Clovis Community Medical Center
Clovis Community Medical Center in Clovis, CA publishes cash prices for 365 common procedures listed here, from its own machine-readable price file updated Sep 11, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the California median for 71 of 72 procedures and below it for 1. By typical cash price it ranks #223 of 226 California hospitals and #7 of 7 hospitals in the Fresno, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
2755 Herndon Ave, Clovis, CA 93611 Collected Oct 24, 2026 Source price file Check a bill from this hospital (559) 324-4000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 050492 · CMS hospital register
The price file shows no self-pay discount
For 518 of the 518 prices listed here, the cash price in Clovis Community 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. Other US hospitals whose cash price is their full list price.
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Clovis Community Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
State law
This state limits hospital bills for lower-income patients
California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Clovis Community Medical Center in Clovis, CA:
- Feb 9, 2026 Met requirements
- Jun 15, 2026 Warning notice
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken. Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT-ABDOMEN W/WO CONTRAST | $4,549.00 | $4,549.00 | $225.59–$3,866.65 | — | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 XRAY EXAM ABDOMEN 2 VIEWS | $901.00 | $901.00 | $30.10–$765.85 | — | — |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XRAY-ANKLE 3+ VIEW | $811.00 | $811.00 | $25.14–$689.35 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE BRACHIAL INDICES (ABI) | $1,068.00 | $1,068.00 | $52.10–$907.80 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 NON INV PHYSIOLOGIC STUDY-UNILAT | $1,068.00 | $1,068.00 | $52.10–$907.80 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT-ELBOW W/O CONTRAST | $4,158.00 | $4,158.00 | $134.46–$3,534.30 | — | — |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XRAY XM ESOPHAGUS SINGLE CONTRAST | $1,411.00 | $1,411.00 | $38.09–$1,199.35 | — | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE IMAGING WHOLE BODY | $4,639.00 | $4,639.00 | $141.03–$3,943.15 | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILATERAL COMPLETE | $946.00 | $946.00 | $96.23–$804.10 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT LTD | $786.00 | $786.00 | $78.46–$668.10 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 POC US BREAST UNILAT LTD | $786.00 | $786.00 | $78.46–$668.10 | — | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN AND PELVIS W/WO | $8,163.00 | $8,163.00 | $351.77–$6,938.55 | — | — |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WITH CONTRAST | $4,992.00 | $4,992.00 | $225.59–$4,243.20 | — | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK WITH CONTRAST | $4,888.00 | $4,888.00 | $225.59–$4,154.80 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA-CHEST W/ CONTRAST | $5,200.00 | $5,200.00 | $225.59–$4,420.00 | — | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST | $5,253.00 | $5,253.00 | $174.31–$4,465.05 | — | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST | $7,488.00 | $7,488.00 | $281.80–$6,364.80 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS 1+ SECTION/REGNS | $8,454.00 | $8,454.00 | $319.24–$7,185.90 | — | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN COMPLETE W CON | $6,066.00 | $6,066.00 | $208.76–$5,156.10 | — | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN WO CONTRAST | $3,311.00 | $3,311.00 | $131.18–$2,814.35 | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-SINUS W/O CONTRAST | $3,640.00 | $3,640.00 | $123.35–$3,094.00 | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-HEAD COMPLETE W/O CONTRAS | $3,016.00 | $3,016.00 | $101.27–$2,563.60 | — | — |
| CT scan of the head with contrast inpatient CPT 70460 CT-HEAD W/CONTRAST | $3,120.00 | $3,120.00 | $142.83–$2,652.00 | — | — |
| CT scan of the head without and with contrast inpatient CPT 70470 CT-HEAD W & WO CONT | $5,026.00 | $5,026.00 | $168.04–$4,272.10 | — | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-L-SPINE W/O CONTRAST | $3,900.00 | $3,900.00 | $124.34–$3,315.00 | — | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-C-SPINE W/O CONTRAST | $4,368.00 | $4,368.00 | $124.99–$3,712.80 | — | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W/CONTRAST | $5,402.00 | $5,402.00 | $204.45–$4,591.70 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID ULTRASOUND BILAT | $2,662.00 | $2,662.00 | $156.64–$2,262.70 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US-BILAT CAROTID DUPLEX | $2,662.00 | $2,662.00 | $156.64–$2,262.70 | — | — |
| Chest CT scan without and with contrast inpatient CPT 71270 CT-CHEST DX W/WO CONTRAST | $5,405.00 | $5,405.00 | $191.61–$4,594.25 | — | — |
| Chest X-ray, 2 views inpatient CPT 71046 XRAY EXAM CHEST 2 VIEWS | $621.00 | $621.00 | $27.48–$527.85 | — | — |
| Chest X-ray, single view inpatient CPT 71045 XRAY EXAM CHEST 1 VIEW | $458.00 | $458.00 | $17.67–$389.30 | — | — |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XRAY-CLAVICLE | $837.00 | $837.00 | $20.78–$711.45 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 POC US RETROPERITONEAL COMPLETE | $1,355.00 | $1,355.00 | $80.72–$1,151.75 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-RETROPERITONEAL COMPLETE | $1,355.00 | $1,355.00 | $80.72–$1,151.75 | — | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XRAY-DEXA SCAN/AXIAL SKELETO | $626.00 | $626.00 | $34.27–$532.10 | — | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA SCAN/APPENDICULAR SKEL. | $591.00 | $591.00 | $25.10–$502.35 | — | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US-PREGNANCY COMPLETE SNGL/1 | $1,567.00 | $1,567.00 | $164.15–$1,331.95 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-CHEST DX WO CONTRAST | $3,196.00 | $3,196.00 | $127.32–$2,716.60 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-HIGH RES CHEST DX WO CONTRAST | $3,196.00 | $3,196.00 | $127.32–$2,716.60 | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-CHEST DX W CONTRAST | $4,680.00 | $4,680.00 | $160.94–$3,978.00 | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI | $904.00 | $904.00 | $148.03–$768.40 | — | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI | $654.00 | $654.00 | $117.08–$555.90 | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US-LOWER EXTREM DUPLEX BILAT | $2,905.00 | $2,905.00 | $96.87–$2,469.25 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US-VENOUS EXT BILAT COMP | $2,989.00 | $2,989.00 | $168.24–$2,540.65 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER, COMPLETE | $2,756.00 | $2,756.00 | $239.76–$2,342.60 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 PEDIATRIC TTE W/DOPPLER COMPLETE | $2,912.00 | $2,912.00 | $239.76–$2,475.20 | — | — |
| Elbow X-ray, 2 views inpatient CPT 73070 XRAY-ELBOW TWO VIEWS | $622.00 | $622.00 | $20.78–$528.70 | — | — |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XRAY-ELBOW 3+ VIEWS | $811.00 | $811.00 | $25.98–$689.35 | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT-ORBIT-SELLA-P FOSSA WO C | $4,509.00 | $4,509.00 | $134.46–$3,832.65 | — | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XRAY-FACIAL BNS MORE THAN 3V | $946.00 | $946.00 | $37.28–$804.10 | — | — |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XRAY-FOREARM 2 VIEWS | $632.00 | $632.00 | $20.78–$537.20 | — | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HEPATOBILIARY WO PHARM INT | $3,059.00 | $3,059.00 | $291.01–$2,600.15 | — | — |
| Hand X-ray, 2 views inpatient CPT 73120 XRAY-HAND 2 VIEWS | $516.00 | $516.00 | $17.30–$438.60 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XRAY-CALCANEUS HEEL 2+ VIEWS | $596.00 | $596.00 | $19.02–$506.60 | — | — |
| Knee X-ray, 3 views inpatient CPT 73562 XRAY-KNEE 3 VIEWS | $734.00 | $734.00 | $23.38–$623.90 | — | — |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XRAY-KNEE 4+ VIEWS | $679.00 | $679.00 | $27.70–$577.15 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT-LOWER EXTREMITY WO CON | $4,150.00 | $4,150.00 | $124.34–$3,527.50 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT-ANKLE W/O CONTRAST | $4,150.00 | $4,150.00 | $124.34–$3,527.50 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 POC US ABDOMEN LTD | $1,290.00 | $1,290.00 | $60.74–$1,096.50 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 POC US SOFT TISSUE ABDOMINAL WALL | $1,290.00 | $1,290.00 | $60.74–$1,096.50 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US-ABDOMEN LTD | $1,290.00 | $1,290.00 | $60.74–$1,096.50 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD NON-VASC EXTRTY W IMG | $1,182.00 | $1,182.00 | $26.25–$1,004.70 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 POC US LMTD NON-VASC EXTRTY W IMG | $1,182.00 | $1,182.00 | $26.25–$1,004.70 | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAZ LUNG CANCER SCR WITHOUT CONTRAST | $564.00 | $564.00 | $122.72–$479.40 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XRAY-TIBIA FIBULA 2 VIEWS | $550.00 | $550.00 | $20.78–$467.50 | — | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA-HEAD-W/O CONTRAST | $4,678.00 | $4,678.00 | $210.94–$3,976.30 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI-TOES W/O CONTRAST | $5,850.00 | $5,850.00 | $196.92–$4,972.50 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI-TOES W&W/O CONTRAST | $8,646.00 | $8,646.00 | $384.87–$7,349.10 | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI-MRCP W/O CONTRAST | $5,172.00 | $5,172.00 | $190.96–$4,396.20 | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI-ABDMEN W & W/O CONTRAST | $7,038.00 | $7,038.00 | $333.52–$5,982.30 | — | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI-BRAIN W/O CONTRAST | $5,283.00 | $5,283.00 | $190.16–$4,490.55 | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI-BRAIN W/&W/O CONTRAST | $8,632.00 | $8,632.00 | $311.06–$7,337.20 | — | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI-L-SPINE W/O CONTRAST | $5,128.00 | $5,128.00 | $186.00–$4,358.80 | — | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI-L-SPINE W/&W/O CONTRAST | $8,691.00 | $8,691.00 | $312.29–$7,387.35 | — | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI-T-SPINE W/O CONTRAST | $5,437.00 | $5,437.00 | $185.35–$4,621.45 | — | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI-C-SPINE W/&W/O CONTRAST | $9,434.00 | $9,434.00 | $313.24–$8,018.90 | — | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI-C-SPINE W/O CONTRAST | $5,763.00 | $5,763.00 | $185.65–$4,898.55 | — | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI-PELVIS W/ & W/O CONTRAST | $9,462.00 | $9,462.00 | $332.91–$8,042.70 | — | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI-SI JOINTS W/O CONTRAST | $6,408.00 | $6,408.00 | $226.34–$5,446.80 | — | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI-PELVIS W/O CONTRAST | $6,408.00 | $6,408.00 | $226.34–$5,446.80 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI U EXTR ANY JOINT WO CNTRST | $5,692.00 | $5,692.00 | $197.26–$4,838.20 | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XRAY-SPINE CERVICAL MIN 4/5V | $1,242.00 | $1,242.00 | $40.00–$1,055.70 | — | — |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT-NECK W/CONTRAST | $4,091.00 | $4,091.00 | $178.55–$3,477.35 | — | — |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT-NECK W/O CONTRAST | $3,611.00 | $3,611.00 | $134.46–$3,069.35 | — | — |
| Neck soft tissue X-ray inpatient CPT 70360 XRAY-NECK SOFT TISSUE | $638.00 | $638.00 | $17.30–$542.30 | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-THALL VIABL STUDY SPECT M | $7,921.00 | $7,921.00 | $348.12–$6,732.85 | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-CARDIAC SPECT STRESS/REST | $7,921.00 | $7,921.00 | $348.12–$6,732.85 | — | — |
| Pelvic CT scan without contrast inpatient CPT 72192 CT-PELVIS W/O CONTRAST | $4,375.00 | $4,375.00 | $127.59–$3,718.75 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIS LTD OR F/U (NON OB | $837.00 | $837.00 | $42.17–$711.45 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 POC US SOFT TISSUE US PELVIC WALL | $837.00 | $837.00 | $42.17–$711.45 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 POC US PELVIS LTD OR F/U (NON OB | $837.00 | $837.00 | $42.17–$711.45 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIS COMPLETE/NON-OB | $1,563.00 | $1,563.00 | $67.65–$1,328.55 | — | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-PREGNANCY 14-17 WEEKS | $1,451.00 | $1,451.00 | $127.94–$1,233.35 | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US-PREG 1ST TRIMESTER COMPLE | $1,378.00 | $1,378.00 | $110.81–$1,171.30 | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 POC US PREG LTD SZ/POS/FETL LOC | $912.00 | $912.00 | $76.53–$775.20 | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-OB LTD STUDY | $912.00 | $912.00 | $76.53–$775.20 | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PREG LTD SZ/POS/FETL LOC | $912.00 | $912.00 | $76.53–$775.20 | — | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XRAY-RIBS UNILAT 2 VIEWS | $818.00 | $818.00 | $27.16–$695.30 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XRAY-RIBS UNILAT W/PA CHEST | $802.00 | $802.00 | $32.32–$681.70 | — | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD | $598.00 | $598.00 | $119.45–$508.30 | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XRAY-SHOULDER 2+ VIEWS | $876.00 | $876.00 | $25.86–$744.60 | — | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XRAY-SINUSES COMPLETE MIN 3V | $652.00 | $652.00 | $33.35–$554.20 | — | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XRAY-SKULL LTD <4V | $736.00 | $736.00 | $25.98–$625.60 | — | — |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE | $4,132.00 | $4,132.00 | $247.29–$3,512.20 | — | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XRAY XM SWALLOW VIDEO CONTRAST STUDY | $1,156.00 | $1,156.00 | $51.91–$982.60 | — | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XRAY FEMUR 2+ VIEWS | $479.00 | $479.00 | $29.15–$407.15 | — | — |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT-T-SPINE W/O CONTRAST | $4,345.00 | $4,345.00 | $124.68–$3,693.25 | — | — |
| Toe X-ray, 2 or more views inpatient CPT 73660 XRAY-TOES MIN 2 VIEWS | $580.00 | $580.00 | $15.59–$493.00 | — | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANSVAGINAL ULTRASOUND | $1,211.00 | $1,211.00 | $67.65–$1,029.35 | — | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 POC US TRANSVAGINAL NON OB | $1,211.00 | $1,211.00 | $67.65–$1,029.35 | — | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 POC US TRANSVAGINAL PREGNANCY | $1,342.00 | $1,342.00 | $87.23–$1,140.70 | — | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-TRANSVAGINAL PREGNANCY | $1,342.00 | $1,342.00 | $87.23–$1,140.70 | — | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN COMPLETE | $1,791.00 | $1,791.00 | $83.20–$1,522.35 | — | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 POC US SCROTUM/TESTICLE | $1,473.00 | $1,473.00 | $59.78–$1,252.05 | — | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US-SCROTUM/TESTICLE | $1,473.00 | $1,473.00 | $59.78–$1,252.05 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 POC US THYROID/SOFT TISSUS-HEAD&NE | $1,297.00 | $1,297.00 | $59.74–$1,102.45 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-THYROID/SOFT TISS-HEAD&NE | $1,297.00 | $1,297.00 | $59.74–$1,102.45 | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY XM UGI TRC SINGLE CONTRAST STUDY | $1,318.00 | $1,318.00 | $102.03–$1,120.30 | — | — |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XRAY-HUMERUS 2 VIEWS | $792.00 | $792.00 | $20.78–$673.20 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 POC US VENOUS EXT UNILAT COMP | $1,744.00 | $1,744.00 | $84.56–$1,482.40 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US-VENOUS EXT UNILAT COMP | $1,744.00 | $1,744.00 | $84.56–$1,482.40 | — | — |
| Wrist X-ray, 2 views inpatient CPT 73100 XRAY-WRIST 2 VIEWS | $671.00 | $671.00 | $17.30–$570.35 | — | — |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY-WRIST 3+ VIEWS | $807.00 | $807.00 | $25.14–$685.95 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY HIP UNILAT 2/3 VWS W/PELVIS IF DONE | $487.00 | $487.00 | $37.28–$413.95 | — | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XRAY EXAM ABDOMEN 1 VIEW | $537.00 | $537.00 | $24.63–$456.45 | — | — |
| X-ray of the ankle, 2 views inpatient CPT 73600 XRAY-ANKLE 2 VIEWS | $731.00 | $731.00 | $19.02–$621.35 | — | — |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XRAY-FINGERS MIN 2 VIEWS | $537.00 | $537.00 | $15.59–$456.45 | — | — |
| X-ray of the foot, 2 views inpatient CPT 73620 XRAY-FOOT 2 VIEWS | $704.00 | $704.00 | $17.30–$598.40 | — | — |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XRAY-FOOT 3+ VIEWS | $832.00 | $832.00 | $24.22–$707.20 | — | — |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XRAY-HAND 3+ VIEWS | $690.00 | $690.00 | $25.14–$586.50 | — | — |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XRAY-KNEE 2 VIEWS | $541.00 | $541.00 | $19.02–$459.85 | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XRAY-SPINE LUMBAR 2/3 VIEWS | $740.00 | $740.00 | $30.29–$629.00 | — | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XRAY-SPINE LUMBAR MIN 4 VIEW | $1,136.00 | $1,136.00 | $43.85–$965.60 | — | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XRAY-THORACIC 2V | $765.00 | $765.00 | $28.04–$650.25 | — | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XRAY-NASAL BONES | $874.00 | $874.00 | $24.79–$742.90 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XRAY-SPINE CERV <=3 VIEWS | $835.00 | $835.00 | $25.98–$709.75 | — | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XRAY-PELVIS 1/2 VIEWS | $708.00 | $708.00 | $21.62–$601.80 | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XRAY-SACRUM AND COCCYX | $866.00 | $866.00 | $25.02–$736.10 | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ACTH blood test inpatient CPT 82024 ACTH;Q | $24.00 | $24.00 | $5.22–$196.23 | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) | $72.00 | $72.00 | $4.58–$61.20 | — | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) | $67.00 | $67.00 | $4.41–$56.95 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PNL | $490.00 | $490.00 | $34.86–$416.50 | 80% above | — |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $92.00 | $92.00 | $4.02–$78.20 | 269% above | — |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, SERUM;Q | $25.85 | $25.85 | $5.62–$207.06 | — | — |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE24HRURINE;Q | $56.52 | $56.52 | $12.29–$207.06 | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $45.00 | $45.00 | $4.13–$38.25 | 22% above | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALP BONE SPECIFIC;Q | $32.12 | $32.12 | $4.13–$27.30 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, INDIVIDUAL;Q | $16.43 | $16.43 | $3.57–$15.30 | — | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP | $208.00 | $208.00 | $16.77–$176.80 | 171% above | — |
| Ammonia blood test CPT 82140 AMMONIA | $291.00 | $291.00 | $12.95–$247.35 | 61% above | — |
| Amylase blood test CPT 82150 AMYLASE SERUM | $212.00 | $212.00 | $5.73–$180.20 | 315% above | — |
| Amylase blood test inpatient CPT 82150 AMYLASE,PANC.FLUID;REDPATH | $18.96 | $18.96 | $4.12–$32.93 | — | — |
| Amylase blood test inpatient CPT 82150 AMYLASE RANDOM URINE | $212.00 | $212.00 | $5.73–$180.20 | — | — |
| Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID | $212.00 | $212.00 | $5.73–$180.20 | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEP;Q | $40.80 | $40.80 | $7.10–$37.96 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB;Q | $17.00 | $17.00 | $3.69–$35.44 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BTYPE NATRIURETIC PEPTIDE BNP | $386.00 | $386.00 | $30.15–$328.10 | 109% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PROBNP;Q | $127.39 | $127.39 | $27.72–$108.28 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SKIN WOUND CULTURE | $240.00 | $240.00 | $7.51–$204.00 | 99% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EAR CULTURE | $240.00 | $240.00 | $7.51–$204.00 | 99% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE | $240.00 | $240.00 | $7.51–$204.00 | 99% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 STERILE FLD CULT (AER & ANA) | $240.00 | $240.00 | $7.51–$204.00 | 99% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LEGIONELLA CULTURE;Q | $25.62 | $25.62 | $5.57–$25.25 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 H PYLORI CULTURE;ARUP | $40.33 | $40.33 | $7.51–$34.28 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND CULTURE (AER & ANA) | $240.00 | $240.00 | $7.51–$204.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE (AER&ANA) | $240.00 | $240.00 | $7.51–$204.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 RESP CULTURE (AER & ANA) | $240.00 | $240.00 | $7.51–$204.00 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $187.00 | $187.00 | $7.27–$158.95 | — | — |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $111.00 | $111.00 | $4.09–$94.35 | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATHOLOGY;UCLA | $196.10 | $196.10 | $40.99–$270.44 | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATH | $200.00 | $200.00 | $40.99–$270.44 | — | — |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE | $224.00 | $224.00 | $8.98–$190.40 | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAWING FEE | $58.00 | $58.00 | $6.21–$49.30 | — | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE 2 HR PP | $104.00 | $104.00 | $3.30–$88.40 | 177% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM RANDOM | $104.00 | $104.00 | $3.30–$88.40 | 177% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE 1 HR PP | $104.00 | $104.00 | $3.30–$88.40 | 177% above | — |
| Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD;Q | $18.00 | $18.00 | $3.91–$61.47 | — | — |
| Blood lead test inpatient CPT 83655 HEAVY METAL LEAD;Q | $22.02 | $22.02 | $4.79–$61.47 | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST, POINT OF CARE | $228.00 | $228.00 | $6.46–$193.80 | 43% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM | $228.00 | $228.00 | $6.46–$193.80 | 43% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO | $483.00 | $483.00 | $2.38–$410.55 | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 UREA DIALYSATE | $39.00 | $39.00 | $3.15–$33.15 | 18% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 BUN SERUM OR PLASMA | $39.00 | $39.00 | $3.15–$33.15 | 18% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 UREA, CAPD | $39.00 | $39.00 | $3.15–$33.15 | 18% above | — |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE;Q | $30.00 | $30.00 | $6.52–$93.13 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP INFLAMMATION | $92.00 | $92.00 | $4.60–$78.20 | 71% above | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE PCR | $347.00 | $347.00 | $28.64–$294.95 | — | — |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 TUMOR ANTIGEN | $153.00 | $153.00 | $18.50–$130.05 | 206% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA125 TUMOR ANTIGEN | $103.00 | $103.00 | $18.50–$87.55 | 25% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19;VCH | $115.00 | $115.00 | $25.02–$110.32 | — | — |
| Calcium blood test, total CPT 82310 CALCIUM SERUM OR PLASMA | $65.00 | $65.00 | $4.10–$55.25 | 7% above | — |
| Calcium blood test, total CPT 82310 CALCIUM RANDOM URINE | $65.00 | $65.00 | $4.10–$55.25 | 7% above | — |
| Calcium blood test, total CPT 82310 CALCIUM BODY FLUID | $65.00 | $65.00 | $4.10–$55.25 | 7% above | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA | $305.00 | $305.00 | $16.85–$259.25 | 265% above | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA, PANC. FLUID; REDPATH | $25.00 | $25.00 | $5.44–$55.62 | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB, IGG | $48.00 | $48.00 | $10.44–$40.80 | 56% above | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB;Q | $13.25 | $13.25 | $2.88–$37.78 | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH AMPLIFIED DN | $179.00 | $179.00 | $25.59–$152.15 | 228% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH AMPLIFIED DN | $105.27 | $105.27 | $22.90–$102.90 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $193.00 | $193.00 | $11.54–$164.05 | 90% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ LIPID;Q | $8.00 | $8.00 | $1.74–$68.08 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTOMATED DIFF | $158.00 | $158.00 | $6.75–$134.30 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM W/PLT CT | $117.00 | $117.00 | $5.71–$99.45 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $210.00 | $210.00 | $9.19–$178.50 | — | — |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM OR PLASMA | $169.00 | $169.00 | $14.49–$143.65 | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK | $156.00 | $156.00 | $5.79–$132.60 | — | — |
| Creatinine blood test inpatient CPT 82565 CREATININE SERUM OR PLASMA | $89.00 | $89.00 | $4.31–$75.65 | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB, IGG;Q | $19.41 | $19.41 | $4.22–$73.12 | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG ABS;Q | $19.41 | $19.41 | $4.22–$73.12 | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV SCREEN | $94.00 | $94.00 | $12.38–$79.90 | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE | $155.00 | $155.00 | $9.05–$131.75 | 8% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE;Q | $17.20 | $17.20 | $3.74–$112.97 | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 UR DRUGS OF ABUSE SCREEN | $520.00 | $520.00 | $43.50–$442.00 | 739% above | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL ALCOHOL URINE;Q | $43.27 | $43.27 | $9.41–$288.14 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TOX MONITORING 8 SCREEN, URINE;Q | $90.74 | $90.74 | $19.74–$288.14 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING, PNL 1, WITH CONF. URINE;Q | $117.74 | $117.74 | $25.62–$288.14 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TOXICOLOGY MONITORING 9 SCREEN, URINE ;Q | $120.18 | $120.18 | $26.15–$288.14 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG PNL UMBILICAL CORD;ARUP | $122.00 | $122.00 | $26.54–$288.14 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN-SERUM;Q | $140.00 | $140.00 | $30.46–$288.14 | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $244.00 | $244.00 | $6.23–$207.40 | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VCA VCA,I;Q | $29.74 | $29.74 | $6.47–$88.57 | — | — |
| Estradiol blood test CPT 82670 ESTRADIOL; TOTAL | $131.00 | $131.00 | $24.71–$141.98 | 52% above | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH;Q | $17.00 | $17.00 | $3.69–$94.40 | — | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH PEDS;Q | $35.78 | $35.78 | $7.78–$94.40 | — | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL;Q | $133.45 | $133.45 | $17.45–$113.43 | — | — |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $246.00 | $246.00 | $12.07–$209.10 | 131% above | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN;Q | $12.25 | $12.25 | $2.66–$69.21 | — | — |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $221.00 | $221.00 | $7.63–$187.85 | — | — |
| Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID, SERUM) | $206.00 | $206.00 | $13.07–$175.10 | 89% above | — |
| Free T3 thyroid hormone test CPT 84481 T3, FREE | $118.00 | $118.00 | $11.93–$100.30 | 46% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 T3, FREE;Q | $19.00 | $19.00 | $4.13–$49.68 | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $211.00 | $211.00 | $7.91–$179.35 | 210% above | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE FTI;Q | $27.90 | $27.90 | $6.07–$45.81 | — | — |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE;Q | $29.75 | $29.75 | $6.47–$129.41 | — | — |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE MALE;Q | $55.00 | $55.00 | $11.96–$129.41 | — | — |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE,FREE-FEMALE OR CHILD;ARUP | $55.76 | $55.76 | $12.13–$129.41 | — | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT | $83.00 | $83.00 | $6.40–$70.55 | 82% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 DIABETIC SCREEN GEST | $20.00 | $20.00 | $4.19–$24.10 | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 HR PG | $20.00 | $20.00 | $4.19–$24.10 | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR PG | $20.00 | $20.00 | $4.19–$24.10 | — | — |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 2 HR | $154.00 | $154.00 | $11.27–$130.90 | 12% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC (N GONORRHOR) AMPLIFED DNA | $184.00 | $184.00 | $25.36–$156.40 | 208% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC (N GONORRHOR) AMPLIFED DNA | $105.27 | $105.27 | $22.90–$102.90 | — | — |
| H. pylori antibody blood test CPT 86677 H.PYLORI AB, IGG | $169.00 | $169.00 | $12.95–$143.65 | 48% above | — |
| H. pylori stool antigen test inpatient CPT 87338 H. PYLORI STOOL ANTIGEN | $163.00 | $163.00 | $12.79–$138.55 | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RNA QNT RT PCR;Q | $70.00 | $70.00 | $15.23–$249.48 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG AB SINGLE RESULT | $166.00 | $166.00 | $20.26–$141.10 | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 INFECTIOUS AGENT HPV HIGH RISK | $105.27 | $105.27 | $22.90–$89.47 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCATED HEMOGLOBIN A1C | $178.00 | $178.00 | $8.54–$151.30 | 173% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 CARDIO IQ HA1C;Q | $16.00 | $16.00 | $3.48–$28.46 | — | — |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN;Q | $3.99 | $3.99 | $0.86–$6.93 | — | — |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $73.00 | $73.00 | $2.07–$62.05 | — | — |
| Hemoglobin blood test inpatient CPT 85018 POC HEMOGLOBIN | $73.00 | $73.00 | $2.07–$62.05 | — | — |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN-NOVA | $73.00 | $73.00 | $2.07–$62.05 | — | — |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE TOT AB | $84.00 | $84.00 | $10.71–$71.40 | 139% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SFC AB | $107.00 | $107.00 | $9.51–$90.95 | — | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SFC AG | $144.00 | $144.00 | $9.12–$122.40 | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB | $150.00 | $150.00 | $12.57–$127.50 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANT (PCR);Q | $98.00 | $98.00 | $21.32–$125.59 | — | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV IGG I&II;Q | $18.97 | $18.97 | $4.12–$38.67 | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG TYPE-SPEC AB;Q | $23.17 | $23.17 | $5.04–$56.74 | — | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP ULTRASENSITIVE | $196.00 | $196.00 | $11.06–$166.60 | 231% above | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO IQ HSCRP;Q | $36.20 | $36.20 | $7.87–$37.96 | — | — |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE;Q | $26.00 | $26.00 | $5.65–$49.45 | — | — |
| Insulin blood test inpatient CPT 83525 INSULIN;Q | $18.00 | $18.00 | $3.91–$58.07 | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $86.00 | $86.00 | $5.72–$73.10 | — | — |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $282.00 | $282.00 | $7.60–$239.70 | 98% above | — |
| LH (luteinizing hormone) test inpatient CPT 83002 LH;Q | $17.00 | $17.00 | $3.69–$94.09 | — | — |
| LH (luteinizing hormone) test inpatient CPT 83002 LH PEDS;Q | $20.50 | $20.50 | $4.46–$94.09 | — | — |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $224.00 | $224.00 | $9.41–$190.40 | 68% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $118.00 | $118.00 | $5.37–$100.30 | 235% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH, BODY FLUID | $160.00 | $160.00 | $5.37–$136.00 | 354% above | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH;Q | $8.00 | $8.00 | $1.74–$30.71 | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $179.00 | $179.00 | $6.08–$152.15 | 86% above | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $208.00 | $208.00 | $6.38–$176.80 | 37% above | — |
| Lyme disease antibody test inpatient CPT 86618 LYMEDISEASE;Q | $23.08 | $23.08 | $5.02–$49.93 | — | — |
| Lyme disease antibody test inpatient CPT 86618 LYME CSF, IGG, EIA;Q | $28.55 | $28.55 | $6.21–$49.93 | — | — |
| Lyme disease antibody test inpatient CPT 86618 LYME CSF, IGM, EIA;Q | $28.56 | $28.56 | $6.21–$49.93 | — | — |
| Magnesium blood test CPT 83735 MAGNESIUM SERUM | $179.00 | $179.00 | $5.96–$152.15 | 186% above | — |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24 HOUR | $186.00 | $186.00 | $5.96–$158.10 | 198% above | — |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEIOLA IGM | $24.70 | $24.70 | $5.37–$37.78 | — | — |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES AB, IGG | $38.00 | $38.00 | $8.26–$37.78 | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $124.00 | $124.00 | $4.49–$105.40 | 21% above | — |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGM; ARUP | $19.92 | $19.92 | $4.33–$38.27 | — | — |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGM AB;Q | $23.29 | $23.29 | $5.06–$38.27 | — | — |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB, IGG | $58.00 | $58.00 | $11.59–$49.30 | — | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA PROSTATE SPECIFIC AG FREE;Q | $14.00 | $14.00 | $3.04–$53.94 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA PROSTATE SPECIFIC AG TOTAL;Q | $22.00 | $22.00 | $4.78–$53.94 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA PROSTATE SPECIFIC ANTIGEN | $183.00 | $183.00 | $16.35–$155.55 | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATHOLOGY | $79.83 | $79.83 | $17.37–$77.67 | — | — |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH/THIN PREP-GYN;SP | $60.78 | $60.78 | $13.22–$102.92 | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY PARATHORMONE/PTH INTACT | $235.00 | $235.00 | $34.84–$209.71 | 114% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN | $163.00 | $163.00 | $5.34–$138.55 | 161% above | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM OR PLASMA | $82.00 | $82.00 | $4.21–$69.70 | — | — |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM OR PLASMA | $98.00 | $98.00 | $3.44–$83.30 | — | — |
| Progesterone blood test CPT 84144 PROGESTERONE | $99.00 | $99.00 | $18.30–$106.01 | 20% above | — |
| Prolactin blood test inpatient CPT 84146 PROLACTIN;Q | $15.00 | $15.00 | $3.26–$98.44 | — | — |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $201.00 | $201.00 | $17.11–$170.85 | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $117.00 | $117.00 | $3.49–$99.45 | 113% above | — |
| Renin blood test inpatient CPT 84244 PLASMA RENIN ACTIVITY;Q | $28.00 | $28.00 | $6.09–$111.75 | — | — |
| Rh blood typing inpatient CPT 86901 RH (D) | $147.00 | $147.00 | $2.46–$124.95 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATIOD FACTOR QUANT;Q | $16.50 | $16.50 | $3.59–$16.64 | — | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $74.00 | $74.00 | $12.79–$62.90 | 46% above | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG;Q | $14.00 | $14.00 | $3.04–$42.21 | — | — |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTO | $142.00 | $142.00 | $2.40–$120.70 | — | — |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE | $288.00 | $288.00 | $12.31–$244.80 | — | — |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM OR PLASMA | $82.00 | $82.00 | $3.51–$69.70 | — | — |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITE EXAM;Q | $15.00 | $15.00 | $3.26–$26.08 | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $44.00 | $44.00 | $2.92–$37.40 | 13% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD IMMUNO | $66.00 | $66.00 | $14.14–$80.82 | 35% above | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 AB TREPONEMA PALLIDUM | $69.00 | $69.00 | $11.40–$58.65 | 326% above | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM ABS;Q | $21.75 | $21.75 | $4.73–$38.81 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR REFLEX TO TP-PA;Q | $13.10 | $13.10 | $2.85–$21.71 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF;Q | $25.66 | $25.66 | $3.18–$21.81 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, FREE FEM/PED;Q | $19.00 | $19.00 | $4.13–$131.15 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOT;Q | $20.00 | $20.00 | $4.35–$131.15 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL FEM/PED;Q | $20.00 | $20.00 | $4.35–$131.15 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE FREE | $256.00 | $256.00 | $22.80–$217.60 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AUTO ABS;Q | $19.68 | $19.68 | $4.28–$42.66 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ABS;Q | $19.98 | $19.98 | $4.34–$42.66 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOME;Q | $27.85 | $27.85 | $6.06–$42.66 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB EACH;Q | $135.45 | $135.45 | $12.93–$115.13 | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $244.00 | $244.00 | $14.76–$207.40 | 164% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH NAPS;NB | $28.25 | $28.25 | $6.14–$49.27 | — | — |
| Total IgE blood test inpatient CPT 82785 IGE, SERUM;Q | $19.00 | $19.00 | $4.13–$83.69 | — | — |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $120.00 | $120.00 | $3.87–$102.00 | 186% above | — |
| Total thyroxine (T4) blood test CPT 84436 THYROXIN TOTAL (T4) | $206.00 | $206.00 | $5.18–$175.10 | 426% above | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4, TOTAL;Q | $18.00 | $18.00 | $3.91–$20.14 | — | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3, TOTAL;Q | $18.00 | $18.00 | $3.91–$41.57 | — | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3, TOTAL | $90.00 | $90.00 | $12.59–$76.50 | — | — |
| Transferrin blood test CPT 84466 TRANSFERRIN | $150.00 | $150.00 | $11.01–$127.50 | 178% above | — |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMPLIFIED DNA PROBE | $177.00 | $177.00 | $30.54–$150.45 | 81% above | — |
| Triglycerides blood test inpatient CPT 84478 CARDIO IQ TRIGLYCERIDES;Q | $7.94 | $7.94 | $1.72–$29.23 | — | — |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE | $139.00 | $139.00 | $5.02–$118.15 | — | — |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN CHARGE | $233.00 | $233.00 | $8.47–$198.05 | — | — |
| Uric acid blood test inpatient CPT 84550 URIC ACID SERUM | $79.00 | $79.00 | $4.01–$67.15 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 AUTOM URINE DIP W MICRO | $107.00 | $107.00 | $2.77–$90.95 | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SPECIFIC GRAVITY | $91.00 | $91.00 | $1.96–$77.35 | — | — |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE 24 HOUR | $101.00 | $101.00 | $5.08–$85.85 | 175% above | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE | $85.00 | $85.00 | $2.80–$72.25 | — | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 (CYANOCOBALAMIN) | $176.00 | $176.00 | $13.33–$149.60 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D | $194.00 | $194.00 | $20.72–$164.90 | 203% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 QUESTASSURED 25 HYDROXYVITAMIN D;Q | $26.00 | $26.00 | $5.65–$150.42 | — | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D, 1, 25 DIHY;Q | $30.00 | $30.00 | $6.52–$164.52 | — | — |
| Zinc blood test inpatient CPT 84630 ZINC SERUM;Q | $22.00 | $22.00 | $4.78–$57.86 | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE | $319.00 | $319.00 | $13.24–$271.15 | 78% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG MALIGNANT | $26.35 | $26.35 | $5.73–$44.15 | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 RADP BX BRST 1ST LESION STRTCTC | $5,672.00 | $5,672.00 | $42.00–$7,438.00 | — | — |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO | $21,967.00 | $21,967.00 | $950.01–$18,671.95 | — | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL | $3,744.00 | $3,744.00 | $122.46–$3,630.00 | — | — |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB | $85,882.00 | $85,882.00 | $880.47–$72,999.70 | — | — |
| Cervical biopsy inpatient CPT 57500 BX SING/MULTI LESION CERVIX | $3,048.00 | $3,048.00 | $39.00–$4,053.00 | — | — |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION AGE >28 DAYS | $7,808.50 | $7,808.50 | $55.00–$8,490.00 | — | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $10,130.00 | $10,130.00 | $2,204.28–$8,610.50 | — | — |
| Coronary stent placement, one artery inpatient CPT 92928 STENT PLACEMENT INCL ANGIOPLASTY | $39,701.00 | $39,701.00 | $483.05–$33,745.85 | — | — |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D&C DIAG OR THERAP NOT OB | $11,131.00 | $11,131.00 | $39.00–$9,461.35 | — | — |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI | $296.00 | $296.00 | $11.54–$3,989.00 | — | — |
| Earwax removal with instruments, one ear inpatient CPT 69210 EAR CERUMEN REMOVAL W INST UNI | $208.00 | $208.00 | $43.20–$3,989.00 | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX, WO CERVICAL DILATION | $781.00 | $781.00 | $55.00–$3,989.00 | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 RADP INJ INTERLAMINAR CRV/THRC | $3,151.00 | $3,151.00 | $223.38–$4,053.00 | — | — |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECTION OF DRUGS | $1,161.00 | $1,161.00 | $70.00–$4,053.00 | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 RADP-FACET INJ LUMAR/SAC 1 L | $3,394.00 | $3,394.00 | $144.45–$4,053.00 | — | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 RADP-CATH HYSTEROSALPINGOGRM | $1,558.00 | $1,558.00 | $30.00–$3,989.00 | — | — |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 MW I.U.D. INSERTION | $5,306.00 | $5,306.00 | $25.00–$4,510.10 | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC, SMPL OR SGL | $1,249.00 | $1,249.00 | $30.00–$5,447.00 | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 RADP - I&D ABSCESS SIMPLE | $1,249.00 | $1,249.00 | $30.00–$5,447.00 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJ JNT/BURSA WO US | $1,282.00 | $1,282.00 | $34.00–$6,354.00 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 RADP-ARTHROCENTESES/MAJ JT A | $1,282.00 | $1,282.00 | $34.00–$6,354.00 | — | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 FAM PLAN INSERT IMPL CONTR CAPSULE | $451.00 | $451.00 | $40.00–$3,989.00 | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTERM JNT/BURSA WO US | $1,120.00 | $1,120.00 | $34.00–$5,447.00 | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 RADP DRAIN/INJ INTERM J W/O US | $1,120.00 | $1,120.00 | $34.00–$5,447.00 | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ SM JNT/BURSA W/O US | $1,033.00 | $1,033.00 | $34.00–$4,053.00 | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 RADP DRAIN/INJ SMALL JT W/O US | $1,033.00 | $1,033.00 | $34.00–$4,053.00 | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 RADP PERQ SACRAL AUGMT UNILAT INJ (SACROPLASTY) | $1,033.00 | $1,033.00 | $34.00–$4,053.00 | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 SUTURE TO 2.5 CM INTERMED | $1,399.00 | $1,399.00 | $35.00–$5,447.00 | — | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY | $13,127.00 | $13,127.00 | $190.00–$16,757.00 | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 RADP INJ INTERLAMINAR LMBR/SAC | $2,424.00 | $2,424.00 | $220.03–$4,053.00 | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRNSFRML EPI LUMB/SACRAL, SINGLE LEVEL | $4,535.00 | $4,535.00 | $143.34–$8,490.00 | — | — |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TXMT MISSED ABORTION 1ST TRMSTR SURG | $12,484.00 | $12,484.00 | $168.65–$10,611.40 | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LES T/A/L <=0.5CM | $5,775.00 | $5,775.00 | $28.00–$5,447.00 | — | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FACE-MM B9+MARG 0.5CM/< | $2,575.00 | $2,575.00 | $36.00–$5,447.00 | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPLE SINGLE | $696.00 | $696.00 | $30.00–$3,989.00 | — | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANESTH/STEROID, GREATER OCCIPITAL NERVE | $1,033.00 | $1,033.00 | $62.92–$4,053.00 | — | — |
| Pacemaker implant (dual chamber) inpatient CPT 33208 PM STYTEM IMPLANT DDD (R) | $36,637.00 | $36,637.00 | $120.00–$31,141.45 | — | — |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING | $3,282.00 | $3,282.00 | $60.00–$5,447.00 | — | — |
| Paracentesis with imaging guidance inpatient CPT 49083 RADP-ABD PARACENTESIS W/IMAGING | $3,282.00 | $3,282.00 | $60.00–$5,447.00 | — | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL & MATRIX PERM | $1,751.00 | $1,751.00 | $39.00–$4,053.00 | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & REM FB, SQ, SMPL | $2,174.00 | $2,174.00 | $34.00–$3,989.00 | — | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST | $1,100.00 | $1,100.00 | $30.00–$3,630.00 | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT FOREARM TO HAND, STATIC | $724.00 | $724.00 | $30.00–$3,630.00 | — | — |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SH LEG CAST | $930.00 | $930.00 | $36.00–$3,630.00 | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT | $684.00 | $684.00 | $26.00–$3,630.00 | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SUT SMPL S/N/A/G/TR/EXT <=2.5CM | $971.00 | $971.00 | $32.00–$5,447.00 | — | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION | $1,499.00 | $1,499.00 | $26.00–$4,696.21 | — | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS | $1,205.00 | $1,205.00 | $22.00–$3,989.00 | — | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR DIAGNOSTIC | $2,424.00 | $2,424.00 | $121.83–$4,053.00 | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SUT SMPL S/N/A/G/TR/EXT 2.6-7.5CM | $1,494.00 | $1,494.00 | $32.00–$5,447.00 | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SUT SMPL F/E/E/N/L/MM <= 2.5CM | $1,135.00 | $1,135.00 | $38.00–$5,447.00 | — | — |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LESION | $696.00 | $696.00 | $26.00–$4,696.21 | — | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACEN,NDL/CATH,ASPIR W/IMAG | $2,685.00 | $2,685.00 | $32.00–$4,053.00 | — | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 RADP-US GUIDED THORACENTESIS | $2,685.00 | $2,685.00 | $32.00–$4,053.00 | — | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 RADP-THORACENTESIS/ASP PLEURA W/IMAGING | $2,685.00 | $2,685.00 | $32.00–$4,053.00 | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIG PT INJ 1/2 MUSCLES | $1,190.00 | $1,190.00 | $52.49–$4,053.00 | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 RADP BX BRST 1ST LESION US IMAG | $5,672.00 | $5,672.00 | $42.00–$7,438.00 | — | — |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 RADP SCLEROTHERAPY RF ABLATION 1ST VEIN | $14,931.00 | $14,931.00 | $25.00–$12,691.35 | — | — |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTR BENIGN LESIONS/UP TO 14 | $696.00 | $696.00 | $106.86–$3,989.00 | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE, SKIN TO SQ TISSUE FIRST 20 SQ CM | $1,499.00 | $1,499.00 | $20.00–$5,494.00 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 LEVEL 1: UP TO 1 HOUR -TRANSF | $1,548.00 | $1,548.00 | $336.84–$4,053.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 LEVEL 2: 1.5-3 HOURS - TRANSF | $2,295.00 | $2,295.00 | $499.39–$4,053.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 LEVEL 3: 3-5.5 HOURS - TRANSF | $3,566.00 | $3,566.00 | $554.62–$4,053.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 LEVEL 4: 5.5-7.0 HOURS TRANSF | $4,353.00 | $4,353.00 | $554.62–$4,053.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 LEVEL 5: 7.5+ HOURS- TRANSF | $5,139.00 | $5,139.00 | $554.62–$4,368.15 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION | $696.00 | $696.00 | $11.70–$605.53 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN/MDI/EZPAP | $696.00 | $696.00 | $11.70–$605.53 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN WITH ANTIBIOTIC | $696.00 | $696.00 | $11.70–$605.53 | — | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEM ADMN,IV INFUS UP TO 1 HR | $1,818.00 | $1,818.00 | $28.59–$1,545.30 | — | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL #6 | $9,517.00 | $9,517.00 | $1,062.41–$8,648.09 | — | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG, AWAKE & DROWSY | $1,588.00 | $1,588.00 | $75.58–$1,349.80 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD ECG (TRACING) | $398.00 | $398.00 | $7.43–$338.30 | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED- MODIFIED TRMT RM #1 | $855.00 | $855.00 | $15.18–$3,772.00 | — | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED- BRIEF TRMT RM #2 | $1,648.00 | $1,648.00 | $24.38–$4,022.00 | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED- LIMITED TRMT RM #3 | $2,812.00 | $2,812.00 | $44.60–$4,098.00 | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED-INTERMEDIATE #4 | $4,326.00 | $4,326.00 | $68.35–$4,098.00 | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED-EXTENDED #5 | $6,502.00 | $6,502.00 | $108.08–$6,532.00 | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 MED NUC STRESS TEST | $1,751.00 | $1,751.00 | $52.50–$1,488.35 | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL STRESS TEST | $1,751.00 | $1,751.00 | $52.50–$1,488.35 | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NUC TREAD STRESS TEST | $1,751.00 | $1,751.00 | $52.50–$1,488.35 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION UP TO 1 HR | $790.00 | $790.00 | $51.30–$955.00 | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER 1ST HOUR | $790.00 | $790.00 | $62.60–$955.00 | — | — |
| IV push of a medicine, first drug inpatient CPT 96374 THERA PROPH INTRA PUSH | $790.00 | $790.00 | $49.82–$955.00 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ, SC/IM | $267.00 | $267.00 | $18.75–$226.95 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RADP-IM THERAPY SEDATION MD | $267.00 | $267.00 | $18.75–$955.00 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM ANTIBIOTIC | $267.00 | $267.00 | $18.75–$226.95 | — | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 ST | $1,204.00 | $1,204.00 | $160.95–$1,031.88 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROM RE-ED/BAL/CRD L2 EA15 | $209.00 | $209.00 | $12.22–$419.00 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROM RE-ED/BAL/CRD EA 15 | $209.00 | $209.00 | $12.22–$419.00 | — | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION - LOW COMPLEXITY | $404.00 | $404.00 | $87.91–$419.00 | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION - HIGH COMPLEXITY | $498.00 | $498.00 | $103.01–$423.30 | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION - LOW COMPLEXITY | $404.00 | $404.00 | $87.91–$419.00 | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION - MODERATE COMPLEXITY | $454.00 | $454.00 | $98.79–$419.00 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MAN THER/TRX/MFR/MOB EA 15 | $209.00 | $209.00 | $22.21–$419.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THRX-STRGT,ENDR,ROM,FLX EA15 | $202.00 | $202.00 | $6.37–$419.00 | — | — |
| Speech and language evaluation inpatient CPT 92523 SLP LANG/ARTIC EVALUATION A | $767.00 | $767.00 | $107.68–$651.95 | — | — |
| Speech and language evaluation inpatient CPT 92523 SLP LANG/ARTIC EVALUATION E | $774.00 | $774.00 | $107.68–$657.90 | — | — |
| Speech and language evaluation inpatient CPT 92523 SLP LANG/ARTIC EVALUATION C | $774.00 | $774.00 | $107.68–$657.90 | — | — |
| Speech and language evaluation inpatient CPT 92523 SLP LANG/ARTIC EVALUATION D | $774.00 | $774.00 | $107.68–$657.90 | — | — |
| Speech and language evaluation inpatient CPT 92523 SLP LANG/ARTIC EVALUATION F | $774.00 | $774.00 | $107.68–$657.90 | — | — |
| Speech and language evaluation inpatient CPT 92523 SLP LANG/ARTIC EVALUATION B | $775.00 | $775.00 | $107.68–$658.75 | — | — |
| Speech therapy session, individual inpatient CPT 92507 SLP TREAT C | $470.00 | $470.00 | $56.41–$590.00 | — | — |
| Speech therapy session, individual inpatient CPT 92507 SLP TREAT A | $470.00 | $470.00 | $56.41–$590.00 | — | — |
| Speech therapy session, individual inpatient CPT 92507 SLP TREAT D | $470.00 | $470.00 | $56.41–$590.00 | — | — |
| Speech therapy session, individual inpatient CPT 92507 SLP TREAT B | $470.00 | $470.00 | $56.41–$590.00 | — | — |
| Spirometry (breathing test) inpatient CPT 94010 SIMPLE SPIRO (SPIROMETRY) | $657.00 | $657.00 | $25.01–$597.08 | — | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PRE&POST SPIRO (BRONCHSPASM PRE&POST BD) | $1,337.00 | $1,337.00 | $45.03–$1,136.45 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 DYNAMIC/FUNC OT ACT EA 15 | $209.00 | $209.00 | $11.14–$177.65 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 DYNAMIC/FUNC PT ACT EA 15 | $209.00 | $209.00 | $11.14–$419.00 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 DYNAMC FUNC OT ACT L2 EA15 | $209.00 | $209.00 | $11.14–$177.65 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 DYNAMC FUNC PT ACT L2 EA15 | $209.00 | $209.00 | $11.14–$419.00 | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC | $417.00 | $417.00 | $16.40–$3,630.00 | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DPAT-IPV (KINRIX) 0.5ML SDPF 4-6YR | $358.98 | $358.98 | $63.67–$305.13 | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE | $214.05 | $214.05 | $31.52–$181.94 | 198% above | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACC 0.5ML(INFANRIX)<7Y | $172.22 | $172.22 | $31.52–$146.38 | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP (DAPTACEL) 0.5ML VL <7Y | $215.11 | $215.11 | $31.52–$182.84 | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE | $767.22 | $767.22 | $98.68–$652.13 | 366% above | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B VACC/DPAT/IP .5ML SYR< | $542.80 | $542.80 | $98.68–$461.38 | — | — |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-HIB-IP VACC IM 0.5ML VIAL | $661.73 | $661.73 | $111.06–$562.47 | — | — |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLU VACCINE IIV3 PF (FLUZONE TRIVALENT) 0.5 ML IM SYRINGE | $523.29 | $523.29 | $45.07–$444.79 | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE IIV3 PF (FLUARIX TRIVALENT) 0.5 ML SYRINGE IM | $153.17 | $153.17 | $23.22–$130.19 | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE IIV3 PF (FLUZONE TRIVALENT) 0.5 ML IM SYRINGE | $154.50 | $154.50 | $23.22–$131.32 | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $2,185.04 | $2,185.04 | $291.25–$1,857.28 | 464% above | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT PF (GARDASIL 9) 0.5 ML SYRINGE IM | $834.57 | $834.57 | $181.60–$709.38 | — | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP B RECOMB/HEP A VIR VACC 1M | $732.50 | $732.50 | $129.16–$622.62 | — | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACC PF (HAVRIX) 1440 UNITS/ML 1ML SYRINGE IM | $255.84 | $255.84 | $55.67–$217.46 | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A VACC (VAQTA)25U/0.5ML- | $238.35 | $238.35 | $41.45–$202.59 | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A PED VACC 720U/0.5ML-2D | $239.98 | $239.98 | $41.45–$203.98 | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP | $535.45 | $535.45 | $74.84–$455.13 | 337% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $535.45 | $535.45 | $74.84–$455.13 | 337% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACC ADULT 10MCG/.5ML | $175.79 | $175.79 | $38.25–$161.56 | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACC ADULT PF (ENGERIX-B) 20MCG/ML 1ML SDV 3 DOSE IM | $422.40 | $422.40 | $74.84–$359.04 | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACC ADULT 20MCG/1ML S | $422.40 | $422.40 | $74.84–$359.04 | — | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEP B VACC PF ADJUVANT (HEPLISAV-B) 20 MCG/0.5 ML IM SYRINGE | $1,048.41 | $1,048.41 | $164.74–$891.14 | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $214.61 | $214.61 | $33.20–$182.41 | 272% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $220.50 | $220.50 | $33.20–$187.42 | 282% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VACCINE 0.5ML-PED/ADOL | $98.45 | $98.45 | $21.42–$83.68 | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VACC PED 10MCG/0.5ML S | $171.10 | $171.10 | $33.20–$145.43 | — | — |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPH B VACC (PRP-OMP) 0.5 | $193.38 | $193.38 | $33.42–$164.37 | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN | $107.13 | $107.13 | $14.29–$91.06 | 156% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH INFLU B VAC PRP-T 1D | $125.32 | $125.32 | $14.29–$106.52 | — | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT | $685.18 | $685.18 | $94.70–$582.40 | 389% above | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M.M.R. VACCINE 1 DOSE | $524.52 | $524.52 | $94.70–$445.84 | — | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLE/MUMP/RUB/VARI VACC .5 | $1,483.21 | $1,483.21 | $271.61–$1,260.72 | — | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $1,246.71 | $1,246.71 | $152.46–$1,059.70 | 377% above | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGCCAL VACC ACWYCRM IM USE | $871.94 | $871.94 | $152.46–$741.14 | — | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION | $1,249.51 | $1,249.51 | $170.69–$1,062.08 | 368% above | — |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL CONJ VACC ACWY TET PF (MENQUADFI) 10 MCG/0.5ML SDV IM | $1,178.64 | $1,178.64 | $170.69–$1,001.84 | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $1,718.35 | $1,718.35 | $227.46–$1,460.59 | 289% above | — |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNCCAL VACC 13VAL 0.5ML SYRINGE | $76.93 | $76.93 | $16.73–$554.68 | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $2,113.46 | $2,113.46 | $293.12–$1,796.44 | 307% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONJ PF (PREVNAR 20) 0.5ML SYRINGE IM -10 | $1,779.86 | $1,779.86 | $293.12–$1,512.88 | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONJ PF (PREVNAR 20) 0.5ML SYRINGE IM -02 | $1,892.06 | $1,892.06 | $293.12–$1,608.25 | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $834.57 | $834.57 | $118.38–$709.38 | 416% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNCCAL VACC 23VAL 0.5ML VL = | $716.30 | $716.30 | $118.38–$608.85 | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL PSV (PNEUMOVAX-23) 0.5ML SYRINGE SQ OR IM 2Y UP | $1,935.71 | $1,935.71 | $118.38–$1,645.35 | — | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOMYELITIS VACC KILLED 0.5ML INJ | $244.43 | $244.43 | $46.35–$207.76 | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $3,785.37 | $3,785.37 | $633.99–$3,217.56 | 291% above | — |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $2,926.94 | $2,926.94 | $315.22–$2,487.89 | 314% above | — |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC (RABAVERT)2.5U K | $2,237.00 | $2,237.00 | $315.22–$1,901.45 | — | — |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VAC LIVE PENT 2ML | $586.48 | $586.48 | $119.45–$498.50 | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $325.89 | $325.89 | $34.80–$277.00 | 300% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA TOXOIDS ADSOR | $190.85 | $190.85 | $34.80–$162.22 | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPTHERIA-DECAVAC | $241.32 | $241.32 | $34.80–$205.12 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $350.24 | $350.24 | $42.77–$297.70 | 203% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACC 0.5ML (ADACEL) >7Y | $317.76 | $317.76 | $42.77–$270.09 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP (BOOSTRIX) IM 0.5ML SYRINGE 7 YRS & OLDER - 52 | $330.99 | $330.99 | $42.77–$281.34 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP (BOOSTRIX) IM 0.5ML VIAL 7 YRS & OLDER - 11 | $330.99 | $330.99 | $42.77–$281.34 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE | $267.00 | $267.00 | $4.46–$226.95 | — | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN-EA ADDL VACCINE | $55.00 | $55.00 | $11.96–$57.36 | — | — |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://mrfs.hyvehealthcare.com/CommunityHealthSystem/941156276_clovis-community-medical-center_standardcharges.csv