Modoc Medical Center
Listed in its price file as “Last Frontier Healthcare District”.
Modoc Medical Center in Alturas, CA publishes cash prices for 135 common procedures listed here, from its own machine-readable price file updated Jun 9, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the California median for 82 of 135 procedures and below it for 50. By typical cash price it ranks #111 of 167 California hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
1111 N Nagle St Alturas CA 96101 Collected Sep 27, 2026 Source price file (530) 233-5131
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 051330 · CMS hospital register
The price file shows no self-pay discount
For 171 of the 171 prices listed here, the cash price in Modoc Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $2,142.80 | $2,142.80 | $343.91–$2,035.66 | 11% below | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $2,526.26 | $2,526.26 | $231.58–$2,399.95 | 1% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast | $3,544.94 | $3,544.94 | $338.61–$3,367.69 | 2% below | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI scan of arm joint without contrast | $2,513.02 | $2,513.02 | $231.58–$2,387.37 | 3% above | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver enzyme (SGPT), level | $85.26 | $85.26 | $5.04–$81.00 | 98% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Liver enzyme (SGOT), level | $81.85 | $81.85 | $4.92–$77.76 | 86% above | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel | $405.03 | $405.03 | $45.25–$384.78 | 72% above | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide (heart and blood vessel protein) level | $250.09 | $250.09 | $37.30–$237.59 | 43% above | — |
| Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total) | $275.09 | $275.09 | $8.04–$261.34 | 42% above | — |
| Blood culture for bacteria CPT 87040 Bacterial blood culture | $185.29 | $185.29 | $9.80–$176.03 | 23% below | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Insertion of needle into vein for collection of blood sample | $22.75 | $22.75 | $8.87–$79.63 | 6% below | — |
| Blood glucose (sugar) test CPT 82947 Blood glucose (sugar) level | $81.44 | $81.44 | $3.73–$77.37 | 117% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin (reproductive hormone) analysis | $128.45 | $128.45 | $7.14–$122.03 | 17% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood group typing (ABO) | $79.57 | $79.57 | $2.84–$75.59 | 3% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Measurement C-reactive protein for detection of infection or inflammation | $89.80 | $89.80 | $4.92–$85.31 | 92% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen | $130.72 | $130.72 | $48.74–$124.18 | 87% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $168.24 | $168.24 | $12.72–$159.83 | 66% above | — |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $125.05 | $125.05 | $7.38–$118.80 | 13% above | — |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $128.45 | $128.45 | $6.15–$122.03 | 69% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $261.46 | $261.46 | $10.03–$248.39 | 2% above | — |
| D-dimer blood test (blood clot marker) CPT 85379 Coagulation function measurement, D-dimer; quantitative | $164.83 | $164.83 | $9.67–$156.59 | 40% above | — |
| Ferritin blood test (iron stores) CPT 82728 Ferritin (blood protein) level | $188.70 | $188.70 | $12.95–$179.27 | 127% above | — |
| Folate (folic acid) blood test CPT 82746 Folic acid level, serum | $202.35 | $202.35 | $13.97–$192.23 | 141% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (thyroid chemical), free | $123.91 | $123.91 | $8.57–$117.71 | 82% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel | $555.87 | $555.87 | $301.00–$555.87 | 100% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Blood glucose (sugar) level after receiving dose of glucose | $61.39 | $61.39 | $4.51–$58.32 | 38% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Blood glucose (sugar) tolerance test, 3 specimens | $147.78 | $147.78 | $12.23–$140.39 | 26% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C level | $101.17 | $101.17 | $9.22–$96.11 | 57% above | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Detection test by immunoassay technique for hepatitis B surface antigen | $191.80 | $191.80 | $9.81–$182.21 | 209% above | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody measurement | $146.79 | $146.79 | $13.56–$139.45 | 187% above | — |
| Iron blood test (serum iron) CPT 83540 Iron level | $96.64 | $96.64 | $6.15–$91.81 | 119% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity | $130.72 | $130.72 | $8.30–$124.18 | 150% above | — |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $477.45 | $477.45 | $8.25–$453.58 | 238% above | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase (fat enzyme) level | $120.49 | $120.49 | $6.55–$114.47 | 60% above | — |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $193.24 | $193.24 | $7.76–$183.58 | 44% above | — |
| Magnesium blood test CPT 83735 Magnesium level | $139.30 | $139.30 | $6.37–$132.34 | 145% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Screening test for mononucleosis (mono) | $97.77 | $97.77 | $4.92–$92.88 | 11% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total | $151.19 | $151.19 | $17.47–$143.63 | 223% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $98.90 | $98.90 | $5.71–$93.96 | 163% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $64.79 | $64.79 | $4.08–$61.55 | 45% above | — |
| Rapid flu test (influenza antigen) CPT 87804 Detection test by immunoassay with direct visual observation for influenza virus | $86.08 | $86.08 | $12.69–$81.78 | 14% above | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep) | $77.30 | $77.30 | $10.03–$73.44 | 27% below | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Red blood cell sedimentation rate, to detect inflammation, automated | $62.52 | $62.52 | $2.57–$59.39 | 39% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay | $90.67 | $90.67 | $15.12–$86.14 | 153% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $169.37 | $169.37 | $15.96–$160.90 | 102% above | — |
| Uric acid blood test CPT 84550 Uric acid level, blood | $72.76 | $72.76 | $4.29–$69.12 | 19% above | — |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $78.44 | $78.44 | $3.01–$74.52 | 5% below | — |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $45.01 | $45.01 | $2.14–$42.76 | 20% below | — |
| Urine culture for bacteria, with colony count CPT 87086 Bacterial colony count, urine | $126.99 | $126.99 | $7.67–$120.64 | 9% below | — |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test | $86.40 | $86.40 | $4.02–$82.08 | 1% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (vitamin B-12) level | $203.48 | $203.48 | $14.33–$193.31 | 251% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D-3 level | $347.85 | $347.85 | $28.12–$330.46 | 444% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (reproductive hormone) level | $196.67 | $196.67 | $14.30–$186.84 | 44% above | — |
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 Removal of ruptured infected appendix | $3,726.20 | $3,726.20 | $725.75–$3,539.89 | 75% above | — |
| Appendectomy, open surgery CPT 44950 Removal of appendix | $7,428.36 | $7,428.36 | $574.61–$7,056.94 | 28% above | — |
| Cataract surgery with lens implant CPT 66984 Removal of cataract with insertion of prosthetic lens | $4,390.58 | $4,390.58 | $1,005.21–$4,171.05 | 21% below | — |
| Cervical biopsy CPT 57500 Biopsy of cervix or removal of growth | $1,219.65 | $1,219.65 | $40.54–$1,158.67 | 37% below | — |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Removal of foreskin (older than 28 days) | $865.44 | $865.44 | $126.58–$2,135.66 | 76% below | — |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare | $1,407.43 | $1,407.43 | $400.22–$1,400.77 | 38% below | — |
| Colonoscopy with tissue sample CPT 45380 Biopsy of large bowel using a flexible endoscope | $2,670.63 | $2,670.63 | $330.23–$2,537.10 | 28% above | — |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using a flexible endoscope | $2,454.26 | $2,454.26 | $295.23–$2,331.55 | 18% above | — |
| Complex cataract surgery with lens implant CPT 66982 Complex removal of cataract with insertion of prosthetic lens | $4,791.61 | $4,791.61 | $1,008.93–$4,552.03 | at median | — |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation and scraping of uterus | $4,739.15 | $4,739.15 | $222.95–$4,502.19 | 12% above | — |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal of impacted ear wax by washing | $143.23 | $143.23 | $11.54–$136.07 | 19% below | — |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal of impacted ear wax by washing | $143.23 | $143.23 | $11.54–$136.07 | — | — |
| Earwax removal with instruments, one ear CPT 69210 Removal of impacted ear wax | $227.36 | $227.36 | $30.53–$215.99 | 30% above | — |
| Earwax removal with instruments, one ear inpatient CPT 69210 Removal of impacted ear wax | $227.36 | $227.36 | $30.53–$215.99 | — | — |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Initial repair of sliding hernia of abdomen, 3-10 cm in length | $3,128.18 | $3,128.18 | $463.51–$6,614.04 | 58% below | — |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Initial repair of sliding hernia of abdomen, less than 3 cm in length | $2,919.02 | $2,919.02 | $277.74–$3,657.95 | 36% below | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic exam of lower portion of large bowel using a flexible endoscope | $1,010.77 | $1,010.77 | $54.73–$960.23 | 43% below | — |
| Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope | $2,809.40 | $2,809.40 | $668.60–$6,176.47 | 79% below | — |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Removal of single external and internal hemorrhoid group | $5,251.65 | $5,251.65 | $423.48–$4,989.07 | 15% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess | $513.83 | $513.83 | $60.88–$488.14 | 10% above | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Simple or single drainage of skin abscess | $513.83 | $513.83 | $60.88–$488.14 | — | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia (5 years or older) | $3,915.25 | $3,915.25 | $493.45–$3,719.49 | 46% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection into tendon or ligament | $619.54 | $619.54 | $65.68–$588.56 | 6% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection into tendon or ligament | $619.54 | $619.54 | $65.68–$588.56 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $607.04 | $607.04 | $45.79–$576.69 | 17% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration and/or injection of fluid from large joint | $607.04 | $607.04 | $45.79–$576.69 | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium joint | $567.25 | $567.25 | $54.46–$538.89 | at median | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Aspiration and/or injection of fluid from medium joint | $567.25 | $567.25 | $54.46–$538.89 | — | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration and/or injection of fluid from small joint | $796.87 | $796.87 | $46.46–$757.03 | 29% above | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Aspiration and/or injection of fluid from small joint | $796.87 | $796.87 | $46.46–$757.03 | — | — |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Removal of appendix using an endoscope | $8,794.26 | $8,794.26 | $273.27–$8,354.55 | 10% above | — |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Repair of groin hernia using an endoscope | $7,541.20 | $7,541.20 | $264.71–$7,164.14 | 53% below | — |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Removal of ovaries and/or tubes using an endoscope | $10,529.51 | $10,529.51 | $488.97–$10,003.03 | 20% above | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Removal of recurring cataract in lens capsule using a laser | $1,654.39 | $1,654.39 | $267.01–$1,571.67 | at median | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $1,261.01 | $1,261.01 | $84.51–$1,197.96 | 45% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $1,311.83 | $1,311.83 | $84.51–$1,246.24 | 51% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $1,311.83 | $1,311.83 | $84.51–$1,246.24 | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less | $1,744.00 | $1,744.00 | $58.08–$1,656.80 | 32% above | — |
| Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $603.63 | $603.63 | $45.93–$573.45 | 34% above | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $603.63 | $603.63 | $45.93–$573.45 | — | — |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $1,557.60 | $1,557.60 | $62.92–$1,479.72 | 89% above | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $1,557.60 | $1,557.60 | $62.92–$1,479.72 | — | — |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $1,777.90 | $1,777.90 | $89.85–$1,689.01 | at median | — |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $3,002.73 | $3,002.73 | $89.85–$2,852.59 | 69% above | — |
| Paracentesis with imaging guidance inpatient CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $1,777.90 | $1,777.90 | $89.85–$1,689.01 | — | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Permanent removal fingernail or toenail | $1,391.40 | $1,391.40 | $120.69–$1,321.83 | 10% above | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Permanent removal fingernail or toenail | $1,391.40 | $1,391.40 | $120.69–$1,321.83 | — | — |
| Removal of a breast lump, open surgery CPT 19120 Removal of growth and tissue of breast, duct, or nipple | $5,557.61 | $5,557.61 | $210.72–$5,279.73 | 11% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $603.63 | $603.63 | $74.23–$573.45 | 23% below | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $603.63 | $603.63 | $74.23–$573.45 | — | — |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $711.37 | $711.37 | $385.21–$2,489.80 | 61% below | — |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $2,484.86 | $2,484.86 | $902.60–$8,697.01 | 24% above | — |
| Short arm cast (elbow to hand) CPT 29075 Application of elbow to finger cast | $333.08 | $333.08 | $82.65–$316.43 | 33% below | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 Application of elbow to finger cast | $333.08 | $333.08 | $82.65–$316.43 | — | — |
| Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint | $334.22 | $334.22 | $52.87–$317.51 | 18% below | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 Application of nonmoveable forearm to hand splint | $334.22 | $334.22 | $52.87–$317.51 | — | — |
| Short leg cast (below the knee) CPT 29405 Application of short leg cast | $435.39 | $435.39 | $122.30–$428.04 | 13% below | — |
| Short leg cast (below the knee) inpatient CPT 29405 Application of short leg cast | $435.39 | $435.39 | $122.30–$428.04 | — | — |
| Short leg splint (calf to foot) CPT 29515 Application of short leg splint from calf to foot | $384.22 | $384.22 | $81.17–$365.01 | 22% below | — |
| Short leg splint (calf to foot) inpatient CPT 29515 Application of short leg splint from calf to foot | $384.22 | $384.22 | $81.17–$365.01 | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $408.10 | $408.10 | $100.39–$387.70 | 8% below | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $408.10 | $408.10 | $100.39–$387.70 | — | — |
| Skin biopsy, punch, one lesion CPT 11104 Punch biopsy, first skin growth | $480.85 | $480.85 | $160.74–$480.85 | 33% below | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch biopsy, first skin growth | $480.85 | $480.85 | $160.74–$480.85 | — | — |
| Skin tag removal, up to 15 tags CPT 11200 Removal of skin tag, 1-15 skin tags | $804.83 | $804.83 | $45.40–$764.59 | 106% above | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tag, 1-15 skin tags | $804.83 | $804.83 | $45.40–$764.59 | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $1,185.65 | $1,185.65 | $81.91–$1,126.37 | 3% below | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $1,185.65 | $1,185.65 | $81.91–$1,126.37 | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $453.57 | $453.57 | $106.81–$430.89 | 33% below | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $453.57 | $453.57 | $106.81–$430.89 | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $459.25 | $459.25 | $72.97–$436.29 | 30% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $459.25 | $459.25 | $72.97–$436.29 | — | — |
| Thoracentesis with imaging guidance CPT 32555 Aspiration of fluid from chest cavity using imaging guidance | $1,023.13 | $1,023.13 | $92.33–$971.97 | 50% below | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection of trigger points, 1-2 muscles | $574.06 | $574.06 | $75.29–$545.36 | 8% below | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection of trigger points, 1-2 muscles | $574.06 | $574.06 | $75.29–$545.36 | — | — |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Destruction of fallopian tubes using an endoscope | $6,880.90 | $6,880.90 | $421.39–$6,536.86 | 59% above | — |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | $2,625.82 | $2,625.82 | $319.89–$2,494.53 | 7% above | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $2,473.94 | $2,473.94 | $234.18–$2,350.24 | 40% above | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $2,233.53 | $2,233.53 | $224.12–$2,121.85 | 19% above | — |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct | $4,116.30 | $4,116.30 | $260.61–$3,910.49 | 59% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $692.28 | $692.28 | $148.99–$657.67 | 2% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $692.28 | $692.28 | $148.99–$657.67 | 2% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $692.28 | $692.28 | $148.99–$657.67 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products | $1,011.73 | $1,011.73 | $428.19–$3,541.06 | 16% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production | $134.15 | $134.15 | $16.78–$223.72 | 57% below | — |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes | $2,647.53 | $2,647.53 | $174.42–$2,515.15 | 47% below | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes | $2,647.53 | $2,647.53 | $174.42–$2,515.15 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $255.01 | $255.01 | $23.52–$242.26 | 25% below | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional | $279.64 | $279.64 | $21.77–$265.66 | 28% below | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional | $279.64 | $279.64 | $21.77–$265.66 | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making | $456.97 | $456.97 | $34.97–$434.12 | 39% below | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making | $456.97 | $456.97 | $34.97–$434.12 | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making | $750.27 | $750.27 | $63.97–$712.76 | 38% below | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making | $750.27 | $750.27 | $63.97–$712.76 | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making | $1,210.66 | $1,210.66 | $98.04–$1,150.13 | 38% below | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making | $1,210.66 | $1,210.66 | $98.04–$1,150.13 | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making | $1,810.86 | $1,810.86 | $155.03–$1,720.32 | 45% below | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making | $1,810.86 | $1,810.86 | $155.03–$1,720.32 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $377.41 | $377.41 | $73.58–$358.54 | 17% below | — |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $455.84 | $455.84 | $89.79–$433.05 | 5% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $87.53 | $87.53 | $26.90–$87.53 | 44% below | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Therapy procedure for nutrition management, each 15 minutes | $168.85 | $168.85 | $25.96–$339.65 | 69% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of blood for a medical problem | $248.95 | $248.95 | $23.52–$236.50 | 17% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of blood for a medical problem | $248.95 | $248.95 | $23.52–$236.50 | 17% below | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Drawing of blood for a medical problem | $248.95 | $248.95 | $23.52–$236.50 | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use | $425.40 | $425.40 | $230.35–$1,488.90 | 76% above | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent | $738.26 | $738.26 | $399.77–$2,583.91 | 92% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine, adult dosage (3 dose schedule) | $247.46 | $247.46 | $134.00–$866.11 | 193% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza vaccine split virus, preservative free | $263.66 | $263.66 | $142.77–$922.81 | 110% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps, and rubella vaccine | $285.60 | $285.60 | $154.65–$999.60 | 144% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine | $424.73 | $424.73 | $229.99–$1,486.56 | 62% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use | $647.12 | $647.12 | $350.42–$2,264.92 | 29% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal vaccine, 23-valent | $351.24 | $351.24 | $190.20–$1,229.34 | 117% above | — |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle | $993.38 | $993.38 | $299.46–$993.38 | 41% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria and tetanus vaccine (7 years or older) | $100.75 | $100.75 | $54.56–$352.63 | 27% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older) | $170.84 | $170.84 | $92.51–$597.94 | 102% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine | $63.66 | $63.66 | $6.40–$73.56 | 37% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of vaccine, each additional vaccine | $45.47 | $45.47 | $16.14–$45.47 | 33% below | — |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbMMCALTURASCA&type=CDMWithoutLabel&fileType=CSV