Does John Muir Medical Center - Walnut Creek Campus have an emergency room?

Yes. Medicare (CMS) data lists emergency services at John Muir Medical Center - Walnut Creek Campus. In a medical emergency, call 911.

Where is John Muir Medical Center - Walnut Creek Campus?

1601 Ygnacio Valley Rd, Walnut Creek, CA 94598, in Contra Costa County, California.

What is the phone number of John Muir Medical Center - Walnut Creek Campus?

(925) 939-3000, as listed by Medicare (CMS).

What is the Medicare star rating of John Muir Medical Center - Walnut Creek Campus?

2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

John Muir Medical Center - Walnut Creek Campus

Quick answers

Does John Muir Medical Center - Walnut Creek Campus have an emergency room?: Yes. Medicare (CMS) data lists emergency services at John Muir Medical Center - Walnut Creek Campus. In a medical emergency, call 911.
Where is John Muir Medical Center - Walnut Creek Campus?: 1601 Ygnacio Valley Rd, Walnut Creek, CA 94598, in Contra Costa County, California.
What is the phone number of John Muir Medical Center - Walnut Creek Campus?: (925) 939-3000, as listed by Medicare (CMS).
What is the Medicare star rating of John Muir Medical Center - Walnut Creek Campus?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Emergency
Trauma
Cancer care
Orthopedics
Neurosciences
Cardiac
Rehabilitation
Obstetrics & Gynecology

Conditions treated^[5][7][10]

Stroke
STEMI (heart attack)

Treatments^[7][10]

Radiation oncology
Interventional stroke procedures

Procedures^[10]

Programs and centers^[4][7][8][9]

Level III Neonatal Intensive Care Unit
Pediatric Intensive Care Unit (with Stanford Medicine Children's Health)
Trauma center
Birth Center
Comprehensive stroke center

Emergency care (hospital website)^[4][6][7][9]

Emergency room	Yes
Trauma designation	Level II
Stroke designation	Advanced Comprehensive Stroke Center

Visiting and practical information

Visiting	Visiting hours 9 a.m. to 9 p.m.; some units such as Labor & Delivery, Pediatrics and PICU may differ^[4]
Parking	Main entrance on La Casa Via off Ygnacio Valley Rd; parking garage at 133 La Casa Via open 24 hours^[4]
Interpreters and languages	Interpreter services available^[4]
Patient portal	MyChart

Recognition^{[4][5][7][9][10]}

Advanced Comprehensive Stroke Center (The Joint Commission / American Heart Association)
The Joint Commission Gold Seal of Approval
Magnet Recognition for Nursing (ANCC)
U.S. News & World Report Best Regional Hospital 2025-2026
Nationally ranked Obstetrics & Gynecology (U.S. News)
Joint Commission Comprehensive Stroke Center certification
American College of Surgeons Level II adult trauma center verification (extended through November 7, 2026)
Get With The Guidelines Stroke Gold Plus 2026
Get With The Guidelines STEMI Receiving Center Gold (Contra Costa County STEMI Receiving Center) 2026
Get With The Guidelines Heart Failure Gold Plus 2026
HIMSS Stage 7 certification
American College of Radiology accreditation for radiation oncology

Doctors and clinicians (1,183)

1,183 doctors and other clinicians list John Muir Medical Center - Walnut Creek Campus 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

And 1,159 more: the button below opens the full list.

Other emergency rooms nearby

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

Kaiser Foundation Hospital - Walnut Creek1.7 mi · Walnut Creek, CA · Acute Care Hospital
John Muir Medical Center - Concord Campus4.8 mi · Concord, CA · Acute Care Hospital
John Muir Behavioral Health Center4.9 mi · Concord, CA · Psychiatric Hospital
Contra Costa Regional Medical Center8.0 mi · Martinez, CA · Acute Care Hospital
San Ramon Regional Medical Center10 mi · San Ramon, CA · Acute Care Hospital

Other hospitals nearby

Alta Bates Summit Medical Center - Alta Bates Camp…13 mi · Berkeley, CA · Acute Care Hospital

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

La Casa Via Transitional Care Center0.4 mi · Walnut Creek, CA · 5 of 5 stars
Tampico Healthcare Center0.4 mi · Walnut Creek, CA · 4 of 5 stars
Pleasant Hill Post Acute1.6 mi · Pleasant Hill, CA · 4 of 5 stars

All nursing homes in the state →

Hospice providers

Prohealth Home Care, Inc1.5 mi · Walnut Creek, CA
Vitas Healthcare Corporation of California1.5 mi · Walnut Creek, CA · 2 of 5 stars
Alameda Care Hospice1.7 mi · Walnut Creek, CA · 4 of 5 stars

All hospice providers in the state →

Home health agencies

Comfort Assisting, Inc1.5 mi · Walnut Creek, CA · 2 of 5 stars
American Rose Homehealth1.7 mi · Walnut Creek, CA
Athome Healthcare Team - East Bay, LLC1.7 mi · Walnut Creek, CA · 2 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Walnut Creek at Home1.5 mi · Walnut Creek, CA
DaVita Walnut Creek Dialysis Center1.5 mi · Walnut Creek, CA · 4 of 5 stars
Fresenius Medical Care - Diablo Walnut Creek1.5 mi · Walnut Creek, CA · 5 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Aspen Surgery Center, LLC1.5 mi · Walnut Creek, CA
Bay Area Surgical Specialist Services LLC1.5 mi · Walnut Creek, CA
Callista Surgery Center, LLC1.5 mi · Walnut Creek, CA

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

La Clinica Monument2.7 mi · Concord, CA · Community health center
Willow Pass Wellness Center3.9 mi · Concord, CA · Community health center
Community Practice Clinic Concord4.5 mi · Concord, CA · Community health center

Clinics and urgent care

American Current Care of California, a Medical Corporation1.7 mi · Walnut Creek, CA · Urgent care center
Stat Med PC a California Medical Professional Corporation4.3 mi · Lafayette, CA · Urgent care center
Parkhill Health Inc5.4 mi · Concord, CA · Urgent care center

Pharmacies

John Muir Health1.5 mi · Walnut Creek, CA · Community/retail pharmacy
Kaiser Foundation Health Plan Inc1.5 mi · Walnut Creek, CA · Community/retail pharmacy
Longs Drug Stores California Inc1.5 mi · Walnut Creek, CA · Community/retail pharmacy

Assisted living nearby

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

A & a Care Home I1.5 mi · Walnut Creek, CA
A Diablo Assisted Living 11.5 mi · Walnut Creek, CA
A Place for Seniors LLC1.5 mi · Walnut Creek, CA
Abemu Residence Care1.5 mi · Walnut Creek, CA

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 John Muir Medical Center - Walnut Creek Campus 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 hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	3 of 5 stars
Rated the hospital 9 or 10 out of 10	69%National average: 72%
Would definitely recommend the hospital	77%National average: 71%
Nurses “always” communicated well	75%National average: 80%
Doctors “always” communicated well	76%National average: 80%
Staff “always” explained medicines before giving them	55%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	65%National average: 74%
Area around the room “always” quiet at night	53%National average: 60%
Completed surveys	758Response rate: 24%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 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)	0.341Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.536Better than the national benchmark
Surgical site infections after colon surgery	2.734Worse than the national benchmark
Surgical site infections after abdominal hysterectomy	1.88No different from the national benchmark
MRSA bloodstream infections	0.245Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.455Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 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 patients	10%
Deaths within 30 days: heart failure patients	9.8%
Deaths within 30 days: pneumonia patients	12.5%
Deaths within 30 days: COPD patients	6.4%
Deaths within 30 days: stroke patients	14.1%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.14No different from the national rate
Complications after hip or knee replacement	3.9%

Source: Complications and Deaths - Hospital — CMS, released September 10, 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)	Not reported to Medicare
Readmitted within 30 days: heart attack	14.7%
Readmitted within 30 days: heart failure	19.9%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	20.4%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	4.9%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 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)	171 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	58%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

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 California Best hospitals in California

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 60 common services exactly as John Muir Medical Center - Walnut Creek Campus 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 →

$ 29 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: HC Eval and Mgmnt of New Patient Lvl 4	$853	$383.85	$68.90 – $980.95
New patient office visit (about 45–59 minutes): 10 of 75 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $188 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $188 ALT MEDICARE [1038004] — MEDICARE [103800401]: $188 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $188 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $763.95 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $188 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $588.23 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $554.45 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $763.95 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $383.85
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: HC Eval Mgmnt Patient Level 3	$659	$296.55	$24 – $12,000
Established patient office visit (about 20–29 minutes): 10 of 78 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $188 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $188 ALT MEDICARE [1038004] — MEDICARE [103800401]: $188 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $188 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $590.20 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $188 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $454.45 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $428.35 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $590.20 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $296.55
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · modifier PO In the file: HC Eval Mgmnt Patient Level 3\|SERVICE/PROC OFF-CAMPUS PBD	$659	$296.55	$24 – $12,000
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $75.20 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $75.20 ALT MEDICARE [1038004] — MEDICARE [103800401]: $75.20 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $75.20 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $75.20 BLUE CROSS BLUE SHIELD MCARE [1007127] — BLUE CROSS MEDICARE ADV PPO [100712701]: $75.20 BLUE CROSS BLUE SHIELD MEDICARE [1007113] — BCBS MEDICARE ADV PPO [100711305]: $75.20 CARE 1ST HEALTH PLAN [1094113] — ABMG-CARE 1ST MEDICARE ADVANTAGE [109411311]: $75.20 CAREMORE [1171113] — CAREMORE HEALTH PLAN [117111301]: $75.20 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · modifier PO\|25 In the file: HC Eval Mgmnt Patient Level 3\|SERVICE/PROC OFF-CAMPUS PBD\|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME	$659	$296.55	$24 – $12,000
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $75.20 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $75.20 ALT MEDICARE [1038004] — MEDICARE [103800401]: $75.20 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $75.20 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $75.20 BLUE CROSS BLUE SHIELD MCARE [1007127] — BLUE CROSS MEDICARE ADV PPO [100712701]: $75.20 BLUE CROSS BLUE SHIELD MEDICARE [1007113] — BCBS MEDICARE ADV PPO [100711305]: $75.20 CARE 1ST HEALTH PLAN [1094113] — ABMG-CARE 1ST MEDICARE ADVANTAGE [109411311]: $75.20 CAREMORE [1171113] — CAREMORE HEALTH PLAN [117111301]: $75.20 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: HC Eval Mgmnt Patient Level 4	$874.75	$393.64	$37.50 – $12,000
Established patient office visit (about 30–39 minutes): 10 of 78 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $188 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $188 ALT MEDICARE [1038004] — MEDICARE [103800401]: $188 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $188 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $783.43 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $188 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $603.23 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $568.59 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $783.43 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $393.64
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · modifier PO\|25 In the file: HC Eval Mgmnt Patient Level 4\|SERVICE/PROC OFF-CAMPUS PBD\|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE SAME	$874.75	$393.64	$37.50 – $12,000
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $75.20 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $75.20 ALT MEDICARE [1038004] — MEDICARE [103800401]: $75.20 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $75.20 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $75.20 BLUE CROSS BLUE SHIELD MCARE [1007127] — BLUE CROSS MEDICARE ADV PPO [100712701]: $75.20 BLUE CROSS BLUE SHIELD MEDICARE [1007113] — BCBS MEDICARE ADV PPO [100711305]: $75.20 CARE 1ST HEALTH PLAN [1094113] — ABMG-CARE 1ST MEDICARE ADVANTAGE [109411311]: $75.20 CAREMORE [1171113] — CAREMORE HEALTH PLAN [117111301]: $75.20 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · modifier PO In the file: HC Eval Mgmnt Patient Level 4\|SERVICE/PROC OFF-CAMPUS PBD	$874.75	$393.64	$37.50 – $12,000
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $75.20 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $75.20 ALT MEDICARE [1038004] — MEDICARE [103800401]: $75.20 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $75.20 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $75.20 BLUE CROSS BLUE SHIELD MCARE [1007127] — BLUE CROSS MEDICARE ADV PPO [100712701]: $75.20 BLUE CROSS BLUE SHIELD MEDICARE [1007113] — BCBS MEDICARE ADV PPO [100711305]: $75.20 CARE 1ST HEALTH PLAN [1094113] — ABMG-CARE 1ST MEDICARE ADVANTAGE [109411311]: $75.20 CAREMORE [1171113] — CAREMORE HEALTH PLAN [117111301]: $75.20 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC ER-Level 003 W/Procedure	$3,777	$1,699.65	$44.60 – $7,018
Emergency room visit (moderate): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $2,609.91 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $2,794.98 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $385.47 AETNA PPO [1001104] — AETNA EPO [100110401]: $2,794.98 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $2,609.91 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $385.47 ALT MEDICARE [1038004] — MEDICARE [103800401]: $385.47 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $385.47 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $385.47
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC Emergency Rm Level 3	$3,777	$1,699.65	$44.60 – $7,018
Emergency room visit (moderate): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $2,609.91 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $2,794.98 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $385.47 AETNA PPO [1001104] — AETNA EPO [100110401]: $2,794.98 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $2,609.91 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $385.47 ALT MEDICARE [1038004] — MEDICARE [103800401]: $385.47 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $385.47 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $385.47
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: HC Emergency Rm Level 3	$4,553.93	$2,049.27	$44.60 – $7,018
Emergency room visit (moderate): 10 of 114 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $385.47 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $385.47 ALT MEDICARE [1038004] — MEDICARE [103800401]: $385.47 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $385.47 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $385.47 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $5,404 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $7,018 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $4,992 BLUE CROSS BLUE SHIELD [1007204] — BLUE CROSS OUT OF STATE [100720401]: $7,018
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC Emergency Rm Level 4	$7,181.25	$3,231.56	$68.35 – $7,018
Emergency room visit (moderately high): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $4,962.24 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $5,314.13 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $589.21 AETNA PPO [1001104] — AETNA EPO [100110401]: $5,314.13 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $4,962.24 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $589.21 ALT MEDICARE [1038004] — MEDICARE [103800401]: $589.21 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $589.21 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $589.21
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER-Level 004 W/Procedure	$7,181.25	$3,231.56	$68.35 – $7,018
Emergency room visit (moderately high): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $4,962.24 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $5,314.13 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $589.21 AETNA PPO [1001104] — AETNA EPO [100110401]: $5,314.13 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $4,962.24 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $589.21 ALT MEDICARE [1038004] — MEDICARE [103800401]: $589.21 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $589.21 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $589.21
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: HC Emergency Rm Level 4	$14,134.47	$6,360.51	$68.35 – $7,018
Emergency room visit (moderately high): 10 of 114 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $589.21 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $589.21 ALT MEDICARE [1038004] — MEDICARE [103800401]: $589.21 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $589.21 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $589.21 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $5,404 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $7,018 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $4,992 BLUE CROSS BLUE SHIELD [1007204] — BLUE CROSS OUT OF STATE [100720401]: $7,018
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: HC Emergency Rm Level 5	$21,297.60	$9,583.92	$108.08 – $27,025
Emergency room visit (high): 10 of 114 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $840.94 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $840.94 ALT MEDICARE [1038004] — MEDICARE [103800401]: $840.94 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $840.94 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $840.94 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $5,404 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $7,018 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $4,992 BLUE CROSS BLUE SHIELD [1007204] — BLUE CROSS OUT OF STATE [100720401]: $7,018
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER-Level 005 W/Procedure	$10,613.50	$4,776.07	$108.08 – $9,552.15
Emergency room visit (high): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $7,333.93 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $7,853.99 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $840.94 AETNA PPO [1001104] — AETNA EPO [100110401]: $7,853.99 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $7,333.93 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $840.94 ALT MEDICARE [1038004] — MEDICARE [103800401]: $840.94 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $840.94 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $840.94
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC Emergency Rm Level 5	$10,613.50	$4,776.07	$108.08 – $9,552.15
Emergency room visit (high): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $7,333.93 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $7,853.99 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $840.94 AETNA PPO [1001104] — AETNA EPO [100110401]: $7,853.99 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $7,333.93 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $840.94 ALT MEDICARE [1038004] — MEDICARE [103800401]: $840.94 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $840.94 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,992 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $840.94

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Lab Basic Metabolic Panel	$960.40	$432.18	$7.27 – $8,000
Basic metabolic panel (blood test): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $649.23 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $694.37 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8.46 AETNA PPO [1001104] — AETNA EPO [100110401]: $694.37 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $649.23 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8.46 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8.46 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8.46 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $81.17 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8.46
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier 59 In the file: Lab Basic Metabolic Panel\|DISTINCT PROCEDURAL SERVICE	$960.40	$432.18	$7.27 – $8,000
Basic metabolic panel (blood test): rates for 3 insurance plans BLUE SHIELD HMO [1006103] — BLUE SHIELD HMO-CALPERS-OTHER MEDICAL GROUP [100610305]: $595.45 BLUE SHIELD-NETWORK [1006026] — BLUE SHIELD HMO-MMG CALPERS [100602602]: $595.45 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $8,000
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier 91 In the file: Lab Basic Metabolic Panel\|REPEAT CLINICAL DIAGNOSTIC LABORATORY TEST	$960.40	$432.18	$7.27 – $8,000
Basic metabolic panel (blood test): rates for 3 insurance plans BLUE SHIELD HMO [1006103] — BLUE SHIELD HMO-CALPERS-OTHER MEDICAL GROUP [100610305]: $595.45 BLUE SHIELD-NETWORK [1006026] — BLUE SHIELD HMO-MMG CALPERS [100602602]: $595.45 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $8,000
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Lab Comp Metabolic Panel	$1,681.30	$756.58	$9.19 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Comprehensive metabolic panel (blood test): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $1,136.56 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $1,215.58 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $10.56 AETNA PPO [1001104] — AETNA EPO [100110401]: $1,215.58 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $1,136.56 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $10.56 ALT MEDICARE [1038004] — MEDICARE [103800401]: $10.56 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $10.56 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $101.52 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier 91 In the file: Lab Comp Metabolic Panel\|REPEAT CLINICAL DIAGNOSTIC LABORATORY TEST	$1,681.30	$756.58	$9.19 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Comprehensive metabolic panel (blood test): rates for 3 insurance plans BLUE SHIELD HMO [1006103] — BLUE SHIELD HMO-CALPERS-OTHER MEDICAL GROUP [100610305]: $1,042.41 BLUE SHIELD-NETWORK [1006026] — BLUE SHIELD HMO-MMG CALPERS [100602602]: $1,042.41 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier 91\|CCI In the file: Lab Comp Metabolic Panel\|REPEAT CLINICAL DIAGNOSTIC LABORATORY TEST\|CCI	$1,681.30	$756.58	$9.19 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Comprehensive metabolic panel (blood test): rates for 3 insurance plans BLUE SHIELD HMO [1006103] — BLUE SHIELD HMO-CALPERS-OTHER MEDICAL GROUP [100610305]: $1,042.41 BLUE SHIELD-NETWORK [1006026] — BLUE SHIELD HMO-MMG CALPERS [100602602]: $1,042.41 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Lab Prenatal Panel #2	$2,309.09	$1,039.09	$35.83 – $2,078.18
Obstetric blood test panel: 10 of 109 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $1,560.94 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $1,669.47 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $47.81 AETNA PPO [1001104] — AETNA EPO [100110401]: $1,669.47 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $1,560.94 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $47.81 ALT MEDICARE [1038004] — MEDICARE [103800401]: $47.81 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $47.81 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $157.96 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $47.81
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lab Lipid Panel	$374.30	$168.43	$11.54 – $4,000
Cholesterol panel (lipid panel): 10 of 112 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $253.03 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $270.62 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $13.39 AETNA PPO [1001104] — AETNA EPO [100110401]: $270.62 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $253.03 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $13.39 ALT MEDICARE [1038004] — MEDICARE [103800401]: $13.39 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $13.39 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $128.45 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lab Lipid Panel #Lc Chg	$26.61	$11.97	$7.98 – $4,000
Cholesterol panel (lipid panel): 10 of 112 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $17.99 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $19.24 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $13.39 AETNA PPO [1001104] — AETNA EPO [100110401]: $19.24 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $17.99 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $13.39 ALT MEDICARE [1038004] — MEDICARE [103800401]: $13.39 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $13.39 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $128.45 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $13.39
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Lab Renal Function Panel	$1,145.90	$515.65	$7.60 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Kidney function panel: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $774.63 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $828.49 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8.68 AETNA PPO [1001104] — AETNA EPO [100110401]: $828.49 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $774.63 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8.68 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8.68 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8.68 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $83.24 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8.68
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Lab Hepatic Func Panel	$841.20	$378.54	$6.38 – $4,000
Liver function panel: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $568.65 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $608.19 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8.17 AETNA PPO [1001104] — AETNA EPO [100110401]: $608.19 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $568.65 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8.17 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8.17 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8.17 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $78.40 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Lab Urinalysis Complete	$446	$200.70	$2.77 – $4,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, with microscope): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $301.50 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $322.46 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $3.17 AETNA PPO [1001104] — AETNA EPO [100110401]: $322.46 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $301.50 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $3.17 ALT MEDICARE [1038004] — MEDICARE [103800401]: $3.17 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $3.17 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $29.32 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $3.17
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Lab Ua W Microscopic(C&S if Indicatd)	$356.60	$160.47	$2.77 – $4,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, with microscope): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $241.06 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $257.82 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $3.17 AETNA PPO [1001104] — AETNA EPO [100110401]: $257.82 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $241.06 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $3.17 ALT MEDICARE [1038004] — MEDICARE [103800401]: $3.17 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $3.17 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $29.32 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $3.17
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Lab Urinalysis Screen,POC	$47	$21.15	$2.15 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (manual, without microscope): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $31.77 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $33.98 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $3.48 AETNA PPO [1001104] — AETNA EPO [100110401]: $33.98 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $31.77 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $3.48 ALT MEDICARE [1038004] — MEDICARE [103800401]: $3.48 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $3.48 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $22.80 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $3.48
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis - Macro Only	$394.20	$177.39	$1.96 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, without microscope): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $266.48 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $285.01 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2.25 AETNA PPO [1001104] — AETNA EPO [100110401]: $285.01 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $266.48 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2.25 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2.25 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2.25 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $21.57 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2.25
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Lab Urine Ph	$385.30	$173.38	$1.96 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, without microscope): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $260.46 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $278.57 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2.25 AETNA PPO [1001104] — AETNA EPO [100110401]: $278.57 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $260.46 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2.25 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2.25 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2.25 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $21.57 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2.25
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC ER Urinalysis Screen	$183.30	$82.48	$1.96 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Urine test (automated, without microscope): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $123.91 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $132.53 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2.25 AETNA PPO [1001104] — AETNA EPO [100110401]: $132.53 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $123.91 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2.25 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2.25 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2.25 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $21.57 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Psa Total #a-Charge Only	$30	$13.50	$9 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
PSA (prostate specific antigen) blood test: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $20.28 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $21.69 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $18.39 AETNA PPO [1001104] — AETNA EPO [100110401]: $21.69 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $20.28 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $18.39 ALT MEDICARE [1038004] — MEDICARE [103800401]: $18.39 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $18.39 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $176.43 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Lab Psa,Total	$128.10	$57.64	$16.35 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
PSA (prostate specific antigen) blood test: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $86.60 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $92.62 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $18.39 AETNA PPO [1001104] — AETNA EPO [100110401]: $92.62 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $86.60 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $18.39 ALT MEDICARE [1038004] — MEDICARE [103800401]: $18.39 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $18.39 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $176.43 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $18.39
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Lab Psa(Ultrasensitive) #Lc-Chg	$30	$13.50	$9 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
PSA (prostate specific antigen) blood test: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $20.28 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $21.69 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $18.39 AETNA PPO [1001104] — AETNA EPO [100110401]: $21.69 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $20.28 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $18.39 ALT MEDICARE [1038004] — MEDICARE [103800401]: $18.39 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $18.39 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $176.43 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Tsh Nb Screening	$26.02	$11.71	$7.81 – $4,000
Thyroid stimulating hormone (TSH) test: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $17.59 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $18.81 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $16.80 AETNA PPO [1001104] — AETNA EPO [100110401]: $18.81 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $17.59 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $16.80 ALT MEDICARE [1038004] — MEDICARE [103800401]: $16.80 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $16.80 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $161.19 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Lab Tsh + Free T4 if Indicated	$977	$439.65	$14.76 – $4,000
Thyroid stimulating hormone (TSH) test: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $660.45 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $706.37 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $16.80 AETNA PPO [1001104] — AETNA EPO [100110401]: $706.37 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $660.45 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $16.80 ALT MEDICARE [1038004] — MEDICARE [103800401]: $16.80 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $16.80 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $161.19 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $16.80
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Lab Tsh,3rd Generation *a Charge Only	$5.14	$2.31	$1.54 – $4,000
Thyroid stimulating hormone (TSH) test: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $3.47 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $3.72 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $16.80 AETNA PPO [1001104] — AETNA EPO [100110401]: $3.72 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $3.47 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $16.80 ALT MEDICARE [1038004] — MEDICARE [103800401]: $16.80 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $16.80 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $161.19 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $16.80
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Lab Cbc W/Auto Diff	$356.60	$160.47	$6.75 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC) with differential: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $241.06 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $257.82 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $7.77 AETNA PPO [1001104] — AETNA EPO [100110401]: $257.82 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $241.06 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $7.77 ALT MEDICARE [1038004] — MEDICARE [103800401]: $7.77 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $7.77 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $74.59 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC Abs Cbc W/Auto Diff	$71.70	$32.26	$6.75 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC) with differential: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $48.47 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $51.84 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $7.77 AETNA PPO [1001104] — AETNA EPO [100110401]: $51.84 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $48.47 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $7.77 ALT MEDICARE [1038004] — MEDICARE [103800401]: $7.77 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $7.77 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $74.59 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $7.77
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier 59 In the file: Lab Cbc W/Auto Diff\|DISTINCT PROCEDURAL SERVICE	$356.60	$160.47	$6.75 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC) with differential: rates for 3 insurance plans BLUE SHIELD HMO [1006103] — BLUE SHIELD HMO-CALPERS-OTHER MEDICAL GROUP [100610305]: $221.09 BLUE SHIELD-NETWORK [1006026] — BLUE SHIELD HMO-MMG CALPERS [100602602]: $221.09 DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Lab Cbc/No Diff	$323.50	$145.57	$5.71 – $8,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC), automated: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $218.69 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $233.89 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $6.47 AETNA PPO [1001104] — AETNA EPO [100110401]: $233.89 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $218.69 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $6.47 ALT MEDICARE [1038004] — MEDICARE [103800401]: $6.47 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $6.47 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $62.06 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Lab H&H W/Plt	$229.70	$103.36	$5.71 – $8,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC), automated: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $155.28 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $166.07 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $6.47 AETNA PPO [1001104] — AETNA EPO [100110401]: $166.07 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $155.28 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $6.47 ALT MEDICARE [1038004] — MEDICARE [103800401]: $6.47 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $6.47 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $62.06 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $6.47
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Lab Hemogram 4 - Wbc, H&H, Plt	$229.70	$103.36	$5.71 – $8,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Complete blood count (CBC), automated: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $155.28 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $166.07 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $6.47 AETNA PPO [1001104] — AETNA EPO [100110401]: $166.07 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $155.28 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $6.47 ALT MEDICARE [1038004] — MEDICARE [103800401]: $6.47 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $6.47 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $62.06 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Lab Pt Mixing Study Mac-P3078	$51.44	$23.15	$3.49 – $4,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Blood clotting time test (prothrombin time, PT): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $34.77 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $37.19 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4.29 AETNA PPO [1001104] — AETNA EPO [100110401]: $37.19 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $34.77 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4.29 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4.29 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4.29 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $37.78 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Lab Prothrombin Time 85610 (Pt) (Lc)	$2.79	$1.26	$0.84 – $4,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Blood clotting time test (prothrombin time, PT): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $1.89 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $2.02 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4.29 AETNA PPO [1001104] — AETNA EPO [100110401]: $2.02 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $1.89 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4.29 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4.29 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4.29 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $37.78 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4.29
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Lab Pt/Inr I-Stat	$333.50	$150.07	$3.49 – $4,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Blood clotting time test (prothrombin time, PT): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $225.45 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $241.12 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4.29 AETNA PPO [1001104] — AETNA EPO [100110401]: $241.12 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $225.45 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4.29 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4.29 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4.29 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $37.78 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Lab Aptt	$425.10	$191.29	$5.34 – $4,000
Blood clotting test (partial thromboplastin time, PTT): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $287.37 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $307.35 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $6.01 AETNA PPO [1001104] — AETNA EPO [100110401]: $307.35 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $287.37 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $6.01 ALT MEDICARE [1038004] — MEDICARE [103800401]: $6.01 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $6.01 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $57.60 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Lab Hexagonal Phospholipid Aptt Mac-P3303	$41.50	$18.67	$5.34 – $4,000
Blood clotting test (partial thromboplastin time, PTT): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $28.05 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $30 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $6.01 AETNA PPO [1001104] — AETNA EPO [100110401]: $30 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $28.05 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $6.01 ALT MEDICARE [1038004] — MEDICARE [103800401]: $6.01 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $6.01 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $57.60 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Lab Vwf Prof - Aptt Chrg Only	$25.63	$11.53	$5.34 – $4,000
Blood clotting test (partial thromboplastin time, PTT): 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $17.33 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $18.53 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $6.01 AETNA PPO [1001104] — AETNA EPO [100110401]: $18.53 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $17.33 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $6.01 ALT MEDICARE [1038004] — MEDICARE [103800401]: $6.01 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $6.01 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $57.60 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $6.01

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: HC CT-Head/Brain WO Contrast	$2,761.50	$1,242.67	$63.10 – $4,000
CT scan of the head or brain, without contrast: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $143.21 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $143.21 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $147.63 AETNA PPO [1001104] — AETNA EPO [100110401]: $143.21 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $143.21 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $147.63 ALT MEDICARE [1038004] — MEDICARE [103800401]: $147.63 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $147.63 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $147.63 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $1,794.98
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier TC\|59 In the file: HC CT-Head/Brain WO Contrast\|TECHNICAL COMPONENT\|DISTINCT PROCEDURAL SERVICE	$2,761.50	$1,242.67	$63.10 – $4,000
CT scan of the head or brain, without contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $97 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $97 AETNA PPO [1001104] — AETNA EPO [100110401]: $97 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $97
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier TC In the file: HC CT-Head/Brain WO Contrast\|TECHNICAL COMPONENT	$2,761.50	$1,242.67	$63.10 – $4,000
CT scan of the head or brain, without contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $97 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $97 AETNA PPO [1001104] — AETNA EPO [100110401]: $97 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $97
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: HC MRI Brain W/WO Cntrst	$9,504	$4,276.80	$217.44 – $9,504
MRI of the brain, before and after contrast: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $436.09 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $436.09 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $492.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $436.09 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $436.09 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $492.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $492.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $492.64 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $492.64 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $6,177.60
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · modifier TC In the file: HC MRI Brain W/WO Cntrst\|TECHNICAL COMPONENT	$9,504	$4,276.80	$217.44 – $9,504
MRI of the brain, before and after contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $311.64 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $311.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $311.64 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $311.64
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: HC X-Ray Exam Chest 2 Views	$662.75	$298.24	$18.72 – $4,000
Chest X-ray, 2 views: 10 of 113 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $99.84 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $101.79 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $122.89 AETNA PPO [1001104] — AETNA EPO [100110401]: $101.79 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $99.84 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $122.89 ALT MEDICARE [1038004] — MEDICARE [103800401]: $122.89 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $122.89 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $220.60 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $122.89
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier TC In the file: HC X-Ray Exam Chest 2 Views\|TECHNICAL COMPONENT	$662.75	$298.24	$18.72 – $4,000
Chest X-ray, 2 views: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $73.23 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $74.31 AETNA PPO [1001104] — AETNA EPO [100110401]: $74.31 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $73.23
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC Lumbosacral Spine (4+ Vws)	$1,017	$457.65	$30.51 – $4,000
X-ray of the lower spine, at least 4 views: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $156.97 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $157.71 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $147.63 AETNA PPO [1001104] — AETNA EPO [100110401]: $157.71 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $156.97 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $147.63 ALT MEDICARE [1038004] — MEDICARE [103800401]: $147.63 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $147.63 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $251.21 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $147.63
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier TC In the file: HC Lumbosacral Spine (4+ Vws)\|TECHNICAL COMPONENT	$1,017	$457.65	$30.51 – $4,000
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $123.96 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $124.68 AETNA PPO [1001104] — AETNA EPO [100110401]: $124.68 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $123.96
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier TC\|59 In the file: HC Lumbosacral Spine (4+ Vws)\|TECHNICAL COMPONENT\|DISTINCT PROCEDURAL SERVICE	$1,017	$457.65	$30.51 – $4,000
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $123.96 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $124.68 AETNA PPO [1001104] — AETNA EPO [100110401]: $124.68 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $123.96
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MRI Lumbar Spine WO Cntrst	$5,155.50	$2,319.97	$124.23 – $5,155.50
MRI of the lower back (lumbar spine), without contrast: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $259.73 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $259.73 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $336.92 AETNA PPO [1001104] — AETNA EPO [100110401]: $259.73 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $259.73 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $336.92 ALT MEDICARE [1038004] — MEDICARE [103800401]: $336.92 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $336.92 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $336.92 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $3,351.08
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier TC In the file: HC MRI Lumbar Spine WO Cntrst\|TECHNICAL COMPONENT	$5,155.50	$2,319.97	$124.23 – $5,155.50
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $179.10 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $179.10 AETNA PPO [1001104] — AETNA EPO [100110401]: $179.10 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $179.10
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC Pelvis W/ Contrast	$4,250.50	$1,912.72	$160.24 – $4,250.50
CT scan of the pelvis, with contrast: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $310.09 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $310.09 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $247.68 AETNA PPO [1001104] — AETNA EPO [100110401]: $310.09 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $310.09 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $247.68 ALT MEDICARE [1038004] — MEDICARE [103800401]: $247.68 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $247.68 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $247.68 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $2,762.83
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier TC\|59 In the file: HC Pelvis W/ Contrast\|TECHNICAL COMPONENT\|DISTINCT PROCEDURAL SERVICE	$4,250.50	$1,912.72	$160.24 – $4,250.50
CT scan of the pelvis, with contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $247.08 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $247.08 AETNA PPO [1001104] — AETNA EPO [100110401]: $247.08 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $247.08
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · modifier TC In the file: HC Pelvis W/ Contrast\|TECHNICAL COMPONENT	$4,250.50	$1,912.72	$160.24 – $4,250.50
CT scan of the pelvis, with contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $247.08 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $247.08 AETNA PPO [1001104] — AETNA EPO [100110401]: $247.08 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $247.08
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC (MRI) Lwr Extrmty Jnt WO Cntrst	$4,911.75	$2,210.29	$139.86 – $4,911.75
MRI of a leg joint (such as the knee), without contrast: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $277.63 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $277.63 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $336.92 AETNA PPO [1001104] — AETNA EPO [100110401]: $277.63 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $277.63 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $336.92 ALT MEDICARE [1038004] — MEDICARE [103800401]: $336.92 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $336.92 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $336.92 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $3,192.64
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC (CT) Abd Pelvis W/Cntrst	$4,415.75	$1,987.09	$205.03 – $4,415.75
CT scan of the abdomen and pelvis, with contrast: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $421.50 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $421.50 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $492.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $421.50 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $421.50 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $492.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $492.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $492.64 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $492.64 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $2,870.24
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier TC In the file: HC (CT) Abd Pelvis W/Cntrst\|TECHNICAL COMPONENT	$4,415.75	$1,987.09	$205.03 – $4,415.75
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $322.51 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $322.51 AETNA PPO [1001104] — AETNA EPO [100110401]: $322.51 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $322.51
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · modifier TC\|59 In the file: HC (CT) Abd Pelvis W/Cntrst\|TECHNICAL COMPONENT\|DISTINCT PROCEDURAL SERVICE	$4,415.75	$1,987.09	$205.03 – $4,415.75
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $322.51 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $322.51 AETNA PPO [1001104] — AETNA EPO [100110401]: $322.51 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $322.51
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC US Abdomen Complete	$1,943	$874.35	$71.48 – $4,000
Ultrasound of the abdomen, complete: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $153.85 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $153.85 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $147.63 AETNA PPO [1001104] — AETNA EPO [100110401]: $153.85 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $153.85 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $147.63 ALT MEDICARE [1038004] — MEDICARE [103800401]: $147.63 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $147.63 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $147.63 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $1,262.95
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier TC In the file: HC US Abdomen Complete\|TECHNICAL COMPONENT	$1,943	$874.35	$71.48 – $4,000
Ultrasound of the abdomen, complete: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $110.04 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $110.04 AETNA PPO [1001104] — AETNA EPO [100110401]: $110.04 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $110.04
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier TC\|59 In the file: HC US Abdomen Complete\|TECHNICAL COMPONENT\|DISTINCT PROCEDURAL SERVICE	$1,943	$874.35	$71.48 – $4,000
Ultrasound of the abdomen, complete: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $110.04 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $110.04 AETNA PPO [1001104] — AETNA EPO [100110401]: $110.04 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $110.04
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC US OB >14 Wks Gestation	$1,405	$632.25	$78.62 – $4,000
Pregnancy ultrasound (after the first trimester): 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $178.30 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $178.30 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $147.63 AETNA PPO [1001104] — AETNA EPO [100110401]: $178.30 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $178.30 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $147.63 ALT MEDICARE [1038004] — MEDICARE [103800401]: $147.63 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $147.63 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $147.63 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $913.25
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: HC US OB >14 Wks Gestation in L&D	$3,430.50	$1,543.72	$78.62 – $4,000
Pregnancy ultrasound (after the first trimester): 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $178.30 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $178.30 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $147.63 AETNA PPO [1001104] — AETNA EPO [100110401]: $178.30 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $178.30 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $147.63 ALT MEDICARE [1038004] — MEDICARE [103800401]: $147.63 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $147.63 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $147.63 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $2,229.83
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · modifier TC In the file: HC US OB >14 Wks Gestation\|TECHNICAL COMPONENT	$1,405	$632.25	$78.62 – $4,000
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $123.69 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $123.69 AETNA PPO [1001104] — AETNA EPO [100110401]: $123.69 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $123.69
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC Transvaginal Echo	$1,303	$586.35	$67.65 – $4,000
Transvaginal ultrasound: 10 of 105 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $159.70 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $159.70 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $147.63 AETNA PPO [1001104] — AETNA EPO [100110401]: $159.70 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $159.70 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $147.63 ALT MEDICARE [1038004] — MEDICARE [103800401]: $147.63 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $147.63 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $147.63 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $846.95
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier TC\|59 In the file: HC Transvaginal Echo\|TECHNICAL COMPONENT\|DISTINCT PROCEDURAL SERVICE	$1,303	$586.35	$67.65 – $4,000
Transvaginal ultrasound: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $121.68 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $121.68 AETNA PPO [1001104] — AETNA EPO [100110401]: $121.68 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $121.68
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier TC In the file: HC Transvaginal Echo\|TECHNICAL COMPONENT	$1,303	$586.35	$67.65 – $4,000
Transvaginal ultrasound: rates for 4 insurance plans AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $121.68 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $121.68 AETNA PPO [1001104] — AETNA EPO [100110401]: $121.68 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $121.68
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: HC Dx Mammo Incl Cad Uni	$676	$304.20	$81.10 – $4,000
Diagnostic mammogram, one breast: 10 of 76 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $374.03 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $380.96 AETNA PPO [1001104] — AETNA EPO [100110401]: $380.96 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $374.03 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $725.99 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $786.12 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $1,020.92 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $439.40 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $725.99 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $304.20
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: HC Dx Mammo Incl Cad Bi	$824	$370.80	$103.45 – $4,000
Diagnostic mammogram, both breasts: 10 of 76 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $472.90 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $481.67 AETNA PPO [1001104] — AETNA EPO [100110401]: $481.67 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $472.90 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $929.41 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $1,006.39 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $1,306.98 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $535.60 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $929.41 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $370.80
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scr Mammo Bi Incl Cad	$701.25	$315.56	$85.76 – $4,000
Screening mammogram, both breasts: 10 of 76 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $384.43 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $391.75 AETNA PPO [1001104] — AETNA EPO [100110401]: $391.75 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $384.43 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $767.57 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $831.15 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $1,079.40 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $455.81 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $767.57 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $315.56

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: HC Lhc--W/Lv Injection	$42,635.25	$19,185.86	$590.46 – $51,758
Left heart catheterization (diagnostic): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $14,036 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $31,550.09 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,577.86 AETNA PPO [1001104] — AETNA EPO [100110401]: $31,550.09 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $14,036 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,577.86 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,577.86 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,577.86 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $36,348 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,577.86
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: HC Ep Study W/O Induct or Attmpt	$17,317	$7,792.65	$596.46 – $54,281
Heart rhythm study (electrophysiology evaluation): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $14,036 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,814.58 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $11,013.72 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,814.58 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $14,036 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $11,013.72 ALT MEDICARE [1038004] — MEDICARE [103800401]: $11,013.72 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $11,013.72 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $29,559 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $11,013.72
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: HC Ep/Ablat All Incl Afib	$114,274.75	$51,423.64	$805.40 – $102,847.28
Heart rhythm study with ablation for atrial fibrillation: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $14,036 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $84,563.32 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $36,908.65 AETNA PPO [1001104] — AETNA EPO [100110401]: $84,563.32 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $14,036 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $36,908.65 ALT MEDICARE [1038004] — MEDICARE [103800401]: $36,908.65 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $36,908.65 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $45,015 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $36,908.65

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: HC Therapeutic Exercise	$328.50	$147.82	$10.96 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $226.99 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $243.09 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $36.84 AETNA PPO [1001104] — AETNA EPO [100110401]: $243.09 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $226.99 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $35.72 ALT MEDICARE [1038004] — MEDICARE [103800401]: $35.72 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $35.72 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $345 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $35.72
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier 59 In the file: HC Therapeutic Exercise\|DISTINCT PROCEDURAL SERVICE	$328.50	$147.82	$10.96 – $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Physical therapy: therapeutic exercise (each 15 minutes): rates for 1 insurance plan DONOR NETWORK WEST [1008103] — TRANSPLANT DONOR NETWORK [100810301]: $12,000 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: HC Physical Therapy Eval Low Complexity 15m	$221	$99.45	$66.30 – $12,000
Physical therapy evaluation (low complexity): 10 of 112 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $152.71 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $163.54 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $102.16 AETNA PPO [1001104] — AETNA EPO [100110401]: $163.54 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $152.71 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $121.33 ALT MEDICARE [1038004] — MEDICARE [103800401]: $121.33 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $121.33 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $345 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $121.33
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: HC Physical Therapy Eval Moderate Complexity 30min	$561	$252.45	$91.94 – $12,000
Physical therapy evaluation (moderate complexity): 10 of 112 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $387.65 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $415.14 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $102.16 AETNA PPO [1001104] — AETNA EPO [100110401]: $415.14 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $387.65 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $121.33 ALT MEDICARE [1038004] — MEDICARE [103800401]: $121.33 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $121.33 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $345 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $121.33
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: HC Physical Therapy Eval High Complexity 45min	$427.75	$192.49	$91.94 – $8,000
Physical therapy evaluation (high complexity): 10 of 112 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $295.58 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $316.54 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $102.16 AETNA PPO [1001104] — AETNA EPO [100110401]: $316.54 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $295.58 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $121.33 ALT MEDICARE [1038004] — MEDICARE [103800401]: $121.33 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $121.33 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $345 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $121.33

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 59\|LT In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls\|DISTINCT PROCEDURAL SERVICE\|LEFT SIDE	$150,647.35 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$67,791.31	$225.89 – $53,372
Shoulder arthroscopy: shaving of shoulder bone: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $10,246.33 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $10,246.33 ALT MEDICARE [1038004] — MEDICARE [103800401]: $10,246.33 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $10,246.33 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $30,480 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $10,246.33
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier LT In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls\|LEFT SIDE	$116,727.95	$52,527.58	$225.89 – $53,372
Shoulder arthroscopy: shaving of shoulder bone: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,620.31 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,620.31 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,620.31 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,620.31 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $29,559 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,620.31
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier RT In the file: Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls\|RIGHT SIDE	$123,136.64	$55,411.49	$225.89 – $53,372
Shoulder arthroscopy: shaving of shoulder bone: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $10,246.33 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $10,246.33 ALT MEDICARE [1038004] — MEDICARE [103800401]: $10,246.33 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $10,246.33 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $29,559 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $10,246.33
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$81,067.58	$36,480.41	$551 – $53,372
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,694 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,902 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,620.31 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,902 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,694 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,620.31 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,620.31 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,620.31 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $29,559 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,620.31
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier LT In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg\|LEFT SIDE	$95,230.29	$42,853.63	$551 – $53,372
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,694 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,902 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,620.31 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,902 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,694 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,620.31 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,620.31 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,620.31 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,620.31
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier RT In the file: Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg\|RIGHT SIDE	$69,305.01	$31,187.25	$551 – $53,372
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,694 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,902 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,620.31 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,902 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,694 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,620.31 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,620.31 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,620.31 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,620.31
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy & Adenoidectomy <Age 12	$63,909.54	$28,759.29	$168.65 – $28,459
Removal of tonsils and adenoids (under age 12): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8,359.25 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8,359.25 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8,359.25 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8,359.25 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8,359.25
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 50 In the file: Tonsillectomy & Adenoidectomy <Age 12\|BILATERAL PROCEDURE	$92,771.88	$41,747.35	$168.65 – $28,459
Removal of tonsils and adenoids (under age 12): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8,359.25 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8,359.25 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8,359.25 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8,359.25 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8,359.25
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 58 In the file: Tonsillectomy & Adenoidectomy <Age 12\|STAGED OR RELATED PROCEDURE OR SERVICE BY THE SAME PHYSICIAN DURING THE POSTOPERATIVE PERIOD	$79,508.46	$35,778.81	$168.65 – $28,459
Removal of tonsils and adenoids (under age 12): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8,359.25 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8,359.25 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8,359.25 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8,359.25 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8,359.25
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy Transoral Diagnostic	$32,747.35	$14,736.31	$163.62 – $26,880
Upper GI endoscopy (diagnostic): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,023 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $11,730 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,280.73 AETNA PPO [1001104] — AETNA EPO [100110401]: $11,730 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,023 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,280.73 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,280.73 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,280.73 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,280.73
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 74 In the file: Esophagogastroduodenoscopy Transoral Diagnostic\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRA	$52,571.79	$23,657.31	$163.62 – $26,880
Upper GI endoscopy (diagnostic): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,023 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $11,730 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $3,919.44 AETNA PPO [1001104] — AETNA EPO [100110401]: $11,730 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,023 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $3,919.44 ALT MEDICARE [1038004] — MEDICARE [103800401]: $3,919.44 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $3,919.44 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $3,919.44
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 59 In the file: Esophagogastroduodenoscopy Transoral Diagnostic\|DISTINCT PROCEDURAL SERVICE	$37,633.53	$16,935.09	$163.62 – $26,880
Upper GI endoscopy (diagnostic): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,023 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $11,730 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $5,444.22 AETNA PPO [1001104] — AETNA EPO [100110401]: $11,730 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,023 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $5,444.22 ALT MEDICARE [1038004] — MEDICARE [103800401]: $5,444.22 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $5,444.22 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $5,444.22
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd Transoral Biopsy Single/Multiple	$38,594.93	$17,367.72	$184.54 – $21,354
Upper GI endoscopy with biopsy: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2,709.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2,709.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2,709.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2,709.64 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2,709.64
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 59 In the file: Egd Transoral Biopsy Single/Multiple\|DISTINCT PROCEDURAL SERVICE	$41,514.19	$18,681.39	$184.54 – $21,354
Upper GI endoscopy with biopsy: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2,709.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2,709.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2,709.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2,709.64 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2,709.64
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 52 In the file: Egd Transoral Biopsy Single/Multiple\|REDUCED SERVICES	$55,970.78	$25,186.85	$184.54 – $21,354
Upper GI endoscopy with biopsy: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8,572.57 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8,572.57 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8,572.57 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8,572.57 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8,572.57
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$31,652.84	$14,243.78	$245.59 – $21,354
Colonoscopy (diagnostic): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,313.17 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,313.17 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,313.17 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,313.17 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,313.17
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 74 In the file: Colonoscopy Flx Dx W/Collj Spec When Pfrmd\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATION	$23,020.54	$10,359.24	$245.59 – $21,354
Colonoscopy (diagnostic): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,313.17 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,313.17 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,313.17 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,313.17 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,313.17
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy W/Biopsy Single/Multiple	$43,461.46	$19,557.66	$266.71 – $21,354
Colonoscopy with biopsy: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2,709.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2,709.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2,709.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2,709.64 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2,709.64
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: HC Colonoscopy W/Biopsy Single/Multiple	$4,471	$2,011.95	$266.71 – $15,785
Colonoscopy with biopsy: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $3,022.40 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $3,232.53 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,689.75 AETNA PPO [1001104] — AETNA EPO [100110401]: $3,232.53 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $3,022.40 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,689.75 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,689.75 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,689.75 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,689.75
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 59 In the file: Colonoscopy W/Biopsy Single/Multiple\|DISTINCT PROCEDURAL SERVICE	$34,396.40	$15,478.38	$266.71 – $21,354
Colonoscopy with biopsy: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,689.75 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,689.75 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,689.75 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,689.75 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,689.75
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$34,549.67	$15,547.35	$338.04 – $21,354
Colonoscopy with removal of polyps (snare): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,689.75 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,689.75 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,689.75 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,689.75 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,689.75
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 59 In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq\|DISTINCT PROCEDURAL SERVICE	$34,726.99	$15,627.15	$338.04 – $21,354
Colonoscopy with removal of polyps (snare): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $3,919.44 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $3,919.44 ALT MEDICARE [1038004] — MEDICARE [103800401]: $3,919.44 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $3,919.44 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $3,919.44
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 52 In the file: Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq\|REDUCED SERVICES	$44,034.51	$19,815.53	$338.04 – $21,354
Colonoscopy with removal of polyps (snare): 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $3,919.44 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $3,919.44 ALT MEDICARE [1038004] — MEDICARE [103800401]: $3,919.44 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $3,919.44 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $3,919.44
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux	$21,303.98	$9,586.79	$169.77 – $21,354
Ultrasound of the lower bowel by endoscope: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,689.75 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,689.75 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,689.75 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,689.75 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,689.75
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy Surg Cholecystectomy	$149,230.75	$67,153.84	$466.12 – $63,311
Gallbladder removal by laparoscope: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $12,031 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $15,640 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8,536.75 AETNA PPO [1001104] — AETNA EPO [100110401]: $15,640 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $12,031 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8,536.75 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8,536.75 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8,536.75 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $45,015 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8,536.75
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$55,334.45	$24,900.50	$344.01 – $35,576
Groin (inguinal) hernia repair, age 5 or older: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,694 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,902 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $5,055.80 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,902 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,694 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $5,055.80 ALT MEDICARE [1038004] — MEDICARE [103800401]: $5,055.80 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $5,055.80 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $5,055.80
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 50 In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible\|BILATERAL PROCEDURE	$55,500.79	$24,975.36	$344.01 – $35,576
Groin (inguinal) hernia repair, age 5 or older: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,694 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,902 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $8,572.57 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,902 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,694 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $8,572.57 ALT MEDICARE [1038004] — MEDICARE [103800401]: $8,572.57 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $8,572.57 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $8,572.57
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier RT In the file: Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible\|RIGHT SIDE	$51,230.76	$23,053.84	$344.01 – $35,576
Groin (inguinal) hernia repair, age 5 or older: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,694 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,902 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $5,055.80 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,902 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,694 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $5,055.80 ALT MEDICARE [1038004] — MEDICARE [103800401]: $5,055.80 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $5,055.80 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $19,398 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $5,055.80
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: HC Biopsy Prostate NDL SGL/MULT	$6,603.75	$2,971.69	$87.49 – $15,785
Prostate biopsy: 10 of 68 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $4,464.14 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $4,774.51 AETNA PPO [1001104] — AETNA EPO [100110401]: $4,774.51 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $4,464.14 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $9,021 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $11,715 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM DOCTORS MEDICAL CENTER [100210407]: $4,292.44 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $8,228 APS HEALTHCARE [1003103] — APS HEALTHCARE BETHESDA INC [100310301]: $2,971.69
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Inpatient or outpatient In the file: HC Lap,Prostatectomy,Radical,W/Nerve Spare,Incl Robotic [55866]	$39,054.75	$17,574.64	$953.09 – $43,398
Prostate removal by laparoscope (radical prostatectomy): 10 of 108 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $26,401.01 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $28,236.58 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $15,010.14 AETNA PPO [1001104] — AETNA EPO [100110401]: $28,236.58 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $26,401.01 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $15,010.14 ALT MEDICARE [1038004] — MEDICARE [103800401]: $15,010.14 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $15,010.14 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $30,480 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $15,010.14
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$81,683.31	$36,757.49	$175.32 – $28,459
Hysteroscopy with biopsy of the uterus lining: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,571.07 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,571.07 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,571.07 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,571.07 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,571.07
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HC Hysteroscopy,W/Endo Bx [58558]	$11,401.50	$5,130.67	$175.32 – $16,838
Hysteroscopy with biopsy of the uterus lining: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $7,707.41 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $8,243.28 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,571.07 AETNA PPO [1001104] — AETNA EPO [100110401]: $8,243.28 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $7,707.41 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,571.07 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,571.07 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,571.07 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,571.07
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 74 In the file: Hysteroscopy Bx Endometrium&/Polypc W/WO D&C\|DISCONTINUED OUT-PATIENT HOSPITAL/AMBULATORY SURGERY CENTER (ASC) PROCEDURE AFTER ADMINISTRATIO	$55,217.54	$24,847.89	$175.32 – $28,459
Hysteroscopy with biopsy of the uterus lining: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $10,026 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $13,033 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $4,571.07 AETNA PPO [1001104] — AETNA EPO [100110401]: $13,033 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $10,026 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $4,571.07 ALT MEDICARE [1038004] — MEDICARE [103800401]: $4,571.07 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $4,571.07 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $4,571.07
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC Njx Interlaminar Lmbr/Sac W/Img Gdn	$3,826.75	$1,722.04	$132.14 – $9,471
Spinal injection, lower back (epidural), with imaging guidance: 10 of 110 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $2,586.88 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $2,766.74 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $996.76 AETNA PPO [1001104] — AETNA EPO [100110401]: $2,766.74 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $2,586.88 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $996.76 ALT MEDICARE [1038004] — MEDICARE [103800401]: $996.76 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $996.76 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $996.76
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Anesth Spine L-S Sgl Lvl	$3,907.25	$1,758.26	$143.34 – $9,471
Nerve root injection, lower back, with imaging guidance: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $2,641.30 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $2,824.94 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,248.94 AETNA PPO [1001104] — AETNA EPO [100110401]: $2,824.94 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $2,641.30 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,248.94 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,248.94 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,248.94 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,248.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: HC Inj Anesth Spine L-S Sgl Lvl	$16,764.46	$7,544.01	$143.34 – $9,471
Nerve root injection, lower back, with imaging guidance: 10 of 114 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,248.94 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,248.94 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,248.94 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,248.94 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,248.94 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $4,552 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $5,911 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $4,151 BLUE CROSS BLUE SHIELD [1007204] — BLUE CROSS OUT OF STATE [100720401]: $5,911
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · modifier 59 In the file: HC Inj Anesth Spine L-S Sgl Lvl\|DISTINCT PROCEDURAL SERVICE	$23,829.40	$10,723.23	$143.34 – $9,471
Nerve root injection, lower back, with imaging guidance: 10 of 114 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $1,248.94 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $1,248.94 ALT MEDICARE [1038004] — MEDICARE [103800401]: $1,248.94 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $1,248.94 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $4,151 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $1,248.94 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $4,552 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $5,911 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $4,151 BLUE CROSS BLUE SHIELD [1007204] — BLUE CROSS OUT OF STATE [100720401]: $5,911
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne	$49,736.72	$22,381.52	$316.83 – $28,459
Carpal tunnel release: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2,757.40 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2,757.40 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2,757.40 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2,757.40 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2,757.40
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: HC Carpal Tunnel Surgery	$8,689.50	$3,910.27	$316.83 – $7,820.55
Carpal tunnel release: 10 of 111 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $5,874.10 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $6,282.51 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2,757.40 AETNA PPO [1001104] — AETNA EPO [100110401]: $6,282.51 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $5,874.10 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2,757.40 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2,757.40 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2,757.40 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $841 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2,757.40
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier RT In the file: Neuroplasty &/Transpos Median Nrv Carpal Tunne\|RIGHT SIDE	$52,715.25	$23,721.86	$316.83 – $28,459
Carpal tunnel release: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $9,691 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $12,599 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $2,757.40 AETNA PPO [1001104] — AETNA EPO [100110401]: $12,599 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $9,691 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $2,757.40 ALT MEDICARE [1038004] — MEDICARE [103800401]: $2,757.40 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $2,757.40 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $2,757.40
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: HC Yag Laser Capsulotomy Bilat	$9,613.03	$4,325.86	$186.15 – $15,785
Laser treatment of clouding after cataract surgery: 10 of 114 insurance plan rates AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $776.64 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $776.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $776.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $776.64 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $776.64 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $9,021 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CROSS PPO [100210401]: $11,715 ANTHEM BLUE CROSS-NETWORK [1002026] — ANTHEM BLUE CROSS HMO-MMG [100202601]: $8,228 BLUE CROSS BLUE SHIELD [1007204] — BLUE CROSS OUT OF STATE [100720401]: $11,715
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier LT In the file: HC Yag Laser Capsulotomy Lt\|LEFT SIDE	$4,445.75	$2,000.59	$186.15 – $15,785
Laser treatment of clouding after cataract surgery: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $3,005.33 AETNA LIFE [1001001] — AETNA LIFE [100100101]: $3,214.28 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $776.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $3,214.28 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $3,005.33 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $776.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $776.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $776.64 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $776.64
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · modifier 50 In the file: HC Yag Laser Capsulotomy Bilat\|BILATERAL PROCEDURE	$8,892	$4,001.40	$186.15 – $15,785
Laser treatment of clouding after cataract surgery: 10 of 114 insurance plan rates AETNA HMO [1001103] — HPMG-AETNA HMO [100110301]: $6,010.99 AETNA MEDICARE [1001113] — AETNA MEDICARE ADVANTAGE HMO [100111301]: $776.64 AETNA PPO [1001104] — AETNA EPO [100110401]: $6,428.92 AETNA-NETWORK [1001026] — AETNA HMO-MMG [100102601]: $6,010.99 ALIGNMENT HEALTH [1177113] — SCCIPA-ALIGNMENT HEALTH PLAN [117711302]: $776.64 ALT MEDICARE [1038004] — MEDICARE [103800401]: $776.64 ALT MEDICARE A/B REBILL [1038003] — MEDICARE A AND B [103800301]: $776.64 ANTHEM BLUE CROSS HMO [1002103] — HPMG-ANTHEM BLUE CROSS HMO [100210301]: $8,228 ANTHEM BLUE CROSS MEDICARE [1002113] — ANTHEM BLUE CROSS MEDICARE ADVANTAGE [100211301]: $776.64 ANTHEM BLUE CROSS PPO [1002104] — ANTHEM BLUE CONNECTION EPO [100210404]: $9,021

Source: John Muir Medical Center - Walnut Creek Campus’s standard charges file (johnmuirhealth.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 23, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	1601 Ygnacio Valley Rd, Walnut Creek, CA 94598
County	Contra Costa County
State	California
Phone	(925) 939‑3000
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	050180
Name in Medicare records	JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS
Profile level	Medicare data + hospital website
Name on the hospital’s website	Walnut Creek Medical Center
Official website	johnmuirhealth.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

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

Walnut Creek Medical Center (John Muir Health) — johnmuirhealth.com
Walnut Creek Medical Center — johnmuirhealth.com
Emergency — johnmuirhealth.com
Stroke — johnmuirhealth.com
Pre-Register Online For Birth — johnmuirhealth.com
Trauma — johnmuirhealth.com
Awards & Recognition — johnmuirhealth.com