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Acute Care Hospital

Antelope Valley Hospital

Also listed as: Antelope Valley Medical Center

Lancaster, California · Los Angeles County · Emergency services listed

Antelope Valley Hospital is an acute care hospital at 1600 W Ave J, Lancaster, CA 93534. Phone: (661) 949-5500. It has an emergency department. Medicare overall rating: 1 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked October 30, 2026).

Summary

Antelope Valley Hospital is an acute care hospital in Lancaster, California. Medicare data lists emergency services. CMS overall star rating: 1 of 5 stars. Its official website lists 23 services, specialties and programs. Medicare lists 301 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

A general hospital for short-term care: emergencies, surgery, illness and injury. Most patients stay a few days. More about hospital types

Call(661) 949‑5500 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-30). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
1 of 5 stars1 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
301Doctors and clinicians
23Services listed

Quick answers

Does Antelope Valley Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Antelope Valley Hospital. In a medical emergency, call 911.
Where is Antelope Valley Hospital?
1600 W Ave J, Lancaster, CA 93534, in Los Angeles County, California.
What is the phone number of Antelope Valley Hospital?
(661) 949-5500, as listed by Medicare (CMS).
What is the Medicare star rating of Antelope Valley Hospital?
1 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Antelope Valley Hospital for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Antelope Valley Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.4264; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[5]

Treatments[5]

  • Infusion care

Programs and centers[4][5]

  • Trauma Center
  • Neonatal Intensive Care Unit
  • Pediatric Intensive Care Unit
  • Women and Infant Pavilion
  • Women's Imaging Center
  • Forensic Services Unit
  • Home Health Services

Emergency care (hospital website)[4][5]

Emergency roomYes

Recognition[4]

  • Baby-Friendly designation

Doctors and clinicians (301)

301 doctors and other clinicians list Antelope Valley Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (301)

And 277 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Lancaster

Hospitals in Los Angeles County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

Licensed homes from the official state license list, by straight-line distance.

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Antelope Valley Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics) 1 of 5 stars
Overall rating of the hospital1 of 5 stars
Would recommend the hospital1 of 5 stars
Nurses communicated well1 of 5 stars
Doctors communicated well1 of 5 stars
Patients got help quickly from staff1 of 5 stars
Staff explained medicines1 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment1 of 5 stars
Care Coordination1 of 5 stars
Symptoms After Stay1 of 5 stars
Rated the hospital 9 or 10 out of 1049%National average: 72%
Would definitely recommend the hospital43%National average: 71%
Nurses “always” communicated well69%National average: 80%
Doctors “always” communicated well66%National average: 80%
“Always” got help as soon as they wanted51%National average: 64%
Staff “always” explained medicines before giving them49%National average: 62%
Were given information about recovery at home78%National average: 86%
Room and bathroom “always” clean69%National average: 73%
Completed surveys356Response rate: 11%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)0.741No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.226No different from the national benchmark
Surgical site infections after colon surgery1.559No different from the national benchmark
MRSA bloodstream infections1.327No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.631No different from the national benchmark
Not reported to MedicareSurgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients11.5%
Deaths within 30 days: heart failure patients14.5%
Deaths within 30 days: pneumonia patients21.7%
Deaths within 30 days: COPD patients11.4%
Deaths within 30 days: stroke patients15.1%
Serious complications (patient safety indicator PSI-90)1.06No different from the national rate
Complications after hip or knee replacement4.9%
Too few cases to reportDeaths within 30 days: coronary bypass surgery (CABG)

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)18.2%
Readmitted within 30 days: heart attack15.2%
Readmitted within 30 days: heart failure21%
Readmitted within 30 days: pneumonia19.1%
Readmitted within 30 days: COPD19.5%
Readmitted within 30 days: coronary bypass surgery12.6%
Readmitted within 30 days: hip or knee replacement6.5%

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)264 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)58%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Antelope Valley Hospital, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026YesCMS applies a 1-percent payment reduction to this hospital.
Total HAC Score0.4264Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack1.0183More readmissions than expected
Heart failure1.0121More readmissions than expected
Pneumonia1.0320More readmissions than expected
COPD (chronic lung disease)1.0254More readmissions than expected
No result publishedHip or knee replacement; Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score19.08 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)40.00 out of 100
Person and community engagement (patient survey)8.00 out of 100
Safety (infections and sepsis care)28.33 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio1.07Above the national median hospital (1.00): Medicare spent more

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in CaliforniaBest hospitals in California

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 66 common services exactly as Antelope Valley Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

$ 6 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 66 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES $522 $522 $74.19 – $550
New patient office visit (about 30–44 minutes): 10 of 41 insurance plan rates
  • Aetna — Commercial: $136.28
  • AIDS Foundation — Medicare Advantage: $85.32
  • Align Senior Care CA — Medicare Advantage: $85.32
  • Alignment Healthcare — Medicare Advantage: $74.19
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $77.90
  • CA State Prison — Government: $96.45
  • Central Health Plan of California — Medicare Adv: $74.19
  • Champion Health Plan — Medicare Advantage: $85.32
  • Citizens Choice Healthplan — Medicare Advantage: $74.19
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: OFFICE O/P NEW LOW 30 MIN $522 $522 $74.19 – $550
New patient office visit (about 30–44 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $85.32
  • Align Senior Care CA — Medicare Advantage: $85.32
  • Alignment Healthcare — Medicare Advantage: $74.19
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $77.90
  • CA State Prison — Government: $96.45
  • Central Health Plan of California — Medicare Adv: $74.19
  • Champion Health Plan — Medicare Advantage: $85.32
  • Citizens Choice Healthplan — Medicare Advantage: $74.19
  • Clever Care Health Plan — Medicare Advantage: $89.03
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW MOD 45 MIN $1,600 $1,600 $121.81 – $550
New patient office visit (about 45–59 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $140.08
  • Align Senior Care CA — Medicare Advantage: $140.08
  • Alignment Healthcare — Medicare Advantage: $121.81
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $127.90
  • CA State Prison — Government: $158.35
  • Central Health Plan of California — Medicare Adv: $121.81
  • Champion Health Plan — Medicare Advantage: $140.08
  • Citizens Choice Healthplan — Medicare Advantage: $121.81
  • Clever Care Health Plan — Medicare Advantage: $146.17
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES $880 $880 $121.81 – $550
New patient office visit (about 45–59 minutes): 10 of 41 insurance plan rates
  • Aetna — Commercial: $230.32
  • AIDS Foundation — Medicare Advantage: $140.08
  • Align Senior Care CA — Medicare Advantage: $140.08
  • Alignment Healthcare — Medicare Advantage: $121.81
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $127.90
  • CA State Prison — Government: $158.35
  • Central Health Plan of California — Medicare Adv: $121.81
  • Champion Health Plan — Medicare Advantage: $140.08
  • Citizens Choice Healthplan — Medicare Advantage: $121.81
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: OFFICE O/P NEW MOD 45 MIN $880 $880 $121.81 – $550
New patient office visit (about 45–59 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $140.08
  • Align Senior Care CA — Medicare Advantage: $140.08
  • Alignment Healthcare — Medicare Advantage: $121.81
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $127.90
  • CA State Prison — Government: $158.35
  • Central Health Plan of California — Medicare Adv: $121.81
  • Champion Health Plan — Medicare Advantage: $140.08
  • Citizens Choice Healthplan — Medicare Advantage: $121.81
  • Clever Care Health Plan — Medicare Advantage: $146.17
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES $945 $945 $166.82 – $550
New patient office visit (about 60–74 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $191.84
  • Align Senior Care CA — Medicare Advantage: $191.84
  • Alignment Healthcare — Medicare Advantage: $166.82
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $175.16
  • CA State Prison — Government: $216.87
  • Central Health Plan of California — Medicare Adv: $166.82
  • Champion Health Plan — Medicare Advantage: $191.84
  • Citizens Choice Healthplan — Medicare Advantage: $166.82
  • Clever Care Health Plan — Medicare Advantage: $200.18
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN $1,500 $1,500 $166.82 – $550
New patient office visit (about 60–74 minutes): 10 of 42 insurance plan rates
  • Aetna — Commercial: $296.18
  • AIDS Foundation — Medicare Advantage: $191.84
  • Align Senior Care CA — Medicare Advantage: $191.84
  • Alignment Healthcare — Medicare Advantage: $166.82
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $175.16
  • CA State Prison — Government: $216.87
  • Central Health Plan of California — Medicare Adv: $166.82
  • Champion Health Plan — Medicare Advantage: $191.84
  • Citizens Choice Healthplan — Medicare Advantage: $166.82
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: OFFICE O/P NEW HI 60 MIN $945 $945 $166.82 – $550
New patient office visit (about 60–74 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $191.84
  • Align Senior Care CA — Medicare Advantage: $191.84
  • Alignment Healthcare — Medicare Advantage: $166.82
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $175.16
  • CA State Prison — Government: $216.87
  • Central Health Plan of California — Medicare Adv: $166.82
  • Champion Health Plan — Medicare Advantage: $191.84
  • Citizens Choice Healthplan — Medicare Advantage: $166.82
  • Clever Care Health Plan — Medicare Advantage: $200.18
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN $457 $457 $60.24 – $550
Established patient office visit (about 20–29 minutes): 10 of 42 insurance plan rates
  • Aetna — Commercial: $90.10
  • AIDS Foundation — Medicare Advantage: $69.28
  • Align Senior Care CA — Medicare Advantage: $69.28
  • Alignment Healthcare — Medicare Advantage: $60.24
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $63.25
  • CA State Prison — Government: $78.31
  • Central Health Plan of California — Medicare Adv: $60.24
  • Champion Health Plan — Medicare Advantage: $69.28
  • Citizens Choice Healthplan — Medicare Advantage: $60.24
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES $396 $396 $60.24 – $550
Established patient office visit (about 20–29 minutes): 10 of 41 insurance plan rates
  • Aetna — Commercial: $90.10
  • AIDS Foundation — Medicare Advantage: $69.28
  • Align Senior Care CA — Medicare Advantage: $69.28
  • Alignment Healthcare — Medicare Advantage: $60.24
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $63.25
  • CA State Prison — Government: $78.31
  • Central Health Plan of California — Medicare Adv: $60.24
  • Champion Health Plan — Medicare Advantage: $69.28
  • Citizens Choice Healthplan — Medicare Advantage: $60.24
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: OFFICE O/P EST LOW 20 MIN $457 $457 $60.24 – $550
Established patient office visit (about 20–29 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $69.28
  • Align Senior Care CA — Medicare Advantage: $69.28
  • Alignment Healthcare — Medicare Advantage: $60.24
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $63.25
  • CA State Prison — Government: $78.31
  • Central Health Plan of California — Medicare Adv: $60.24
  • Champion Health Plan — Medicare Advantage: $69.28
  • Citizens Choice Healthplan — Medicare Advantage: $60.24
  • Clever Care Health Plan — Medicare Advantage: $72.29
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES $522 $522 $88.44 – $550
Established patient office visit (about 30–39 minutes): 10 of 41 insurance plan rates
  • Aetna — Commercial: $138.70
  • AIDS Foundation — Medicare Advantage: $101.71
  • Align Senior Care CA — Medicare Advantage: $101.71
  • Alignment Healthcare — Medicare Advantage: $88.44
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $92.86
  • CA State Prison — Government: $114.97
  • Central Health Plan of California — Medicare Adv: $88.44
  • Champion Health Plan — Medicare Advantage: $101.71
  • Citizens Choice Healthplan — Medicare Advantage: $88.44
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN $538 $538 $88.44 – $550
Established patient office visit (about 30–39 minutes): 10 of 41 insurance plan rates
  • Aetna — Commercial: $138.70
  • AIDS Foundation — Medicare Advantage: $101.71
  • Align Senior Care CA — Medicare Advantage: $101.71
  • Alignment Healthcare — Medicare Advantage: $88.44
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $92.86
  • CA State Prison — Government: $114.97
  • Central Health Plan of California — Medicare Adv: $88.44
  • Champion Health Plan — Medicare Advantage: $101.71
  • Citizens Choice Healthplan — Medicare Advantage: $88.44
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: OFFICE O/P EST MOD 30 MIN $538 $538 $88.44 – $550
Established patient office visit (about 30–39 minutes): 10 of 42 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $101.71
  • Align Senior Care CA — Medicare Advantage: $101.71
  • Alignment Healthcare — Medicare Advantage: $88.44
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $92.86
  • CA State Prison — Government: $114.97
  • Central Health Plan of California — Medicare Adv: $88.44
  • Champion Health Plan — Medicare Advantage: $101.71
  • Citizens Choice Healthplan — Medicare Advantage: $88.44
  • Clever Care Health Plan — Medicare Advantage: $106.13
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM $2,081 $2,081 $349.37 – $99,283 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Emergency room visit (moderate): 10 of 45 insurance plan rates
  • Aetna — Commercial: $99,283 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AIDS Foundation — Medicare Advantage: $401.78
  • Align Senior Care CA — Medicare Advantage: $401.78
  • Alignment Healthcare — Medicare Advantage: $349.37
  • Blue Shield — Covered California/EPN: $397.55
  • Blue Shield — HMO & PPO: $2,443.43
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $366.84
  • CA State Prison — Government: $454.18
  • Central Health Plan of California — Medicare Adv: $349.37
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $2,040 $2,040 $349.37 – $99,283 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Emergency room visit (moderate): 10 of 45 insurance plan rates
  • Aetna — Commercial: $99,283 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AIDS Foundation — Medicare Advantage: $401.78
  • Align Senior Care CA — Medicare Advantage: $401.78
  • Alignment Healthcare — Medicare Advantage: $349.37
  • Blue Shield — Covered California/EPN: $397.55
  • Blue Shield — HMO & PPO: $2,443.43
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $366.84
  • CA State Prison — Government: $454.18
  • Central Health Plan of California — Medicare Adv: $349.37
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY $2,040 $2,040 $349.37 – $99,283 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Emergency room visit (moderate): 10 of 45 insurance plan rates
  • Aetna — Commercial: $99,283 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
  • AIDS Foundation — Medicare Advantage: $401.78
  • Align Senior Care CA — Medicare Advantage: $401.78
  • Alignment Healthcare — Medicare Advantage: $349.37
  • Blue Shield — HMO & PPO: $2,443.43
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $366.84
  • CA State Prison — Government: $454.18
  • Central Health Plan of California — Medicare Adv: $349.37
  • Champion Health Plan — Medicare Advantage: $401.78
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM $3,121 $3,121 $400 – $4,908.20
Emergency room visit (moderately high): 10 of 45 insurance plan rates
  • Aetna — Commercial: $1,615
  • AIDS Foundation — Medicare Advantage: $614.15
  • Align Senior Care CA — Medicare Advantage: $614.15
  • Alignment Healthcare — Medicare Advantage: $534.04
  • Blue Shield — Covered California/EPN: $626.19
  • Blue Shield — HMO & PPO: $4,908.20
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $560.74
  • CA State Prison — Government: $694.25
  • Central Health Plan of California — Medicare Adv: $534.04
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $3,060 $3,060 $400 – $4,908.20
Emergency room visit (moderately high): 10 of 45 insurance plan rates
  • Aetna — Commercial: $1,615
  • AIDS Foundation — Medicare Advantage: $614.15
  • Align Senior Care CA — Medicare Advantage: $614.15
  • Alignment Healthcare — Medicare Advantage: $534.04
  • Blue Shield — Covered California/EPN: $626.19
  • Blue Shield — HMO & PPO: $4,908.20
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $560.74
  • CA State Prison — Government: $694.25
  • Central Health Plan of California — Medicare Adv: $534.04
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25_27 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY $3,060 $3,060 $400 – $4,908.20
Emergency room visit (moderately high): 10 of 45 insurance plan rates
  • Aetna — Commercial: $1,615
  • AIDS Foundation — Medicare Advantage: $614.15
  • Align Senior Care CA — Medicare Advantage: $614.15
  • Alignment Healthcare — Medicare Advantage: $534.04
  • Blue Shield — HMO & PPO: $4,908.20
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $560.74
  • CA State Prison — Government: $694.25
  • Central Health Plan of California — Medicare Adv: $534.04
  • Champion Health Plan — Medicare Advantage: $614.15
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM $5,202 $5,202 $400 – $4,908.20
Emergency room visit (high): 10 of 45 insurance plan rates
  • Aetna — Commercial: $2,695
  • AIDS Foundation — Medicare Advantage: $876.53
  • Align Senior Care CA — Medicare Advantage: $876.53
  • Alignment Healthcare — Medicare Advantage: $762.20
  • Blue Shield — Covered California/EPN: $898.03
  • Blue Shield — HMO & PPO: $4,908.20
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $800.31
  • CA State Prison — Government: $990.86
  • Central Health Plan of California — Medicare Adv: $762.20
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $5,100 $5,100 $400 – $4,908.20
Emergency room visit (high): 10 of 45 insurance plan rates
  • Aetna — Commercial: $2,695
  • AIDS Foundation — Medicare Advantage: $876.53
  • Align Senior Care CA — Medicare Advantage: $876.53
  • Alignment Healthcare — Medicare Advantage: $762.20
  • Blue Shield — Covered California/EPN: $898.03
  • Blue Shield — HMO & PPO: $4,908.20
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $800.31
  • CA State Prison — Government: $990.86
  • Central Health Plan of California — Medicare Adv: $762.20
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY $5,100 $5,100 $400 – $4,908.20
Emergency room visit (high): 10 of 45 insurance plan rates
  • Aetna — Commercial: $2,695
  • AIDS Foundation — Medicare Advantage: $876.53
  • Align Senior Care CA — Medicare Advantage: $876.53
  • Alignment Healthcare — Medicare Advantage: $762.20
  • Blue Shield — HMO & PPO: $4,908.20
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $800.31
  • CA State Prison — Government: $990.86
  • Central Health Plan of California — Medicare Adv: $762.20
  • Champion Health Plan — Medicare Advantage: $876.53

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $100 $100 $8.46 – $550
Basic metabolic panel (blood test): 10 of 42 insurance plan rates
  • Aetna — Commercial: $20.75
  • AIDS Foundation — Medicare Advantage: $9.73
  • Align Senior Care CA — Medicare Advantage: $9.73
  • Alignment Healthcare — Medicare Advantage: $8.46
  • Blue Shield — Covered California/EPN: $15.06
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.88
  • CA State Prison — Government: $11
  • Central Health Plan of California — Medicare Adv: $8.46
  • Champion Health Plan — Medicare Advantage: $9.73
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $100 $100 $8.46 – $550
Basic metabolic panel (blood test): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $9.73
  • Align Senior Care CA — Medicare Advantage: $9.73
  • Alignment Healthcare — Medicare Advantage: $8.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.88
  • CA State Prison — Government: $11
  • Central Health Plan of California — Medicare Adv: $8.46
  • Champion Health Plan — Medicare Advantage: $9.73
  • Citizens Choice Healthplan — Medicare Advantage: $8.46
  • Clever Care Health Plan — Medicare Advantage: $10.15
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) $122 $122 $8.46 – $550
Basic metabolic panel (blood test): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $9.73
  • Align Senior Care CA — Medicare Advantage: $9.73
  • Alignment Healthcare — Medicare Advantage: $8.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.88
  • CA State Prison — Government: $11
  • Central Health Plan of California — Medicare Adv: $8.46
  • Champion Health Plan — Medicare Advantage: $9.73
  • Citizens Choice Healthplan — Medicare Advantage: $8.46
  • Clever Care Health Plan — Medicare Advantage: $10.15
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $80 $80 $10.56 – $550
Comprehensive metabolic panel (blood test): 10 of 42 insurance plan rates
  • Aetna — Commercial: $25.91
  • AIDS Foundation — Medicare Advantage: $12.14
  • Align Senior Care CA — Medicare Advantage: $12.14
  • Alignment Healthcare — Medicare Advantage: $10.56
  • Blue Shield — Covered California/EPN: $18.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $11.09
  • CA State Prison — Government: $13.73
  • Central Health Plan of California — Medicare Adv: $10.56
  • Champion Health Plan — Medicare Advantage: $12.14
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $80 $80 $10.56 – $550
Comprehensive metabolic panel (blood test): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $12.14
  • Align Senior Care CA — Medicare Advantage: $12.14
  • Alignment Healthcare — Medicare Advantage: $10.56
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $11.09
  • CA State Prison — Government: $13.73
  • Central Health Plan of California — Medicare Adv: $10.56
  • Champion Health Plan — Medicare Advantage: $12.14
  • Citizens Choice Healthplan — Medicare Advantage: $10.56
  • Clever Care Health Plan — Medicare Advantage: $12.67
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS $80 $80 $10.56 – $550
Comprehensive metabolic panel (blood test): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $12.14
  • Align Senior Care CA — Medicare Advantage: $12.14
  • Alignment Healthcare — Medicare Advantage: $10.56
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $11.09
  • CA State Prison — Government: $13.73
  • Central Health Plan of California — Medicare Adv: $10.56
  • Champion Health Plan — Medicare Advantage: $12.14
  • Citizens Choice Healthplan — Medicare Advantage: $10.56
  • Clever Care Health Plan — Medicare Advantage: $12.67
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC BLOOD TEST PANEL $205 $205 $47.81 – $550
Obstetric blood test panel: 10 of 42 insurance plan rates
  • Aetna — Commercial: $125.69
  • AIDS Foundation — Medicare Advantage: $54.98
  • Align Senior Care CA — Medicare Advantage: $54.98
  • Alignment Healthcare — Medicare Advantage: $47.81
  • Blue Shield — Covered California/EPN: $85.10
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $50.20
  • CA State Prison — Government: $62.15
  • Central Health Plan of California — Medicare Adv: $47.81
  • Champion Health Plan — Medicare Advantage: $54.98
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $147 $147 $13.39 – $550
Cholesterol panel (lipid panel): 10 of 42 insurance plan rates
  • Aetna — Commercial: $32.84
  • AIDS Foundation — Medicare Advantage: $15.40
  • Align Senior Care CA — Medicare Advantage: $15.40
  • Alignment Healthcare — Medicare Advantage: $13.39
  • Blue Shield — Covered California/EPN: $23.83
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $14.06
  • CA State Prison — Government: $17.41
  • Central Health Plan of California — Medicare Adv: $13.39
  • Champion Health Plan — Medicare Advantage: $15.40
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 90 In the file: LIPID PANEL $9.72 $9.72 $13.39 – $550
Cholesterol panel (lipid panel): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $15.40
  • Align Senior Care CA — Medicare Advantage: $15.40
  • Alignment Healthcare — Medicare Advantage: $13.39
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $14.06
  • CA State Prison — Government: $17.41
  • Central Health Plan of California — Medicare Adv: $13.39
  • Champion Health Plan — Medicare Advantage: $15.40
  • Citizens Choice Healthplan — Medicare Advantage: $13.39
  • Clever Care Health Plan — Medicare Advantage: $16.07
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 90_XU In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) $9.72 $9.72 $13.39 – $550
Cholesterol panel (lipid panel): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $15.40
  • Align Senior Care CA — Medicare Advantage: $15.40
  • Alignment Healthcare — Medicare Advantage: $13.39
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $14.06
  • CA State Prison — Government: $17.41
  • Central Health Plan of California — Medicare Adv: $13.39
  • Champion Health Plan — Medicare Advantage: $15.40
  • Citizens Choice Healthplan — Medicare Advantage: $13.39
  • Clever Care Health Plan — Medicare Advantage: $16.07
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL $95 $95 $8.68 – $550
Kidney function panel: 10 of 42 insurance plan rates
  • Aetna — Commercial: $21.30
  • AIDS Foundation — Medicare Advantage: $9.98
  • Align Senior Care CA — Medicare Advantage: $9.98
  • Alignment Healthcare — Medicare Advantage: $8.68
  • Blue Shield — Covered California/EPN: $15.45
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $9.11
  • CA State Prison — Government: $11.28
  • Central Health Plan of California — Medicare Adv: $8.68
  • Champion Health Plan — Medicare Advantage: $9.98
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: KIDNEY FUNCTION BLOOD TEST PANEL $95 $95 $8.68 – $550
Kidney function panel: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $9.98
  • Align Senior Care CA — Medicare Advantage: $9.98
  • Alignment Healthcare — Medicare Advantage: $8.68
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $9.11
  • CA State Prison — Government: $11.28
  • Central Health Plan of California — Medicare Adv: $8.68
  • Champion Health Plan — Medicare Advantage: $9.98
  • Citizens Choice Healthplan — Medicare Advantage: $8.68
  • Clever Care Health Plan — Medicare Advantage: $10.42
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL $60 $60 $8.17 – $550
Liver function panel: 10 of 42 insurance plan rates
  • Aetna — Commercial: $20.03
  • AIDS Foundation — Medicare Advantage: $9.40
  • Align Senior Care CA — Medicare Advantage: $9.40
  • Alignment Healthcare — Medicare Advantage: $8.17
  • Blue Shield — Covered California/EPN: $14.54
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.58
  • CA State Prison — Government: $10.62
  • Central Health Plan of California — Medicare Adv: $8.17
  • Champion Health Plan — Medicare Advantage: $9.40
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: LIVER FUNCTION BLOOD TEST PANEL $60 $60 $8.17 – $550
Liver function panel: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $9.40
  • Align Senior Care CA — Medicare Advantage: $9.40
  • Alignment Healthcare — Medicare Advantage: $8.17
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.58
  • CA State Prison — Government: $10.62
  • Central Health Plan of California — Medicare Adv: $8.17
  • Champion Health Plan — Medicare Advantage: $9.40
  • Citizens Choice Healthplan — Medicare Advantage: $8.17
  • Clever Care Health Plan — Medicare Advantage: $9.80
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: LIVER FUNCTION BLOOD TEST PANEL $82 $82 $8.17 – $550
Liver function panel: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $9.40
  • Align Senior Care CA — Medicare Advantage: $9.40
  • Alignment Healthcare — Medicare Advantage: $8.17
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.58
  • CA State Prison — Government: $10.62
  • Central Health Plan of California — Medicare Adv: $8.17
  • Champion Health Plan — Medicare Advantage: $9.40
  • Citizens Choice Healthplan — Medicare Advantage: $8.17
  • Clever Care Health Plan — Medicare Advantage: $9.80
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $35 $35 $3.17 – $550
Urine test (automated, with microscope): 10 of 42 insurance plan rates
  • Aetna — Commercial: $7.75
  • AIDS Foundation — Medicare Advantage: $3.65
  • Align Senior Care CA — Medicare Advantage: $3.65
  • Alignment Healthcare — Medicare Advantage: $3.17
  • Blue Shield — Covered California/EPN: $5.64
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $3.33
  • CA State Prison — Government: $4.12
  • Central Health Plan of California — Medicare Adv: $3.17
  • Champion Health Plan — Medicare Advantage: $3.65
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $35 $35 $3.17 – $550
Urine test (automated, with microscope): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $3.65
  • Align Senior Care CA — Medicare Advantage: $3.65
  • Alignment Healthcare — Medicare Advantage: $3.17
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $3.33
  • CA State Prison — Government: $4.12
  • Central Health Plan of California — Medicare Adv: $3.17
  • Champion Health Plan — Medicare Advantage: $3.65
  • Citizens Choice Healthplan — Medicare Advantage: $3.17
  • Clever Care Health Plan — Medicare Advantage: $3.80
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91_TC In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED $35 $35 $3.17 – $550
Urine test (automated, with microscope): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $3.65
  • Align Senior Care CA — Medicare Advantage: $3.65
  • Alignment Healthcare — Medicare Advantage: $3.17
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $3.33
  • CA State Prison — Government: $4.12
  • Central Health Plan of California — Medicare Adv: $3.17
  • Champion Health Plan — Medicare Advantage: $3.65
  • Citizens Choice Healthplan — Medicare Advantage: $3.17
  • Clever Care Health Plan — Medicare Advantage: $3.80
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE $29 $29 $3.48 – $550
Urine test (manual, without microscope): 10 of 42 insurance plan rates
  • Aetna — Commercial: $6.27
  • AIDS Foundation — Medicare Advantage: $4
  • Align Senior Care CA — Medicare Advantage: $4
  • Alignment Healthcare — Medicare Advantage: $3.48
  • Blue Shield — Covered California/EPN: $6.19
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $3.65
  • CA State Prison — Government: $4.52
  • Central Health Plan of California — Medicare Adv: $3.48
  • Champion Health Plan — Medicare Advantage: $4
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST $50 $50 $2.25 – $550
Urine test (automated, without microscope): 10 of 42 insurance plan rates
  • Aetna — Commercial: $5.51
  • AIDS Foundation — Medicare Advantage: $2.59
  • Align Senior Care CA — Medicare Advantage: $2.59
  • Alignment Healthcare — Medicare Advantage: $2.25
  • Blue Shield — Covered California/EPN: $4
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $2.36
  • CA State Prison — Government: $2.92
  • Central Health Plan of California — Medicare Adv: $2.25
  • Champion Health Plan — Medicare Advantage: $2.59
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE $19 $19 $2.25 – $550
Urine test (automated, without microscope): 10 of 42 insurance plan rates
  • Aetna — Commercial: $5.51
  • AIDS Foundation — Medicare Advantage: $2.59
  • Align Senior Care CA — Medicare Advantage: $2.59
  • Alignment Healthcare — Medicare Advantage: $2.25
  • Blue Shield — Covered California/EPN: $4
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $2.36
  • CA State Prison — Government: $2.92
  • Central Health Plan of California — Medicare Adv: $2.25
  • Champion Health Plan — Medicare Advantage: $2.59
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: AUTOMATED URINALYSIS TEST $25 $25 $2.25 – $550
Urine test (automated, without microscope): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $2.59
  • Align Senior Care CA — Medicare Advantage: $2.59
  • Alignment Healthcare — Medicare Advantage: $2.25
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $2.36
  • CA State Prison — Government: $2.92
  • Central Health Plan of California — Medicare Adv: $2.25
  • Champion Health Plan — Medicare Advantage: $2.59
  • Citizens Choice Healthplan — Medicare Advantage: $2.25
  • Clever Care Health Plan — Medicare Advantage: $2.70
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $120 $120 $18.39 – $550
PSA (prostate specific antigen) blood test: 10 of 42 insurance plan rates
  • Aetna — Commercial: $45.12
  • AIDS Foundation — Medicare Advantage: $21.15
  • Align Senior Care CA — Medicare Advantage: $21.15
  • Alignment Healthcare — Medicare Advantage: $18.39
  • Blue Shield — Covered California/EPN: $32.73
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $19.31
  • CA State Prison — Government: $23.91
  • Central Health Plan of California — Medicare Adv: $18.39
  • Champion Health Plan — Medicare Advantage: $21.15
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 90 In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL $43.88 $43.88 $18.39 – $550
PSA (prostate specific antigen) blood test: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $21.15
  • Align Senior Care CA — Medicare Advantage: $21.15
  • Alignment Healthcare — Medicare Advantage: $18.39
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $19.31
  • CA State Prison — Government: $23.91
  • Central Health Plan of California — Medicare Adv: $18.39
  • Champion Health Plan — Medicare Advantage: $21.15
  • Citizens Choice Healthplan — Medicare Advantage: $18.39
  • Clever Care Health Plan — Medicare Advantage: $22.07
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 90 In the file: ASSAY OF PSA TOTAL $16 $16 $18.39 – $550
PSA (prostate specific antigen) blood test: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $21.15
  • Align Senior Care CA — Medicare Advantage: $21.15
  • Alignment Healthcare — Medicare Advantage: $18.39
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $19.31
  • CA State Prison — Government: $23.91
  • Central Health Plan of California — Medicare Adv: $18.39
  • Champion Health Plan — Medicare Advantage: $21.15
  • Citizens Choice Healthplan — Medicare Advantage: $18.39
  • Clever Care Health Plan — Medicare Advantage: $22.07
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $145 $145 $16.80 – $550
Thyroid stimulating hormone (TSH) test: 10 of 42 insurance plan rates
  • Aetna — Commercial: $41.18
  • AIDS Foundation — Medicare Advantage: $19.32
  • Align Senior Care CA — Medicare Advantage: $19.32
  • Alignment Healthcare — Medicare Advantage: $16.80
  • Blue Shield — Covered California/EPN: $29.90
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17.64
  • CA State Prison — Government: $21.84
  • Central Health Plan of California — Medicare Adv: $16.80
  • Champion Health Plan — Medicare Advantage: $19.32
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $145 $145 $16.80 – $550
Thyroid stimulating hormone (TSH) test: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $19.32
  • Align Senior Care CA — Medicare Advantage: $19.32
  • Alignment Healthcare — Medicare Advantage: $16.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17.64
  • CA State Prison — Government: $21.84
  • Central Health Plan of California — Medicare Adv: $16.80
  • Champion Health Plan — Medicare Advantage: $19.32
  • Citizens Choice Healthplan — Medicare Advantage: $16.80
  • Clever Care Health Plan — Medicare Advantage: $20.16
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH) $145 $145 $16.80 – $550
Thyroid stimulating hormone (TSH) test: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $19.32
  • Align Senior Care CA — Medicare Advantage: $19.32
  • Alignment Healthcare — Medicare Advantage: $16.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17.64
  • CA State Prison — Government: $21.84
  • Central Health Plan of California — Medicare Adv: $16.80
  • Champion Health Plan — Medicare Advantage: $19.32
  • Citizens Choice Healthplan — Medicare Advantage: $16.80
  • Clever Care Health Plan — Medicare Advantage: $20.16
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $70 $70 $7.77 – $550
Complete blood count (CBC) with differential: 10 of 42 insurance plan rates
  • Aetna — Commercial: $19.07
  • AIDS Foundation — Medicare Advantage: $8.94
  • Align Senior Care CA — Medicare Advantage: $8.94
  • Alignment Healthcare — Medicare Advantage: $7.77
  • Blue Shield — Covered California/EPN: $13.83
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.16
  • CA State Prison — Government: $10.10
  • Central Health Plan of California — Medicare Adv: $7.77
  • Champion Health Plan — Medicare Advantage: $8.94
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $70 $70 $7.77 – $550
Complete blood count (CBC) with differential: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $8.94
  • Align Senior Care CA — Medicare Advantage: $8.94
  • Alignment Healthcare — Medicare Advantage: $7.77
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.16
  • CA State Prison — Government: $10.10
  • Central Health Plan of California — Medicare Adv: $7.77
  • Champion Health Plan — Medicare Advantage: $8.94
  • Citizens Choice Healthplan — Medicare Advantage: $7.77
  • Clever Care Health Plan — Medicare Advantage: $9.32
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91_TC In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT $70 $70 $7.77 – $550
Complete blood count (CBC) with differential: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $8.94
  • Align Senior Care CA — Medicare Advantage: $8.94
  • Alignment Healthcare — Medicare Advantage: $7.77
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8.16
  • CA State Prison — Government: $10.10
  • Central Health Plan of California — Medicare Adv: $7.77
  • Champion Health Plan — Medicare Advantage: $8.94
  • Citizens Choice Healthplan — Medicare Advantage: $7.77
  • Clever Care Health Plan — Medicare Advantage: $9.32
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED $70 $70 $6.47 – $550
Complete blood count (CBC), automated: 10 of 42 insurance plan rates
  • Aetna — Commercial: $15.87
  • AIDS Foundation — Medicare Advantage: $7.44
  • Align Senior Care CA — Medicare Advantage: $7.44
  • Alignment Healthcare — Medicare Advantage: $6.47
  • Blue Shield — Covered California/EPN: $11.52
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $6.79
  • CA State Prison — Government: $8.41
  • Central Health Plan of California — Medicare Adv: $6.47
  • Champion Health Plan — Medicare Advantage: $7.44
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $140 $140 $6.47 – $550
Complete blood count (CBC), automated: 10 of 42 insurance plan rates
  • Aetna — Commercial: $15.87
  • AIDS Foundation — Medicare Advantage: $7.44
  • Align Senior Care CA — Medicare Advantage: $7.44
  • Alignment Healthcare — Medicare Advantage: $6.47
  • Blue Shield — Covered California/EPN: $11.52
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $6.79
  • CA State Prison — Government: $8.41
  • Central Health Plan of California — Medicare Adv: $6.47
  • Champion Health Plan — Medicare Advantage: $7.44
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST $70 $70 $6.47 – $550
Complete blood count (CBC), automated: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $7.44
  • Align Senior Care CA — Medicare Advantage: $7.44
  • Alignment Healthcare — Medicare Advantage: $6.47
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $6.79
  • CA State Prison — Government: $8.41
  • Central Health Plan of California — Medicare Adv: $6.47
  • Champion Health Plan — Medicare Advantage: $7.44
  • Citizens Choice Healthplan — Medicare Advantage: $6.47
  • Clever Care Health Plan — Medicare Advantage: $7.76
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME $35 $35 $4.29 – $550
Blood clotting time test (prothrombin time, PT): 10 of 42 insurance plan rates
  • Aetna — Commercial: $9.64
  • AIDS Foundation — Medicare Advantage: $4.93
  • Align Senior Care CA — Medicare Advantage: $4.93
  • Alignment Healthcare — Medicare Advantage: $4.29
  • Blue Shield — Covered California/EPN: $7.64
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4.50
  • CA State Prison — Government: $5.58
  • Central Health Plan of California — Medicare Adv: $4.29
  • Champion Health Plan — Medicare Advantage: $4.93
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: BLOOD TEST; CLOTTING TIME $35 $35 $4.29 – $550
Blood clotting time test (prothrombin time, PT): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $4.93
  • Align Senior Care CA — Medicare Advantage: $4.93
  • Alignment Healthcare — Medicare Advantage: $4.29
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4.50
  • CA State Prison — Government: $5.58
  • Central Health Plan of California — Medicare Adv: $4.29
  • Champion Health Plan — Medicare Advantage: $4.93
  • Citizens Choice Healthplan — Medicare Advantage: $4.29
  • Clever Care Health Plan — Medicare Advantage: $5.15
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; CLOTTING TIME $35 $35 $4.29 – $550
Blood clotting time test (prothrombin time, PT): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $4.93
  • Align Senior Care CA — Medicare Advantage: $4.93
  • Alignment Healthcare — Medicare Advantage: $4.29
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4.50
  • CA State Prison — Government: $5.58
  • Central Health Plan of California — Medicare Adv: $4.29
  • Champion Health Plan — Medicare Advantage: $4.93
  • Citizens Choice Healthplan — Medicare Advantage: $4.29
  • Clever Care Health Plan — Medicare Advantage: $5.15
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $55 $55 $6.01 – $550
Blood clotting test (partial thromboplastin time, PTT): 10 of 42 insurance plan rates
  • Aetna — Commercial: $14.72
  • AIDS Foundation — Medicare Advantage: $6.91
  • Align Senior Care CA — Medicare Advantage: $6.91
  • Alignment Healthcare — Medicare Advantage: $6.01
  • Blue Shield — Covered California/EPN: $10.70
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $6.31
  • CA State Prison — Government: $7.81
  • Central Health Plan of California — Medicare Adv: $6.01
  • Champion Health Plan — Medicare Advantage: $6.91
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $29.70 $29.70 $6.01 – $550
Blood clotting test (partial thromboplastin time, PTT): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $6.91
  • Align Senior Care CA — Medicare Advantage: $6.91
  • Alignment Healthcare — Medicare Advantage: $6.01
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $6.31
  • CA State Prison — Government: $7.81
  • Central Health Plan of California — Medicare Adv: $6.01
  • Champion Health Plan — Medicare Advantage: $6.91
  • Citizens Choice Healthplan — Medicare Advantage: $6.01
  • Clever Care Health Plan — Medicare Advantage: $7.21
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD $77 $77 $6.01 – $550
Blood clotting test (partial thromboplastin time, PTT): 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $6.91
  • Align Senior Care CA — Medicare Advantage: $6.91
  • Alignment Healthcare — Medicare Advantage: $6.01
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $6.31
  • CA State Prison — Government: $7.81
  • Central Health Plan of California — Medicare Adv: $6.01
  • Champion Health Plan — Medicare Advantage: $6.91
  • Citizens Choice Healthplan — Medicare Advantage: $6.01
  • Clever Care Health Plan — Medicare Advantage: $7.21

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE $623 $623 $133.80 – $743
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $329.78
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $840 $840 $133.80 – $743
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $329.78
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 76_TC In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST $840 $840 $133.80 – $743
CT scan of the head or brain, without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $329.78
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
  • Citizens Choice Healthplan — Medicare Advantage: $133.80
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE $1,997 $1,997 $446.51 – $1,562.50
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $513.49
  • Align Senior Care CA — Medicare Advantage: $513.49
  • Alignment Healthcare — Medicare Advantage: $446.51
  • Blue Shield — Covered California/EPN: $679.69
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $468.84
  • CA State Prison — Government: $580.46
  • Central Health Plan of California — Medicare Adv: $446.51
  • Champion Health Plan — Medicare Advantage: $513.49
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $1,890 $1,890 $446.51 – $1,562.50
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $513.49
  • Align Senior Care CA — Medicare Advantage: $513.49
  • Alignment Healthcare — Medicare Advantage: $446.51
  • Blue Shield — Covered California/EPN: $679.69
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $468.84
  • CA State Prison — Government: $580.46
  • Central Health Plan of California — Medicare Adv: $446.51
  • Champion Health Plan — Medicare Advantage: $513.49
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST $1,890 $1,890 $446.51 – $1,486
MRI of the brain, before and after contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $513.49
  • Align Senior Care CA — Medicare Advantage: $513.49
  • Alignment Healthcare — Medicare Advantage: $446.51
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $468.84
  • CA State Prison — Government: $580.46
  • Central Health Plan of California — Medicare Adv: $446.51
  • Champion Health Plan — Medicare Advantage: $513.49
  • Citizens Choice Healthplan — Medicare Advantage: $446.51
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS $492 $492 $40.30 – $550
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $40.30
  • AIDS Foundation — Medicare Advantage: $128.09
  • Align Senior Care CA — Medicare Advantage: $128.09
  • Alignment Healthcare — Medicare Advantage: $111.38
  • Blue Shield — Covered California/EPN: $142.06
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $116.95
  • CA State Prison — Government: $144.79
  • Central Health Plan of California — Medicare Adv: $111.38
  • Champion Health Plan — Medicare Advantage: $128.09
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS $420 $420 $40.30 – $550
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $40.30
  • AIDS Foundation — Medicare Advantage: $128.09
  • Align Senior Care CA — Medicare Advantage: $128.09
  • Alignment Healthcare — Medicare Advantage: $111.38
  • Blue Shield — Covered California/EPN: $142.06
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $116.95
  • CA State Prison — Government: $144.79
  • Central Health Plan of California — Medicare Adv: $111.38
  • Champion Health Plan — Medicare Advantage: $128.09
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF CHEST; 2 VIEWS $420 $420 $40.30 – $550
Chest X-ray, 2 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $40.30
  • AIDS Foundation — Medicare Advantage: $128.09
  • Align Senior Care CA — Medicare Advantage: $128.09
  • Alignment Healthcare — Medicare Advantage: $111.38
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $116.95
  • CA State Prison — Government: $144.79
  • Central Health Plan of California — Medicare Adv: $111.38
  • Champion Health Plan — Medicare Advantage: $128.09
  • Citizens Choice Healthplan — Medicare Advantage: $111.38
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $630 $630 $84.93 – $550
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $84.93
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS $595 $595 $84.93 – $550
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $84.93
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS $595 $595 $84.93 – $550
X-ray of the lower spine, at least 4 views: 10 of 42 insurance plan rates
  • Aetna — Commercial: $84.93
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
  • Citizens Choice Healthplan — Medicare Advantage: $133.80
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE $1,351 $1,351 $305.38 – $1,486
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $351.19
  • Align Senior Care CA — Medicare Advantage: $351.19
  • Alignment Healthcare — Medicare Advantage: $305.38
  • Blue Shield — Covered California/EPN: $414.81
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $320.65
  • CA State Prison — Government: $396.99
  • Central Health Plan of California — Medicare Adv: $305.38
  • Champion Health Plan — Medicare Advantage: $351.19
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $1,260 $1,260 $305.38 – $1,486
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $351.19
  • Align Senior Care CA — Medicare Advantage: $351.19
  • Alignment Healthcare — Medicare Advantage: $305.38
  • Blue Shield — Covered California/EPN: $414.81
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $320.65
  • CA State Prison — Government: $396.99
  • Central Health Plan of California — Medicare Adv: $305.38
  • Champion Health Plan — Medicare Advantage: $351.19
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST $1,260 $1,260 $305.38 – $1,486
MRI of the lower back (lumbar spine), without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $351.19
  • Align Senior Care CA — Medicare Advantage: $351.19
  • Alignment Healthcare — Medicare Advantage: $305.38
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $320.65
  • CA State Prison — Government: $396.99
  • Central Health Plan of California — Medicare Adv: $305.38
  • Champion Health Plan — Medicare Advantage: $351.19
  • Citizens Choice Healthplan — Medicare Advantage: $305.38
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST $1,050 $1,050 $224.48 – $1,299.76
CT scan of the pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $504.59
  • AIDS Foundation — Medicare Advantage: $258.15
  • Align Senior Care CA — Medicare Advantage: $258.15
  • Alignment Healthcare — Medicare Advantage: $224.48
  • Blue Shield — Covered California/EPN: $324.35
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $235.70
  • CA State Prison — Government: $291.82
  • Central Health Plan of California — Medicare Adv: $224.48
  • Champion Health Plan — Medicare Advantage: $258.15
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF PELVIS WITH CONTRAST $1,050 $1,050 $224.48 – $743
CT scan of the pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $504.59
  • AIDS Foundation — Medicare Advantage: $258.15
  • Align Senior Care CA — Medicare Advantage: $258.15
  • Alignment Healthcare — Medicare Advantage: $224.48
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $235.70
  • CA State Prison — Government: $291.82
  • Central Health Plan of California — Medicare Adv: $224.48
  • Champion Health Plan — Medicare Advantage: $258.15
  • Citizens Choice Healthplan — Medicare Advantage: $224.48
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: CT SCAN OF PELVIS WITH CONTRAST $1,050 $1,050 $224.48 – $743
CT scan of the pelvis, with contrast: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $258.15
  • Align Senior Care CA — Medicare Advantage: $258.15
  • Alignment Healthcare — Medicare Advantage: $224.48
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $235.70
  • CA State Prison — Government: $291.82
  • Central Health Plan of California — Medicare Adv: $224.48
  • Champion Health Plan — Medicare Advantage: $258.15
  • Citizens Choice Healthplan — Medicare Advantage: $224.48
  • Clever Care Health Plan — Medicare Advantage: $269.38
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,260 $1,260 $305.38 – $1,486
MRI of a leg joint (such as the knee), without contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $686.75
  • AIDS Foundation — Medicare Advantage: $351.19
  • Align Senior Care CA — Medicare Advantage: $351.19
  • Alignment Healthcare — Medicare Advantage: $305.38
  • Blue Shield — Covered California/EPN: $414.81
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $320.65
  • CA State Prison — Government: $396.99
  • Central Health Plan of California — Medicare Adv: $305.38
  • Champion Health Plan — Medicare Advantage: $351.19
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,260 $1,260 $305.38 – $1,486
MRI of a leg joint (such as the knee), without contrast: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $351.19
  • Align Senior Care CA — Medicare Advantage: $351.19
  • Alignment Healthcare — Medicare Advantage: $305.38
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $320.65
  • CA State Prison — Government: $396.99
  • Central Health Plan of California — Medicare Adv: $305.38
  • Champion Health Plan — Medicare Advantage: $351.19
  • Citizens Choice Healthplan — Medicare Advantage: $305.38
  • Clever Care Health Plan — Medicare Advantage: $366.46
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST $1,260 $1,260 $305.38 – $1,486
MRI of a leg joint (such as the knee), without contrast: 10 of 41 insurance plan rates
  • AIDS Foundation — Medicare Advantage: $351.19
  • Align Senior Care CA — Medicare Advantage: $351.19
  • Alignment Healthcare — Medicare Advantage: $305.38
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $320.65
  • CA State Prison — Government: $396.99
  • Central Health Plan of California — Medicare Adv: $305.38
  • Champion Health Plan — Medicare Advantage: $351.19
  • Citizens Choice Healthplan — Medicare Advantage: $305.38
  • Clever Care Health Plan — Medicare Advantage: $366.46
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $2,625 $2,625 $446.51 – $1,626.41
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $534.19
  • AIDS Foundation — Medicare Advantage: $513.49
  • Align Senior Care CA — Medicare Advantage: $513.49
  • Alignment Healthcare — Medicare Advantage: $446.51
  • Blue Shield — Covered California/EPN: $679.69
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $468.84
  • CA State Prison — Government: $580.46
  • Central Health Plan of California — Medicare Adv: $446.51
  • Champion Health Plan — Medicare Advantage: $513.49
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $2,625 $2,625 $446.51 – $743
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $534.19
  • AIDS Foundation — Medicare Advantage: $513.49
  • Align Senior Care CA — Medicare Advantage: $513.49
  • Alignment Healthcare — Medicare Advantage: $446.51
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $468.84
  • CA State Prison — Government: $580.46
  • Central Health Plan of California — Medicare Adv: $446.51
  • Champion Health Plan — Medicare Advantage: $513.49
  • Citizens Choice Healthplan — Medicare Advantage: $446.51
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST $2,625 $2,625 $446.51 – $743
CT scan of the abdomen and pelvis, with contrast: 10 of 42 insurance plan rates
  • Aetna — Commercial: $534.19
  • AIDS Foundation — Medicare Advantage: $513.49
  • Align Senior Care CA — Medicare Advantage: $513.49
  • Alignment Healthcare — Medicare Advantage: $446.51
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $468.84
  • CA State Prison — Government: $580.46
  • Central Health Plan of California — Medicare Adv: $446.51
  • Champion Health Plan — Medicare Advantage: $513.49
  • Citizens Choice Healthplan — Medicare Advantage: $446.51
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $792 $792 $133.80 – $550
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates
  • Aetna — Commercial: $204.12
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN $792 $792 $133.80 – $550
Ultrasound of the abdomen, complete: 10 of 42 insurance plan rates
  • Aetna — Commercial: $204.12
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
  • Citizens Choice Healthplan — Medicare Advantage: $133.80
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $623 $623 $133.80 – $550
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates
  • Aetna — Commercial: $204.12
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS $623 $623 $133.80 – $550
Pregnancy ultrasound (after the first trimester): 10 of 42 insurance plan rates
  • Aetna — Commercial: $204.12
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
  • Citizens Choice Healthplan — Medicare Advantage: $133.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $792 $792 $133.80 – $550
Transvaginal ultrasound: 10 of 42 insurance plan rates
  • Aetna — Commercial: $193.99
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield — Covered California/EPN: $199.50
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC_XU In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $792 $792 $133.80 – $550
Transvaginal ultrasound: 10 of 42 insurance plan rates
  • Aetna — Commercial: $193.99
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
  • Citizens Choice Healthplan — Medicare Advantage: $133.80
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA $792 $792 $133.80 – $550
Transvaginal ultrasound: 10 of 42 insurance plan rates
  • Aetna — Commercial: $193.99
  • AIDS Foundation — Medicare Advantage: $153.87
  • Align Senior Care CA — Medicare Advantage: $153.87
  • Alignment Healthcare — Medicare Advantage: $133.80
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $140.49
  • CA State Prison — Government: $173.94
  • Central Health Plan of California — Medicare Adv: $133.80
  • Champion Health Plan — Medicare Advantage: $153.87
  • Citizens Choice Healthplan — Medicare Advantage: $133.80

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY $17,982 $17,982 $550 – $11,792.87
Left heart catheterization (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $5,803
  • Affiliated Health Funds — Commercial: $3,950
  • AIDS Foundation — Medicare Advantage: $4,771.63
  • Align Senior Care CA — Medicare Advantage: $4,771.63
  • Alignment Healthcare — Medicare Advantage: $4,149.24
  • Blue Shield — Covered California/EPN: $5,072.91
  • Blue Shield — HMO & PPO: $11,792.87
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,356.70
  • CA State Prison — Government: $5,394.01
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION $42,422 $42,422 $550 – $14,973.76
Heart rhythm study (electrophysiology evaluation): 10 of 42 insurance plan rates
  • Aetna — Commercial: $5,803
  • Affiliated Health Funds — Commercial: $3,950
  • AIDS Foundation — Medicare Advantage: $11,479.89
  • Align Senior Care CA — Medicare Advantage: $11,479.89
  • Alignment Healthcare — Medicare Advantage: $9,982.51
  • Blue Shield — Covered California/EPN: $10,476.56
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $10,481.64
  • CA State Prison — Government: $12,977.26
  • Central Health Plan of California — Medicare Adv: $9,982.51
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB $137,151 $137,151 $550 – $50,179.38
Heart rhythm study with ablation for atrial fibrillation: 10 of 42 insurance plan rates
  • Aetna — Commercial: $5,803
  • Affiliated Health Funds — Commercial: $3,950
  • AIDS Foundation — Medicare Advantage: $38,470.86
  • Align Senior Care CA — Medicare Advantage: $38,470.86
  • Alignment Healthcare — Medicare Advantage: $33,452.92
  • Blue Shield — Covered California/EPN: $36,374.78
  • Blue Shield — HMO & PPO: $11,792.87
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $35,125.57
  • CA State Prison — Government: $43,488.80
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM $4,700 $4,700 $550 – $1,648.60
Sleep study (overnight, in a sleep lab): 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,234.24
  • AIDS Foundation — Medicare Advantage: $1,263.93
  • Align Senior Care CA — Medicare Advantage: $1,263.93
  • Alignment Healthcare — Medicare Advantage: $1,099.07
  • Blue Shield — Covered California/EPN: $1,617.93
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,154.02
  • CA State Prison — Government: $1,428.79
  • Central Health Plan of California — Medicare Adv: $1,099.07
  • Champion Health Plan — Medicare Advantage: $1,263.93

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $158 $158 $32.07 – $550
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $36.88
  • Align Senior Care CA — Medicare Advantage: $36.88
  • Alignment Healthcare — Medicare Advantage: $32.07
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $33.67
  • CA State Prison — Government: $41.69
  • Central Health Plan of California — Medicare Adv: $32.07
  • Champion Health Plan — Medicare Advantage: $36.88
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES $158 $158 $32.07 – $550
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $36.88
  • Align Senior Care CA — Medicare Advantage: $36.88
  • Alignment Healthcare — Medicare Advantage: $32.07
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $33.67
  • CA State Prison — Government: $41.69
  • Central Health Plan of California — Medicare Adv: $32.07
  • Champion Health Plan — Medicare Advantage: $36.88
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES $368 $368 $90 – $550
Physical therapy evaluation (low complexity): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $124.53
  • Align Senior Care CA — Medicare Advantage: $124.53
  • Alignment Healthcare — Medicare Advantage: $108.29
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $113.70
  • CA State Prison — Government: $140.78
  • Central Health Plan of California — Medicare Adv: $108.29
  • Champion Health Plan — Medicare Advantage: $124.53
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $450 $450 $90 – $550
Physical therapy evaluation (moderate complexity): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $124.53
  • Align Senior Care CA — Medicare Advantage: $124.53
  • Alignment Healthcare — Medicare Advantage: $108.29
  • Blue Shield — Covered California/EPN: $161.91
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $113.70
  • CA State Prison — Government: $140.78
  • Central Health Plan of California — Medicare Adv: $108.29
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEX 30 MIN $450 $450 $90 – $550
Physical therapy evaluation (moderate complexity): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $124.53
  • Align Senior Care CA — Medicare Advantage: $124.53
  • Alignment Healthcare — Medicare Advantage: $108.29
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $113.70
  • CA State Prison — Government: $140.78
  • Central Health Plan of California — Medicare Adv: $108.29
  • Champion Health Plan — Medicare Advantage: $124.53
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES $420 $420 $90 – $550
Physical therapy evaluation (moderate complexity): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $124.53
  • Align Senior Care CA — Medicare Advantage: $124.53
  • Alignment Healthcare — Medicare Advantage: $108.29
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $113.70
  • CA State Prison — Government: $140.78
  • Central Health Plan of California — Medicare Adv: $108.29
  • Champion Health Plan — Medicare Advantage: $124.53
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN $570 $570 $90 – $550
Physical therapy evaluation (high complexity): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $124.53
  • Align Senior Care CA — Medicare Advantage: $124.53
  • Alignment Healthcare — Medicare Advantage: $108.29
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $113.70
  • CA State Prison — Government: $140.78
  • Central Health Plan of California — Medicare Adv: $108.29
  • Champion Health Plan — Medicare Advantage: $124.53
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES $473 $473 $90 – $550
Physical therapy evaluation (high complexity): 10 of 42 insurance plan rates
  • Aetna — Commercial: $201
  • AIDS Foundation — Medicare Advantage: $124.53
  • Align Senior Care CA — Medicare Advantage: $124.53
  • Alignment Healthcare — Medicare Advantage: $108.29
  • Blue Shield — HMO & PPO: $274
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $113.70
  • CA State Prison — Government: $140.78
  • Central Health Plan of California — Medicare Adv: $108.29
  • Champion Health Plan — Medicare Advantage: $124.53

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $10,200 $10,200 $550 – $7,516.83
Removal of breast growth (open surgery): 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $5,762.90
  • Align Senior Care CA — Medicare Advantage: $5,762.90
  • Alignment Healthcare — Medicare Advantage: $5,011.22
  • Blue Shield — Covered California/EPN: $5,392.60
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $5,261.78
  • CA State Prison — Government: $6,514.59
  • Central Health Plan of California — Medicare Adv: $5,011.22
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $10,200 $10,200 $550 – $7,516.83
Removal of breast growth (open surgery): 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $5,762.90
  • Align Senior Care CA — Medicare Advantage: $5,762.90
  • Alignment Healthcare — Medicare Advantage: $5,011.22
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $5,261.78
  • CA State Prison — Government: $6,514.59
  • Central Health Plan of California — Medicare Adv: $5,011.22
  • Champion Health Plan — Medicare Advantage: $5,762.90
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE $2,450 $2,450 $550 – $7,516.83
Removal of breast growth (open surgery): 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $5,762.90
  • Align Senior Care CA — Medicare Advantage: $5,762.90
  • Alignment Healthcare — Medicare Advantage: $5,011.22
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $5,261.78
  • CA State Prison — Government: $6,514.59
  • Central Health Plan of California — Medicare Adv: $5,011.22
  • Champion Health Plan — Medicare Advantage: $5,762.90
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $22,032 $22,032 $550 – $24,647.67
Total hip replacement: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,889
  • AIDS Foundation — Medicare Advantage: $18,896.55
  • Align Senior Care CA — Medicare Advantage: $18,896.55
  • Alignment Healthcare — Medicare Advantage: $16,431.78
  • Blue Shield — Covered California/EPN: $21,183.26
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17,253.37
  • CA State Prison — Government: $21,361.31
  • Central Health Plan of California — Medicare Adv: $16,431.78
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $32,334 $32,334 $550 – $24,647.67
Total hip replacement: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,889
  • AIDS Foundation — Medicare Advantage: $18,896.55
  • Align Senior Care CA — Medicare Advantage: $18,896.55
  • Alignment Healthcare — Medicare Advantage: $16,431.78
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17,253.37
  • CA State Prison — Government: $21,361.31
  • Central Health Plan of California — Medicare Adv: $16,431.78
  • Champion Health Plan — Medicare Advantage: $18,896.55
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS $19,584 $19,584 $550 – $24,647.67
Total hip replacement: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,889
  • AIDS Foundation — Medicare Advantage: $18,896.55
  • Align Senior Care CA — Medicare Advantage: $18,896.55
  • Alignment Healthcare — Medicare Advantage: $16,431.78
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17,253.37
  • CA State Prison — Government: $21,361.31
  • Central Health Plan of California — Medicare Adv: $16,431.78
  • Champion Health Plan — Medicare Advantage: $18,896.55
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $26,928 $26,928 $550 – $24,647.67
Total knee replacement: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,889
  • AIDS Foundation — Medicare Advantage: $18,896.55
  • Align Senior Care CA — Medicare Advantage: $18,896.55
  • Alignment Healthcare — Medicare Advantage: $16,431.78
  • Blue Shield — Covered California/EPN: $21,183.26
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17,253.37
  • CA State Prison — Government: $21,361.31
  • Central Health Plan of California — Medicare Adv: $16,431.78
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $25,296 $25,296 $550 – $24,647.67
Total knee replacement: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,889
  • AIDS Foundation — Medicare Advantage: $18,896.55
  • Align Senior Care CA — Medicare Advantage: $18,896.55
  • Alignment Healthcare — Medicare Advantage: $16,431.78
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17,253.37
  • CA State Prison — Government: $21,361.31
  • Central Health Plan of California — Medicare Adv: $16,431.78
  • Champion Health Plan — Medicare Advantage: $18,896.55
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE $22,032 $22,032 $550 – $24,647.67
Total knee replacement: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,889
  • AIDS Foundation — Medicare Advantage: $18,896.55
  • Align Senior Care CA — Medicare Advantage: $18,896.55
  • Alignment Healthcare — Medicare Advantage: $16,431.78
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $17,253.37
  • CA State Prison — Government: $21,361.31
  • Central Health Plan of California — Medicare Adv: $16,431.78
  • Champion Health Plan — Medicare Advantage: $18,896.55
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $14,280 $14,280 $150.70 – $6,041.67
Shoulder arthroscopy: shaving of shoulder bone: 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $173.31
  • Align Senior Care CA — Medicare Advantage: $173.31
  • Alignment Healthcare — Medicare Advantage: $150.70
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $158.23
  • CA State Prison — Government: $195.91
  • Central Health Plan of California — Medicare Adv: $150.70
  • Champion Health Plan — Medicare Advantage: $173.31
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE $5,440 $5,440 $150.70 – $6,041.67
Shoulder arthroscopy: shaving of shoulder bone: 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $173.30
  • Align Senior Care CA — Medicare Advantage: $173.30
  • Alignment Healthcare — Medicare Advantage: $150.70
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $158.24
  • CA State Prison — Government: $195.91
  • Central Health Plan of California — Medicare Adv: $150.70
  • Champion Health Plan — Medicare Advantage: $173.30
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $14,790 $14,790 $550 – $7,470.75
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,200
  • AIDS Foundation — Medicare Advantage: $4,815.88
  • Align Senior Care CA — Medicare Advantage: $4,815.88
  • Alignment Healthcare — Medicare Advantage: $4,187.72
  • Blue Shield — HMO & PPO: $7,470.75
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,397.11
  • CA State Prison — Government: $5,444.04
  • Central Health Plan of California — Medicare Adv: $4,187.72
  • Champion Health Plan — Medicare Advantage: $4,815.88
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE $16,167 $16,167 $550 – $7,470.75
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,200
  • AIDS Foundation — Medicare Advantage: $4,815.88
  • Align Senior Care CA — Medicare Advantage: $4,815.88
  • Alignment Healthcare — Medicare Advantage: $4,187.72
  • Blue Shield — HMO & PPO: $7,470.75
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,397.11
  • CA State Prison — Government: $5,444.04
  • Central Health Plan of California — Medicare Adv: $4,187.72
  • Champion Health Plan — Medicare Advantage: $4,815.88
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $8,874 $8,874 $550 – $11,364.87
Removal of tonsils and adenoids (under age 12): 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $8,713.07
  • Align Senior Care CA — Medicare Advantage: $8,713.07
  • Alignment Healthcare — Medicare Advantage: $7,576.58
  • Blue Shield — Covered California/EPN: $8,633.94
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $7,955.41
  • CA State Prison — Government: $9,849.55
  • Central Health Plan of California — Medicare Adv: $7,576.58
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $7,276 $7,276 $550 – $11,364.87
Removal of tonsils and adenoids (under age 12): 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $8,713.07
  • Align Senior Care CA — Medicare Advantage: $8,713.07
  • Alignment Healthcare — Medicare Advantage: $7,576.58
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $7,955.41
  • CA State Prison — Government: $9,849.55
  • Central Health Plan of California — Medicare Adv: $7,576.58
  • Champion Health Plan — Medicare Advantage: $8,713.07
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UA In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) $10,102 $10,102 $550 – $11,364.87
Removal of tonsils and adenoids (under age 12): 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $8,713.07
  • Align Senior Care CA — Medicare Advantage: $8,713.07
  • Alignment Healthcare — Medicare Advantage: $7,576.58
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $7,955.41
  • CA State Prison — Government: $9,849.55
  • Central Health Plan of California — Medicare Adv: $7,576.58
  • Champion Health Plan — Medicare Advantage: $8,713.07
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $2,032 $2,032 $550 – $3,950.32
Upper GI endoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,334.93
  • Align Senior Care CA — Medicare Advantage: $1,334.93
  • Alignment Healthcare — Medicare Advantage: $1,160.81
  • Blue Shield — Covered California/EPN: $1,398.94
  • Blue Shield — HMO & PPO: $3,950.32
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,218.85
  • CA State Prison — Government: $1,509.05
  • Central Health Plan of California — Medicare Adv: $1,160.81
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $4,064 $4,064 $550 – $3,950.32
Upper GI endoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,334.93
  • Align Senior Care CA — Medicare Advantage: $1,334.93
  • Alignment Healthcare — Medicare Advantage: $1,160.81
  • Blue Shield — HMO & PPO: $3,950.32
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,218.85
  • CA State Prison — Government: $1,509.05
  • Central Health Plan of California — Medicare Adv: $1,160.81
  • Champion Health Plan — Medicare Advantage: $1,334.93
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UA In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $24,287 $24,287 $550 – $3,950.32
Upper GI endoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,334.93
  • Align Senior Care CA — Medicare Advantage: $1,334.93
  • Alignment Healthcare — Medicare Advantage: $1,160.81
  • Blue Shield — HMO & PPO: $3,950.32
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,218.85
  • CA State Prison — Government: $1,509.05
  • Central Health Plan of California — Medicare Adv: $1,160.81
  • Champion Health Plan — Medicare Advantage: $1,334.93
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $4,064 $4,064 $550 – $5,286.46
Upper GI endoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,334.93
  • Align Senior Care CA — Medicare Advantage: $1,334.93
  • Alignment Healthcare — Medicare Advantage: $1,160.81
  • Blue Shield — Covered California/EPN: $1,398.94
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,218.85
  • CA State Prison — Government: $1,509.05
  • Central Health Plan of California — Medicare Adv: $1,160.81
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE $5,242 $5,242 $550 – $3,767
Upper GI endoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,334.93
  • Align Senior Care CA — Medicare Advantage: $1,334.93
  • Alignment Healthcare — Medicare Advantage: $1,160.81
  • Blue Shield — Covered California/EPN: $1,398.94
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,218.85
  • CA State Prison — Government: $1,509.05
  • Central Health Plan of California — Medicare Adv: $1,160.81
  • Champion Health Plan — Medicare Advantage: $1,334.93
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE $2,032 $2,032 $550 – $5,286.46
Upper GI endoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,334.93
  • Align Senior Care CA — Medicare Advantage: $1,334.93
  • Alignment Healthcare — Medicare Advantage: $1,160.81
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,218.85
  • CA State Prison — Government: $1,509.05
  • Central Health Plan of California — Medicare Adv: $1,160.81
  • Champion Health Plan — Medicare Advantage: $1,334.93
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,029 $4,029 $550 – $5,286.46
Colonoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,368.75
  • Align Senior Care CA — Medicare Advantage: $1,368.75
  • Alignment Healthcare — Medicare Advantage: $1,190.22
  • Blue Shield — Covered California/EPN: $1,359.71
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,249.73
  • CA State Prison — Government: $1,547.29
  • Central Health Plan of California — Medicare Adv: $1,190.22
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,029 $4,029 $550 – $5,286.46
Colonoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,368.75
  • Align Senior Care CA — Medicare Advantage: $1,368.75
  • Alignment Healthcare — Medicare Advantage: $1,190.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,249.73
  • CA State Prison — Government: $1,547.29
  • Central Health Plan of California — Medicare Adv: $1,190.22
  • Champion Health Plan — Medicare Advantage: $1,368.75
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,046.50 $4,046.50 $550 – $5,286.46
Colonoscopy (diagnostic): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,368.75
  • Align Senior Care CA — Medicare Advantage: $1,368.75
  • Alignment Healthcare — Medicare Advantage: $1,190.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,249.73
  • CA State Prison — Government: $1,547.29
  • Central Health Plan of California — Medicare Adv: $1,190.22
  • Champion Health Plan — Medicare Advantage: $1,368.75
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,029 $4,029 $550 – $5,286.46
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — Covered California/EPN: $1,787.51
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT_UB In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $4,046.50 $4,046.50 $550 – $5,286.46
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
  • Champion Health Plan — Medicare Advantage: $1,761.27
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT_XS In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $2,014.50 $2,014.50 $550 – $5,286.46
Colonoscopy with biopsy: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
  • Champion Health Plan — Medicare Advantage: $1,761.27
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $4,029 $4,029 $550 – $5,286.46
Colonoscopy with removal of polyps (snare): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — Covered California/EPN: $1,787.51
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $4,046.50 $4,046.50 $550 – $5,286.46
Colonoscopy with removal of polyps (snare): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
  • Champion Health Plan — Medicare Advantage: $1,761.27
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PT In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE $4,029 $4,029 $550 – $5,286.46
Colonoscopy with removal of polyps (snare): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
  • Champion Health Plan — Medicare Advantage: $1,761.27
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE $1,731 $1,731 $550 – $3,950.32
Ultrasound of the lower bowel by endoscope: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,761.27
  • Align Senior Care CA — Medicare Advantage: $1,761.27
  • Alignment Healthcare — Medicare Advantage: $1,531.54
  • Blue Shield — Covered California/EPN: $1,787.51
  • Blue Shield — HMO & PPO: $3,950.32
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,608.12
  • CA State Prison — Government: $1,991
  • Central Health Plan of California — Medicare Adv: $1,531.54
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $4,029 $4,029 $550 – $5,286.46
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,368.75
  • Align Senior Care CA — Medicare Advantage: $1,368.75
  • Alignment Healthcare — Medicare Advantage: $1,190.22
  • Blue Shield — Covered California/EPN: $1,359.71
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,249.73
  • CA State Prison — Government: $1,547.29
  • Central Health Plan of California — Medicare Adv: $1,190.22
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $4,029 $4,029 $550 – $5,286.46
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,368.75
  • Align Senior Care CA — Medicare Advantage: $1,368.75
  • Alignment Healthcare — Medicare Advantage: $1,190.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,249.73
  • CA State Prison — Government: $1,547.29
  • Central Health Plan of California — Medicare Adv: $1,190.22
  • Champion Health Plan — Medicare Advantage: $1,368.75
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UA In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK $5,953.50 $5,953.50 $550 – $5,286.46
Screening colonoscopy (not high risk): 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $1,368.75
  • Align Senior Care CA — Medicare Advantage: $1,368.75
  • Alignment Healthcare — Medicare Advantage: $1,190.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,249.73
  • CA State Prison — Government: $1,547.29
  • Central Health Plan of California — Medicare Adv: $1,190.22
  • Champion Health Plan — Medicare Advantage: $1,368.75
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $20,604 $20,604 $550 – $11,792.87
Gallbladder removal by laparoscope: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,500
  • AIDS Foundation — Medicare Advantage: $8,898.08
  • Align Senior Care CA — Medicare Advantage: $8,898.08
  • Alignment Healthcare — Medicare Advantage: $7,737.46
  • Blue Shield — Covered California/EPN: $8,604
  • Blue Shield — HMO & PPO: $11,792.87
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8,124.33
  • CA State Prison — Government: $10,058.70
  • Central Health Plan of California — Medicare Adv: $7,737.46
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $20,400 $20,400 $550 – $11,792.87
Gallbladder removal by laparoscope: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,500
  • AIDS Foundation — Medicare Advantage: $8,898.08
  • Align Senior Care CA — Medicare Advantage: $8,898.08
  • Alignment Healthcare — Medicare Advantage: $7,737.46
  • Blue Shield — HMO & PPO: $11,792.87
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8,124.33
  • CA State Prison — Government: $10,058.70
  • Central Health Plan of California — Medicare Adv: $7,737.46
  • Champion Health Plan — Medicare Advantage: $8,898.08
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE $31,968 $31,968 $550 – $11,792.87
Gallbladder removal by laparoscope: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,500
  • AIDS Foundation — Medicare Advantage: $8,898.08
  • Align Senior Care CA — Medicare Advantage: $8,898.08
  • Alignment Healthcare — Medicare Advantage: $7,737.46
  • Blue Shield — HMO & PPO: $11,792.87
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8,124.33
  • CA State Prison — Government: $10,058.70
  • Central Health Plan of California — Medicare Adv: $7,737.46
  • Champion Health Plan — Medicare Advantage: $8,898.08
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $12,546 $12,546 $550 – $7,470.75
Groin (inguinal) hernia repair, age 5 or older: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,200
  • AIDS Foundation — Medicare Advantage: $5,269.79
  • Align Senior Care CA — Medicare Advantage: $5,269.79
  • Alignment Healthcare — Medicare Advantage: $4,582.43
  • Blue Shield — Covered California/EPN: $5,534.63
  • Blue Shield — HMO & PPO: $7,470.75
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,811.55
  • CA State Prison — Government: $5,957.16
  • Central Health Plan of California — Medicare Adv: $4,582.43
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_UB In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $11,220 $11,220 $550 – $7,470.75
Groin (inguinal) hernia repair, age 5 or older: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,200
  • AIDS Foundation — Medicare Advantage: $5,269.79
  • Align Senior Care CA — Medicare Advantage: $5,269.79
  • Alignment Healthcare — Medicare Advantage: $4,582.43
  • Blue Shield — HMO & PPO: $7,470.75
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,811.55
  • CA State Prison — Government: $5,957.16
  • Central Health Plan of California — Medicare Adv: $4,582.43
  • Champion Health Plan — Medicare Advantage: $5,269.79
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) $9,792 $9,792 $550 – $11,654.90
Groin (inguinal) hernia repair, age 5 or older: 10 of 42 insurance plan rates
  • Aetna — Commercial: $6,200
  • AIDS Foundation — Medicare Advantage: $8,935.42
  • Align Senior Care CA — Medicare Advantage: $8,935.42
  • Alignment Healthcare — Medicare Advantage: $7,769.93
  • Blue Shield — HMO & PPO: $7,470.75
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $8,158.43
  • CA State Prison — Government: $10,100.91
  • Central Health Plan of California — Medicare Adv: $7,769.93
  • Champion Health Plan — Medicare Advantage: $8,935.42
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND $3,570 $3,570 $550 – $5,286.46
Prostate biopsy: 10 of 25 insurance plan rates
  • Aetna — Commercial: $3,767
  • Blue Shield — Covered California/EPN: $3,153.36
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Aetna — Medicare Advantage: 12.4% (a percentage in the contract, not a dollar amount)
  • Affiliated Health Funds — Commercial: 75% (a percentage in the contract, not a dollar amount)
  • AIDS Foundation - Medi — Cal: 35% (a percentage in the contract, not a dollar amount)
  • Anthem Blue Cross - Medi — Cal: 27% (a percentage in the contract, not a dollar amount)
  • Blue Cross - Medi — Cal & Healthy Families: 27% (a percentage in the contract, not a dollar amount)
  • Brand New Day - Medi — Cal: 30% (a percentage in the contract, not a dollar amount)
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: BIOPSY OF PROSTATE GLAND $15,479 $15,479 $550 – $5,286.46
Prostate biopsy: 10 of 25 insurance plan rates
  • Aetna — Commercial: $3,767
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Aetna — Medicare Advantage: 12.4% (a percentage in the contract, not a dollar amount)
  • Affiliated Health Funds — Commercial: 75% (a percentage in the contract, not a dollar amount)
  • AIDS Foundation - Medi — Cal: 35% (a percentage in the contract, not a dollar amount)
  • Anthem Blue Cross - Medi — Cal: 27% (a percentage in the contract, not a dollar amount)
  • Blue Cross - Medi — Cal & Healthy Families: 27% (a percentage in the contract, not a dollar amount)
  • Blue Shield — Covered California/EPN: 24.9% (a percentage in the contract, not a dollar amount)
  • Brand New Day - Medi — Cal: 30% (a percentage in the contract, not a dollar amount)
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $12,648 $12,648 $550 – $6,214.62
Hysteroscopy with biopsy of the uterus lining: 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $4,764.54
  • Align Senior Care CA — Medicare Advantage: $4,764.54
  • Alignment Healthcare — Medicare Advantage: $4,143.08
  • Blue Shield — Covered California/EPN: $4,446.62
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,350.23
  • CA State Prison — Government: $5,386
  • Central Health Plan of California — Medicare Adv: $4,143.08
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $8,874 $8,874 $550 – $6,214.62
Hysteroscopy with biopsy of the uterus lining: 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $4,764.54
  • Align Senior Care CA — Medicare Advantage: $4,764.54
  • Alignment Healthcare — Medicare Advantage: $4,143.08
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,350.23
  • CA State Prison — Government: $5,386
  • Central Health Plan of California — Medicare Adv: $4,143.08
  • Champion Health Plan — Medicare Advantage: $4,764.54
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE $8,313 $8,313 $550 – $6,214.62
Hysteroscopy with biopsy of the uterus lining: 10 of 42 insurance plan rates
  • Aetna — Commercial: $4,896
  • AIDS Foundation — Medicare Advantage: $4,764.54
  • Align Senior Care CA — Medicare Advantage: $4,764.54
  • Alignment Healthcare — Medicare Advantage: $4,143.08
  • Blue Shield — HMO & PPO: $6,041.67
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $4,350.23
  • CA State Prison — Government: $5,386
  • Central Health Plan of California — Medicare Adv: $4,143.08
  • Champion Health Plan — Medicare Advantage: $4,764.54
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE $4,507 $4,507 $550 – $1,700
Spinal injection, lower back (epidural), with imaging guidance: 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,038.94
  • Align Senior Care CA — Medicare Advantage: $1,038.94
  • Alignment Healthcare — Medicare Advantage: $903.43
  • Blue Shield — Covered California/EPN: $1,112.59
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $948.60
  • CA State Prison — Government: $1,174.46
  • Central Health Plan of California — Medicare Adv: $903.43
  • Champion Health Plan — Medicare Advantage: $1,038.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1 $4,977 $4,977 $550 – $1,700
Nerve root injection, lower back, with imaging guidance: 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,301.81
  • Align Senior Care CA — Medicare Advantage: $1,301.81
  • Alignment Healthcare — Medicare Advantage: $1,132.01
  • Blue Shield — Covered California/EPN: $1,445.45
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,188.61
  • CA State Prison — Government: $1,471.61
  • Central Health Plan of California — Medicare Adv: $1,132.01
  • Champion Health Plan — Medicare Advantage: $1,301.81
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL $3,116 $3,116 $550 – $1,700
Nerve root injection, lower back, with imaging guidance: 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,301.81
  • Align Senior Care CA — Medicare Advantage: $1,301.81
  • Alignment Healthcare — Medicare Advantage: $1,132.01
  • Blue Shield — Covered California/EPN: $1,445.45
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,188.61
  • CA State Prison — Government: $1,471.61
  • Central Health Plan of California — Medicare Adv: $1,132.01
  • Champion Health Plan — Medicare Advantage: $1,301.81
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_UA In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL $4,507 $4,507 $550 – $1,700
Nerve root injection, lower back, with imaging guidance: 10 of 42 insurance plan rates
  • Aetna — Commercial: $1,700
  • AIDS Foundation — Medicare Advantage: $1,301.81
  • Align Senior Care CA — Medicare Advantage: $1,301.81
  • Alignment Healthcare — Medicare Advantage: $1,132.01
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $1,188.61
  • CA State Prison — Government: $1,471.61
  • Central Health Plan of California — Medicare Adv: $1,132.01
  • Champion Health Plan — Medicare Advantage: $1,301.81
  • Citizens Choice Healthplan — Medicare Advantage: $1,132.01
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $10,200 $10,200 $550 – $5,286.46
Carpal tunnel release: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $2,874.10
  • Align Senior Care CA — Medicare Advantage: $2,874.10
  • Alignment Healthcare — Medicare Advantage: $2,499.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $2,624.18
  • CA State Prison — Government: $3,248.99
  • Central Health Plan of California — Medicare Adv: $2,499.22
  • Champion Health Plan — Medicare Advantage: $2,874.10
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_UB In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $8,976 $8,976 $550 – $5,286.46
Carpal tunnel release: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $2,874.10
  • Align Senior Care CA — Medicare Advantage: $2,874.10
  • Alignment Healthcare — Medicare Advantage: $2,499.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $2,624.18
  • CA State Prison — Government: $3,248.99
  • Central Health Plan of California — Medicare Adv: $2,499.22
  • Champion Health Plan — Medicare Advantage: $2,874.10
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE $10,200 $10,200 $550 – $5,286.46
Carpal tunnel release: 10 of 42 insurance plan rates
  • Aetna — Commercial: $3,767
  • AIDS Foundation — Medicare Advantage: $2,874.10
  • Align Senior Care CA — Medicare Advantage: $2,874.10
  • Alignment Healthcare — Medicare Advantage: $2,499.22
  • Blue Shield — HMO & PPO: $5,286.46
  • Blue Shield of California — Promise: $550
  • Brand New Day — Medicare: $2,624.18
  • CA State Prison — Government: $3,248.99
  • Central Health Plan of California — Medicare Adv: $2,499.22
  • Champion Health Plan — Medicare Advantage: $2,874.10

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC WITH CARD CATH WITH COMORBITY Not listed in the file Not listed in the file $2,207 – $150,020.44
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 40 insurance plan rates
  • Aetna — Medicare Advantage: $100,013.63
  • AIDS Foundation — Medicare Advantage: $115,015.67
  • Align Senior Care CA — Medicare Advantage: $115,015.67
  • Alignment Healthcare — Medicare Advantage: $100,013.63
  • Anthem Blue Cross - Medi — Cal: $2,366
  • Blue Cross - Medi — Cal & Healthy Families: $2,366
  • Blue Shield — Covered California/EPN: $132,801.58
  • Blue Shield of California — Promise: $2,370
  • Brand New Day — Medicare: $105,014.31
  • Brand New Day - Medi — Cal: $2,207
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY Not listed in the file Not listed in the file $2,207 – $30,716.24
Hip or knee replacement (major joint of the leg), without major complications: 10 of 40 insurance plan rates
  • Aetna — Medicare Advantage: $20,477.49
  • AIDS Foundation — Medicare Advantage: $23,549.11
  • Align Senior Care CA — Medicare Advantage: $23,549.11
  • Alignment Healthcare — Medicare Advantage: $20,477.49
  • Anthem Blue Cross - Medi — Cal: $2,366
  • Blue Cross - Medi — Cal & Healthy Families: $2,366
  • Blue Shield — Covered California/EPN: $26,063.02
  • Blue Shield of California — Promise: $2,370
  • Brand New Day — Medicare: $21,501.36
  • Brand New Day - Medi — Cal: $2,207
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $2,207 – $38,499.82
Neck (cervical) spinal fusion, without complications: 10 of 40 insurance plan rates
  • Aetna — Medicare Advantage: $25,666.55
  • AIDS Foundation — Medicare Advantage: $29,516.53
  • Align Senior Care CA — Medicare Advantage: $29,516.53
  • Alignment Healthcare — Medicare Advantage: $25,666.55
  • Anthem Blue Cross - Medi — Cal: $2,366
  • Blue Cross - Medi — Cal & Healthy Families: $2,366
  • Blue Shield — Covered California/EPN: $34,558.48
  • Blue Shield of California — Promise: $2,370
  • Brand New Day — Medicare: $26,949.88
  • Brand New Day - Medi — Cal: $2,207
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY Not listed in the file Not listed in the file $2,207 – $20,262.18
Uterus and ovary surgery (not for cancer), without complications: 10 of 40 insurance plan rates
  • Aetna — Medicare Advantage: $13,508.12
  • AIDS Foundation — Medicare Advantage: $15,534.34
  • Align Senior Care CA — Medicare Advantage: $15,534.34
  • Alignment Healthcare — Medicare Advantage: $13,508.12
  • Anthem Blue Cross - Medi — Cal: $2,366
  • Blue Cross - Medi — Cal & Healthy Families: $2,366
  • Blue Shield — Covered California/EPN: $15,957.62
  • Blue Shield of California — Promise: $2,370
  • Brand New Day — Medicare: $14,183.53
  • Brand New Day - Medi — Cal: $2,207

Source: Antelope Valley Hospital’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 13, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typeAcute Care Hospital
Address1600 W Ave J, Lancaster, CA 93534
CountyLos Angeles County
StateCalifornia
Phone(661) 949‑5500
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall rating1 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number050056
Name in Medicare recordsANTELOPE VALLEY HOSPITAL
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(661) 949‑5000[4]
Name on the hospital’s websiteAntelope Valley Medical Center
Official websiteavmc.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

  1. Antelope Valley Medical Center — avmc.org
  2. Services — avmc.org