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Acute Care Hospital

Huntington Hospital

Also listed as: Huntington Hospital (Huntington Health, an affiliate of Cedars-Sinai)

Pasadena, California · Los Angeles County · Emergency services listed

Huntington Hospital is an acute care hospital at 100 W California Blvd, Pasadena, CA 91109. Phone: (626) 397-5000. It has an emergency department.

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked November 2, 2026).

Summary

Huntington Hospital is an acute care hospital in Pasadena, California. Medicare data lists emergency services. Its official website lists 54 services, specialties and programs. Medicare lists 699 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(626) 397‑5000 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 2026-11-02). 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
Not ratedNot rated by CMSMedicare rating
YesBirthing-friendly (CMS)
699Doctors and clinicians
54Services listed

Quick answers

Does Huntington Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Huntington Hospital. In a medical emergency, call 911.
Where is Huntington Hospital?
100 W California Blvd, Pasadena, CA 91109, in Los Angeles County, California.
What is the phone number of Huntington Hospital?
(626) 397-5000, as listed by Medicare (CMS).
What is the Medicare star rating of Huntington Hospital?
CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.
Does Medicare reduce its payments to Huntington Hospital for hospital-acquired conditions?
Yes. For fiscal year 2026, CMS applies a 1-percent reduction to Medicare payments to Huntington Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 1.1788; 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[4][5]

Conditions treated[4][5]

Treatments[5]

  • Aquablation therapy
  • Transfusion clinic
  • Nutrition counseling

Procedures[4][5]

Programs and centers[4][5][6]

  • Nan & Howard Schow Emergency & Trauma Center
  • Huntington Cancer Center
  • Stroke Center
  • Spine Program
  • Della Martin Center for Mental Health Services
  • Family Birth Center
  • Maternal Wellness Program
  • Breastfeeding Center
  • Senior Care Network
  • Injury Prevention
  • Graduate Medical Education
  • Blood donation

Emergency care (hospital website)[5]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel II

Visiting and practical information

VisitingAdult inpatient: two visitors at a time, 6 a.m.-10 p.m., one overnight visitor; check in with ID at visitor stations[6]
Patient portalMy CS-Link

Recognition[5]

  • Level II Trauma Center (only one in the San Gabriel Valley)

Doctors and clinicians (699)

699 doctors and other clinicians list Huntington 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 (699)

And 675 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 Pasadena

All hospitals in Pasadena · 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 Huntington 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) 3 of 5 stars
Overall rating of the hospital3 of 5 stars
Would recommend the hospital4 of 5 stars
Nurses communicated well3 of 5 stars
Doctors communicated well3 of 5 stars
Patients got help quickly from staff3 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home3 of 5 stars
Room and bathroom kept clean4 of 5 stars
Restfulness of Environment2 of 5 stars
Care Coordination2 of 5 stars
Symptoms After Stay2 of 5 stars
Rated the hospital 9 or 10 out of 1071%National average: 72%
Would definitely recommend the hospital77%National average: 71%
Nurses “always” communicated well75%National average: 80%
Doctors “always” communicated well76%National average: 80%
“Always” got help as soon as they wanted58%National average: 64%
Staff “always” explained medicines before giving them57%National average: 62%
Were given information about recovery at home84%National average: 86%
Room and bathroom “always” clean73%National average: 73%
Completed surveys1,750Response rate: 24%

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)0.497No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.724Worse than the national benchmark
Surgical site infections after colon surgery0.168Better than the national benchmark
MRSA bloodstream infections0.495No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections1.607Worse than 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 patients8.8%
Deaths within 30 days: heart failure patients9.4%
Deaths within 30 days: pneumonia patients10.7%
Deaths within 30 days: COPD patients7.6%
Deaths within 30 days: stroke patients10.4%
Deaths within 30 days: coronary bypass surgery (CABG)1.8%
Serious complications (patient safety indicator PSI-90)0.87No different from the national rate
Complications after hip or knee replacement4%

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)16%
Readmitted within 30 days: heart attack13.9%
Readmitted within 30 days: heart failure18.9%
Readmitted within 30 days: pneumonia17.2%
Readmitted within 30 days: COPD19.4%
Readmitted within 30 days: coronary bypass surgery10.1%
Readmitted within 30 days: hip or knee replacement6.1%

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)248 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)4%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)88%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 Huntington 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 Score1.1788Lower 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 attack1.0801More readmissions than expected
Heart failure1.1182More readmissions than expected
Pneumonia1.0699More readmissions than expected
COPD (chronic lung disease)0.9859Fewer readmissions than expected
Hip or knee replacement0.8911Fewer readmissions than expected
Coronary bypass surgery (CABG)1.0005More readmissions than expected

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 Score26.00 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)53.33 out of 100
Person and community engagement (patient survey)24.00 out of 100
Safety (infections and sepsis care)26.67 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, ratio1.03Above 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 77 common services exactly as Huntington 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 →

Show the prices of 77 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) In the file: HB NEW PATIENT, LEVEL 3 $211.92 $137.75 $62.30
New patient office visit (about 30–44 minutes): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $62.30
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — POS: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: 70% (a percentage in the contract, not a dollar amount)
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: HB NEW PATIENT, LEVEL 4 $371.89 $241.73 $105.39
New patient office visit (about 45–59 minutes): 10 of 60 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $105.39
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — POS: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: 70% (a percentage in the contract, not a dollar amount)
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HB EST. PATIENT, LEVEL 3 $211.92 $137.75 $41.33
Established patient office visit (about 20–29 minutes): 10 of 60 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $41.33
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — POS: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: 70% (a percentage in the contract, not a dollar amount)
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) In the file: HB EST. PATIENT, LEVEL 3 $211.92 $137.75 Not listed in the file
Established patient office visit (about 20–29 minutes): rates for 6 insurance plans
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 75% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Health Value Management, Inc. d/b/a ChoiceCare Network — PPO: 80% (a percentage in the contract, not a dollar amount)
  • MultiPlan, Inc. — PPO Comlementary Network: 75% (a percentage in the contract, not a dollar amount)
  • MultiPlan, Inc. — PPO Primary Network: 60% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HB EST. PATIENT, LEVEL 4 $371.89 $241.73 $63.67
Established patient office visit (about 30–39 minutes): 10 of 60 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $63.67
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — POS: 70% (a percentage in the contract, not a dollar amount)
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: 70% (a percentage in the contract, not a dollar amount)
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HB ED FACILITY LEVEL 3 $2,296.55 $1,492.76 $50.88 – $2,596.82
Emergency room visit (moderate): 10 of 38 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $50.88
  • Avanti Hospitals, LLC — Medi-Cal: $344.78
  • Avanti Hospitals, LLC — Medicare Advantage: $344.78
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $344.78
  • Dignity Health — Medicare Advantage: $344.78
  • Health Net of California, Inc. — Ambetter PPO: $491.31
  • Health Net of California, Inc. — Medicare Advantage: $355.12
  • Health Net of California, Inc. — Tailored: $491.31
  • Humana Health Plan, Inc. — Medicare Advantage: $344.78
  • Inter Valley Health Plan — Medicare Advantage: $344.78
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HB ED FACILITY LEVEL 3 W/PROC $2,296.55 $1,492.76 $50.88 – $2,596.82
Emergency room visit (moderate): 10 of 38 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $50.88
  • Avanti Hospitals, LLC — Medi-Cal: $344.78
  • Avanti Hospitals, LLC — Medicare Advantage: $344.78
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $344.78
  • Dignity Health — Medicare Advantage: $344.78
  • Health Net of California, Inc. — Ambetter PPO: $491.31
  • Health Net of California, Inc. — Medicare Advantage: $355.12
  • Health Net of California, Inc. — Tailored: $491.31
  • Humana Health Plan, Inc. — Medicare Advantage: $344.78
  • Inter Valley Health Plan — Medicare Advantage: $344.78
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency Services $2,296.55 $1,492.76 $50.88 – $2,596.82
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Heritage Provider Network — Medi-Cal: $560.52
  • Heritage Provider Network — Medicare Advantage: $344.78
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: $540
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $344.78
  • Heritage Provider Network — Covered: 50% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — HMO: 50% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — HMO: 100% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — Covered: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HB ED FACILITY LEVEL 4 $3,444.82 $2,239.13 $95.58 – $5,764.95
Emergency room visit (moderately high): 10 of 38 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $95.58
  • Avanti Hospitals, LLC — Medi-Cal: $530.23
  • Avanti Hospitals, LLC — Medicare Advantage: $530.23
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $530.23
  • Dignity Health — Medicare Advantage: $530.23
  • Health Net of California, Inc. — Ambetter PPO: $755.57
  • Health Net of California, Inc. — Medicare Advantage: $546.13
  • Health Net of California, Inc. — Tailored: $755.57
  • Humana Health Plan, Inc. — Medicare Advantage: $530.23
  • Inter Valley Health Plan — Medicare Advantage: $530.23
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HB ED FACILITY LEVEL 4 W/PROC $3,444.82 $2,239.13 $95.58 – $5,764.95
Emergency room visit (moderately high): 10 of 38 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $95.58
  • Avanti Hospitals, LLC — Medi-Cal: $530.23
  • Avanti Hospitals, LLC — Medicare Advantage: $530.23
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $530.23
  • Dignity Health — Medicare Advantage: $530.23
  • Health Net of California, Inc. — Ambetter PPO: $755.57
  • Health Net of California, Inc. — Medicare Advantage: $546.13
  • Health Net of California, Inc. — Tailored: $755.57
  • Humana Health Plan, Inc. — Medicare Advantage: $530.23
  • Inter Valley Health Plan — Medicare Advantage: $530.23
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency Services $3,444.82 $2,239.13 $95.58 – $5,764.95
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Heritage Provider Network — Medi-Cal: $560.52
  • Heritage Provider Network — Medicare Advantage: $530.23
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: $540
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $530.23
  • Heritage Provider Network — Covered: 50% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — HMO: 50% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — HMO: 100% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — Covered: 100% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $6,889.65 $4,478.27 $140.25 – $2,290.27
Emergency room visit (high): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $140.25
  • Avanti Hospitals, LLC — Medi-Cal: $763.42
  • Avanti Hospitals, LLC — Medicare Advantage: $763.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $763.42
  • Dignity Health — Medicare Advantage: $763.42
  • Health Net of California, Inc. — Ambetter PPO: $1,087.88
  • Health Net of California, Inc. — Medicare Advantage: $786.33
  • Health Net of California, Inc. — Tailored: $1,087.88
  • Humana Health Plan, Inc. — Medicare Advantage: $763.42
  • Inter Valley Health Plan — Medicare Advantage: $763.42
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HB ED FACILITY LEVEL 5 W/PROC $6,889.65 $4,478.27 $140.25 – $7,534.80
Emergency room visit (high): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $140.25
  • Avanti Hospitals, LLC — Medi-Cal: $763.42
  • Avanti Hospitals, LLC — Medicare Advantage: $763.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $763.42
  • Dignity Health — Medicare Advantage: $763.42
  • Health Net of California, Inc. — Ambetter PPO: $1,087.88
  • Health Net of California, Inc. — Medicare Advantage: $786.33
  • Health Net of California, Inc. — Tailored: $1,087.88
  • Humana Health Plan, Inc. — Medicare Advantage: $763.42
  • Inter Valley Health Plan — Medicare Advantage: $763.42
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency Services $6,889.65 $4,478.27 $140.25 – $6,364.22
Emergency room visit (high): 10 of 12 insurance plan rates
  • Heritage Provider Network — Medi-Cal: $560.52
  • Heritage Provider Network — Medicare Advantage: $763.42
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: $540
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $763.42
  • Heritage Provider Network — Covered: 50% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — HMO: 50% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — HMO: 100% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Kaiser Foundation Hospitals on behalf of its Southern Califo — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — Covered: 100% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $648.75 $421.69 $10.12
Basic metabolic panel (blood test): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $10.12
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: HB LAB BASIC METABOLIC PANEL $648.75 $421.69 $10.12
Basic metabolic panel (blood test): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $10.12
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $648.75 $421.69 $44.20 – $203.45
Basic metabolic panel (blood test): rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $203.45
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $203.45
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $203.45
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $203.45
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $676.40 $439.66 $12.64
Comprehensive metabolic panel (blood test): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $12.64
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: HB LAB COMP METABOLIC PANEL $676.40 $439.66 $12.64
Comprehensive metabolic panel (blood test): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $12.64
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $676.40 $439.66 $55.21 – $254.01
Comprehensive metabolic panel (blood test): rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $254.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $254.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $254.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $254.01
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $245.54 $159.60 $16.02
Cholesterol panel (lipid panel): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $16.02
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: HB LAB LIPID PANEL $245.54 $159.60 $16.02
Cholesterol panel (lipid panel): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $16.02
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $245.54 $159.60 $69.98 – $321.94
Cholesterol panel (lipid panel): rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $321.94
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $321.94
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $321.94
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $321.94
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: HB LAB RENAL FUNCTION PANEL $388.34 $252.42 $10.39
Kidney function panel: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $10.39
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $388.34 $252.42 $45.38 – $208.61
Kidney function panel: rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $208.61
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $208.61
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $208.61
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $208.61
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Laboratory Services $388.34 $252.42 $45.38 – $208.61
Kidney function panel: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $45.38
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $45.38
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $45.38
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $411.25 $267.31 $9.77
Liver function panel: 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $9.77
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HB LAB HEPATIC FUNCTION PANEL $411.25 $267.31 $9.77
Liver function panel: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $9.77
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $411.25 $267.31 $20.51 – $196.39
Liver function panel: rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $196.39
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $196.39
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $196.39
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $196.39
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $122.44 $79.59 $3.78
Urine test (automated, with microscope): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $3.78
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: HB LAB URINALYSIS W/ MICROSCOPY $122.44 $79.59 $3.78
Urine test (automated, with microscope): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $3.78
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $122.44 $79.59 $16.51 – $76.19
Urine test (automated, with microscope): rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $76.19
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $76.19
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $76.19
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $76.19
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: HB LAB URINALYSIS $115.45 $75.04 $3.06
Urine test (manual, without microscope): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $3.06
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $115.45 $75.04 $13.37 – $61.39
Urine test (manual, without microscope): rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $61.39
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $61.39
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $61.39
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $61.39
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Laboratory Services $115.45 $75.04 $13.37 – $61.39
Urine test (manual, without microscope): rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $13.37
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $13.37
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $13.37
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $101.88 $66.22 $2.69
Urine test (automated, without microscope): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $2.69
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: HB LAB URINALYSIS W/ MICROSCOPY $122.44 $79.59 $2.69
Urine test (automated, without microscope): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $2.69
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $101.88 $66.22 $11.75 – $54
Urine test (automated, without microscope): rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $54
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $54
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $54
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $54
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HB MISCELLANEOUS TEST 1 $18.74 $12.18 $22.01
PSA (prostate specific antigen) blood test: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $22.01
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HB PROSTATE SPECIFIC ANTIGEN, TOTAL $18.74 $12.18 $22.01
PSA (prostate specific antigen) blood test: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $22.01
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: HB LAB PROSTATE SPECIFIC ANTGN $18.74 $12.18 $22.01
PSA (prostate specific antigen) blood test: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $22.01
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $163.84 $106.50 $20.09
Thyroid stimulating hormone (TSH) test: 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $20.09
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: HB LAB THYRO TSH SE RI $163.84 $106.50 $20.09
Thyroid stimulating hormone (TSH) test: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $20.09
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $163.84 $106.50 $87.75 – $403.63
Thyroid stimulating hormone (TSH) test: rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $403.63
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $403.63
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $403.63
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $403.63
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $337.98 $219.69 $9.30
Complete blood count (CBC) with differential: 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $9.30
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: HB CBC WITH AUTO DIFF $337.98 $219.69 $9.30
Complete blood count (CBC) with differential: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $9.30
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $337.98 $219.69 $40.62 – $186.77
Complete blood count (CBC) with differential: rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $186.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $186.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $186.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $186.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: HB LAB CBC HEMOGRAM W/PLT $135.75 $88.24 $7.74
Complete blood count (CBC), automated: 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $7.74
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Outpatient Clinical Laboratory Services $135.75 $88.24 $16.26 – $155.46
Complete blood count (CBC), automated: rates for 4 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $155.46
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $155.46
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $155.46
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $155.46
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Laboratory Services $135.75 $88.24 $16.26 – $155.46
Complete blood count (CBC), automated: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $33.81
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $33.81
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $33.81
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $103.19 $67.07 $4.70
Blood clotting time test (prothrombin time, PT): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $4.70
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HB LAB WHOLE BLOOD PROTIME $103.19 $67.07 $4.70
Blood clotting time test (prothrombin time, PT): 10 of 40 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $4.70
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: HB PROTHROMBIN TIME $103.19 $67.07 $4.70
Blood clotting time test (prothrombin time, PT): 10 of 40 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $4.70
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $20.87 $13.57 $7.18
Blood clotting test (partial thromboplastin time, PTT): 10 of 53 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $7.18
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HB LAB PTT PL $20.87 $13.57 $7.18
Blood clotting test (partial thromboplastin time, PTT): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $7.18
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: HB PARTIAL THROMBOPLASTIN TIME $20.87 $13.57 $7.18
Blood clotting test (partial thromboplastin time, PTT): 10 of 42 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $7.18
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Capp Care, Inc. — Worker's Compensation: 100% (a percentage in the contract, not a dollar amount)
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: 63% (a percentage in the contract, not a dollar amount)

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) In the file: CONVERSION DUMMY EAP-DONT USE $4,867.50 $3,163.88 $132.41 – $397.24
CT scan of the head or brain, without contrast: 10 of 57 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $167.20
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: HB CT HEAD/BRAIN WO CONT $4,867.50 $3,163.88 $132.41 – $397.24
CT scan of the head or brain, without contrast: 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $167.20
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
  • Inter Valley Health Plan — Medicare Advantage: $132.41
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT (per scan) $4,867.50 $3,163.88 $132.41 – $730.33
CT scan of the head or brain, without contrast: rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $456
  • PROSPECT HEALTH PLAN, INC. — HMO: $456
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $132.41
  • PROSPECT HEALTH PLAN, INC. — PPO: $456
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: HB MRI HEAD/PITUITARY WO/W CNT $10,386.20 $6,751.03 $335 – $1,334.08
MRI of the brain, before and after contrast: 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $335
  • Avanti Hospitals, LLC — Medi-Cal: $444.69
  • Avanti Hospitals, LLC — Medicare Advantage: $444.69
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $444.69
  • Dignity Health — Medicare Advantage: $444.69
  • Health Net of California, Inc. — Ambetter PPO: $633.69
  • Health Net of California, Inc. — Medicare Advantage: $458.03
  • Health Net of California, Inc. — Tailored: $633.69
  • Humana Health Plan, Inc. — Medicare Advantage: $444.69
  • Inter Valley Health Plan — Medicare Advantage: $444.69
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI (per scan) $10,386.20 $6,751.03 $444.69 – $1,463.28
MRI of the brain, before and after contrast: rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $681
  • PROSPECT HEALTH PLAN, INC. — HMO: $681
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $444.69
  • PROSPECT HEALTH PLAN, INC. — PPO: $681
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Radiology Services $10,386.20 $6,751.03 $444.69 – $1,463.28
MRI of the brain, before and after contrast: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $1,463.28
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $1,463.28
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $1,463.28
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $1,110.26 $721.67 $17.96 – $328.92
Chest X-ray, 2 views: 10 of 57 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $17.96
  • Avanti Hospitals, LLC — Medi-Cal: $109.64
  • Avanti Hospitals, LLC — Medicare Advantage: $109.64
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $109.64
  • Dignity Health — Medicare Advantage: $109.64
  • Health Net of California, Inc. — Ambetter PPO: $156.24
  • Health Net of California, Inc. — Medicare Advantage: $112.93
  • Health Net of California, Inc. — Tailored: $156.24
  • Heritage Provider Network — Medicare Advantage: $109.64
  • Humana Health Plan, Inc. — Medicare Advantage: $109.64
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HB XR EXAM CHEST 2 VIEWS $1,110.26 $721.67 $17.96 – $328.92
Chest X-ray, 2 views: 10 of 48 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $17.96
  • Avanti Hospitals, LLC — Medi-Cal: $109.64
  • Avanti Hospitals, LLC — Medicare Advantage: $109.64
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $109.64
  • Dignity Health — Medicare Advantage: $109.64
  • Health Net of California, Inc. — Ambetter PPO: $156.24
  • Health Net of California, Inc. — Medicare Advantage: $112.93
  • Health Net of California, Inc. — Tailored: $156.24
  • Heritage Provider Network — Medicare Advantage: $109.64
  • Humana Health Plan, Inc. — Medicare Advantage: $109.64
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiology Services $1,110.26 $721.67 $78.45 – $528.03
Chest X-ray, 2 views: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $78.45
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $78.45
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $78.45
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: HB XR L-SPINE 4-5VW $1,944.90 $1,264.19 $36.58 – $397.24
X-ray of the lower spine, at least 4 views: 10 of 48 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $36.58
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiology Services $1,944.90 $1,264.19 $159.78 – $649.57
X-ray of the lower spine, at least 4 views: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $159.78
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $159.78
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $159.78
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiology Services not otherwise listed herein $1,944.90 $1,264.19 $159.78 – $649.57
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $486.39
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $649.57
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: HB MRI L-SPINE WO CONTRAST $9,069.93 $5,895.45 $300.99 – $902.96
MRI of the lower back (lumbar spine), without contrast: 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $335
  • Avanti Hospitals, LLC — Medi-Cal: $300.99
  • Avanti Hospitals, LLC — Medicare Advantage: $300.99
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $300.99
  • Dignity Health — Medicare Advantage: $300.99
  • Health Net of California, Inc. — Ambetter PPO: $428.91
  • Health Net of California, Inc. — Medicare Advantage: $310.02
  • Health Net of California, Inc. — Tailored: $428.91
  • Humana Health Plan, Inc. — Medicare Advantage: $300.99
  • Inter Valley Health Plan — Medicare Advantage: $300.99
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI (per scan) $9,069.93 $5,895.45 $300.99 – $1,463.28
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $681
  • PROSPECT HEALTH PLAN, INC. — HMO: $681
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $300.99
  • PROSPECT HEALTH PLAN, INC. — PPO: $681
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Radiology Services $9,069.93 $5,895.45 $300.99 – $1,463.28
MRI of the lower back (lumbar spine), without contrast: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $1,463.28
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $1,463.28
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $1,463.28
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: HB CT PELVIS W CONTRAST $7,663.28 $4,981.13 $221.67 – $665.01
CT scan of the pelvis, with contrast: 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $255.84
  • Avanti Hospitals, LLC — Medi-Cal: $221.67
  • Avanti Hospitals, LLC — Medicare Advantage: $221.67
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $221.67
  • Dignity Health — Medicare Advantage: $221.67
  • Health Net of California, Inc. — Ambetter PPO: $315.88
  • Health Net of California, Inc. — Medicare Advantage: $228.32
  • Health Net of California, Inc. — Tailored: $315.88
  • Humana Health Plan, Inc. — Medicare Advantage: $221.67
  • Inter Valley Health Plan — Medicare Advantage: $221.67
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT (per scan) $7,663.28 $4,981.13 $221.67 – $1,117.51
CT scan of the pelvis, with contrast: rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $456
  • PROSPECT HEALTH PLAN, INC. — HMO: $456
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $221.67
  • PROSPECT HEALTH PLAN, INC. — PPO: $456
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Radiology Services $7,663.28 $4,981.13 $221.67 – $1,117.51
CT scan of the pelvis, with contrast: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $1,117.51
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $1,117.51
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $1,117.51
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: HB MRI EXT LOW JT WO CONT UNI $8,756.56 $5,691.76 $300.99 – $902.96
MRI of a leg joint (such as the knee), without contrast: 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $335
  • Avanti Hospitals, LLC — Medi-Cal: $300.99
  • Avanti Hospitals, LLC — Medicare Advantage: $300.99
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $300.99
  • Dignity Health — Medicare Advantage: $300.99
  • Health Net of California, Inc. — Ambetter PPO: $428.91
  • Health Net of California, Inc. — Medicare Advantage: $310.02
  • Health Net of California, Inc. — Tailored: $428.91
  • Humana Health Plan, Inc. — Medicare Advantage: $300.99
  • Inter Valley Health Plan — Medicare Advantage: $300.99
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: MRI (per scan) $8,756.56 $5,691.76 $300.99 – $1,463.28
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $681
  • PROSPECT HEALTH PLAN, INC. — HMO: $681
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $300.99
  • PROSPECT HEALTH PLAN, INC. — PPO: $681
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Radiology Services $8,756.56 $5,691.76 $300.99 – $1,463.28
MRI of a leg joint (such as the knee), without contrast: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $1,463.28
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $1,463.28
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $1,463.28
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $13,628.20 $8,858.33 $270.86 – $1,334.08
CT scan of the abdomen and pelvis, with contrast: 10 of 57 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $270.86
  • Avanti Hospitals, LLC — Medi-Cal: $444.69
  • Avanti Hospitals, LLC — Medicare Advantage: $444.69
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $444.69
  • Dignity Health — Medicare Advantage: $444.69
  • Health Net of California, Inc. — Ambetter PPO: $633.69
  • Health Net of California, Inc. — Medicare Advantage: $458.03
  • Health Net of California, Inc. — Tailored: $633.69
  • Heritage Provider Network — Medicare Advantage: $444.69
  • Humana Health Plan, Inc. — Medicare Advantage: $444.69
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HB CT ABD & PELVIS W CONTRAST $13,628.20 $8,858.33 $270.86 – $1,334.08
CT scan of the abdomen and pelvis, with contrast: 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $270.86
  • Avanti Hospitals, LLC — Medi-Cal: $444.69
  • Avanti Hospitals, LLC — Medicare Advantage: $444.69
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $444.69
  • Dignity Health — Medicare Advantage: $444.69
  • Health Net of California, Inc. — Ambetter PPO: $633.69
  • Health Net of California, Inc. — Medicare Advantage: $458.03
  • Health Net of California, Inc. — Tailored: $633.69
  • Humana Health Plan, Inc. — Medicare Advantage: $444.69
  • Inter Valley Health Plan — Medicare Advantage: $444.69
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT (per scan) $13,628.20 $8,858.33 $444.69 – $1,183.12
CT scan of the abdomen and pelvis, with contrast: rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $456
  • PROSPECT HEALTH PLAN, INC. — HMO: $456
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $444.69
  • PROSPECT HEALTH PLAN, INC. — PPO: $456
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $1,906.15 $1,239 $87.95 – $397.24
Ultrasound of the abdomen, complete: 10 of 57 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $87.95
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: HB US ABDOMEN COMPLETE $1,906.15 $1,239 $87.95 – $397.24
Ultrasound of the abdomen, complete: 10 of 48 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $87.95
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Radiology Services $1,906.15 $1,239 $384.17 – $649.57
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $384.17
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $384.17
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $384.17
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HB ULTRASOUND OB >14 WEEKS $1,906.31 $1,239.10 $87.95 – $397.24
Pregnancy ultrasound (after the first trimester): 10 of 48 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $87.95
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Radiology Services $1,906.31 $1,239.10 $384.17 – $649.57
Pregnancy ultrasound (after the first trimester): rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $384.17
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $384.17
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $384.17
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Radiology Services not otherwise listed herein $1,906.31 $1,239.10 $384.17 – $649.57
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $486.39
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $649.57
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $1,945.32 $1,264.46 $83.59 – $397.24
Transvaginal ultrasound: 10 of 57 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $83.59
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HB US PELVIS TRANSVAGINAL $1,945.32 $1,264.46 $83.59 – $397.24
Transvaginal ultrasound: 10 of 48 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $83.59
  • Avanti Hospitals, LLC — Medi-Cal: $132.41
  • Avanti Hospitals, LLC — Medicare Advantage: $132.41
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $132.41
  • Dignity Health — Medicare Advantage: $132.41
  • Health Net of California, Inc. — Ambetter PPO: $188.69
  • Health Net of California, Inc. — Medicare Advantage: $136.39
  • Health Net of California, Inc. — Tailored: $188.69
  • Heritage Provider Network — Medicare Advantage: $132.41
  • Humana Health Plan, Inc. — Medicare Advantage: $132.41
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Radiology Services $1,945.32 $1,264.46 $365.12 – $649.57
Transvaginal ultrasound: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $365.12
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $365.12
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $365.12

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Cardiac Catheterization $25,214.30 $16,389.30 $4,005.04 – $14,675.44
Left heart catheterization (diagnostic): rates for 7 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $14,675.44
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $14,675.44
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $14,675.44
  • Health Net of California, Inc. — EPO: $11,592.19
  • Health Net of California, Inc. — HMO: $11,425.79
  • Health Net of California, Inc. — POS: $11,592.19
  • Health Net of California, Inc. — PPO: $11,370.33
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Outpatient Procedures 5 $25,214.30 $16,389.30 $8,316.34 – $16,657.29
Left heart catheterization (diagnostic): rates for 6 insurance plans
  • UnitedHealthcare — Core: $14,122.33
  • UnitedHealthcare — Doctor's Plan: $14,122.33
  • UnitedHealthcare — HMO: $16,657.29
  • UnitedHealthcare — Navigate: $14,122.33
  • UnitedHealthcare — PPO: $16,657.29
  • UnitedHealthcare — Select: $14,122.33
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Cardiac Cath (per case) $25,214.30 $16,389.30 $4,005.04 – $14,675.44
Left heart catheterization (diagnostic): rates for 5 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $5,670
  • PROSPECT HEALTH PLAN, INC. — HMO: $5,670
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $4,005.04
  • PROSPECT HEALTH PLAN, INC. — PPO: $5,670
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Electrophysiology Studies $18,761.80 $12,195.17 $9,448.61 – $11,592.19
Heart rhythm study (electrophysiology evaluation): rates for 9 insurance plans
  • Heritage Provider Network — Medicare Advantage: $9,448.61
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $9,448.61
  • Heritage Provider Network — Covered: 50% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — HMO: 50% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — Covered: 50% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — HMO: 50% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
  • PROSPECT HEALTH PLAN, INC. — PPO: 50% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Outpatient Procedures 6 $18,761.80 $12,195.17 $15,074.05 – $17,780.27
Heart rhythm study (electrophysiology evaluation): rates for 6 insurance plans
  • UnitedHealthcare — Core: $15,074.05
  • UnitedHealthcare — Doctor's Plan: $15,074.05
  • UnitedHealthcare — HMO: $17,780.27
  • UnitedHealthcare — Navigate: $15,074.05
  • UnitedHealthcare — PPO: $17,780.27
  • UnitedHealthcare — Select: $15,074.05
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Electrophysiology Studies (EPS) (including EPS, lntracardiac Ablation and Radio Frequency Ablation) $18,761.80 $12,195.17 $9,448.61 – $11,592.19
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $11,592.19
  • Health Net of California, Inc. — HMO: $11,425.79
  • Health Net of California, Inc. — POS: $11,592.19
  • Health Net of California, Inc. — PPO: $11,370.33
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: HB COMP ATRIAL FIB PULM VEIN ISL 3D MAP S&I $40,029.50 $26,019.17 $984.64 – $91,641.98
Heart rhythm study with ablation for atrial fibrillation: 10 of 56 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $984.64
  • Avanti Hospitals, LLC — Medi-Cal: $30,547.33
  • Avanti Hospitals, LLC — Medicare Advantage: $30,547.33
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $30,547.33
  • Dignity Health — Medicare Advantage: $30,547.33
  • Health Net of California, Inc. — Ambetter PPO: $43,529.94
  • Health Net of California, Inc. — Medicare Advantage: $31,463.75
  • Health Net of California, Inc. — Tailored: $43,529.94
  • Heritage Provider Network — Medicare Advantage: $30,547.33
  • Humana Health Plan, Inc. — Medicare Advantage: $30,547.33
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Outpatient Procedures 8 $40,029.50 $26,019.17 $8,316.34 – $22,959.41
Heart rhythm study with ablation for atrial fibrillation: rates for 6 insurance plans
  • UnitedHealthcare — Core: $19,465.97
  • UnitedHealthcare — Doctor's Plan: $19,465.97
  • UnitedHealthcare — HMO: $22,959.41
  • UnitedHealthcare — Navigate: $19,465.97
  • UnitedHealthcare — PPO: $22,959.41
  • UnitedHealthcare — Select: $19,465.97
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 7 $40,029.50 $26,019.17 $984.64 – $91,641.98
Heart rhythm study with ablation for atrial fibrillation: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $8,316.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $10,820.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $10,820.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $10,820.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $10,820.18
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Sleep Studies - Attended $2,491.60 $1,619.54 $2,875.76 – $3,392.73
Sleep study (overnight, in a sleep lab): rates for 6 insurance plans
  • UnitedHealthcare — Core: $2,875.76
  • UnitedHealthcare — Doctor's Plan: $2,875.76
  • UnitedHealthcare — HMO: $3,392.73
  • UnitedHealthcare — Navigate: $2,875.76
  • UnitedHealthcare — PPO: $3,392.73
  • UnitedHealthcare — Select: $2,875.76
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Sleep Studies Not listed in the file Not listed in the file $2,455.91
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $2,455.91
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $2,455.91
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $2,455.91

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $303.27 $197.13 $19.98
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 55 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $19.98
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HB OT UPPER EXT EXERCISE EA 15M $303.27 $197.13 $19.98
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $19.98
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HB THER EXERCISE EA 15M $303.27 $197.13 $19.98
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $19.98
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: CONVERSION DUMMY EAP-DONT USE $434.62 $282.50 $55.30
Physical therapy evaluation (low complexity): 10 of 55 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $55.30
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HB PT EVAL LOW COMPLEXITY $434.62 $282.50 $55.30
Physical therapy evaluation (low complexity): 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $55.30
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: PT/OT/ST $434.62 $282.50 $162 – $173.69
Physical therapy evaluation (low complexity): rates for 4 insurance plans
  • Heritage Provider Network — Covered: $162
  • Heritage Provider Network — HMO: $165.24
  • Heritage Provider Network — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HB PT EVAL MOD COMPLEXITY $653.52 $424.79 $55.30
Physical therapy evaluation (moderate complexity): 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $55.30
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: PT/OT/ST $653.52 $424.79 $162 – $173.69
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans
  • Heritage Provider Network — Covered: $162
  • Heritage Provider Network — HMO: $165.24
  • Heritage Provider Network — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical, Occupational and Speech Therapy $653.52 $424.79 $162 – $173.69
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $173.69
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $173.69
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $173.69
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HB PT EVAL HIGH COMPLEXITY $869.25 $565.01 $55.30
Physical therapy evaluation (high complexity): 10 of 44 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $55.30
  • Affiliated Health Funds — PPO: 80% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medi-Cal: 100% (a percentage in the contract, not a dollar amount)
  • Avanti Hospitals, LLC — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California — Medi-Cal: 110% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: 18.62% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: 28.18% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: 33.69% (a percentage in the contract, not a dollar amount)
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: 18.62% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: PT/OT/ST $869.25 $565.01 $162 – $173.69
Physical therapy evaluation (high complexity): rates for 4 insurance plans
  • Heritage Provider Network — Covered: $162
  • Heritage Provider Network — HMO: $165.24
  • Heritage Provider Network — Medi-Cal: 130% (a percentage in the contract, not a dollar amount)
  • Heritage Provider Network — Medicare Advantage: 100% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical, Occupational and Speech Therapy $869.25 $565.01 $162 – $173.69
Physical therapy evaluation (high complexity): rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $173.69
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $173.69
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $173.69
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: HB PSYCHOTHERAPY 30 MINUTES $594.34 $386.32 $75 – $600.19
Psychotherapy, 30 minutes: 10 of 58 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $75
  • Avanti Hospitals, LLC — Medi-Cal: $200.06
  • Avanti Hospitals, LLC — Medicare Advantage: $200.06
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $200.06
  • Dignity Health — Medicare Advantage: $200.06
  • Health Net of California, Inc. — Ambetter PPO: $285.09
  • Health Net of California, Inc. — Medicare Advantage: $206.07
  • Health Net of California, Inc. — Tailored: $285.09
  • Heritage Provider Network — Medicare Advantage: $200.06
  • Humana Health Plan, Inc. — Medicare Advantage: $200.06
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychiatric Outpatient Services Partial Hospitalization $594.34 $386.32 $659.08 – $671.94
Psychotherapy, 30 minutes: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychiatric Outpatient Services Partial Hospitalization $891.52 $579.49 $659.08 – $671.94
Psychotherapy, 45 minutes: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: HB PSYCHOTHERAPY 60 MINUTES $1,188.67 $772.64 $146.16 – $600.19
Psychotherapy, 60 minutes: 10 of 58 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $146.16
  • Avanti Hospitals, LLC — Medi-Cal: $200.06
  • Avanti Hospitals, LLC — Medicare Advantage: $200.06
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $200.06
  • Dignity Health — Medicare Advantage: $200.06
  • Health Net of California, Inc. — Ambetter PPO: $285.09
  • Health Net of California, Inc. — Medicare Advantage: $206.07
  • Health Net of California, Inc. — Tailored: $285.09
  • Heritage Provider Network — Medicare Advantage: $200.06
  • Humana Health Plan, Inc. — Medicare Advantage: $200.06
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychiatric Outpatient Services Partial Hospitalization $1,188.67 $772.64 $659.08 – $671.94
Psychotherapy, 60 minutes: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Psychiatric Outpatient Services Partial Hospitalization Not listed in the file Not listed in the file $659.08 – $671.94
Family psychotherapy, without the patient: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Psychiatric Outpatient Services Partial Hospitalization Not listed in the file Not listed in the file $659.08 – $671.94
Family psychotherapy, with the patient: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: HB GROUP THERAPY $459.48 $298.66 $41 – $671.94
Group psychotherapy: 10 of 54 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $41
  • Avanti Hospitals, LLC — Medi-Cal: $115.18
  • Avanti Hospitals, LLC — Medicare Advantage: $115.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $115.18
  • Dignity Health — Medicare Advantage: $115.18
  • Health Net of California, Inc. — Ambetter PPO: $164.13
  • Health Net of California, Inc. — Medicare Advantage: $118.64
  • Health Net of California, Inc. — Tailored: $164.13
  • Heritage Provider Network — Medicare Advantage: $115.18
  • Humana Health Plan, Inc. — Medicare Advantage: $115.18
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Chemical Dependency Outpatient Services Partial Hospitalization $459.48 $298.66 $659.08 – $671.94
Group psychotherapy: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Psychiatric Outpatient Services Partial Hospitalization $459.48 $298.66 $41 – $671.94
Group psychotherapy: rates for 4 insurance plans
  • Health Net of California, Inc. — EPO: $671.94
  • Health Net of California, Inc. — HMO: $662.29
  • Health Net of California, Inc. — POS: $671.94
  • Health Net of California, Inc. — PPO: $659.08

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Outpatient Procedures 3 $4,108.59 $2,670.58 $4,260.59 – $11,139.71
Removal of breast growth (open surgery): rates for 6 insurance plans
  • UnitedHealthcare — Core: $9,445.10
  • UnitedHealthcare — Doctor's Plan: $9,445.10
  • UnitedHealthcare — HMO: $11,139.71
  • UnitedHealthcare — Navigate: $9,445.10
  • UnitedHealthcare — PPO: $11,139.71
  • UnitedHealthcare — Select: $9,445.10
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $2,661.95 $1,730.27 $4,260.59 – $11,139.71
Removal of breast growth (open surgery): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 3 $4,108.59 $2,670.58 $4,260.59 – $11,139.71
Removal of breast growth (open surgery): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $6,585.82
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $7,308.08
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Outpatient Procedures 7 $23,255.50 $15,116.08 $4,260.59 – $20,376.05
Total hip replacement: rates for 6 insurance plans
  • UnitedHealthcare — Core: $17,274.13
  • UnitedHealthcare — Doctor's Plan: $17,274.13
  • UnitedHealthcare — HMO: $20,376.05
  • UnitedHealthcare — Navigate: $17,274.13
  • UnitedHealthcare — PPO: $20,376.05
  • UnitedHealthcare — Select: $17,274.13
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $2,661.95 $1,730.27 $4,260.59 – $20,376.05
Total hip replacement: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: OP Total Joint Replacement (CPTs: ) Not listed in the file Not listed in the file $16,021.61 – $26,435.66
Total hip replacement: rates for 4 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $26,435.66
  • PROSPECT HEALTH PLAN, INC. — HMO: $26,435.66
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $16,021.61
  • PROSPECT HEALTH PLAN, INC. — PPO: $26,435.66
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Outpatient Procedures 7 $3,803.43 $2,472.23 $4,260.59 – $20,376.05
Total knee replacement: rates for 6 insurance plans
  • UnitedHealthcare — Core: $17,274.13
  • UnitedHealthcare — Doctor's Plan: $17,274.13
  • UnitedHealthcare — HMO: $20,376.05
  • UnitedHealthcare — Navigate: $17,274.13
  • UnitedHealthcare — PPO: $20,376.05
  • UnitedHealthcare — Select: $17,274.13
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $2,661.95 $1,730.27 $4,260.59 – $20,376.05
Total knee replacement: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: OP Total Joint Replacement (CPTs: ) Not listed in the file Not listed in the file $16,021.61 – $26,435.66
Total knee replacement: rates for 4 insurance plans
  • PROSPECT HEALTH PLAN, INC. — Covered: $26,435.66
  • PROSPECT HEALTH PLAN, INC. — HMO: $26,435.66
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $16,021.61
  • PROSPECT HEALTH PLAN, INC. — PPO: $26,435.66
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Outpatient Procedures 0 $3,803.43 $2,472.23 $1,227.76 – $7,308.08
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans
  • UnitedHealthcare — Core: $1,227.76
  • UnitedHealthcare — Doctor's Plan: $1,227.76
  • UnitedHealthcare — HMO: $1,447.97
  • UnitedHealthcare — Navigate: $1,227.76
  • UnitedHealthcare — PPO: $1,447.97
  • UnitedHealthcare — Select: $1,227.76
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $1,765.84 $1,147.80 $4,260.59 – $5,543.34
Shoulder arthroscopy: shaving of shoulder bone: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 3 $4,108.59 $2,670.58 $1,227.76 – $7,308.08
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $6,585.82
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $7,308.08
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Outpatient Procedures 4 $3,803.43 $2,472.23 $5,268.38 – $14,247.81
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 6 insurance plans
  • UnitedHealthcare — Core: $12,082.93
  • UnitedHealthcare — Doctor's Plan: $12,082.93
  • UnitedHealthcare — HMO: $14,247.81
  • UnitedHealthcare — Navigate: $12,082.93
  • UnitedHealthcare — PPO: $14,247.81
  • UnitedHealthcare — Select: $12,082.93
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 4 $23,255.50 $15,116.08 $5,268.38 – $14,247.81
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $5,268.38
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $6,854.56
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $6,854.56
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $6,854.56
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $6,854.56
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 4 $2,661.95 $1,730.27 $5,268.38 – $14,247.81
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $8,639.64
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $9,107.28
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Outpatient Procedures 3 $3,803.43 $2,472.23 $4,260.59 – $11,139.71
Removal of tonsils and adenoids (under age 12): rates for 6 insurance plans
  • UnitedHealthcare — Core: $9,445.10
  • UnitedHealthcare — Doctor's Plan: $9,445.10
  • UnitedHealthcare — HMO: $11,139.71
  • UnitedHealthcare — Navigate: $9,445.10
  • UnitedHealthcare — PPO: $11,139.71
  • UnitedHealthcare — Select: $9,445.10
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $2,661.95 $1,730.27 $4,260.59 – $11,139.71
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 3 $4,108.59 $2,670.58 $4,260.59 – $11,139.71
Removal of tonsils and adenoids (under age 12): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $6,585.82
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $7,308.08
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $3,039.91 $1,975.94 $2,785.77 – $5,061.15
Upper GI endoscopy (diagnostic): rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 1 $3,039.91 $1,975.94 $2,785.77 – $5,061.15
Upper GI endoscopy (diagnostic): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $2,785.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $3,624.49
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 1 $3,039.91 $1,975.94 $2,785.77 – $5,061.15
Upper GI endoscopy (diagnostic): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $3,346.47
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $3,709.68
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $3,039.91 $1,975.94 $3,728.01 – $5,061.15
Upper GI endoscopy with biopsy: rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $3,039.91 $1,975.94 $3,728.01 – $5,061.15
Upper GI endoscopy with biopsy: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $3,039.91 $1,975.94 $3,728.01 – $5,061.15
Upper GI endoscopy with biopsy: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $4,108.59 $2,670.58 $3,728.01 – $5,061.15
Colonoscopy (diagnostic): rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $3,803.43 $2,472.23 $3,728.01 – $5,061.15
Colonoscopy (diagnostic): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $2,661.95 $1,730.27 $3,728.01 – $5,061.15
Colonoscopy (diagnostic): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $3,803.43 $2,472.23 $3,728.01 – $5,061.15
Colonoscopy with biopsy: rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $4,108.59 $2,670.58 $3,728.01 – $5,061.15
Colonoscopy with biopsy: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $2,661.95 $1,730.27 $3,728.01 – $5,061.15
Colonoscopy with biopsy: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $3,803.43 $2,472.23 $3,728.01 – $5,061.15
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $4,108.59 $2,670.58 $3,728.01 – $5,061.15
Colonoscopy with removal of polyps (snare): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $2,661.95 $1,730.27 $3,728.01 – $5,061.15
Colonoscopy with removal of polyps (snare): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $23,255.50 $15,116.08 $2,785.77 – $5,061.15
Ultrasound of the lower bowel by endoscope: rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 1 $1,765.84 $1,147.80 $2,785.77 – $3,624.49
Ultrasound of the lower bowel by endoscope: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $2,785.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $3,624.49
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $2,661.95 $1,730.27 $4,431.06 – $4,907.76
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Outpatient Procedures $4,108.59 $2,670.58 $2,686.24 – $4,907.76
Screening colonoscopy (not high risk): rates for 6 insurance plans
  • UnitedHealthcare — Core: $2,686.24
  • UnitedHealthcare — Doctor's Plan: $2,686.24
  • UnitedHealthcare — HMO: $3,167.10
  • UnitedHealthcare — Navigate: $2,686.24
  • UnitedHealthcare — PPO: $3,167.10
  • UnitedHealthcare — Select: $2,686.24
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $3,803.43 $2,472.23 $2,686.24 – $4,907.76
Screening colonoscopy (not high risk): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $3,803.43 $2,472.23 $2,686.24 – $4,907.76
Screening colonoscopy (not high risk): rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Outpatient Procedures 6 $3,803.43 $2,472.23 $8,316.34 – $17,780.27
Gallbladder removal by laparoscope: rates for 6 insurance plans
  • UnitedHealthcare — Core: $15,074.05
  • UnitedHealthcare — Doctor's Plan: $15,074.05
  • UnitedHealthcare — HMO: $17,780.27
  • UnitedHealthcare — Navigate: $15,074.05
  • UnitedHealthcare — PPO: $17,780.27
  • UnitedHealthcare — Select: $15,074.05
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 7 $3,803.43 $2,472.23 $8,316.34 – $17,780.27
Gallbladder removal by laparoscope: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $8,316.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $10,820.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $10,820.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $10,820.18
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $10,820.18
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopic Cholecystectomy Not listed in the file Not listed in the file $7,264.88 – $15,090.40
Gallbladder removal by laparoscope: rates for 6 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $12,856.46
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $15,090.40
  • Health Net of California, Inc. — EPO: $11,881.65
  • Health Net of California, Inc. — HMO: $11,711.10
  • Health Net of California, Inc. — POS: $11,881.65
  • Health Net of California, Inc. — PPO: $11,654.25
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Outpatient Procedures 4 $5,667.12 $3,683.63 $5,268.38 – $14,247.81
Groin (inguinal) hernia repair, age 5 or older: rates for 6 insurance plans
  • UnitedHealthcare — Core: $12,082.93
  • UnitedHealthcare — Doctor's Plan: $12,082.93
  • UnitedHealthcare — HMO: $14,247.81
  • UnitedHealthcare — Navigate: $12,082.93
  • UnitedHealthcare — PPO: $14,247.81
  • UnitedHealthcare — Select: $12,082.93
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 4 $5,667.12 $3,683.63 $5,268.38 – $14,247.81
Groin (inguinal) hernia repair, age 5 or older: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $5,268.38
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $6,854.56
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $6,854.56
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $6,854.56
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $6,854.56
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 4 $5,667.12 $3,683.63 $5,268.38 – $14,247.81
Groin (inguinal) hernia repair, age 5 or older: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $8,639.64
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $9,107.28
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Outpatient Procedures 2 $4,108.59 $2,670.58 $3,728.01 – $5,061.15
Prostate biopsy: rates for 6 insurance plans
  • UnitedHealthcare — Core: $4,294.07
  • UnitedHealthcare — Doctor's Plan: $4,294.07
  • UnitedHealthcare — HMO: $5,061.15
  • UnitedHealthcare — Navigate: $4,294.07
  • UnitedHealthcare — PPO: $5,061.15
  • UnitedHealthcare — Select: $4,294.07
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $3,803.43 $2,472.23 $3,728.01 – $5,061.15
Prostate biopsy: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $2,661.95 $1,730.27 $3,728.01 – $5,061.15
Prostate biopsy: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Outpatient Procedures 7 $4,108.59 $2,670.58 $2,785.77 – $20,376.05
Prostate removal by laparoscope (radical prostatectomy): rates for 6 insurance plans
  • UnitedHealthcare — Core: $17,274.13
  • UnitedHealthcare — Doctor's Plan: $17,274.13
  • UnitedHealthcare — HMO: $20,376.05
  • UnitedHealthcare — Navigate: $17,274.13
  • UnitedHealthcare — PPO: $20,376.05
  • UnitedHealthcare — Select: $17,274.13
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 1 $23,255.50 $15,116.08 $2,785.77 – $20,376.05
Prostate removal by laparoscope (radical prostatectomy): rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $2,785.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $3,624.49
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Outpatient Procedures 3 $3,803.43 $2,472.23 $4,260.59 – $11,139.71
Hysteroscopy with biopsy of the uterus lining: rates for 6 insurance plans
  • UnitedHealthcare — Core: $9,445.10
  • UnitedHealthcare — Doctor's Plan: $9,445.10
  • UnitedHealthcare — HMO: $11,139.71
  • UnitedHealthcare — Navigate: $9,445.10
  • UnitedHealthcare — PPO: $11,139.71
  • UnitedHealthcare — Select: $9,445.10
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $2,661.95 $1,730.27 $4,260.59 – $11,139.71
Hysteroscopy with biopsy of the uterus lining: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 3 $3,803.43 $2,472.23 $4,260.59 – $11,139.71
Hysteroscopy with biopsy of the uterus lining: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $6,585.82
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $7,308.08
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HB DIAG LUMB SPINAL PUNCT W/ FLUORO/CT $4,462.50 $2,900.63 $82.15 – $3,709.68
Spinal injection, lower back (epidural), with imaging guidance: 10 of 43 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $82.15
  • Avanti Hospitals, LLC — Medi-Cal: $862.32
  • Avanti Hospitals, LLC — Medicare Advantage: $862.32
  • California PhysiciansÆ Service, dba Blue Shield of Californi — Medicare Advantage: $862.32
  • Dignity Health — Medicare Advantage: $862.32
  • Health Net of California, Inc. — Ambetter PPO: $1,228.80
  • Health Net of California, Inc. — Medicare Advantage: $888.19
  • Health Net of California, Inc. — Tailored: $1,228.80
  • Humana Health Plan, Inc. — Medicare Advantage: $862.32
  • Inter Valley Health Plan — Medicare Advantage: $862.32
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Outpatient Procedures $4,462.50 $2,900.63 $2,686.24 – $3,709.68
Spinal injection, lower back (epidural), with imaging guidance: rates for 6 insurance plans
  • UnitedHealthcare — Core: $2,686.24
  • UnitedHealthcare — Doctor's Plan: $2,686.24
  • UnitedHealthcare — HMO: $3,167.10
  • UnitedHealthcare — Navigate: $2,686.24
  • UnitedHealthcare — PPO: $3,167.10
  • UnitedHealthcare — Select: $2,686.24
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 1 $4,462.50 $2,900.63 $2,686.24 – $3,624.49
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $2,785.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $3,624.49
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Outpatient Procedures $8,565.07 $5,567.30 $2,686.24 – $3,709.68
Nerve root injection, lower back, with imaging guidance: rates for 6 insurance plans
  • UnitedHealthcare — Core: $2,686.24
  • UnitedHealthcare — Doctor's Plan: $2,686.24
  • UnitedHealthcare — HMO: $3,167.10
  • UnitedHealthcare — Navigate: $2,686.24
  • UnitedHealthcare — PPO: $3,167.10
  • UnitedHealthcare — Select: $2,686.24
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 1 $8,565.07 $5,567.30 $2,686.24 – $3,624.49
Nerve root injection, lower back, with imaging guidance: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $2,785.77
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $3,624.49
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $3,624.49
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 1 $8,565.07 $5,567.30 $2,686.24 – $3,709.68
Nerve root injection, lower back, with imaging guidance: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $3,346.47
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $3,709.68
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Outpatient Procedures 3 $23,255.50 $15,116.08 $3,728.01 – $11,139.71
Carpal tunnel release: rates for 6 insurance plans
  • UnitedHealthcare — Core: $9,445.10
  • UnitedHealthcare — Doctor's Plan: $9,445.10
  • UnitedHealthcare — HMO: $11,139.71
  • UnitedHealthcare — Navigate: $9,445.10
  • UnitedHealthcare — PPO: $11,139.71
  • UnitedHealthcare — Select: $9,445.10
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $23,255.50 $15,116.08 $3,728.01 – $11,139.71
Carpal tunnel release: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $4,108.59 $2,670.58 $3,728.01 – $11,139.71
Carpal tunnel release: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Outpatient Procedures $3,803.43 $2,472.23 $2,686.24 – $4,907.76
Laser treatment of clouding after cataract surgery: rates for 6 insurance plans
  • UnitedHealthcare — Core: $2,686.24
  • UnitedHealthcare — Doctor's Plan: $2,686.24
  • UnitedHealthcare — HMO: $3,167.10
  • UnitedHealthcare — Navigate: $2,686.24
  • UnitedHealthcare — PPO: $3,167.10
  • UnitedHealthcare — Select: $2,686.24
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $23,255.50 $15,116.08 $2,686.24 – $4,907.76
Laser treatment of clouding after cataract surgery: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 2 $2,661.95 $1,730.27 $2,686.24 – $4,907.76
Laser treatment of clouding after cataract surgery: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $4,431.06
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $4,907.76
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Outpatient Procedures 3 $3,803.43 $2,472.23 $8,103.31 – $15,702.96
Cataract removal with lens implant: rates for 6 insurance plans
  • UnitedHealthcare — Core: $9,445.10
  • UnitedHealthcare — Doctor's Plan: $9,445.10
  • UnitedHealthcare — HMO: $11,139.71
  • UnitedHealthcare — Navigate: $9,445.10
  • UnitedHealthcare — PPO: $11,139.71
  • UnitedHealthcare — Select: $9,445.10
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 8 $4,108.59 $2,670.58 $8,103.31 – $15,702.96
Cataract removal with lens implant: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $8,103.31
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $10,543.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $10,543.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $10,543.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $10,543.01
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Ambulatory Surgery û Cigna Grouper Schedule* Grouper 8 $3,803.43 $2,472.23 $8,103.31 – $15,702.96
Cataract removal with lens implant: rates for 2 insurance plans
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — HMO: $14,150.14
  • Cigna HealthCare of California, Inc. (CHC) and Cigna Health — PPO: $15,702.96

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $23,255.50 $15,116.08 $3,728.01 – $4,850.42
Vaginal delivery, with care before and after: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 3 $2,661.95 $1,730.27 $4,260.59 – $5,543.34
Cesarean delivery (C-section), with care before and after: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $4,260.59
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $5,543.34
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $5,543.34
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Outpatient Surgical Services Group 2 $3,803.43 $2,472.23 $3,728.01 – $4,850.42
Vaginal delivery after a previous C-section, with care before and after: rates for 5 insurance plans
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $3,728.01
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — HMO: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — POS: $4,850.42
  • California PhysiciansÆ Service, dba Blue Shield of Californi — PPO: $4,850.42

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) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC Not listed in the file Not listed in the file $11,578.23 – $261,240.84
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 39 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $94,996.67
  • Avanti Hospitals, LLC — Medicare Advantage: $94,996.67
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: $159,609.89
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: $159,609.89
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: $116,942.38
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: $131,718.21
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: $159,609.89
  • Blue Cross of California d/b/a Anthem Blue Cross — PPO: $159,609.89
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $127,390.53
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $154,654.58
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: Cardiac Valve & Other Major Cardiothoracic Procedures with Cardiac Catheterization w MCC Not listed in the file Not listed in the file $11,578.23 – $261,240.84
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 6 insurance plans
  • UnitedHealthcare — Core: $152,306.10
  • UnitedHealthcare — Doctor's Plan: $152,306.10
  • UnitedHealthcare — HMO: $179,688.42
  • UnitedHealthcare — Navigate: $152,306.10
  • UnitedHealthcare — PPO: $179,688.42
  • UnitedHealthcare — Select: $152,306.10
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: Cardiac Valve & Oth Maj Car Not listed in the file Not listed in the file $11,578.23 – $261,240.84
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $72,665.84
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $72,665.84
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $72,665.84
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) In the file: Spinal Fusion Except Cervica Not listed in the file Not listed in the file $41,054
Spinal fusion (not neck), without major complications: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $41,054
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $41,054
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $41,054
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC Not listed in the file Not listed in the file $18,908.14 – $51,997.37
Hip or knee replacement (major joint of the leg), without major complications: 10 of 34 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $18,908.14
  • Avanti Hospitals, LLC — Medicare Advantage: $18,908.14
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: $31,182.40
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: $31,182.40
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: $22,846.60
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: $25,733.30
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: $31,182.40
  • Blue Cross of California d/b/a Anthem Blue Cross — PPO: $31,182.40
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $25,355.81
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $30,782.44
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: IP Total Joint Replacement Not listed in the file Not listed in the file $18,908.14 – $51,997.37
Hip or knee replacement (major joint of the leg), without major complications: rates for 8 insurance plans
  • Heritage Provider Network — Covered: $26,471.39
  • Heritage Provider Network — HMO: $26,471.39
  • Heritage Provider Network — Medi-Cal: $24,580.58
  • Heritage Provider Network — Medicare Advantage: $18,908.14
  • PROSPECT HEALTH PLAN, INC. — Covered: $31,198.42
  • PROSPECT HEALTH PLAN, INC. — HMO: $31,198.42
  • PROSPECT HEALTH PLAN, INC. — Medicare Advantage: $18,908.14
  • PROSPECT HEALTH PLAN, INC. — PPO: $31,198.42
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: Major Joint Replacement Not listed in the file Not listed in the file $18,908.14 – $51,997.37
Hip or knee replacement (major joint of the leg), without major complications: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $34,180.64
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $34,180.64
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $34,180.64
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $23,629.86 – $64,982.13
Neck (cervical) spinal fusion, without complications: 10 of 41 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $23,629.86
  • Avanti Hospitals, LLC — Medicare Advantage: $23,629.86
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: $39,152.06
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: $39,152.06
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: $28,685.79
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: $32,310.28
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: $39,152.06
  • Blue Cross of California d/b/a Anthem Blue Cross — PPO: $39,152.06
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $31,687.65
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $38,469.42
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: Cervical Spinal Fusion Not listed in the file Not listed in the file $23,629.86 – $64,982.13
Neck (cervical) spinal fusion, without complications: rates for 3 insurance plans
  • Aetna Health of California, Inc. and Aetna Health Management — HMO: $27,608.88
  • Aetna Health of California, Inc. and Aetna Health Management — POS: $27,608.88
  • Aetna Health of California, Inc. and Aetna Health Management — PPO: $27,608.88
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $12,178.76 – $33,491.60
Uterus and ovary surgery (not for cancer), without complications: 10 of 41 insurance plan rates
  • Aetna Health of California Inc. and Aetna Health Management, — Medicare Advantage: $12,178.76
  • Avanti Hospitals, LLC — Medicare Advantage: $12,178.76
  • Blue Cross of California d/b/a Anthem Blue Cross — Covered: $19,824.10
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO: $19,824.10
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, City of LA, Vivity: $14,524.65
  • Blue Cross of California d/b/a Anthem Blue Cross — HMO, Non-City of LA, Vivity: $16,359.86
  • Blue Cross of California d/b/a Anthem Blue Cross — Medicare Advantage: $19,824.10
  • Blue Cross of California d/b/a Anthem Blue Cross — PPO: $19,824.10
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPN/IFP: $16,331.72
  • California PhysiciansÆ Service, dba Blue Shield of Californi — EPO: $19,827.03

Source: Huntington Hospital’s standard charges file (media.huntingtonhealth.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on November 26, 2025; retrieved November 5, 2026. The hospital’s price transparency page →

Found through the price transparency link on the hospital’s website (huntingtonhealth.org), because the hospital has no cms-hpt.txt file; both are 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
Address100 W California Blvd, Pasadena, CA 91109
CountyLos Angeles County
StateCalifornia
Phone(626) 397‑5000
Emergency servicesYes
OwnershipVoluntary non-profit - Other
Medicare overall ratingNot rated by CMS
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number050438
Name in Medicare recordsHUNTINGTON HOSPITAL
Profile levelMedicare data + hospital website
Name on the hospital’s websiteHuntington Hospital (Huntington Health, an affiliate of Cedars-Sinai)
Official websitehuntingtonhealth.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 2026-11-02.

  1. Huntington Hospital | Pasadena Hospital & Medical Center — huntingtonhealth.org
  2. Huntington Hospital Services — huntingtonhealth.org
  3. Visitor Information | Huntington Hospital — huntingtonhealth.org