%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hc Hepatitis B Surface Ag, Eia $10.00 $296.89 $9.81–$296.89 84% below 97%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Hep C Antibody, High Risk - 86803 - 30200256 $14.00 $324.44 $13.56–$328.63 73% below 96%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Hepatitis C Ab Test $14.00 $328.63 $13.56–$328.63 73% below 96%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hc Iadna Hepatitis C Quant & Reverse Transcription $42.00 $551.93 $36.16–$551.93 46% below 92%
Herpes blood test, HSV-1 antibody CPT 86695 Hc Herpes Simplex Test, Type 1 $13.00 $120.31 $12.53–$120.31 31% below 89%
Herpes blood test, HSV-2 antibody CPT 86696 Hc Herpes Simplex Test, Type 2 $19.00 $227.50 $13.76–$227.50 29% below 92%
High-sensitivity CRP (hs-CRP) test CPT 86141 Hc C-Reactive Protein,High Sensitivity $12.00 $173.20 $8.85–$173.20 74% below 93%
Homocysteine blood test CPT 83090 Hc Assay Of Homocystine $17.00 $171.01 $11.99–$171.01 59% below 90%
Insulin blood test CPT 83525 Hc Assay Of Insulin,Total $11.00 $152.00 $9.18–$152.00 67% below 93%
Iron blood test (serum iron) CPT 83540 Hc Assay Of Iron $6.00 $228.17 $6.15–$228.17 86% below 97%
Iron-binding capacity (TIBC) test CPT 83550 Hc Iron Binding Test $8.00 $259.88 $7.91–$259.88 86% below 97%
LH (luteinizing hormone) test CPT 83002 Hc Gonadotropin (Lh) $18.00 $364.68 $17.59–$364.68 77% below 95%
Lipase blood test (pancreas enzyme) CPT 83690 Hc Assay Of Lipase $6.00 $338.73 $6.55–$338.73 92% below 98%
Lyme disease antibody test CPT 86618 Hc Lyme Disease Antibody $17.00 $196.38 $16.18–$196.38 29% below 91%
Magnesium blood test CPT 83735 Hc Assay Of Magnesium $6.00 $248.35 $6.37–$248.35 90% below 98%
Measles (rubeola) antibody test CPT 86765 Hc Rubeola $12.00 $157.21 $12.24–$157.21 43% below 92%
PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Prostate Specific Antigen,Free $18.00 $190.16 $14.77–$190.16 48% below 91%
PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Assay Of Prostate Specific Antigen Total - 84153 - 30100312 $18.00 $251.59 $17.47–$251.59 62% below 93%
Parathyroid hormone (PTH) blood test CPT 83970 Hc Assay Of Parathormone $41.00 $422.40 $39.22–$422.40 60% below 90%
Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial $6.00 $249.12 $5.71–$249.12 84% below 98%
Progesterone blood test CPT 84144 Hc Assay Of Progesterone $20.00 $363.47 $19.82–$363.47 64% below 94%
Prolactin blood test CPT 84146 Hc Assay Of Prolactin $19.00 $398.76 $18.41–$398.76 79% below 95%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time $4.00 $181.98 $4.00–$181.98 92% below 98%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Hc Drug Screen Prsmv Qual Dir Optical Obs Per Day $12.00 $306.08 $10.08–$306.08 86% below 96%
Rapid flu test (influenza antigen) CPT 87804 Hc Detect Agent,Immun,Dir Obs,Influenza $16.00 $285.31 $7.08–$285.31 79% below 94%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Hc Strep A Assay W/Optic $16.00 $82.65 $8.02–$82.65 85% below 81%
Rheumatoid factor (RF) test CPT 86431 Hc Rheumatoid Factor, Quant $5.00 $149.59 $5.39–$149.59 62% below 97%
Rubella antibody test (immunity check) CPT 86762 Hc Rubella $14.00 $280.00 $13.67–$280.00 65% below 95%
Stool ova and parasites exam CPT 87177 Hc Ova And Parasites Smears $8.00 $270.71 $8.24–$270.71 55% below 97%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hc Occult Blood Stool $4.00 $83.00 $3.35–$83.00 90% below 95%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Syphilis Test Non Treponemal Antibody Qual $4.00 $138.75 $3.65–$138.75 73% below 97%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Hc Tb Test, Cell Mdiatd Antgen Resps Gamma Intfron $61.00 $586.25 $34.71–$586.25 14% below 90%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Assay Of Total Testosterone $25.00 $254.00 $24.52–$254.00 38% below 90%
Thyroid peroxidase (TPO) antibody test CPT 86376 Hc Microsomal Antibody $14.00 $211.25 $13.82–$211.25 39% below 93%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Assay Thyroid Stim Hormone $16.00 $434.50 $15.96–$434.50 81% below 96%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amplif $35.00 $175.45 $30.54–$175.45 60% below 80%
Urinalysis with microscope exam, manual CPT 81000 Hc Urinalysis, Nonauto, W/Scope $4.00 $69.26 $2.96–$69.26 91% below 94%
Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis Nonauto W/O Scope $3.00 $81.03 $2.47–$81.03 89% below 96%
Urine culture for bacteria, with colony count CPT 87086 Hc Urine Culture, Colony Count $8.00 $522.50 $6.48–$522.50 94% below 98%
Urine pregnancy test, read by color change CPT 81025 Hc Urine Pregnancy Test $8.00 $258.75 $4.02–$258.75 91% below 97%
Vitamin B12 (cobalamin) blood test CPT 82607 Hc Vitamin B-12 $15.00 $380.88 $14.33–$380.88 76% below 96%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Hc Assay Vit D, 25-Hydroxy W Fractions $29.00 $212.30 $23.78–$212.30 55% below 86%
Zinc blood test CPT 84630 Hc Assay Of Zinc $11.00 $205.00 $10.82–$205.00 21% below 95%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Chorionic Gonadotropin, Quant $15.00 $486.58 $14.30–$486.58 89% below 97%

Surgery and procedures

ProcedureCash price List priceInsurers payvs CaliforniaOff list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Removal Of Adenoids - 42830 - OR36042830 $4,243.00 $11,700.00 $169.29–$11,700.00 45% below 64%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Knee Arthroscopy/Surgery - 29888 - OR36029888 $9,286.00 $22,766.70 $967.66–$22,766.70 at median 59%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Sho arthrs srg rt8tr cuf rpr $9,286.00 $20,713.20 $494.04–$20,713.21 47% above 55%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NSLSINS NDSC SURG MAX SINS $9,032.00 $7,583.34 $149.29–$7,583.34 59% above -19%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Cor Hlx Vlgs Dstl Mtar Osteo $4,187.00 $19,062.50 $574.61–$19,062.50 at median 78%
Bunion correction with removal of part of the big toe joint CPT 28292 Cor hlx vlgs rsc prx phlx bs $4,187.00 $5,585.93 $423.48–$5,585.93 at median 25%
Cardiac catheterization with coronary angiogram CPT 93458 Hc Cath Plc/Cor Angio Rs/I W L Hrt Ventriculogrphy $4,149.00 $18,228.50 $693.51–$18,228.50 68% below 77%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Cardioversion, Elective;Extern $845.00 $3,875.63 $175.66–$3,875.63 53% below 78%
Carpal tunnel release, open surgery CPT 64721 Carpal Tunnel Surgery $2,499.00 $9,400.00 $454.46–$9,400.00 31% below 73%
Catheter ablation for atrial fibrillation CPT 93656 Hc Ephys Evl Trnsptl Tx Atril Fib Isolat Pulm Vein $33,452.00 $127,852.00 $880.47–$127,852.00 10% above 74%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX $1,178.00 $4,700.00 $58.15–$4,700.00 40% below 75%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circum 28 Days Or Older $2,675.00 $11,883.30 $181.57–$11,883.30 27% below 77%
Colonoscopy with polyp removal CPT 45385 Hc Colonoscopy,Remv Lesn,Snare $1,531.00 $8,495.31 $574.08–$8,495.31 33% below 82%
Colonoscopy with polyp removal CPT 45385 Colonoscopy W/Lesion Removal $1,531.00 $8,415.40 $574.08–$8,495.31 33% below 82%
Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy,Biopsy $1,531.00 $7,723.01 $473.68–$9,270.80 26% below 80%
Colonoscopy with tissue sample CPT 45380 Colonoscopy And Biopsy $1,531.00 $9,270.80 $473.68–$9,270.80 26% below 83%
Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy,Diagnostic $1,190.00 $5,910.28 $423.48–$8,523.70 43% below 80%
Colonoscopy, diagnostic CPT 45378 Hc Colorectal Cancer Screen, Colonoscopy High Risk - 45378 - 75000068 $1,190.00 $5,442.56 $423.48–$8,523.70 43% below 78%
Colonoscopy, diagnostic CPT 45378 Diagnostic Colonoscopy $1,190.00 $8,523.70 $423.48–$8,523.70 43% below 86%
Colonoscopy, diagnostic CPT 45378 Hc Colorectal Cancer Scrn, Colonoscopy Not High Risk - 45378 - 75000071 $1,190.00 $6,501.30 $423.48–$8,523.70 43% below 82%
Coronary stent placement, one artery CPT 92928 Hc Perc Drug-El Cor Stent Sing - 92928 - 48100192 $14,775.00 $59,846.40 $483.05–$59,846.40 at median 75%
Cystoscopy with ureteral stent placement CPT 52332 Cystoscopy And Treatment - 52332 - OR36052332 $4,511.00 $14,533.30 $789.82–$14,533.30 21% below 69%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY $892.00 $27,500.00 $124.43–$27,500.00 45% below 97%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation And Curettage $4,143.00 $9,400.00 $319.80–$9,400.00 2% below 56%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Create Eardrum Opening $1,985.00 $9,792.63 $173.03–$9,792.63 60% below 80%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Hc Remove Impacted Ear Wax Uni $75.00 $342.17 $11.54–$342.17 58% below 78%
Earwax removal with instruments, one ear one side CPT 69210 Hc Removal Impacted Cerumen Instrumentation Unilat $75.00 $414.59 $43.79–$414.59 57% below 82%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASALSINUS ENDOSCOPY SURGICAL $9,032.00 $6,533.15 $514.26–$6,533.15 9% below -38%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSLSINS NDSC FRNT TISS RMVL $9,032.00 $4,128.18 $484.37–$4,128.18 9% below -119%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS $4,771.00 $5,835.98 $242.99–$5,835.98 28% below 18%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS $9,032.00 $5,798.77 $372.21–$5,798.77 9% below -56%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Interlaminar Crv/Thrc $903.00 $9,382.39 $223.38–$9,382.39 53% below 90%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Hc Inj Dx/Thr Paravrt Facet Jnt Img Lumb/Sac 1St Lvl $1,132.00 $4,342.25 $144.45–$9,400.00 45% below 74%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1 Lev $1,132.00 $9,400.00 $144.45–$9,400.00 45% below 88%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hrn 1St 3-10 Rdc $8,285.00 $36,504.20 $463.51–$36,504.20 11% above 77%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 Rpr Aa Hrn 1St > 10 Rdc $8,285.00 $39,000.00 $622.86–$39,000.00 11% above 79%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hrn 1St < 3 Cm Rdc $4,582.00 $22,833.30 $277.74–$22,833.30 at median 80%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Hc Colorectal Cancer Screen, Flex Sigmoidscope - 45330 - 75000067 $1,190.00 $5,910.28 $78.50–$5,910.28 33% below 80%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Hc Sigmoidoscopy,Diagnostic $1,190.00 $4,558.55 $78.50–$5,910.28 33% below 74%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopic Cholecystectomy $7,737.00 $19,706.30 $668.60–$19,706.30 41% below 61%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laparo Cholecystectomy/Graph $7,737.00 $19,586.00 $769.53–$19,586.00 7% below 60%
Hammertoe correction surgery CPT 28285 Repair Of Hammertoe $4,187.00 $12,500.00 $290.51–$12,500.00 at median 67%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hc Hemorrhoidectomy Intern Rubber Band Ligations $1,190.00 $4,172.94 $110.55–$4,172.94 36% below 71%
Hemorrhoidectomy (internal and external), one area CPT 46255 Remove intext hem 1 group $3,552.00 $8,200.00 $423.48–$8,200.00 22% below 57%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY - 27132 - $16,431.00 $13,750.00 $1,705.00–$13,750.00 208% above -19%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Ablation $6,402.00 $9,112.59 $2,438.45–$9,112.59 at median 30%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy Biopsy $4,143.00 $9,633.79 $251.48–$9,633.79 42% below 57%
Incision and drainage of a simple or single skin abscess CPT 10060 Hc Incision & Drain Skin Abscess Simple $256.00 $1,337.44 $60.88–$1,337.44 45% below 81%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp I/Hern Init Reduc >5 Yr $4,582.00 $22,204.50 $493.45–$22,204.50 35% below 79%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Asp/Drain Large Joint/Bursa $392.00 $1,945.83 $65.68–$9,124.66 46% below 80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inj Joint/Bursa W/O Us $392.00 $9,124.66 $65.68–$9,124.66 46% below 96%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Drain/Inject Intermediate Joint/Bursa $392.00 $1,656.85 $54.46–$1,656.85 31% below 76%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Drain/Inject Small Joint/Bursa $392.00 $994.11 $46.46–$994.11 37% below 61%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Knee Arthroscopy/Surgery - 29882 - OR36029882 $4,187.00 $15,000.00 $801.04–$15,000.00 at median 72%
Knee arthroscopy with meniscus trim CPT 29881 Knee Arthroscopy/Surgery - 29881 - OR36029881 $4,187.00 $15,225.00 $790.35–$15,225.00 19% below 72%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Knee Arthroscopy/Surgery - 29880 - OR36029880 $4,187.00 $16,250.00 $790.35–$16,250.00 at median 74%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopy Appendectomy $7,737.00 $15,930.00 $391.98–$15,930.00 3% below 51%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH WTO 250 G OR LESS $13,604.00 $13,750.00 $748.40–$13,750.00 24% above 1%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap Ing Hernia Repair Init $7,737.00 $33,437.50 $379.70–$33,437.50 51% below 77%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Lap Ing Hernia Repair Recur $7,737.00 $39,000.00 $463.00–$39,000.00 37% above 80%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy Remove Adnexa $7,737.00 $20,215.90 $701.38–$20,215.90 12% below 62%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hc Repr Wnd Intrmd Body/Scalp/Extr <2.5 Cm $520.00 $2,059.37 $121.22–$2,059.37 40% below 75%
Left heart catheterization, diagnostic one side CPT 93452 Hc Left Heart Cath Inj Vetriculography, Rs/I $4,149.00 $14,792.30 $549.26–$14,792.30 58% below 72%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac $903.00 $9,111.54 $220.03–$9,111.54 46% below 90%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrm Epi L/S 1 $1,132.00 $9,333.60 $205.61–$9,333.60 42% below 88%
Lumpectomy (partial mastectomy) CPT 19301 Partial Mastectomy $5,011.00 $14,060.90 $333.58–$14,060.90 25% below 64%
Mastectomy (total removal of the breast) CPT 19303 Mast Simple Complete $8,498.00 $31,250.00 $762.84–$31,250.00 at median 73%
Miscarriage treatment with D&C, first trimester CPT 59820 Care Of Miscarriage $4,143.00 $8,051.33 $241.91–$8,051.33 8% below 49%
Nail removal (partial or complete), one nail CPT 11730 Hc Removal Of Nail Plate $256.00 $1,337.44 $45.93–$1,337.44 43% below 81%
Occipital nerve block (injection for headaches) CPT 64405 Hc Inj Nerv Blck, Greater Occipital $392.00 $1,475.95 $90.25–$1,475.95 53% below 73%
Pacemaker implant (dual chamber) CPT 33208 Hc Insert Art & Ventr Pm W Transvenous Electrod $13,377.00 $77,439.30 $1,068.05–$77,439.30 8% below 83%
Paracentesis with imaging guidance CPT 49083 Hc Abdom Paracentesis Dx/Ther W Imaging Guidance $1,160.00 $6,232.50 $89.72–$6,232.50 35% below 81%
Partial knee replacement (one compartment) CPT 27446 Revision Of Knee Joint $16,431.00 $40,125.00 $5,478.00–$40,125.00 18% below 59%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hc Removal Of Nail Bed $520.00 $2,230.59 $121.22–$2,230.59 58% below 77%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destroy lumbsac facet jnt $2,499.00 $8,111.20 $195.46–$8,111.20 24% below 69%
Removal of a breast lump, open surgery CPT 19120 Removal Of Breast Lesion $5,011.00 $10,166.70 $302.26–$10,166.70 at median 51%
Removal of a foreign object under the skin, simple CPT 10120 Inc&Rmvl Fb Subq Tiss Smpl $520.00 $9,400.00 $74.23–$9,400.00 31% below 94%
Removal of a foreign object under the skin, simple CPT 10120 Hc Remove Foreign Body Simple $520.00 $2,059.37 $74.23–$9,400.00 31% below 75%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 Partial Removal Of Thyroid $7,737.00 $43,566.00 $794.63–$43,566.00 13% above 82%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Hc Colorectal Cancer Scrn, Colonoscopy Not High Risk - G0121 - 75000071 $1,190.00 $6,501.30 $968.65–$6,501.30 30% below 82%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Hc Colorectal Cancer Screen, Colonoscopy High Risk - G0105 - 75000068 $1,190.00 $5,442.56 $968.65–$5,442.56 34% below 78%
Septoplasty to straighten the nasal septum CPT 30520 Repair Of Nasal Septum $4,243.00 $39,000.00 $534.03–$39,000.00 14% below 89%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Fragmenting Of Kidney Stone $4,511.00 $14,389.40 $961.25–$14,389.40 31% below 69%
Short arm splint (forearm and hand) CPT 29125 Hc Apply Forearm Splint Static $170.00 $923.78 $75.84–$923.78 58% below 82%
Short leg splint (calf to foot) CPT 29515 Hc Apply Lower Leg Splint $207.00 $1,052.19 $81.17–$1,052.19 58% below 80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Hc Repr Wnd Smp Body/Scalp/Extr <2.5 Cm $256.00 $1,471.18 $100.39–$1,471.18 42% below 83%
Skin tag removal, up to 15 tags CPT 11200 Hc Removal Of Skin Tags, Up To 15 $256.00 $1,069.95 $45.40–$1,069.95 34% below 76%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Hc Spinal Puncture,Lumbar,Diagnostic $903.00 $3,868.53 $117.49–$3,868.53 26% below 77%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Hc Repr Wnd Smp Body/Scalp/Extr 2.6-7.5 Cm $256.00 $1,337.44 $106.81–$1,337.44 62% below 81%
TURP (transurethral resection of the prostate) CPT 52601 Prostatectomy (Turp) $6,862.00 $18,945.80 $1,068.05–$18,945.80 36% below 64%
Thoracentesis with imaging guidance CPT 32555 Hc Thoracentesis Ndl/Cath Pleura Asp W Imag $802.00 $4,298.04 $92.33–$4,298.04 61% below 81%
Tonsil and adenoid removal, age 12 or older CPT 42821 Remove Tonsils And Adenoids - 42821 - OR36042821 $4,243.00 $13,443.80 $290.51–$13,443.80 at median 68%
Tonsil and adenoid removal, child under 12 CPT 42820 Remove Tonsils And Adenoids - 42820 - OR36042820 $7,576.00 $13,895.90 $241.91–$13,895.90 12% above 45%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Removal Of Tonsils - 42826 - OR36042826 $4,243.00 $12,305.70 $290.51–$12,305.70 14% below 66%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Removal Of Tonsils - 42825 - OR36042825 $7,576.00 $9,400.00 $241.91–$9,400.00 at median 19%
Total hip replacement CPT 27130 Total Hip Arthroplasty - 27130 - OR36027130 $16,431.00 $39,738.90 $2,136.11–$39,738.90 79% above 59%
Total knee replacement CPT 27447 Total Knee Arthroplasty $16,431.00 $35,096.30 $2,136.11–$35,096.30 36% below 53%
Total shoulder replacement CPT 23472 Reconstruct Shoulder Joint $22,440.00 $35,625.00 $4,132.00–$35,625.00 98% above 37%
Total thyroid removal (thyroidectomy) CPT 60240 Removal Of Thyroid $7,737.00 $51,559.20 $967.66–$51,559.20 77% below 85%
Trigger finger release surgery CPT 26055 Incise finger tendon sheath $2,058.00 $3,714.28 $302.26–$3,714.28 33% below 45%
Trigger point injections, 1 or 2 muscles CPT 20552 Hc Inject Trigger Point1-2 Muscle $392.00 $1,945.83 $52.49–$1,945.83 37% below 80%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Laparoscopy Tubal Cautery $7,737.00 $13,049.80 $604.44–$13,049.80 79% above 41%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Hc Bx Breast W Device Us Guide 1St Lesion $2,113.00 $7,497.75 $613.92–$7,497.75 32% below 72%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Esoph Egd Dilation <30 Mm $2,455.00 $5,354.00 $319.89–$9,677.23 at median 54%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Hc Egd Balloon Dilation Esophagus <30 Mm Diam $2,455.00 $9,677.23 $319.89–$9,677.23 at median 75%
Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd Transoral Biopsy Single/Multiple $1,160.00 $6,026.29 $335.91–$9,176.81 34% below 81%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Biopsy Single/Multiple $1,160.00 $9,176.81 $335.91–$9,176.81 34% below 87%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Hc Esophagogastroduodenoscopy Submucosal Injection $1,160.00 $6,026.29 $243.11–$6,026.29 38% below 81%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Remove Lesion Snare $2,455.00 $9,400.00 $1,475.29–$12,096.50 25% below 74%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Hc Egd Removal Tumor Polyp/Other Lesion Snare Tech $2,455.00 $12,096.50 $1,475.29–$12,096.50 25% below 80%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Hc Egd Insert Guide Wire Dilator Passage Esophagus $1,160.00 $6,026.29 $212.00–$6,026.29 30% below 81%
Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash $1,160.00 $5,354.00 $321.48–$6,026.29 38% below 78%
Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd Transoral Diagnostic $1,160.00 $6,026.29 $321.48–$6,026.29 38% below 81%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy $6,862.00 $20,990.70 $354.06–$20,990.70 43% below 67%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Dbrdmt Subq Tis 1St 20Sqcm/< $520.00 $5,449.00 $148.99–$5,449.00 24% below 90%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Optx Dst Rd Xartc Fx/Epi Sep $9,286.00 $24,600.00 $579.30–$24,600.00 88% above 62%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs CaliforniaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Hc Blood Transfusion Service $564.00 $3,251.70 $399.69–$3,251.70 35% below 83%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Airway Inhalation Treatment $280.00 $1,539.93 $16.78–$1,539.93 9% below 82%
Chemotherapy IV infusion, first hour CPT 96413 Hc Chemother, Iv Infusion, 1 Hr $422.00 $1,613.40 $28.59–$1,613.40 52% below 74%
Critical care, first 30 to 74 minutes CPT 99291 Hc Critical Care, E/M 30-74 Minutes - 99291 - 45000006 $1,057.00 $7,580.38 $174.42–$7,580.38 79% below 86%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Hc Eeg,W/Awake & Drowsy Record $276.00 $2,188.23 $56.37–$2,188.23 69% below 87%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Hc Electrocardiogram, Tracing $75.00 $699.88 $23.52–$699.88 78% below 89%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Hc Ed Level 1 - 99281 - 45000001 $107.00 $754.88 $21.77–$754.88 72% below 86%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Hc Ed Level 2 - 99282 - 45000002 $196.00 $1,290.44 $34.97–$1,290.44 74% below 85%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Hc Ed Level 3 - 99283 - 45000003 $349.00 $2,284.44 $63.97–$2,284.44 71% below 85%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Hc Ed Level 4 - 99284 - 45000004 $534.00 $3,409.93 $98.04–$3,409.93 73% below 84%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Hc Ed Level 5 - 99285 - 45000005 $762.00 $5,058.67 $155.03–$5,058.67 77% below 85%
Exercise stress test, tracing only, the hospital charge CPT 93017 Hc Cardiac Stress Tst,Tracing Only (93017) $276.00 $3,029.13 $75.31–$3,029.13 77% below 91%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Iv Infu, Hydration, 31-60 Min $272.00 $1,675.92 $51.30–$1,675.92 40% below 84%
IV infusion of a medicine, first hour CPT 96365 Hc Iv Infu, Therap/Proph/Diagn, Init, 1St Hr $272.00 $1,675.92 $62.60–$1,675.92 43% below 84%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Inj, Therap/Proph/Diagn, Im Or Subcut - 96372 - 94000001 $92.00 $507.91 $18.75–$507.91 41% below 82%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Neuromusc Reeducat,1+ Areas, Ea 15 Min $36.00 $269.50 $17.53–$405.00 72% below 87%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Neuromusc Reeducat,1+ Areas Complex, Ea 15 Min - 97112 - 42000064 $36.00 $405.00 $17.53–$405.00 72% below 91%
Occupational therapy evaluation, low complexity CPT 97165 Hc Occup Thrp Eval, Low Complexity, 30 Min $111.00 $499.95 $105.89–$499.95 57% below 78%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hc Phys Thrp Eval, High Complexity, 45 Min $108.00 $943.69 $102.90–$943.69 76% below 89%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Hc Phys Thrp Eval, Low Complexity, 20 Min $108.00 $624.18 $102.89–$624.18 56% below 83%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hc Phys Thrp Eval, Moderate Complexity, 30 Min $108.00 $858.25 $102.89–$858.25 70% below 87%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Manual Therapy 1/> Regions Ea 15 Min $30.00 $201.00 $29.05–$201.00 75% below 85%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Therapeutic Exercises, Ea 15 Min $32.00 $380.81 $9.14–$380.81 75% below 92%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Ot Exercise Ota Complex Ea 15 - 97110 - 42000162 $32.00 $288.75 $9.14–$380.81 75% below 89%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Pt Exercise Pta Complex Ea 15 $32.00 $288.75 $9.14–$380.81 75% below 89%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Therapeutic Exercises Complex, Ea 15 Min $32.00 $202.50 $9.14–$380.81 75% below 84%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Hc Tobacco Cessation Intermed 3-10 Min $47.00 $170.88 $10.41–$195.75 15% below 72%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Hc Tobacco Cessation Asymptomatic 3-10 Min $47.00 $195.75 $10.41–$195.75 15% below 76%
Speech and language evaluation CPT 92523 Hc St Eval Speech Sound Prod Languag Comprhns, 15 Min $249.00 $1,127.70 $107.68–$1,127.70 46% below 78%
Speech therapy session, individual CPT 92507 Hc Speech/Hearing Therapy Individual, 15 Min $83.00 $222.49 $66.75–$222.49 70% below 63%
Spirometry (breathing test) CPT 94010 Hc Breathing Capacity Test $276.00 $1,039.79 $21.17–$1,039.79 14% below 73%
Spirometry before and after a bronchodilator CPT 94060 Hc Eval Of Bronchospasm $477.00 $1,755.84 $38.75–$1,755.84 38% below 73%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Therapeut Actvity Direct Pt Contact Ea 15 Min $39.00 $480.15 $15.98–$480.15 72% below 92%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Ot Thr Activity Ota Complex Ea 1 - 97530 - 42000167 $39.00 $351.25 $15.98–$480.15 72% below 89%

Vaccines

ProcedureCash price List priceInsurers payvs CaliforniaOff list
Rabies vaccine, one dose CPT 90675 Hc Rabies Vaccine, Im $319.00 $1,233.45 $291.32–$1,233.45 55% below 74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hc Immuniz Admin, Inj, Init Vac $92.00 $507.91 $4.46–$507.91 9% below 82%

Source file: https://sandimashospital.com/wp-content/uploads/2026/09/930000139_SanDimasCommunityHospital_standardcharges.json