Bear Valley Community Hospital
Listed in its price file as “Bear Valley Healthcare District”.
Bear Valley Community Hospital in Big Bear Lake, CA publishes cash prices for 167 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 155 of 167 procedures and above it for 12. By typical cash price it ranks #34 of 217 California hospitals and #9 of 25 hospitals in the Riverside, CA area, cheapest first. Click a procedure to compare it with other hospitals nearby.
41870 Garstin Drive, PO Box 1649, Big Bear Lake, CA, 92315-1649 Collected Sep 29, 2026 Source price file (909) 866-6501
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 051335 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITCOL ULTRA SOUND/AFI | $103.25 | $147.50 | $49.15–$125.38 | 83% below | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $14.00 | $20.00 | $5.04–$17.00 | 68% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) | $14.00 | $20.00 | $5.04–$17.00 | — | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $14.00 | $20.00 | $4.92–$17.00 | 69% below | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $14.00 | $20.00 | $4.92–$17.00 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (B TYPE NATRIURETIC PEPTIDE | $123.38 | $176.25 | $37.30–$149.81 | 41% below | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (B TYPE NATRIURETIC PEPTIDE | $123.38 | $176.25 | $37.30–$149.81 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 ISTAT CHEM 8 | $105.70 | $151.00 | $8.04–$128.35 | 45% below | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $105.70 | $151.00 | $8.04–$128.35 | 45% below | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 ISTAT CHEM 8 | $105.70 | $151.00 | $8.04–$128.35 | — | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $105.70 | $151.00 | $8.04–$128.35 | — | 30% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD #1 | $117.95 | $168.50 | $9.80–$143.22 | 57% below | 30% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD #1 | $117.95 | $168.50 | $9.80–$143.22 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 LAB CORP VENIPUNCTURE | $8.40 | $12.00 | $4.00–$10.20 | 58% below | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 NONCOVERED VENIPUNCTURE | $12.25 | $17.50 | $5.83–$14.88 | 39% below | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $24.50 | $35.00 | $8.39–$29.75 | 22% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LAB CORP VENIPUNCTURE | $8.40 | $12.00 | $4.00–$10.20 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 NONCOVERED VENIPUNCTURE | $12.25 | $17.50 | $5.83–$14.88 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $24.50 | $35.00 | $8.39–$29.75 | — | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $14.00 | $20.00 | $6.66–$17.00 | 63% below | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $14.00 | $20.00 | $6.66–$17.00 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL | $74.90 | $107.00 | $7.14–$90.95 | 57% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL | $74.90 | $107.00 | $7.14–$90.95 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPE | $42.53 | $60.75 | $20.25–$115.62 | 61% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO RH TYPE | $84.00 | $120.00 | $39.98–$115.62 | 23% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPE | $42.53 | $60.75 | $20.25–$115.62 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO RH TYPE | $84.00 | $120.00 | $39.98–$115.62 | — | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFF (IN-HOUSE) | $39.90 | $57.00 | $18.99–$48.45 | 74% below | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFF (IN-HOUSE) | $39.90 | $57.00 | $18.99–$48.45 | — | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID Ag PCR (IH) | $140.00 | $200.00 | $66.64–$170.00 | 52% above | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID Ag PCR (IH) | $140.00 | $200.00 | $66.64–$170.00 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL CHL TRG HDL LDL | $152.08 | $217.25 | $72.39–$184.66 | 33% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL CHL TRG HDL LDL | $152.08 | $217.25 | $72.39–$184.66 | — | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTOMATED DIFFERENTIAL | $67.73 | $96.75 | $7.38–$82.24 | 39% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 REPEAT CBC | $67.73 | $96.75 | $7.38–$82.24 | 39% below | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTOMATED DIFFERENTIAL | $67.73 | $96.75 | $7.38–$82.24 | — | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 REPEAT CBC | $67.73 | $96.75 | $7.38–$82.24 | — | 30% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $54.08 | $77.25 | $6.15–$65.66 | 39% below | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $54.08 | $77.25 | $6.15–$65.66 | — | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $182.00 | $260.00 | $10.03–$221.00 | 29% below | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $182.00 | $260.00 | $10.03–$221.00 | — | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER | $121.80 | $174.00 | $9.67–$147.90 | 15% below | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER | $121.80 | $174.00 | $9.67–$147.90 | — | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $38.50 | $55.00 | $12.95–$46.75 | 64% below | 30% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $38.50 | $55.00 | $12.95–$46.75 | — | 30% |
| Folate (folic acid) blood test CPT 82746 FOLATE (IH) | $42.00 | $60.00 | $13.96–$51.00 | 62% below | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE (IH) | $42.00 | $60.00 | $13.96–$51.00 | — | 30% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE (IH) | $88.20 | $126.00 | $16.09–$107.10 | 14% below | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE (IH) | $88.20 | $126.00 | $16.09–$107.10 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $60.20 | $86.00 | $8.57–$73.10 | 12% below | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE | $60.20 | $86.00 | $8.57–$73.10 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, 1HR POST-GLU DOSE | $23.80 | $34.00 | $11.33–$28.90 | 52% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOL 1HR. | $88.73 | $126.75 | $42.24–$107.74 | 79% above | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, 1HR POST-GLU DOSE | $23.80 | $34.00 | $11.33–$28.90 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOL 1HR. | $88.73 | $126.75 | $42.24–$107.74 | — | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 2HR. | $132.65 | $189.50 | $63.14–$161.08 | 3% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 3HR. | $145.60 | $208.00 | $69.31–$176.80 | 6% above | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 4HR. | $169.75 | $242.50 | $80.80–$206.12 | 24% above | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 5HR. | $192.85 | $275.50 | $91.80–$234.18 | 41% above | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 2HR. | $132.65 | $189.50 | $63.14–$161.08 | — | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 3HR. | $145.60 | $208.00 | $69.31–$176.80 | — | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 4HR. | $169.75 | $242.50 | $80.80–$206.12 | — | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 5HR. | $192.85 | $275.50 | $91.80–$234.18 | — | 30% |
| H. pylori stool antigen test CPT 87338 HELIOBACTER PYLORI STOOL | $70.00 | $100.00 | $13.66–$85.00 | 17% below | 30% |
| H. pylori stool antigen test inpatient CPT 87338 HELIOBACTER PYLORI STOOL | $70.00 | $100.00 | $13.66–$85.00 | — | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV 1/2 ANTIBODY | $42.00 | $60.00 | $13.02–$51.00 | 30% below | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 STI HIV INHOUSE | $42.00 | $60.00 | $13.02–$51.00 | 30% below | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 STI HIV INHOUSE | $42.00 | $60.00 | $13.02–$51.00 | — | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 RAPID HIV 1/2 ANTIBODY | $42.00 | $60.00 | $13.02–$51.00 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 ANTI HIV 1+2 | $63.00 | $90.00 | $22.88–$76.50 | 28% below | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 ANTI HIV 1+2 | $63.00 | $90.00 | $22.88–$76.50 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $47.95 | $68.50 | $9.22–$58.22 | 27% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $47.95 | $68.50 | $9.22–$58.22 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 ANTI HBS | $28.00 | $40.00 | $10.20–$34.00 | 37% below | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 ANTI HBS | $28.00 | $40.00 | $10.20–$34.00 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG | $27.30 | $39.00 | $9.81–$33.15 | 62% below | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG | $27.30 | $39.00 | $9.81–$33.15 | — | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 ANTI HCV | $37.80 | $54.00 | $13.56–$45.90 | 38% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 STI HCV (in house) | $105.00 | $150.00 | $13.56–$127.50 | 73% above | 30% |
| Hepatitis C antibody blood test (screening) one side CPT 86803 HCV AB W/ RFLX QT RT PCR (in house) | $105.00 | $150.00 | $13.56–$127.50 | 73% above | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 ANTI HCV | $37.80 | $54.00 | $13.56–$45.90 | — | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 STI HCV (in house) | $105.00 | $150.00 | $13.56–$127.50 | — | 30% |
| Hepatitis C antibody blood test (screening) inpatient one side CPT 86803 HCV AB W/ RFLX QT RT PCR (in house) | $105.00 | $150.00 | $13.56–$127.50 | — | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY CARDIAC | $33.60 | $48.00 | $12.30–$40.80 | 51% below | 30% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY CARDIAC | $33.60 | $48.00 | $12.30–$40.80 | — | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $45.50 | $65.00 | $17.02–$55.25 | 36% below | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $45.50 | $65.00 | $17.02–$55.25 | — | 30% |
| Iron blood test (serum iron) CPT 83540 IRON (IH) | $14.00 | $20.00 | $6.15–$17.00 | 76% below | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON (IH) | $14.00 | $20.00 | $6.15–$17.00 | — | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC DIRECT | $17.50 | $25.00 | $8.30–$21.25 | 76% below | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON & TIBC W% SAT (IH) | $23.80 | $34.00 | $8.30–$28.90 | 68% below | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC DIRECT | $17.50 | $25.00 | $8.30–$21.25 | — | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON & TIBC W% SAT (IH) | $23.80 | $34.00 | $8.30–$28.90 | — | 30% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $135.28 | $193.25 | $8.25–$164.26 | 5% below | 30% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $135.28 | $193.25 | $8.25–$164.26 | — | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $56.18 | $80.25 | $6.55–$68.21 | 53% below | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $56.18 | $80.25 | $6.55–$68.21 | — | 30% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION PANEL | $94.85 | $135.50 | $7.76–$115.18 | 37% below | 30% |
| Liver function blood test panel inpatient CPT 80076 LIVER FUNCTION PANEL | $94.85 | $135.50 | $7.76–$115.18 | — | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $43.93 | $62.75 | $4.92–$53.34 | 58% below | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN | $43.93 | $62.75 | $4.92–$53.34 | — | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $48.30 | $69.00 | $17.47–$58.65 | 19% below | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $48.30 | $69.00 | $17.47–$58.65 | — | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $105.00 | $150.00 | $39.22–$127.50 | 5% below | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $105.00 | $150.00 | $39.22–$127.50 | — | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT | $71.05 | $101.50 | $5.71–$86.28 | 3% below | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT | $71.05 | $101.50 | $5.71–$86.28 | — | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT INR (PT) | $71.05 | $101.50 | $4.08–$86.28 | 8% above | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR (PT) | $71.05 | $101.50 | $4.08–$86.28 | — | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR | $14.70 | $21.00 | $5.39–$17.85 | 11% above | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR | $14.70 | $21.00 | $5.39–$17.85 | — | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG | $37.80 | $54.00 | $13.67–$45.90 | 38% below | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG | $37.80 | $54.00 | $13.67–$45.90 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT | $34.30 | $49.00 | $16.33–$41.65 | 12% below | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT | $34.30 | $49.00 | $16.33–$41.65 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 IMMUNO-FECAL OCCULT BLOOD - IN HOUSE | $46.41 | $66.30 | $15.12–$56.36 | 18% above | 30% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IMMUNO-FECAL OCCULT BLOOD - IN HOUSE | $46.41 | $66.30 | $15.12–$56.36 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR IN HOUSE W/ REFLEX | $114.10 | $163.00 | $54.31–$138.55 | 394% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGEN | $114.10 | $163.00 | $54.31–$138.55 | 394% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 STI RPR INHOUSE | $114.10 | $163.00 | $54.31–$138.55 | 394% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 STI RPR INHOUSE | $114.10 | $163.00 | $54.31–$138.55 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR IN HOUSE W/ REFLEX | $114.10 | $163.00 | $54.31–$138.55 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGEN | $114.10 | $163.00 | $54.31–$138.55 | — | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $67.20 | $96.00 | $24.52–$81.60 | 36% above | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE | $67.20 | $96.00 | $24.52–$81.60 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORM (TSH) | $155.05 | $221.50 | $15.96–$188.28 | 43% above | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORM (TSH) | $155.05 | $221.50 | $15.96–$188.28 | — | 30% |
| Uric acid blood test CPT 84550 URIC ACID | $41.83 | $59.75 | $4.29–$50.79 | 37% below | 30% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $41.83 | $59.75 | $4.29–$50.79 | — | 30% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W MICRO | $28.00 | $40.00 | $3.01–$34.00 | 66% below | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W MICRO | $28.00 | $40.00 | $3.01–$34.00 | — | 30% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS MICRO CHEM | $48.30 | $69.00 | $3.82–$58.65 | 52% above | 30% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS MICRO CHEM | $48.30 | $69.00 | $3.82–$58.65 | — | 30% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O MICRO | $24.50 | $35.00 | $2.14–$29.75 | 56% below | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O MICRO | $24.50 | $35.00 | $2.14–$29.75 | — | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS W/O SCOPE | $26.25 | $37.50 | $3.31–$31.88 | 26% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS CHEM ONLY | $27.13 | $38.75 | $3.31–$32.94 | 24% below | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS W/O SCOPE | $26.25 | $37.50 | $3.31–$31.88 | — | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS CHEM ONLY | $27.13 | $38.75 | $3.31–$32.94 | — | 30% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE SCREEN | $94.85 | $135.50 | $7.67–$115.18 | 32% below | 30% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE SCREEN | $94.85 | $135.50 | $7.67–$115.18 | — | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST | $21.00 | $30.00 | $8.18–$25.50 | 76% below | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST | $21.00 | $30.00 | $8.18–$25.50 | — | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 (IH) | $42.00 | $60.00 | $14.33–$51.00 | 55% below | 30% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 (IH) | $42.00 | $60.00 | $14.33–$51.00 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY | $85.40 | $122.00 | $28.12–$103.70 | 34% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY | $85.40 | $122.00 | $28.12–$103.70 | — | 30% |
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 - ABCESS | $1,735.83 | $2,479.75 | $826.26–$1,735.82 | 12% below | 30% |
| Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY - ABCESS | $1,735.83 | $2,479.75 | $826.26–$1,735.82 | — | 30% |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY PROFESSIONAL | $1,735.83 | $2,479.75 | $826.26–$6,847.99 | 70% below | 30% |
| Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY PROFESSIONAL | $1,735.83 | $2,479.75 | $826.26–$6,847.99 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXT | $680.30 | $971.85 | $323.82–$826.07 | 64% below | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE EXT | $680.30 | $971.85 | $323.82–$826.07 | — | 30% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL - PROF | $925.75 | $1,322.50 | $440.66–$1,747.65 | 74% below | 30% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL - PROF | $925.75 | $1,322.50 | $440.66–$1,747.65 | — | 30% |
| Cervical biopsy CPT 57500 CERIX BX | $183.40 | $262.00 | $85.11–$727.66 | 88% below | 30% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY REM OF POLYP - PROF | $925.75 | $1,322.50 | $440.66–$1,124.12 | 60% below | 30% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY REM OF POLYP - PROF | $925.75 | $1,322.50 | $440.66–$1,124.12 | — | 30% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY | $810.08 | $1,157.25 | $385.60–$1,068.14 | 61% below | 30% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY | $810.08 | $1,157.25 | $385.60–$1,068.14 | — | 30% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY PROFESSIONAL | $682.85 | $975.50 | $325.04–$829.18 | 67% below | 30% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEX DIAG SPECIMEN | $1,658.65 | $2,369.50 | $789.52–$1,658.65 | 20% below | 30% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $1,857.10 | $2,653.00 | $827.27–$1,857.10 | 11% below | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY PROFESSIONAL | $682.85 | $975.50 | $325.04–$829.18 | — | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEX DIAG SPECIMEN | $1,658.65 | $2,369.50 | $789.52–$1,658.65 | — | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY | $1,857.10 | $2,653.00 | $827.27–$1,857.10 | — | 30% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 CULPO W/ BX & CX & ECC | $197.05 | $281.50 | $149.72–$290.38 | 79% below | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 BENIGN OR PM* ONE | $81.90 | $117.00 | $38.98–$117.00 | 74% below | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 BENIGN OR PM* ONE | $81.90 | $117.00 | $38.98–$117.00 | — | 30% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR WAX LAVAGE ONLY | $51.10 | $73.00 | $24.32–$62.05 | 71% below | 30% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR LAVAGE | $157.22 | $224.60 | $74.83–$190.91 | 11% below | 30% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR LAVAGE | $157.22 | $224.60 | $74.83–$190.91 | — | 30% |
| Earwax removal with instruments, one ear CPT 69210 EAR WAX REMOVAL W/ INTRUMENTATION | $51.10 | $73.00 | $24.32–$62.05 | 71% below | 30% |
| Earwax removal with instruments, one ear CPT 69210 IMPACTED EAR WAX REMOVAL W/ INSTRUMENTS | $169.05 | $241.50 | $80.47–$205.28 | 4% below | 30% |
| Earwax removal with instruments, one ear inpatient CPT 69210 IMPACTED EAR WAX REMOVAL W/ INSTRUMENTS | $169.05 | $241.50 | $80.47–$205.28 | — | 30% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDIMETRAL BIOPSY | $69.65 | $99.50 | $67.16–$180.37 | 87% below | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVER FACET | $308.53 | $440.75 | $146.86–$825.03 | 85% below | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVER FACET | $308.53 | $440.75 | $146.86–$825.03 | — | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY PROFESSIONAL | $127.23 | $181.75 | $60.56–$827.27 | 92% below | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOID FLEX W/ COLLEC SPECIMEN | $1,658.65 | $2,369.50 | $789.52–$1,658.65 | 3% above | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY PROFESSIONAL | $127.23 | $181.75 | $60.56–$827.27 | — | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOID FLEX W/ COLLEC SPECIMEN | $1,658.65 | $2,369.50 | $789.52–$1,658.65 | — | 30% |
| Gallbladder removal, laparoscopic CPT 47562 PROFESSIONAL LAP CHOLE | $1,080.10 | $1,543.00 | $514.13–$5,222.71 | 92% below | 30% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PROFESSIONAL LAP CHOLE | $1,080.10 | $1,543.00 | $514.13–$5,222.71 | — | 30% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECOMY | $1,928.68 | $2,755.25 | $918.05–$1,928.68 | 1% above | 30% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECOMY | $1,928.68 | $2,755.25 | $918.05–$1,928.68 | — | 30% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRIHOIDECTOMY BANDING (CLINIC) | $282.14 | $403.06 | $134.30–$827.27 | 85% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE SINGLE | $375.90 | $537.00 | $178.93–$456.45 | 20% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D OF ABSCESS | $375.90 | $537.00 | $178.93–$456.45 | 20% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION OF ABSCESS | $424.77 | $606.81 | $202.19–$515.79 | 9% below | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D OF ABSCESS | $375.90 | $537.00 | $178.93–$456.45 | — | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE SINGLE | $375.90 | $537.00 | $178.93–$456.45 | — | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION OF ABSCESS | $424.77 | $606.81 | $202.19–$515.79 | — | 30% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA REPAIR | $795.90 | $1,137.00 | $378.85–$3,131.52 | 89% below | 30% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA REPAIR | $795.90 | $1,137.00 | $378.85–$3,131.52 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON/LIGAMENT/CYST | $343.18 | $490.25 | $163.36–$416.71 | 48% below | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH LIGAMENT | $343.18 | $490.25 | $163.36–$416.71 | 48% below | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH LIGAMENT | $343.18 | $490.25 | $163.36–$416.71 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON/LIGAMENT/CYST | $343.18 | $490.25 | $163.36–$416.71 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 LG JOINT INJ | $53.87 | $76.95 | $25.64–$268.09 | 94% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION OF JOINT | $319.80 | $456.86 | $152.22–$388.33 | 66% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION OF JOINT | $319.80 | $456.86 | $152.22–$388.33 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INT JOINT INJ | $50.38 | $71.97 | $23.98–$268.09 | 92% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ANKLE INJECTION | $548.45 | $783.50 | $261.06–$665.98 | 10% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INT JOINT INJ | $548.45 | $783.50 | $261.06–$665.98 | 10% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION INJE INTER JOINT BURSA | $548.45 | $783.50 | $261.06–$665.98 | 10% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INT JOINT INJ | $548.45 | $783.50 | $261.06–$665.98 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION INJE INTER JOINT BURSA | $548.45 | $783.50 | $261.06–$665.98 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ANKLE INJECTION | $548.45 | $783.50 | $261.06–$665.98 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 SM JOINT INJ | $49.53 | $70.76 | $23.58–$268.09 | 93% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 SM JOINT INJ | $548.45 | $783.50 | $261.06–$665.98 | 25% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION INJ OF SMALL JOINT BURSA | $548.45 | $783.50 | $261.06–$665.98 | 25% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION INJ OF SMALL JOINT BURSA | $548.45 | $783.50 | $261.06–$665.98 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SM JOINT INJ | $548.45 | $783.50 | $261.06–$665.98 | — | 30% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MENISETOMY | $1,346.10 | $1,923.00 | $640.74–$2,929.83 | 74% below | 30% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MENISETOMY | $1,346.10 | $1,923.00 | $640.74–$2,929.83 | — | 30% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PRO-LAP ADDENDECTOMY | $1,427.30 | $2,039.00 | $679.39–$5,222.71 | 82% below | 30% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 PRO-LAP ADDENDECTOMY | $1,427.30 | $2,039.00 | $679.39–$5,222.71 | — | 30% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HERNIA REPAIR LAPAR-PROF | $636.65 | $909.50 | $303.05–$5,222.71 | 96% below | 30% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HERNIA REPAIR LAPAR-PROF | $636.65 | $909.50 | $303.05–$5,222.71 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACERATION REPAIR INTERMEDIATE | $287.00 | $410.00 | $136.61–$348.50 | 67% below | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LACERATION REPAIR INTERMEDIATE | $287.00 | $410.00 | $136.61–$348.50 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPIDURAL ROOM CHRG | $424.38 | $606.25 | $202.01–$606.25 | 78% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 EPIDURAL ROOM CHRG | $424.38 | $606.25 | $202.01–$606.25 | — | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 TAL<.6CM | $238.35 | $340.50 | $113.45–$340.50 | 82% below | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 TAL<.6CM | $238.35 | $340.50 | $113.45–$340.50 | — | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 FACE<.6 CM3 | $501.38 | $716.25 | $238.66–$670.36 | 66% below | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 FACE<.6 CM3 | $501.38 | $716.25 | $238.66–$670.36 | — | 30% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL/REPAIR OF NAIL PLATE | $350.69 | $500.99 | $166.93–$425.84 | 27% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVE NAIL PLATE | $377.09 | $538.70 | $179.50–$457.90 | 22% below | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL/REPAIR OF NAIL PLATE | $350.69 | $500.99 | $166.93–$425.84 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVE NAIL PLATE | $377.09 | $538.70 | $179.50–$457.90 | — | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ - OCCIPITAL NERVE | $207.73 | $296.75 | $98.88–$252.24 | 76% below | 30% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ - OCCIPITAL NERVE | $207.73 | $296.75 | $98.88–$252.24 | — | 30% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS PERITONEAL CAVITY W/US GUID | $678.50 | $969.29 | $322.97–$823.90 | 63% below | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS PERITONEAL CAVITY W/US GUID | $678.50 | $969.29 | $322.97–$823.90 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 TOE NAIL REMOVAL | $278.60 | $398.00 | $132.61–$360.92 | 78% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT NAIL REMOVAL | $726.25 | $1,037.50 | $345.70–$881.88 | 44% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PERMANENT NAIL REMOVAL | $726.25 | $1,037.50 | $345.70–$881.88 | — | 30% |
| Removal of a breast lump, open surgery CPT 19120 EXC BREAS MASS | $810.08 | $1,157.25 | $385.60–$3,450.20 | 81% below | 30% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAS MASS | $810.08 | $1,157.25 | $385.60–$3,450.20 | — | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 I&D OF FOREIGN BODY SIMPLE | $726.25 | $1,037.50 | $345.70–$881.88 | 26% below | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 REM FB SUBQ SIMPLE | $820.67 | $1,172.38 | $390.64–$996.52 | 16% below | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I&D OF FOREIGN BODY SIMPLE | $726.25 | $1,037.50 | $345.70–$881.88 | — | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REM FB SUBQ SIMPLE | $820.67 | $1,172.38 | $390.64–$996.52 | — | 30% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY | $2,600.68 | $3,715.25 | $1,237.93–$3,321.58 | 60% below | 30% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY | $2,600.68 | $3,715.25 | $1,237.93–$3,321.58 | — | 30% |
| Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM | $63.13 | $90.18 | $30.05–$243.09 | 87% below | 30% |
| Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM | $415.10 | $593.00 | $197.59–$504.05 | 17% below | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM | $415.10 | $593.00 | $197.59–$504.05 | — | 30% |
| Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM | $62.64 | $89.48 | $29.81–$115.62 | 85% below | 30% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT | $334.00 | $477.14 | $158.99–$405.57 | 18% below | 30% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT | $334.00 | $477.14 | $158.99–$405.57 | — | 30% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $295.58 | $422.25 | $140.70–$358.91 | 41% below | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST | $295.58 | $422.25 | $140.70–$358.91 | — | 30% |
| Short leg splint (calf to foot) CPT 29515 SHORT LEG CAST APPLICATION | $298.76 | $426.80 | $142.21–$362.78 | 40% below | 30% |
| Short leg splint (calf to foot) CPT 29515 SPLINT LOWER LEG APPLICATION | $337.60 | $482.28 | $160.70–$409.94 | 32% below | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG CAST APPLICATION | $298.76 | $426.80 | $142.21–$362.78 | — | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 SPLINT LOWER LEG APPLICATION | $337.60 | $482.28 | $160.70–$409.94 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACERATION REPAIR SIMPLE - SECOND PROCED | $125.83 | $179.75 | $59.90–$152.79 | 77% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP SUPERFICIAL WOUND 2.5CM OR LESS | $377.09 | $538.70 | $179.50–$457.90 | 32% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACERATION REPAIR SIMPLE | $426.11 | $608.73 | $202.83–$517.42 | 23% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACERATION REPAIR SIMPLE - SECOND PROCED | $125.83 | $179.75 | $59.90–$152.79 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP SUPERFICIAL WOUND 2.5CM OR LESS | $377.09 | $538.70 | $179.50–$457.90 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACERATION REPAIR SIMPLE | $426.11 | $608.73 | $202.83–$517.42 | — | 30% |
| Skin biopsy, punch, one lesion CPT 11104 BIOPSY PUNCH 1ST | $68.42 | $97.74 | $32.57–$360.92 | 91% below | 30% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN 1 LESION | $726.25 | $1,037.50 | $345.70–$881.88 | at median | 30% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN 1 LESION | $726.25 | $1,037.50 | $345.70–$881.88 | — | 30% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 TAL<.6CM | $207.73 | $296.75 | $98.88–$296.75 | 89% below | 30% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 TAL<.6CM | $207.73 | $296.75 | $98.88–$296.75 | — | 30% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS | $63.25 | $90.36 | $30.11–$181.21 | 84% below | 30% |
| Skin tag removal, up to 15 tags CPT 11200 TAGS UP TO/INCL 15 LESIONS | $108.15 | $154.50 | $51.48–$154.50 | 73% below | 30% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG UP TO 15 LESION | $439.78 | $628.25 | $209.34–$534.01 | 11% above | 30% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 TAGS UP TO/INCL 15 LESIONS | $108.15 | $154.50 | $51.48–$154.50 | — | 30% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAG UP TO 15 LESION | $439.78 | $628.25 | $209.34–$534.01 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $696.08 | $994.40 | $331.34–$845.24 | 47% below | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE | $696.08 | $994.40 | $331.34–$845.24 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND 2.6 7.5 | $377.09 | $538.70 | $179.50–$457.90 | 50% below | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND | $426.11 | $608.73 | $202.83–$517.42 | 43% below | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR SUPERFICIAL WOUND 2.6 7.5 | $377.09 | $538.70 | $179.50–$457.90 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR SUPERFICIAL WOUND | $426.11 | $608.73 | $202.83–$517.42 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REPAIR - PROFESSIONAL | $169.75 | $242.50 | $80.80–$206.12 | 74% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC REPAIR SIMPLE | $284.37 | $406.24 | $135.36–$345.30 | 57% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REPAIR - PROFESSIONAL | $169.75 | $242.50 | $80.80–$206.12 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REPAIR SIMPLE | $284.37 | $406.24 | $135.36–$345.30 | — | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN LESION | $68.42 | $97.74 | $32.57–$181.21 | 88% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 SHAVE BIOPSY 1ST | $68.42 | $97.74 | $32.57–$181.21 | 88% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN 1 LESION | $377.09 | $538.70 | $179.50–$457.90 | 32% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 SKIN - 1 LESION | $377.09 | $538.70 | $179.50–$457.90 | 32% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 SKIN - 1 LESION | $377.09 | $538.70 | $179.50–$457.90 | — | 30% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN 1 LESION | $377.09 | $538.70 | $179.50–$457.90 | — | 30% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE OR CATH ASPIRATION | $999.60 | $1,428.00 | $475.81–$1,213.80 | 51% below | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE OR CATH ASPIRATION | $999.60 | $1,428.00 | $475.81–$1,213.80 | — | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT 1-2 MUSCLES | $157.50 | $225.00 | $74.97–$268.09 | 75% below | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION 1-2 SITES | $319.15 | $455.93 | $151.92–$387.54 | 49% below | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT ONE/TWO MUSCLES | $343.18 | $490.25 | $163.36–$416.71 | 45% below | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT 1-2 MUSCLES | $157.50 | $225.00 | $74.97–$268.09 | — | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT ONE/TWO MUSCLES | $343.18 | $490.25 | $163.36–$416.71 | — | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ESOPHAGOGASTRO W/ BIOSPY | $525.00 | $750.00 | $249.90–$750.00 | 70% below | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY - PROF | $590.10 | $843.00 | $280.89–$820.51 | 67% below | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ESOPHAGOGASTRO W/ BIOSPY | $525.00 | $750.00 | $249.90–$750.00 | — | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY - PROF | $590.10 | $843.00 | $280.89–$820.51 | — | 30% |
| Wart removal, up to 14 warts CPT 17110 CRYOTHERAPY | $70.95 | $101.35 | $33.77–$181.21 | 80% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBREDEMENT SKIN SQ TISSUE 1ST | $675.42 | $964.88 | $321.50–$820.15 | 1% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE 20 SQ CM | $675.42 | $964.88 | $321.50–$820.15 | 1% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDGE 20 SQ CM | $675.42 | $964.88 | $321.50–$820.15 | 1% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT OF SKIN SQ TISSUE 1ST | $726.25 | $1,037.50 | $345.70–$881.88 | 7% above | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBREDEMENT SKIN SQ TISSUE 1ST | $675.42 | $964.88 | $321.50–$820.15 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE 20 SQ CM | $675.42 | $964.88 | $321.50–$820.15 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDGE 20 SQ CM | $675.42 | $964.88 | $321.50–$820.15 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT OF SKIN SQ TISSUE 1ST | $726.25 | $1,037.50 | $345.70–$881.88 | — | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BB TRANSFUSION BLOOD OR BLOOD PR | $693.53 | $990.75 | $330.12–$842.14 | 21% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION INPATIENT | $816.20 | $1,166.00 | $388.51–$991.10 | 7% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION O/P | $922.31 | $1,317.58 | $439.02–$1,119.94 | 6% above | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BB TRANSFUSION BLOOD OR BLOOD PR | $693.53 | $990.75 | $330.12–$842.14 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION INPATIENT | $816.20 | $1,166.00 | $388.51–$991.10 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION O/P | $922.31 | $1,317.58 | $439.02–$1,119.94 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM COLLECTION | $37.58 | $53.68 | $8.38–$193.06 | 89% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IS DAILY INPT | $87.59 | $125.13 | $41.69–$193.06 | 73% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL ADMIN | $109.20 | $156.00 | $51.98–$193.06 | 67% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 COOL AEROSOL | $112.53 | $160.75 | $53.57–$193.06 | 66% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL FFN | $166.33 | $237.62 | $79.17–$201.98 | 49% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MIST TENT S/U INPT | $175.18 | $250.25 | $83.39–$212.71 | 46% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION AIRWAY TREATMENT MEDICATED | $213.50 | $305.00 | $101.63–$259.25 | 35% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM COLLECTION | $37.58 | $53.68 | $8.38–$193.06 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IS DAILY INPT | $87.59 | $125.13 | $41.69–$193.06 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL ADMIN | $109.20 | $156.00 | $51.98–$193.06 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 COOL AEROSOL | $112.53 | $160.75 | $53.57–$193.06 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL FFN | $166.33 | $237.62 | $79.17–$201.98 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MIST TENT S/U INPT | $175.18 | $250.25 | $83.39–$212.71 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION AIRWAY TREATMENT MEDICATED | $213.50 | $305.00 | $101.63–$259.25 | — | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE | $2,327.72 | $3,325.31 | $1,108.00–$2,327.72 | 50% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG INITIAL | $280.61 | $400.87 | $55.37–$340.74 | 17% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG INITIAL | $280.61 | $400.87 | $55.37–$340.74 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPUTIC INJECTION IM/SC | $43.23 | $61.75 | $20.58–$63.76 | 76% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPUTIC INJECTION IM/SC | $43.23 | $61.75 | $20.58–$63.76 | — | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 INITIAL PSYCHIATRIC EVALUATION | $192.50 | $275.00 | $91.63–$233.75 | 54% below | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 TELEHEALTH INITIAL PSYCH | $192.50 | $275.00 | $91.63–$233.75 | 54% below | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED BALANCE 97112 | $65.65 | $93.79 | $31.25–$79.72 | 48% below | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-ED BALANCE 97112 | $65.65 | $93.79 | $31.25–$79.72 | 48% below | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-ED BALANCE 97112 | $65.65 | $93.79 | $31.25–$79.72 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-ED BALANCE 97112 | $65.65 | $93.79 | $31.25–$79.72 | — | 30% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT LEVEL 3 | $147.00 | $210.00 | $69.97–$178.50 | 31% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 LEVEL 3 INITIAL VISIT | $219.42 | $313.46 | $104.45–$266.44 | 2% above | 30% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT LEVEL 4 | $171.50 | $245.00 | $81.63–$208.25 | 30% below | 30% |
| New patient office visit, about 45 minutes CPT 99204 CONSULT/OP | $180.25 | $257.50 | $85.80–$218.88 | 27% below | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 LEVEL 4 INITIAL VISIT | $300.96 | $429.94 | $143.26–$365.45 | — | 30% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT LEVEL 5 | $182.00 | $260.00 | $86.63–$221.00 | 40% below | 30% |
| New patient office visit, about 60 minutes CPT 99205 LEVEL 5 INITIAL VISIT | $404.08 | $577.25 | $192.34–$490.66 | 33% above | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL 1 INITIAL VISIT | $63.34 | $90.49 | $30.15–$76.92 | 57% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT LEVEL 2 | $119.00 | $170.00 | $56.64–$144.50 | 19% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL 2 INITIAL VISIT | $129.92 | $185.60 | $61.84–$157.76 | 12% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY 97165 | $133.29 | $190.41 | $63.45–$161.85 | 49% below | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY 97165 | $133.29 | $190.41 | $63.45–$161.85 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL 97163 HIGH COMPLEXITY | $170.45 | $243.50 | $81.13–$206.98 | 60% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY | $251.94 | $359.91 | $119.92–$305.92 | 41% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 OT EVAL HIGH COMPLEXITY 97163 | $251.94 | $359.91 | $119.92–$305.92 | 41% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL 97163 HIGH COMPLEXITY | $170.45 | $243.50 | $81.13–$206.98 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 OT EVAL HIGH COMPLEXITY 97163 | $251.94 | $359.91 | $119.92–$305.92 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY | $251.94 | $359.91 | $119.92–$305.92 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY | $133.29 | $190.41 | $63.45–$161.85 | 44% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY | $133.29 | $190.41 | $63.45–$161.85 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY | $192.61 | $275.16 | $91.68–$233.89 | 46% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 OT EVAL MODERATE COMPLEXITY 97162 | $192.61 | $275.16 | $91.68–$233.89 | 46% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 OT EVAL MODERATE COMPLEXITY 97162 | $192.61 | $275.16 | $91.68–$233.89 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY | $192.61 | $275.16 | $91.68–$233.89 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 97140 | $55.77 | $79.67 | $26.55–$67.72 | 53% below | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 97140 | $55.77 | $79.67 | $26.55–$67.72 | 53% below | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY 97140 | $55.77 | $79.67 | $26.55–$67.72 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 97140 | $55.77 | $79.67 | $26.55–$67.72 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXERCISE 97110 | $65.65 | $93.79 | $31.25–$79.72 | 49% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE 97110 | $65.65 | $93.79 | $31.25–$79.72 | — | 30% |
| Preventive checkup, new patient aged 18–39 CPT 99385 NEW PT WELL EXAM | $99.40 | $142.00 | $47.31–$120.70 | 38% below | 30% |
| Preventive checkup, new patient aged 40–64 CPT 99386 NEW PT WELL EXAM 40-64 YO | $84.90 | $121.29 | $40.42–$103.10 | 54% below | 30% |
| Preventive checkup, new patient aged 65 or older CPT 99387 ANNUAL PHYSICAL EXAM NEW PATIENT | $112.35 | $160.50 | $53.48–$136.42 | 38% below | 30% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 EST PT WELL EXAM | $83.30 | $119.00 | $39.65–$101.15 | 46% below | 30% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 EST PT WELL EXAM 40-64YO | $76.00 | $108.57 | $36.17–$92.28 | 52% below | 30% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 EST PAT PREVENTATIVE MED SERVICES | $79.25 | $113.21 | $37.72–$96.23 | 50% below | 30% |
| Psychiatric evaluation with medical services CPT 90792 INITIAL PSYCHIATRIC W MED SERV | $192.50 | $275.00 | $91.63–$233.75 | 42% below | 30% |
| Psychiatric evaluation with medical services CPT 90792 TELEHEALTH EVAL 90792 | $192.50 | $275.00 | $91.63–$233.75 | 42% below | 30% |
| Psychotherapy session, 30 minutes CPT 90832 TELE HEALTH PSYCHIACTRIC 20-30W/ MED E/M | $87.50 | $125.00 | $41.65–$144.31 | 73% below | 30% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS | $87.50 | $125.00 | $41.65–$144.31 | 73% below | 30% |
| Psychotherapy session, 30 minutes CPT 90832 TELEHEALTH PSYCH 90832 | $87.50 | $125.00 | $41.65–$144.31 | 73% below | 30% |
| Psychotherapy session, 45 minutes CPT 90834 TELEHEALTH PSYCH 90834 | $93.80 | $134.00 | $44.65–$144.31 | 71% below | 30% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY | $93.80 | $134.00 | $44.65–$144.31 | 71% below | 30% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN | $112.35 | $160.50 | $53.48–$144.31 | 69% below | 30% |
| Psychotherapy session, 60 minutes CPT 90837 TELEHEALTH EVAL 90837 | $112.35 | $160.50 | $53.48–$144.31 | 69% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTB PT LEVEL 5 (40 MIN ONE ON ONE) | $157.50 | $225.00 | $74.97–$191.25 | 28% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 TELEHEALTH VISIT 99215 | $157.50 | $225.00 | $74.97–$191.25 | 28% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 LEVEL 5 FOLLOW UP VISIT | $268.08 | $382.97 | $127.61–$325.52 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPECIALY PROVIDER | $87.50 | $125.00 | $41.65–$106.25 | 40% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL 3 FOLLOW UP VISIT | $119.53 | $170.75 | $56.90–$145.14 | 17% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEHEALTH 99213 MEDICAL VISIT | $122.50 | $175.00 | $58.31–$148.75 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTB PT LEVEL 3 | $122.50 | $175.00 | $58.31–$148.75 | 15% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OBSERVATION SURGERY SERVICE | $85.05 | $121.50 | $40.48–$103.28 | 55% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEHEALTH VISIT 99214 | $147.00 | $210.00 | $69.97–$178.50 | 21% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTB PT LEVEL 4 | $147.00 | $210.00 | $69.97–$178.50 | 21% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 LEVEL 4 FOLLOW UP VISIT | $184.49 | $263.56 | $87.82–$224.03 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL 2 FOLLOW UP VISIT | $61.33 | $87.61 | $29.19–$74.47 | 45% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTB PT LEVEL 2 | $94.50 | $135.00 | $44.98–$114.75 | 15% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TELEHEALTH EVAL 99212 | $94.50 | $135.00 | $44.98–$114.75 | 15% below | 30% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT - MODERATE | $112.35 | $160.50 | $53.48–$136.42 | 39% below | 30% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT - HIGH | $131.25 | $187.50 | $62.48–$159.38 | 50% below | 30% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $120.76 | $172.52 | $57.49–$146.64 | 66% below | 30% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $120.76 | $172.52 | $57.49–$146.64 | — | 30% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY BRONCHODILATOR B&A | $256.82 | $366.89 | $122.25–$311.86 | 68% below | 30% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY BRONCHODILATOR B&A | $256.82 | $366.89 | $122.25–$311.86 | — | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT FUNCTIONAL ACTIVITIES 97530 | $45.90 | $65.57 | $21.84–$55.73 | 67% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT FUNCTIONAL ACTIVITIES 97530 | $45.90 | $65.57 | $21.84–$55.73 | 67% below | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT FUNCTIONAL ACTIVITIES 97530 | $45.90 | $65.57 | $21.84–$55.73 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT FUNCTIONAL ACTIVITIES 97530 | $45.90 | $65.57 | $21.84–$55.73 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBATOMY-THERAPEUTIC | $92.58 | $132.25 | $44.07–$112.41 | 71% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THEURAPEUTIC PHLEBOTOMY | $104.61 | $149.44 | $100.87–$127.02 | 68% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THEURAPEUTIC PHLEBOTOMY | $104.61 | $149.44 | $100.87–$127.02 | — | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA LIVE(VARIVAX) 0.5ML | $139.97 | $199.95 | $66.62–$169.96 | 55% below | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA | $140.70 | $201.00 | $66.97–$170.85 | 55% below | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA LIVE(VARIVAX) 0.5ML | $139.97 | $199.95 | $66.62–$169.96 | — | 30% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE(HAVRIX) | $194.25 | $277.50 | $92.46–$235.88 | 39% above | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE(HAVRIX) | $194.25 | $277.50 | $92.46–$235.88 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA QUAD HD65+(FLUZONE)23/24 0.7ML | $66.50 | $95.00 | $31.65–$80.75 | 47% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA QUAD HD65+(FLUZONE)23/24 0.7ML | $66.50 | $95.00 | $31.65–$80.75 | — | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VIRUS IMMUN. | $50.05 | $71.50 | $23.82–$60.78 | 63% below | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MUMP-MEASLES-RUB (MMR II) VACCINE | $117.95 | $168.50 | $56.14–$143.22 | 14% below | 30% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MUMP-MEASLES-RUB (MMR II) VACCINE | $117.95 | $168.50 | $56.14–$143.22 | — | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONG(PREVNAR-20) VACC 0.5ML | $241.50 | $345.00 | $114.95–$293.25 | 52% below | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONG(PREVNAR-20) VACC 0.5ML | $241.50 | $345.00 | $114.95–$293.25 | — | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO IMMUNIZATION | $116.20 | $166.00 | $55.31–$141.10 | 28% below | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL(PNEUMOVAX-23) 0.5ML | $140.18 | $200.25 | $66.73–$170.21 | 13% below | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL(PNEUMOVAX-23) 0.5ML | $140.18 | $200.25 | $66.73–$170.21 | — | 30% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV (ABRYSVO) VACCINE 0.5ML | $245.00 | $350.00 | $116.62–$297.50 | 21% below | 30% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV (ABRYSVO) VACCINE 0.5ML | $245.00 | $350.00 | $116.62–$297.50 | — | 30% |
| Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE(RABAVERT) PFS | $692.83 | $989.75 | $321.57–$841.29 | 2% below | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE(RABAVERT) PFS | $692.83 | $989.75 | $321.57–$841.29 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA (DECAVAC) VL | $44.63 | $63.75 | $21.25–$54.19 | 45% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DT IMMUNIZATION | $61.25 | $87.50 | $29.16–$74.38 | 25% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA (DECAVAC) VL | $44.63 | $63.75 | $21.25–$54.19 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap (ADACEL) VACCINE 0.5ML | $111.83 | $159.75 | $53.23–$135.79 | 4% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap (BOOSTRIX) VACCINE 0.5ML | $111.83 | $159.75 | $53.23–$135.79 | 4% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap (BOOSTRIX) VACCINE 0.5ML | $111.83 | $159.75 | $53.23–$135.79 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap (ADACEL) VACCINE 0.5ML | $111.83 | $159.75 | $53.23–$135.79 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUN > 8YR | $13.65 | $19.50 | $6.50–$63.76 | 87% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE UNDER 65 | $19.43 | $27.75 | $9.25–$63.76 | 81% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE 65+ | $19.43 | $27.75 | $9.25–$63.76 | 81% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACC PNEUMOCCOCCAL 65+ | $19.43 | $27.75 | $9.25–$63.76 | 81% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN IMMUN > 8YR | $100.25 | $143.22 | $47.72–$121.74 | 4% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE UNDER 65 | $19.43 | $27.75 | $9.25–$63.76 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE 65+ | $19.43 | $27.75 | $9.25–$63.76 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACC PNEUMOCCOCCAL 65+ | $19.43 | $27.75 | $9.25–$63.76 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN IMMUN > 8YR | $100.25 | $143.22 | $47.72–$121.74 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUN + ADDITIONAL > 8 YRS | $9.10 | $13.00 | $8.78–$17.40 | 88% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN IMMUN + ADDITIONAL > 8 YRS | $18.19 | $25.99 | $17.40–$22.09 | 77% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN IMMUN + ADDITIONAL > 8 YRS | $18.19 | $25.99 | $17.40–$22.09 | — | 30% |
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 CDT D4341 PERI SCALING/ROOT PLANING 4+ PER QUAD | $105.00 | $150.00 | $49.98–$796.96 | 87% below | 30% |
| Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 IMPACTED TOOTH REMOVAL - BONY | $370.65 | $529.50 | $176.43–$796.96 | 91% below | 30% |
| Root canal treatment on a molar (back tooth), not including the final crown CDT D3330 ENDODONIC THERAPY MOLAR TEETH | $695.10 | $993.00 | $330.87–$844.05 | 16% below | 30% |
| Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 PROPHYLAXIS-ADULT | $89.95 | $128.50 | $42.82–$119.65 | 7% below | 30% |
| Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION ERUPTED TOOTH | $96.60 | $138.00 | $45.98–$796.96 | 98% below | 30% |
Source file: https://bvchd.com/wp-content/uploads/2024/09/330294751_BEAR-VALLEY-COMMUNITY-HOSPITAL_standardcharges.csv