Does Mountains Community Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Mountains Community Hospital. In a medical emergency, call 911.

Where is Mountains Community Hospital?

29101 Hospital Road, Lake Arrowhead, CA 92352, in San Bernardino County, California.

What is the phone number of Mountains Community Hospital?

(909) 336-3651, as listed by Medicare (CMS).

What is the Medicare star rating of Mountains Community Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Mountains Community Hospital — Lake Arrowhead, CA

Quick answers

Does Mountains Community Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Mountains Community Hospital. In a medical emergency, call 911.
Where is Mountains Community Hospital?: 29101 Hospital Road, Lake Arrowhead, CA 92352, in San Bernardino County, California.
What is the phone number of Mountains Community Hospital?: (909) 336-3651, as listed by Medicare (CMS).
What is the Medicare star rating of Mountains Community Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][6][7]

Emergency care
Inpatient acute care
Surgical services
Orthopedics
Radiology
Laboratory
Physical therapy and rehabilitation
Rural health clinics
Skilled nursing
General Surgery
Ear, Nose and Throat
Podiatry
Cardiopulmonary testing

Conditions treated^[6][8]

Hernia
Gallbladder and appendix issues
Wrist and ankle fractures
Broken bones
Joint and back issues
Osteoporosis
Neurological conditions

Treatments^[5][6][7][8]

Hernia repair
Colonoscopy and endoscopy
Minimally invasive surgical options
Physical therapy
Occupational therapy
Speech therapy
Respiratory therapy
IV therapy
Wound care
Electrocardiogram (ECG or EKG)
Pulmonary function test
Arterial blood gas
Treadmill stress test
Holter monitor
Nebulizer therapy
Ventilator therapy
BiPAP therapy
CT scan
Ultrasound
Digital mammography
Bone density (DEXA) scanning
Digital X-ray
Digital fluoroscopy

Procedures^[6]

General and orthopedic surgery
Gallbladder and appendix surgery
Colonoscopy
Endoscopy

Programs and centers^[4][6]

Swing bed program
Orthopedic rehabilitation program

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

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Interpreters and languages	Free language assistance 24 hours a day; interpreter services available at MCH^[9]
Patient portal	Patient Portal

Recognition^[4]

Joint Commission accredited

Doctors and clinicians (64)

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

Main specialties

Doctors with a page on this site (64)

Alfred W. Fernandez, MDEmergency Medicine
Ali A. Mahdi, MDSleep Medicine
Andro N. Sharobiem, MDInternal Medicine
Ashok Nath, MDNephrology
Bashar Saad, MDEndocrinology
Belen K. Sachs, PAPhysician Assistant
Benedict C. Del Buono, MDEmergency Medicine
Bijan Motamedi, MDFamily Practice
Brent A. Beaird, MDFamily Practice
Buqing Liang, MDNeurosurgery
Carnaghi V. Martin, MDGeneral Surgery
Choon S. Koo, MDPathology
Christopher M. Mantik, MDPhysical Medicine and Rehabilitation
Christopher Y. Yau, MDDiagnostic Radiology
Daniel J. Lama, MDUrology
Eric D. Shelton, MDDiagnostic Radiology
Eric M. Peters, MDDiagnostic Radiology
Eric T. Teacher, MDEmergency Medicine
Gregory E. Dahlquist, MDInternal Medicine
Hagop J. Keleshian, DOEmergency Medicine
Hai N. Dao, MDInternal Medicine
Hasan Syed, MDOrthopedic Surgery
Hassan Sheikho, MDInternal Medicine
Janette Francis, NPNurse Practitioner

And 40 more: the button below opens the full list.

Other emergency rooms nearby

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

St Bernardine Medical Center11 mi · San Bernardino, CA · Acute Care Hospital
Community Hospital of San Bernardino12 mi · San Bernardino, CA · Acute Care Hospital
Desert Valley Hospital15 mi · Victorville, CA · Acute Care Hospital
Loma Linda VA Medical Center15 mi · Loma Linda, CA · Federal/VA Acute Care Hospital
Redlands Community Hospital16 mi · Redlands, CA · Acute Care Hospital

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

Other hospitals near Lake Arrowhead

Ballard Rehabilitation Hospital12 mi · San Bernardino, CA · Inpatient Rehabilitation Hospital
Totally Kids Rehabilitation Hospital14 mi · Loma Linda, CA · Inpatient Rehabilitation Hospital

Hospitals in San Bernardino County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

Mountains Community Hospital DP/SNF1.0 mi · Lake Arrowhead, CA · 5 of 5 stars
Arrowhead Healthcare Center, LLC9.1 mi · San Bernardino, CA · 5 of 5 stars
Sierra Vista9.4 mi · Highland, CA · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Alta Hospice of California11 mi · San Bernardino, CA
Beta Hospice Care Inc11 mi · San Bernardino, CA
Bellview Hospice Care, Inc13 mi · San Bernardino, CA

All hospice providers in the state →

Home health agencies

Lake Arrowhead Home Healthcare, LLC0.0 mi · Lake Arrowhead, CA · 2 of 5 stars
All in One Home Health Agency Inc6.8 mi · San Bernardino, CA · 2 of 5 stars
Providence Home Health High Desert9.7 mi · Hesperia, CA · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Hesperia Dialysis Center9.7 mi · Hesperia, CA · 3 of 5 stars
DaVita Highland Ranch Dialysis Center9.9 mi · Highland, CA · 3 of 5 stars
DaVita Mountain Vista Dialysis Center12 mi · San Bernardino, CA · 2 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.

Seven Oaks Surgery Center LLC6.8 mi · San Bernardino, CA
Premier Outpatient Surgery Center14 mi · San Bernardino, CA
Advanced Ambulatory Surgery Center14 mi · Redlands, 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

Blessing Community Health Center8.9 mi · San Bernardino, CA · Community health center
SAC Pacific HS11 mi · San Bernardino, CA · Community health center
Unicare Community Health Center, Inc. - San Bernardino 19011 mi · San Bernardino, CA · Community health center

Clinics and urgent care

Mountains Community Hospital0.0 mi · Lake Arrowhead, CA · Rural health clinic
Martin Rocha MD Inc2.6 mi · Cedar Glen, CA · Rural health clinic
Running Springs Rural Health Clinic6.0 mi · Running Springs, CA · Rural health clinic

Pharmacies

Garfield Beach CVS LLC0.0 mi · Lake Arrowhead, CA · Pharmacy
Mountain Healthcare Inc0.0 mi · Lake Arrowhead, CA · Community/retail pharmacy
KBC Pharmacy Inc5.3 mi · Crestline, CA · Community/retail pharmacy

Assisted living nearby

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

Abria del Cielo6.8 mi · San Bernardin, CA
Broadmoor Assisted Living6.8 mi · San Bernardino, CA
Fisher Manor 16.8 mi · San Bernardino, CA
Fisher Manor 26.8 mi · San Bernardino, 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 Mountains Community Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	16.4%
Not reported to Medicare	Readmitted within 30 days: heart attack; Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart failure; Readmitted within 30 days: pneumonia; Readmitted within 30 days: COPD

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	124 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Not reported to Medicare	Sepsis patients who got all the recommended early care (SEP-1)

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

Not reported to Medicare: the patient survey, infections caught in the hospital, complications and deaths. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

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 87 common services exactly as Mountains Community Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

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

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

Show the prices of 87 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OUTPT VISIT LEVEL 3	$200	$80	$90 – $170
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $140 AETNA — MED ADV: $96 BLUE CROSS — ALL PRODUCTS: $153.10 BLUE SHIELD — COVERED CALIFORNIA: $124.20 CCN — ALL PRODUCTS: $150 CIGNA — ALL PRODUCTS: $140 HEALTHNET — ALL PRODUCTS: $161.10 KAISER — ALL PRODUCTS: $128 KAISER — MED ADV: $57.20 MOLINA — MED ADV: $90
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OUTPT VISIT LEVEL 4	$220	$88	$99 – $187
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $154 AETNA — MED ADV: $105.60 BLUE CROSS — ALL PRODUCTS: $168.41 BLUE SHIELD — COVERED CALIFORNIA: $136.62 CCN — ALL PRODUCTS: $165 CIGNA — ALL PRODUCTS: $154 HEALTHNET — ALL PRODUCTS: $177.21 KAISER — ALL PRODUCTS: $140.80 KAISER — MED ADV: $68.90 MOLINA — MED ADV: $99
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT OUTPT VISIT LEVEL 5	$240	$96	$108 – $204
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $168 AETNA — MED ADV: $115.20 BLUE CROSS — ALL PRODUCTS: $183.72 BLUE SHIELD — COVERED CALIFORNIA: $149.04 CCN — ALL PRODUCTS: $180 CIGNA — ALL PRODUCTS: $168 HEALTHNET — ALL PRODUCTS: $193.32 KAISER — ALL PRODUCTS: $153.60 KAISER — MED ADV: $82.70 MOLINA — MED ADV: $108
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST PT OUTPT VISIT LEVEL 3	$185	$74	$83.25 – $157.25
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $129.50 AETNA — MED ADV: $88.80 BLUE CROSS — ALL PRODUCTS: $141.62 BLUE SHIELD — COVERED CALIFORNIA: $114.89 CCN — ALL PRODUCTS: $138.75 CIGNA — ALL PRODUCTS: $129.50 HEALTHNET — ALL PRODUCTS: $149.02 KAISER — ALL PRODUCTS: $118.40 KAISER — MED ADV: $24 MOLINA — MED ADV: $83.25
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EST PT OUTPT VISIT LEVEL 4	$205	$82	$92.25 – $174.25
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $143.50 AETNA — MED ADV: $98.40 BLUE CROSS — ALL PRODUCTS: $156.93 BLUE SHIELD — COVERED CALIFORNIA: $127.31 CCN — ALL PRODUCTS: $153.75 CIGNA — ALL PRODUCTS: $143.50 HEALTHNET — ALL PRODUCTS: $165.13 KAISER — ALL PRODUCTS: $131.20 KAISER — MED ADV: $37.50 MOLINA — MED ADV: $92.25
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	Not listed in the file	Not listed in the file	$59.50
Office consultation with a specialist (moderate): rates for 1 insurance plan KAISER — MED ADV: $59.50
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	Not listed in the file	Not listed in the file	$81.40
Office consultation with a specialist (moderate to high): rates for 1 insurance plan KAISER — MED ADV: $81.40
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT YOUNG ADULT 18-39	$225	$90	$101.25 – $191.25
Preventive checkup, new patient, age 18–39: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $157.50 AETNA — MED ADV: $108 BLUE CROSS — ALL PRODUCTS: $172.24 BLUE SHIELD — COVERED CALIFORNIA: $139.73 CCN — ALL PRODUCTS: $168.75 CIGNA — ALL PRODUCTS: $157.50 HEALTHNET — ALL PRODUCTS: $181.24 KAISER — ALL PRODUCTS: $144 KAISER — MED ADV: $114.10 MOLINA — MED ADV: $101.25
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PT ADULT 40-64 YRS	$250	$100	$112.50 – $212.50
Preventive checkup, new patient, age 40–64: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $175 AETNA — MED ADV: $120 BLUE CROSS — ALL PRODUCTS: $191.38 BLUE SHIELD — COVERED CALIFORNIA: $155.25 CCN — ALL PRODUCTS: $187.50 CIGNA — ALL PRODUCTS: $175 HEALTHNET — ALL PRODUCTS: $201.38 KAISER — ALL PRODUCTS: $160 KAISER — MED ADV: $132.20 MOLINA — MED ADV: $112.50
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$1,711	$684.40	$769.95 – $1,454.35
Emergency room visit (moderate): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $1,190 AETNA — MED ADV: $821.28 BLUE CROSS — ALL PRODUCTS: $1,028 BLUE SHIELD — COVERED CALIFORNIA: $1,231.92 BLUE SHIELD — HMO/POS/PPO: $1,368.80 CCN — ALL PRODUCTS: $245.03 CIGNA — ALL PRODUCTS: $1,197.70 HEALTHNET — ALL PRODUCTS: $1,378.21 KAISER — ALL PRODUCTS: $1,095.04 KAISER — MED ADV: $44.60
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$2,897	$1,158.80	$1,190 – $2,462.45
Emergency room visit (moderately high): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $1,190 AETNA — MED ADV: $1,390.56 BLUE CROSS — ALL PRODUCTS: $1,028 BLUE SHIELD — COVERED CALIFORNIA: $2,085.84 BLUE SHIELD — HMO/POS/PPO: $2,317.60 CCN — ALL PRODUCTS: $381.61 CIGNA — ALL PRODUCTS: $2,027.90 HEALTHNET — ALL PRODUCTS: $2,333.53 KAISER — ALL PRODUCTS: $1,854.08 KAISER — MED ADV: $68.35
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	$4,211	$1,684.40	$1,190 – $3,579.35
Emergency room visit (high): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $1,190 AETNA — MED ADV: $2,021.28 BLUE CROSS — ALL PRODUCTS: $1,028 BLUE SHIELD — COVERED CALIFORNIA: $2,336 BLUE SHIELD — HMO/POS/PPO: $2,595 CCN — ALL PRODUCTS: $548.11 CIGNA — ALL PRODUCTS: $2,947.70 HEALTHNET — ALL PRODUCTS: $3,391.96 KAISER — ALL PRODUCTS: $2,695.04 KAISER — MED ADV: $108.08

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BMP	$24	$9.60	$10.80 – $20.40
Basic metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $16.80 AETNA — MED ADV: $11.52 BLUE CROSS — ALL PRODUCTS: $43.82 BLUE SHIELD — COVERED CALIFORNIA: $27.68 BLUE SHIELD — HMO/POS/PPO: $30.76 CCN — ALL PRODUCTS: $8.46 CIGNA — ALL PRODUCTS: $16.80 HEALTHNET — ALL PRODUCTS: $19.33 KAISER — ALL PRODUCTS: $15.36 KAISER — MED ADV: $7.27
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BMP, PLASMA	$24	$9.60	$10.80 – $20.40
Basic metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $16.80 AETNA — MED ADV: $11.52 BLUE CROSS — ALL PRODUCTS: $43.82 BLUE SHIELD — COVERED CALIFORNIA: $27.68 BLUE SHIELD — HMO/POS/PPO: $30.76 CCN — ALL PRODUCTS: $8.46 CIGNA — ALL PRODUCTS: $16.80 HEALTHNET — ALL PRODUCTS: $19.33 KAISER — ALL PRODUCTS: $15.36 KAISER — MED ADV: $7.27
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE METABOLIC P	$30	$12	$13.50 – $25.50
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $21 AETNA — MED ADV: $14.40 BLUE CROSS — ALL PRODUCTS: $54.80 BLUE SHIELD — COVERED CALIFORNIA: $34.56 BLUE SHIELD — HMO/POS/PPO: $38.40 CCN — ALL PRODUCTS: $10.56 CIGNA — ALL PRODUCTS: $21 HEALTHNET — ALL PRODUCTS: $24.17 KAISER — ALL PRODUCTS: $19.20 KAISER — MED ADV: $9.28
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP, PLASMA	$30	$12	$13.50 – $25.50
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $21 AETNA — MED ADV: $14.40 BLUE CROSS — ALL PRODUCTS: $54.80 BLUE SHIELD — COVERED CALIFORNIA: $34.56 BLUE SHIELD — HMO/POS/PPO: $38.40 CCN — ALL PRODUCTS: $10.56 CIGNA — ALL PRODUCTS: $21 HEALTHNET — ALL PRODUCTS: $24.17 KAISER — ALL PRODUCTS: $19.20 KAISER — MED ADV: $9.28
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CMP	$284	$113.60	$127.80 – $241.40
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $198.80 AETNA — MED ADV: $136.32 BLUE CROSS — ALL PRODUCTS: $54.80 BLUE SHIELD — COVERED CALIFORNIA: $34.56 BLUE SHIELD — HMO/POS/PPO: $38.40 CCN — ALL PRODUCTS: $10.56 CIGNA — ALL PRODUCTS: $198.80 HEALTHNET — ALL PRODUCTS: $228.76 KAISER — ALL PRODUCTS: $181.76 KAISER — MED ADV: $9.28
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRENATAL PANEL 1	$186	$74.40	$83.70 – $158.10
Obstetric blood test panel: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $130.20 AETNA — MED ADV: $89.28 BLUE CROSS — ALL PRODUCTS: $85.27 BLUE SHIELD — COVERED CALIFORNIA: $130.49 BLUE SHIELD — HMO/POS/PPO: $144.79 CCN — ALL PRODUCTS: $47.81 CIGNA — ALL PRODUCTS: $130.20 HEALTHNET — ALL PRODUCTS: $149.82 KAISER — ALL PRODUCTS: $119.04 KAISER — MED ADV: $35.83
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$26.50	$10.60	$11.93 – $22.53
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $18.55 AETNA — MED ADV: $12.72 BLUE CROSS — ALL PRODUCTS: $69.34 BLUE SHIELD — COVERED CALIFORNIA: $43.80 BLUE SHIELD — HMO/POS/PPO: $48.67 CCN — ALL PRODUCTS: $13.39 CIGNA — ALL PRODUCTS: $18.55 HEALTHNET — ALL PRODUCTS: $21.35 KAISER — ALL PRODUCTS: $16.96 KAISER — MED ADV: $11.54
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL PANEL	$106	$42.40	$47.70 – $90.10
Kidney function panel: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $74.20 AETNA — MED ADV: $50.88 BLUE CROSS — ALL PRODUCTS: $44.93 BLUE SHIELD — COVERED CALIFORNIA: $28.38 BLUE SHIELD — HMO/POS/PPO: $31.54 CCN — ALL PRODUCTS: $8.68 CIGNA — ALL PRODUCTS: $74.20 HEALTHNET — ALL PRODUCTS: $85.38 KAISER — ALL PRODUCTS: $67.84 KAISER — MED ADV: $7.60
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNC PANEL	$23.91	$9.56	$10.76 – $20.32
Liver function panel: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $16.74 AETNA — MED ADV: $11.48 BLUE CROSS — ALL PRODUCTS: $42.32 BLUE SHIELD — COVERED CALIFORNIA: $26.72 BLUE SHIELD — HMO/POS/PPO: $29.69 CCN — ALL PRODUCTS: $8.17 CIGNA — ALL PRODUCTS: $16.74 HEALTHNET — ALL PRODUCTS: $19.26 KAISER — ALL PRODUCTS: $15.30 KAISER — MED ADV: $6.38
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$222	$88.80	$99.90 – $188.70
Liver function panel: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $155.40 AETNA — MED ADV: $106.56 BLUE CROSS — ALL PRODUCTS: $42.32 BLUE SHIELD — COVERED CALIFORNIA: $26.72 BLUE SHIELD — HMO/POS/PPO: $29.69 CCN — ALL PRODUCTS: $8.17 CIGNA — ALL PRODUCTS: $155.40 HEALTHNET — ALL PRODUCTS: $178.82 KAISER — ALL PRODUCTS: $142.08 KAISER — MED ADV: $6.38
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: UA MICRO REFLEX	$60	$24	$27 – $51
Urine test (automated, with microscope): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $42 AETNA — MED ADV: $28.80 BLUE CROSS — ALL PRODUCTS: $15.83 BLUE SHIELD — COVERED CALIFORNIA: $10.37 BLUE SHIELD — HMO/POS/PPO: $11.52 CCN — ALL PRODUCTS: $3.17 CIGNA — ALL PRODUCTS: $42 HEALTHNET — ALL PRODUCTS: $48.33 KAISER — ALL PRODUCTS: $38.40 KAISER — MED ADV: $2.77
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	Not listed in the file	Not listed in the file	$2.15 – $12.31
Urine test (manual, without microscope): rates for 5 insurance plans BLUE CROSS — ALL PRODUCTS: $12.31 BLUE SHIELD — COVERED CALIFORNIA: $8.35 BLUE SHIELD — HMO/POS/PPO: $9.28 CCN — ALL PRODUCTS: $3.48 KAISER — MED ADV: $2.15
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SPECIFIC GRAVITY URINE	$7.25	$2.90	$3.26 – $6.16
Urine test (automated, without microscope): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $5.08 AETNA — MED ADV: $3.48 BLUE CROSS — ALL PRODUCTS: $11.64 BLUE SHIELD — COVERED CALIFORNIA: $7.35 BLUE SHIELD — HMO/POS/PPO: $8.16 CCN — ALL PRODUCTS: $2.25 CIGNA — ALL PRODUCTS: $5.08 HEALTHNET — ALL PRODUCTS: $5.84 KAISER — ALL PRODUCTS: $4.64 KAISER — MED ADV: $1.96
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NO MICRO AUTOMATED	$39	$15.60	$17.55 – $33.15
Urine test (automated, without microscope): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $27.30 AETNA — MED ADV: $18.72 BLUE CROSS — ALL PRODUCTS: $11.64 BLUE SHIELD — COVERED CALIFORNIA: $7.35 BLUE SHIELD — HMO/POS/PPO: $8.16 CCN — ALL PRODUCTS: $2.25 CIGNA — ALL PRODUCTS: $27.30 HEALTHNET — ALL PRODUCTS: $31.41 KAISER — ALL PRODUCTS: $24.96 KAISER — MED ADV: $1.96
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RHC UA DIPSTICK	$30	$12	$13.50 – $25.50
Urine test (automated, without microscope): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $21 AETNA — MED ADV: $14.40 BLUE CROSS — ALL PRODUCTS: $11.64 BLUE SHIELD — COVERED CALIFORNIA: $7.35 BLUE SHIELD — HMO/POS/PPO: $8.16 CCN — ALL PRODUCTS: $2.25 CIGNA — ALL PRODUCTS: $21 HEALTHNET — ALL PRODUCTS: $24.17 KAISER — ALL PRODUCTS: $19.20 KAISER — MED ADV: $1.96
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL/FREE	$23.75	$9.50	$10.69 – $20.19
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $16.63 AETNA — MED ADV: $11.40 BLUE CROSS — ALL PRODUCTS: $95.24 BLUE SHIELD — COVERED CALIFORNIA: $60.14 BLUE SHIELD — HMO/POS/PPO: $66.82 CCN — ALL PRODUCTS: $18.39 CIGNA — ALL PRODUCTS: $16.63 HEALTHNET — ALL PRODUCTS: $19.13 KAISER — ALL PRODUCTS: $15.20 KAISER — MED ADV: $16.35
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA TOTAL	$36.51	$14.60	$16.43 – $31.03
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $25.56 AETNA — MED ADV: $17.52 BLUE CROSS — ALL PRODUCTS: $95.24 BLUE SHIELD — COVERED CALIFORNIA: $60.14 BLUE SHIELD — HMO/POS/PPO: $66.82 CCN — ALL PRODUCTS: $18.39 CIGNA — ALL PRODUCTS: $25.56 HEALTHNET — ALL PRODUCTS: $29.41 KAISER — ALL PRODUCTS: $23.37 KAISER — MED ADV: $16.35
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA PANEL	$188	$75.20	$84.60 – $159.80
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $131.60 AETNA — MED ADV: $90.24 BLUE CROSS — ALL PRODUCTS: $95.24 BLUE SHIELD — COVERED CALIFORNIA: $60.14 BLUE SHIELD — HMO/POS/PPO: $66.82 CCN — ALL PRODUCTS: $18.39 CIGNA — ALL PRODUCTS: $131.60 HEALTHNET — ALL PRODUCTS: $151.43 KAISER — ALL PRODUCTS: $120.32 KAISER — MED ADV: $16.35
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH W/ REFLEX TO FT4	$32.37	$12.95	$14.57 – $27.51
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $22.66 AETNA — MED ADV: $15.54 BLUE CROSS — ALL PRODUCTS: $87.01 BLUE SHIELD — COVERED CALIFORNIA: $54.92 BLUE SHIELD — HMO/POS/PPO: $61.02 CCN — ALL PRODUCTS: $16.80 CIGNA — ALL PRODUCTS: $22.66 HEALTHNET — ALL PRODUCTS: $26.07 KAISER — ALL PRODUCTS: $20.72 KAISER — MED ADV: $14.76
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$42.31	$16.92	$19.04 – $35.96
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $29.62 AETNA — MED ADV: $20.31 BLUE CROSS — ALL PRODUCTS: $87.01 BLUE SHIELD — COVERED CALIFORNIA: $54.92 BLUE SHIELD — HMO/POS/PPO: $61.02 CCN — ALL PRODUCTS: $16.80 CIGNA — ALL PRODUCTS: $29.62 HEALTHNET — ALL PRODUCTS: $34.08 KAISER — ALL PRODUCTS: $27.08 KAISER — MED ADV: $14.76
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THY PNL 3RD GEN CPT2	$21.49	$8.60	$9.67 – $18.27
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $15.04 AETNA — MED ADV: $10.32 BLUE CROSS — ALL PRODUCTS: $87.01 BLUE SHIELD — COVERED CALIFORNIA: $54.92 BLUE SHIELD — HMO/POS/PPO: $61.02 CCN — ALL PRODUCTS: $16.80 CIGNA — ALL PRODUCTS: $15.04 HEALTHNET — ALL PRODUCTS: $17.31 KAISER — ALL PRODUCTS: $13.75 KAISER — MED ADV: $14.76
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: cbc w/diff/plts	$8.17	$3.27	$3.68 – $6.94
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $5.72 AETNA — MED ADV: $3.92 BLUE CROSS — ALL PRODUCTS: $40.26 BLUE SHIELD — COVERED CALIFORNIA: $25.41 BLUE SHIELD — HMO/POS/PPO: $28.24 CCN — ALL PRODUCTS: $7.77 CIGNA — ALL PRODUCTS: $5.72 HEALTHNET — ALL PRODUCTS: $6.58 KAISER — ALL PRODUCTS: $5.23 KAISER — MED ADV: $6.75
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CBC W/ DIFF	$69	$27.60	$31.05 – $58.65
Complete blood count (CBC) with differential: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $48.30 AETNA — MED ADV: $33.12 BLUE CROSS — ALL PRODUCTS: $40.26 BLUE SHIELD — COVERED CALIFORNIA: $25.41 BLUE SHIELD — HMO/POS/PPO: $28.24 CCN — ALL PRODUCTS: $7.77 CIGNA — ALL PRODUCTS: $48.30 HEALTHNET — ALL PRODUCTS: $55.58 KAISER — ALL PRODUCTS: $44.16 KAISER — MED ADV: $6.75
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEMOGRAM	$46	$18.40	$20.70 – $39.10
Complete blood count (CBC), automated: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $32.20 AETNA — MED ADV: $22.08 BLUE CROSS — ALL PRODUCTS: $33.50 BLUE SHIELD — COVERED CALIFORNIA: $21.15 BLUE SHIELD — HMO/POS/PPO: $23.50 CCN — ALL PRODUCTS: $6.47 CIGNA — ALL PRODUCTS: $32.20 HEALTHNET — ALL PRODUCTS: $37.05 KAISER — ALL PRODUCTS: $29.44 KAISER — MED ADV: $5.71
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT	$53.17	$21.27	$23.93 – $45.19
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $37.22 AETNA — MED ADV: $25.52 BLUE CROSS — ALL PRODUCTS: $20.39 BLUE SHIELD — COVERED CALIFORNIA: $12.85 BLUE SHIELD — HMO/POS/PPO: $14.27 CCN — ALL PRODUCTS: $4.29 CIGNA — ALL PRODUCTS: $37.22 HEALTHNET — ALL PRODUCTS: $42.83 KAISER — ALL PRODUCTS: $34.03 KAISER — MED ADV: $3.49
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$67	$26.80	$30.15 – $56.95
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $46.90 AETNA — MED ADV: $32.16 BLUE CROSS — ALL PRODUCTS: $20.39 BLUE SHIELD — COVERED CALIFORNIA: $12.85 BLUE SHIELD — HMO/POS/PPO: $14.27 CCN — ALL PRODUCTS: $4.29 CIGNA — ALL PRODUCTS: $46.90 HEALTHNET — ALL PRODUCTS: $53.97 KAISER — ALL PRODUCTS: $42.88 KAISER — MED ADV: $3.49
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT	$16.12	$6.45	$7.25 – $13.70
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $11.28 AETNA — MED ADV: $7.74 BLUE CROSS — ALL PRODUCTS: $31.10 BLUE SHIELD — COVERED CALIFORNIA: $19.61 BLUE SHIELD — HMO/POS/PPO: $21.79 CCN — ALL PRODUCTS: $6.01 CIGNA — ALL PRODUCTS: $11.28 HEALTHNET — ALL PRODUCTS: $12.98 KAISER — ALL PRODUCTS: $10.32 KAISER — MED ADV: $5.34
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LUPUS EVAL W/ REFLEX	$29.17	$11.67	$13.13 – $24.79
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $20.42 AETNA — MED ADV: $14 BLUE CROSS — ALL PRODUCTS: $31.10 BLUE SHIELD — COVERED CALIFORNIA: $19.61 BLUE SHIELD — HMO/POS/PPO: $21.79 CCN — ALL PRODUCTS: $6.01 CIGNA — ALL PRODUCTS: $20.42 HEALTHNET — ALL PRODUCTS: $23.50 KAISER — ALL PRODUCTS: $18.67 KAISER — MED ADV: $5.34
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VAN WILLIBRANDS CPT5	$73.97	$29.59	$33.29 – $62.87
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $51.78 AETNA — MED ADV: $35.51 BLUE CROSS — ALL PRODUCTS: $31.10 BLUE SHIELD — COVERED CALIFORNIA: $19.61 BLUE SHIELD — HMO/POS/PPO: $21.79 CCN — ALL PRODUCTS: $6.01 CIGNA — ALL PRODUCTS: $51.78 HEALTHNET — ALL PRODUCTS: $59.58 KAISER — ALL PRODUCTS: $47.34 KAISER — MED ADV: $5.34

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 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD WO CONTRAST	$2,920	$1,168	$1,314 – $2,482
CT scan of the head or brain, without contrast: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $2,044 AETNA — MED ADV: $1,401.60 BLUE CROSS — ALL PRODUCTS: $694.06 BLUE SHIELD — COVERED CALIFORNIA: $471.95 BLUE SHIELD — HMO/POS/PPO: $523.70 CCN — ALL PRODUCTS: $106.88 CIGNA — ALL PRODUCTS: $2,044 HEALTHNET — ALL PRODUCTS: $2,352.06 KAISER — ALL PRODUCTS: $1,868.80 KAISER — MED ADV: $101.27
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	Not listed in the file	Not listed in the file	$311.06 – $3,229.50
MRI of the brain, before and after contrast: rates for 5 insurance plans BLUE CROSS — ALL PRODUCTS: $3,229.50 BLUE SHIELD — COVERED CALIFORNIA: $2,486.68 BLUE SHIELD — HMO/POS/PPO: $2,759.34 CCN — ALL PRODUCTS: $368.43 KAISER — MED ADV: $311.06
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XR CHEST PT & LAT	$421	$168.40	$189.45 – $357.85
Chest X-ray, 2 views: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $294.70 AETNA — MED ADV: $202.08 BLUE CROSS — ALL PRODUCTS: $120.79 BLUE SHIELD — COVERED CALIFORNIA: $52.50 BLUE SHIELD — HMO/POS/PPO: $58.25 CCN — ALL PRODUCTS: $86.88 CIGNA — ALL PRODUCTS: $294.70 HEALTHNET — ALL PRODUCTS: $339.12 KAISER — ALL PRODUCTS: $269.44 KAISER — MED ADV: $27.48
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$855	$342	$384.75 – $726.75
X-ray of the lower spine, at least 4 views: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $598.50 AETNA — MED ADV: $410.40 BLUE CROSS — ALL PRODUCTS: $135.61 BLUE SHIELD — COVERED CALIFORNIA: $91.43 BLUE SHIELD — HMO/POS/PPO: $101.46 CCN — ALL PRODUCTS: $106.88 CIGNA — ALL PRODUCTS: $598.50 HEALTHNET — ALL PRODUCTS: $688.70 KAISER — ALL PRODUCTS: $547.20 KAISER — MED ADV: $43.85
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	Not listed in the file	Not listed in the file	$186 – $1,818.12
MRI of the lower back (lumbar spine), without contrast: rates for 5 insurance plans BLUE CROSS — ALL PRODUCTS: $1,818.12 BLUE SHIELD — COVERED CALIFORNIA: $1,241.35 BLUE SHIELD — HMO/POS/PPO: $1,377.46 CCN — ALL PRODUCTS: $233.52 KAISER — MED ADV: $186
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS WITH CONTRAST	$3,761	$1,504.40	$1,692.45 – $3,196.85
CT scan of the pelvis, with contrast: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $2,632.70 AETNA — MED ADV: $1,805.28 BLUE CROSS — ALL PRODUCTS: $1,003.31 BLUE SHIELD — COVERED CALIFORNIA: $683.87 BLUE SHIELD — HMO/POS/PPO: $758.85 CCN — ALL PRODUCTS: $180.34 CIGNA — ALL PRODUCTS: $2,632.70 HEALTHNET — ALL PRODUCTS: $3,029.49 KAISER — ALL PRODUCTS: $2,407.04 KAISER — MED ADV: $204.45
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	Not listed in the file	Not listed in the file	$390.48 – $1,633.92
MRI of a leg joint (such as the knee), without contrast: rates for 5 insurance plans BLUE CROSS — ALL PRODUCTS: $1,633.92 BLUE SHIELD — COVERED CALIFORNIA: $1,105.21 BLUE SHIELD — HMO/POS/PPO: $1,226.40 CCN — ALL PRODUCTS: $233.52 KAISER — MED ADV: $390.48
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD/PELVIS WITH CONTRAST	$5,647	$2,258.80	$2,541.15 – $4,799.95
CT scan of the abdomen and pelvis, with contrast: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $2,704 AETNA — MED ADV: $2,710.56 BLUE CROSS — ALL PRODUCTS: $1,039.04 BLUE SHIELD — COVERED CALIFORNIA: $709.73 BLUE SHIELD — HMO/POS/PPO: $787.55 CCN — ALL PRODUCTS: $368.43 CIGNA — ALL PRODUCTS: $3,952.90 HEALTHNET — ALL PRODUCTS: $4,548.66 KAISER — ALL PRODUCTS: $3,614.08 KAISER — MED ADV: $281.80
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US ABDOMEN COMPLETE	$1,242	$496.80	$558.90 – $1,055.70
Ultrasound of the abdomen, complete: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $869.40 AETNA — MED ADV: $596.16 BLUE CROSS — ALL PRODUCTS: $292.75 BLUE SHIELD — COVERED CALIFORNIA: $197.53 BLUE SHIELD — HMO/POS/PPO: $219.18 CCN — ALL PRODUCTS: $106.88 CIGNA — ALL PRODUCTS: $869.40 HEALTHNET — ALL PRODUCTS: $1,000.43 KAISER — ALL PRODUCTS: $794.88 KAISER — MED ADV: $83.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US PREG UTERUS >14 WEEKS	$598	$239.20	$269.10 – $508.30
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $418.60 AETNA — MED ADV: $287.04 BLUE CROSS — ALL PRODUCTS: $303.70 BLUE SHIELD — COVERED CALIFORNIA: $209.73 BLUE SHIELD — HMO/POS/PPO: $232.72 CCN — ALL PRODUCTS: $106.88 CIGNA — ALL PRODUCTS: $418.60 HEALTHNET — ALL PRODUCTS: $481.69 KAISER — ALL PRODUCTS: $382.72 KAISER — MED ADV: $94.32
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US TRANSVAGINAL	$567	$226.80	$255.15 – $481.95
Transvaginal ultrasound: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $396.90 AETNA — MED ADV: $272.16 BLUE CROSS — ALL PRODUCTS: $227.25 BLUE SHIELD — COVERED CALIFORNIA: $152.70 BLUE SHIELD — HMO/POS/PPO: $169.45 CCN — ALL PRODUCTS: $106.88 CIGNA — ALL PRODUCTS: $396.90 HEALTHNET — ALL PRODUCTS: $456.72 KAISER — ALL PRODUCTS: $362.88 KAISER — MED ADV: $67.65
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$117.08 – $397.51
Diagnostic mammogram, one breast: rates for 5 insurance plans BLUE CROSS — ALL PRODUCTS: $397.51 BLUE SHIELD — COVERED CALIFORNIA: $197.93 BLUE SHIELD — HMO/POS/PPO: $219.63 CCN — ALL PRODUCTS: $165.45 KAISER — MED ADV: $117.08
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MG MAMMOGRAM UNILAT LT	$507	$202.80	$228.15 – $430.95
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $354.90 AETNA — MED ADV: $243.36 BLUE CROSS — ALL PRODUCTS: $388.11 BLUE SHIELD — COVERED CALIFORNIA: $314.85 CCN — ALL PRODUCTS: $380.25 CIGNA — ALL PRODUCTS: $354.90 HEALTHNET — ALL PRODUCTS: $408.39 KAISER — ALL PRODUCTS: $324.48 KAISER — MED ADV: $228.15 MOLINA — MED ADV: $228.15
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MG MAMMOGRAM CONE DOWN LT	$507	$202.80	$228.15 – $430.95
Diagnostic mammogram, one breast: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $354.90 AETNA — MED ADV: $243.36 BLUE CROSS — ALL PRODUCTS: $388.11 BLUE SHIELD — COVERED CALIFORNIA: $314.85 CCN — ALL PRODUCTS: $380.25 CIGNA — ALL PRODUCTS: $354.90 HEALTHNET — ALL PRODUCTS: $408.39 KAISER — ALL PRODUCTS: $324.48 KAISER — MED ADV: $228.15 MOLINA — MED ADV: $228.15
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMO CONE DOWN BILAT	$529	$211.60	$238.05 – $449.65
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $370.30 AETNA — MED ADV: $253.92 BLUE CROSS — ALL PRODUCTS: $508.89 BLUE SHIELD — COVERED CALIFORNIA: $289.85 BLUE SHIELD — HMO/POS/PPO: $321.63 CCN — ALL PRODUCTS: $209.15 CIGNA — ALL PRODUCTS: $370.30 HEALTHNET — ALL PRODUCTS: $426.11 KAISER — ALL PRODUCTS: $338.56 KAISER — MED ADV: $148.03
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMOGRAM BILATERAL	$571	$228.40	$256.95 – $485.35
Diagnostic mammogram, both breasts: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $399.70 AETNA — MED ADV: $274.08 BLUE CROSS — ALL PRODUCTS: $508.89 BLUE SHIELD — COVERED CALIFORNIA: $289.85 BLUE SHIELD — HMO/POS/PPO: $321.63 CCN — ALL PRODUCTS: $209.15 CIGNA — ALL PRODUCTS: $399.70 HEALTHNET — ALL PRODUCTS: $459.94 KAISER — ALL PRODUCTS: $365.44 KAISER — MED ADV: $148.03
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	$546	$218.40	$245.70 – $464.10
Screening mammogram, both breasts: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $382.20 AETNA — MED ADV: $262.08 BLUE CROSS — ALL PRODUCTS: $420.27 BLUE SHIELD — COVERED CALIFORNIA: $293.69 BLUE SHIELD — HMO/POS/PPO: $325.89 CCN — ALL PRODUCTS: $170.16 CIGNA — ALL PRODUCTS: $382.20 HEALTHNET — ALL PRODUCTS: $439.80 KAISER — ALL PRODUCTS: $349.44 KAISER — MED ADV: $119.45
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MG MAMMOGRAM SCREENING	$546	$218.40	$245.70 – $464.10
Screening mammogram, both breasts: 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $382.20 AETNA — MED ADV: $262.08 BLUE CROSS — ALL PRODUCTS: $420.27 BLUE SHIELD — COVERED CALIFORNIA: $293.69 BLUE SHIELD — HMO/POS/PPO: $325.89 CCN — ALL PRODUCTS: $170.16 CIGNA — ALL PRODUCTS: $382.20 HEALTHNET — ALL PRODUCTS: $439.80 KAISER — ALL PRODUCTS: $349.44 KAISER — MED ADV: $119.45

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$28.70 – $141.39
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans BLUE CROSS — ALL PRODUCTS: $141.39 BLUE SHIELD — COVERED CALIFORNIA: $50.99 BLUE SHIELD — HMO/POS/PPO: $56.58 KAISER — MED ADV: $28.70
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LEFT HRT CATH W/VENTRCLGRPHY	Not listed in the file	Not listed in the file	$2,958.46
Left heart catheterization (diagnostic): rates for 2 insurance plans CCN — ALL PRODUCTS: $2,958.46 KAISER — MED ADV: $762.86
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHENSIVE EP EVALUATION	Not listed in the file	Not listed in the file	$596.46 – $859.86
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans BLUE SHIELD — COVERED CALIFORNIA: $774.89 BLUE SHIELD — HMO/POS/PPO: $859.86 CCN — ALL PRODUCTS: $6,732.75 KAISER — MED ADV: $596.46
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPRE EP EVAL ABLTJ ATR FIB	Not listed in the file	Not listed in the file	$23,481.29
Heart rhythm study with ablation for atrial fibrillation: rates for 2 insurance plans CCN — ALL PRODUCTS: $23,481.29 KAISER — MED ADV: $880.47
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM	Not listed in the file	Not listed in the file	$348.07 – $1,718.43
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans BLUE CROSS — ALL PRODUCTS: $976.18 BLUE SHIELD — COVERED CALIFORNIA: $1,548.62 BLUE SHIELD — HMO/POS/PPO: $1,718.43 CCN — ALL PRODUCTS: $934.38 KAISER — MED ADV: $348.07

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) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	Not listed in the file	Not listed in the file	$10.96 – $35.59
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans BLUE SHIELD — COVERED CALIFORNIA: $32.08 BLUE SHIELD — HMO/POS/PPO: $35.59 KAISER — MED ADV: $10.96
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CQ In the file: PTA- THER EXERCISE 15MIN	$85	$34	$38.25 – $72.25
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $59.50 AETNA — MED ADV: $40.80 BLUE CROSS — ALL PRODUCTS: $114 BLUE SHIELD — COVERED CALIFORNIA: $122 BLUE SHIELD — HMO/POS/PPO: $135 CCN — ALL PRODUCTS: $63.75 CIGNA — ALL PRODUCTS: $59.50 HEALTHNET — ALL PRODUCTS: $68.47 KAISER — ALL PRODUCTS: $125 KAISER — MED ADV: $38.25
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: THER EXERCISE 15MIN	$85	$34	$38.25 – $72.25
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $59.50 AETNA — MED ADV: $40.80 BLUE CROSS — ALL PRODUCTS: $114 BLUE SHIELD — COVERED CALIFORNIA: $122 BLUE SHIELD — HMO/POS/PPO: $135 CCN — ALL PRODUCTS: $63.75 CIGNA — ALL PRODUCTS: $59.50 HEALTHNET — ALL PRODUCTS: $68.47 KAISER — ALL PRODUCTS: $125 KAISER — MED ADV: $38.25
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEXITY	$108	$43.20	$48.60 – $91.80
Physical therapy evaluation (low complexity): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $75.60 AETNA — MED ADV: $51.84 BLUE CROSS — ALL PRODUCTS: $114 BLUE SHIELD — COVERED CALIFORNIA: $122 BLUE SHIELD — HMO/POS/PPO: $135 CCN — ALL PRODUCTS: $81 CIGNA — ALL PRODUCTS: $75.60 HEALTHNET — ALL PRODUCTS: $86.99 KAISER — ALL PRODUCTS: $125 KAISER — MED ADV: $48.60
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL MOD COMPLEXITY	$215	$86	$96.75 – $182.75
Physical therapy evaluation (moderate complexity): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $150.50 AETNA — MED ADV: $103.20 BLUE CROSS — ALL PRODUCTS: $114 BLUE SHIELD — COVERED CALIFORNIA: $122 BLUE SHIELD — HMO/POS/PPO: $135 CCN — ALL PRODUCTS: $161.25 CIGNA — ALL PRODUCTS: $150.50 HEALTHNET — ALL PRODUCTS: $173.18 KAISER — ALL PRODUCTS: $125 KAISER — MED ADV: $96.75
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$135.56
Physical therapy evaluation (high complexity): rates for 1 insurance plan KAISER — MED ADV: $135.56
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEXITY	$323	$129.20	$145.35 – $274.55
Physical therapy evaluation (high complexity): 10 of 13 insurance plan rates AETNA — ALL PRODUCTS: $226.10 AETNA — MED ADV: $155.04 BLUE CROSS — ALL PRODUCTS: $114 BLUE SHIELD — COVERED CALIFORNIA: $122 BLUE SHIELD — HMO/POS/PPO: $135 CCN — ALL PRODUCTS: $242.25 CIGNA — ALL PRODUCTS: $226.10 HEALTHNET — ALL PRODUCTS: $260.18 KAISER — ALL PRODUCTS: $125 KAISER — MED ADV: $145.35
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 30 MINUTES	Not listed in the file	Not listed in the file	$145.70
Psychotherapy, 30 minutes: rates for 2 insurance plans CCN — ALL PRODUCTS: $145.70 KAISER — MED ADV: $52.87
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CG In the file: PSYCHOTHERAPY 30 MINUTES	$120	$48	$54 – $102
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $84 AETNA — MED ADV: $57.60 BLUE CROSS — ALL PRODUCTS: $91.86 BLUE SHIELD — COVERED CALIFORNIA: $74.52 CCN — ALL PRODUCTS: $90 CIGNA — ALL PRODUCTS: $84 HEALTHNET — ALL PRODUCTS: $96.66 KAISER — ALL PRODUCTS: $76.80 KAISER — MED ADV: $54 MOLINA — MED ADV: $54
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 45 MINUTES	Not listed in the file	Not listed in the file	$145.70
Psychotherapy, 45 minutes: rates for 2 insurance plans CCN — ALL PRODUCTS: $145.70 KAISER — MED ADV: $67.16
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CG In the file: PSYCHOTHERAPY 45 MINUTES	$180	$72	$81 – $153
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $126 AETNA — MED ADV: $86.40 BLUE CROSS — ALL PRODUCTS: $137.79 BLUE SHIELD — COVERED CALIFORNIA: $111.78 CCN — ALL PRODUCTS: $135 CIGNA — ALL PRODUCTS: $126 HEALTHNET — ALL PRODUCTS: $144.99 KAISER — ALL PRODUCTS: $115.20 KAISER — MED ADV: $81 MOLINA — MED ADV: $81
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSYTX W PT 60 MINUTES	Not listed in the file	Not listed in the file	$145.70
Psychotherapy, 60 minutes: rates for 2 insurance plans CCN — ALL PRODUCTS: $145.70 KAISER — MED ADV: $98.02
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CG In the file: PSYCHOTHERAPY 60 MINUTES	$240	$96	$108 – $204
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $168 AETNA — MED ADV: $115.20 BLUE CROSS — ALL PRODUCTS: $183.72 BLUE SHIELD — COVERED CALIFORNIA: $149.04 CCN — ALL PRODUCTS: $180 CIGNA — ALL PRODUCTS: $168 HEALTHNET — ALL PRODUCTS: $193.32 KAISER — ALL PRODUCTS: $153.60 KAISER — MED ADV: $108 MOLINA — MED ADV: $108
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/O PT 50 MIN	Not listed in the file	Not listed in the file	$44 – $86.64
Family psychotherapy, without the patient: rates for 4 insurance plans BLUE SHIELD — COVERED CALIFORNIA: $44 BLUE SHIELD — HMO/POS/PPO: $48.83 CCN — ALL PRODUCTS: $145.70 KAISER — MED ADV: $86.64
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CG In the file: FAMILY THERAPY W/O PT	$126	$50.40	$56.70 – $107.10
Family psychotherapy, without the patient: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $88.20 AETNA — MED ADV: $60.48 BLUE CROSS — ALL PRODUCTS: $96.45 BLUE SHIELD — COVERED CALIFORNIA: $78.25 CCN — ALL PRODUCTS: $94.50 CIGNA — ALL PRODUCTS: $88.20 HEALTHNET — ALL PRODUCTS: $101.49 KAISER — ALL PRODUCTS: $80.64 KAISER — MED ADV: $56.70 MOLINA — MED ADV: $56.70
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: FAMILY PSYTX W/PT 50 MIN	Not listed in the file	Not listed in the file	$50.45 – $89.65
Family psychotherapy, with the patient: rates for 4 insurance plans BLUE SHIELD — COVERED CALIFORNIA: $50.45 BLUE SHIELD — HMO/POS/PPO: $55.98 CCN — ALL PRODUCTS: $145.70 KAISER — MED ADV: $89.65
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier CG In the file: FAMILY PSYTX W/PT 50 MIN	$157.50	$63	$70.88 – $133.88
Family psychotherapy, with the patient: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $110.25 AETNA — MED ADV: $75.60 BLUE CROSS — ALL PRODUCTS: $120.57 BLUE SHIELD — COVERED CALIFORNIA: $97.81 CCN — ALL PRODUCTS: $118.13 CIGNA — ALL PRODUCTS: $110.25 HEALTHNET — ALL PRODUCTS: $126.87 KAISER — ALL PRODUCTS: $100.80 KAISER — MED ADV: $70.88 MOLINA — MED ADV: $70.88
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$14.48 – $22.06
Group psychotherapy: rates for 4 insurance plans BLUE SHIELD — COVERED CALIFORNIA: $19.88 BLUE SHIELD — HMO/POS/PPO: $22.06 CCN — ALL PRODUCTS: $75.85 KAISER — MED ADV: $14.48

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	$925	$370	$416.25 – $786.25
Removal of breast growth (open surgery): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $647.50 AETNA — MED ADV: $444 BLUE CROSS — ALL PRODUCTS: $708.09 BLUE SHIELD — COVERED CALIFORNIA: $574.43 CCN — ALL PRODUCTS: $3,437.80 CIGNA — ALL PRODUCTS: $647.50 HEALTHNET — ALL PRODUCTS: $745.09 KAISER — ALL PRODUCTS: $592 KAISER — MED ADV: $210.72 MOLINA — MED ADV: $416.25
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$13,048.08
Total hip replacement: rates for 2 insurance plans CCN — ALL PRODUCTS: $13,048.08 KAISER — MED ADV: $1,489.20
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$13,048.08
Total knee replacement: rates for 2 insurance plans CCN — ALL PRODUCTS: $13,048.08 KAISER — MED ADV: $1,489.20
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SHO ARTHRS SRG DECOMPRESSION	Not listed in the file	Not listed in the file	$421.82
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan KAISER — MED ADV: $421.82
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$2,976.66
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans CCN — ALL PRODUCTS: $2,976.66 KAISER — MED ADV: $551
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$5,339.67
Removal of tonsils and adenoids (under age 12): rates for 2 insurance plans CCN — ALL PRODUCTS: $5,339.67 KAISER — MED ADV: $168.65
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	$268	$107.20	$120.60 – $227.80
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $187.60 AETNA — MED ADV: $128.64 BLUE CROSS — ALL PRODUCTS: $205.15 BLUE SHIELD — COVERED CALIFORNIA: $166.43 CCN — ALL PRODUCTS: $825.51 CIGNA — ALL PRODUCTS: $187.60 HEALTHNET — ALL PRODUCTS: $215.87 KAISER — ALL PRODUCTS: $171.52 KAISER — MED ADV: $224.12 MOLINA — MED ADV: $120.60
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	$301	$120.40	$135.45 – $255.85
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $210.70 AETNA — MED ADV: $144.48 BLUE CROSS — ALL PRODUCTS: $230.42 BLUE SHIELD — COVERED CALIFORNIA: $186.92 CCN — ALL PRODUCTS: $825.51 CIGNA — ALL PRODUCTS: $210.70 HEALTHNET — ALL PRODUCTS: $242.46 KAISER — ALL PRODUCTS: $192.64 KAISER — MED ADV: $234.18 MOLINA — MED ADV: $135.45
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	$402	$160.80	$180.90 – $341.70
Colonoscopy (diagnostic): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $281.40 AETNA — MED ADV: $192.96 BLUE CROSS — ALL PRODUCTS: $307.73 BLUE SHIELD — COVERED CALIFORNIA: $249.64 CCN — ALL PRODUCTS: $831.04 CIGNA — ALL PRODUCTS: $281.40 HEALTHNET — ALL PRODUCTS: $323.81 KAISER — ALL PRODUCTS: $257.28 KAISER — MED ADV: $295.23 MOLINA — MED ADV: $180.90
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	$756	$302.40	$340.20 – $642.60
Colonoscopy with biopsy: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $529.20 AETNA — MED ADV: $362.88 BLUE CROSS — ALL PRODUCTS: $578.72 BLUE SHIELD — COVERED CALIFORNIA: $469.48 CCN — ALL PRODUCTS: $1,082.91 CIGNA — ALL PRODUCTS: $529.20 HEALTHNET — ALL PRODUCTS: $608.96 KAISER — ALL PRODUCTS: $483.84 KAISER — MED ADV: $330.23 MOLINA — MED ADV: $340.20
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	$555	$222	$249.75 – $471.75
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $388.50 AETNA — MED ADV: $266.40 BLUE CROSS — ALL PRODUCTS: $424.85 BLUE SHIELD — COVERED CALIFORNIA: $344.66 CCN — ALL PRODUCTS: $1,082.91 CIGNA — ALL PRODUCTS: $388.50 HEALTHNET — ALL PRODUCTS: $447.05 KAISER — ALL PRODUCTS: $355.20 KAISER — MED ADV: $400.22 MOLINA — MED ADV: $249.75
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$1,082.91
Ultrasound of the lower bowel by endoscope: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,082.91 KAISER — MED ADV: $169.65
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$831.04
Screening colonoscopy (not high risk): rates for 1 insurance plan CCN — ALL PRODUCTS: $831.04
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	$1,466	$586.40	$659.70 – $1,246.10
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $1,026.20 AETNA — MED ADV: $703.68 BLUE CROSS — ALL PRODUCTS: $1,122.22 BLUE SHIELD — COVERED CALIFORNIA: $910.39 CCN — ALL PRODUCTS: $5,212.15 CIGNA — ALL PRODUCTS: $1,026.20 HEALTHNET — ALL PRODUCTS: $1,180.86 KAISER — ALL PRODUCTS: $938.24 KAISER — MED ADV: $466.12 MOLINA — MED ADV: $659.70
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	$1,895	$758	$852.75 – $1,610.75
Groin (inguinal) hernia repair, age 5 or older: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $1,326.50 AETNA — MED ADV: $909.60 BLUE CROSS — ALL PRODUCTS: $1,450.62 BLUE SHIELD — COVERED CALIFORNIA: $1,176.80 CCN — ALL PRODUCTS: $3,541.93 CIGNA — ALL PRODUCTS: $1,326.50 HEALTHNET — ALL PRODUCTS: $1,526.42 KAISER — ALL PRODUCTS: $1,212.80 KAISER — MED ADV: $344.01 MOLINA — MED ADV: $852.75
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$1,854.88
Prostate biopsy: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,854.88 KAISER — MED ADV: $87.49
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$9,087.30
Prostate removal by laparoscope (radical prostatectomy): rates for 2 insurance plans CCN — ALL PRODUCTS: $9,087.30 KAISER — MED ADV: $953.26
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	$505	$202	$227.25 – $429.25
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $353.50 AETNA — MED ADV: $242.40 BLUE CROSS — ALL PRODUCTS: $386.58 BLUE SHIELD — COVERED CALIFORNIA: $313.61 CCN — ALL PRODUCTS: $2,827.44 CIGNA — ALL PRODUCTS: $353.50 HEALTHNET — ALL PRODUCTS: $406.78 KAISER — ALL PRODUCTS: $323.20 KAISER — MED ADV: $175.32 MOLINA — MED ADV: $227.25
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$644.34
Spinal injection, lower back (epidural), with imaging guidance: rates for 2 insurance plans CCN — ALL PRODUCTS: $644.34 KAISER — MED ADV: $220.03
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	Not listed in the file	Not listed in the file	$852.18
Nerve root injection, lower back, with imaging guidance: rates for 2 insurance plans CCN — ALL PRODUCTS: $852.18 KAISER — MED ADV: $143.34
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$1,797.52
Carpal tunnel release: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,797.52 KAISER — MED ADV: $316.83
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: YAG LASER TREATMENT	$905	$362	$407.25 – $769.25
Laser treatment of clouding after cataract surgery: 10 of 12 insurance plan rates AETNA — ALL PRODUCTS: $633.50 AETNA — MED ADV: $434.40 BLUE CROSS — ALL PRODUCTS: $692.78 BLUE SHIELD — COVERED CALIFORNIA: $562.01 CCN — ALL PRODUCTS: $530.77 CIGNA — ALL PRODUCTS: $633.50 HEALTHNET — ALL PRODUCTS: $728.98 KAISER — ALL PRODUCTS: $579.20 KAISER — MED ADV: $186.15 MOLINA — MED ADV: $407.25
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$2,159.44
Cataract removal with lens implant: rates for 2 insurance plans CCN — ALL PRODUCTS: $2,159.44 KAISER — MED ADV: $1,005.21

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRICAL CARE	Not listed in the file	Not listed in the file	$1,390.14
Vaginal delivery, with care before and after: rates for 1 insurance plan KAISER — MED ADV: $1,390.14
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CESAREAN DELIVERY	Not listed in the file	Not listed in the file	$1,390.97
Cesarean delivery (C-section), with care before and after: rates for 1 insurance plan KAISER — MED ADV: $1,390.97
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: VBAC DELIVERY	Not listed in the file	Not listed in the file	$1,390.14
Vaginal delivery after a previous C-section, with care before and after: rates for 1 insurance plan KAISER — MED ADV: $1,390.14

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$1,910 – $2,120
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,910 USA — ALL PRODUCTS: $2,120
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$1,910 – $2,120
Spinal fusion (not neck), without major complications: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,910 USA — ALL PRODUCTS: $2,120
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	$1,910 – $2,120
Hip or knee replacement (major joint of the leg), without major complications: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,910 USA — ALL PRODUCTS: $2,120
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,910 – $2,120
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,910 USA — ALL PRODUCTS: $2,120
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,910 – $2,120
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans CCN — ALL PRODUCTS: $1,910 USA — ALL PRODUCTS: $2,120

Source: Mountains Community Hospital’s standard charges file (mountains.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on January 14, 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	Critical Access Hospital
Address	29101 Hospital Road, Lake Arrowhead, CA 92352
County	San Bernardino County
State	California
Phone	(909) 336‑3651
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	Not rated by CMS
CMS Certification Number	051312
Name in Medicare records	MOUNTAINS COMMUNITY HOSPITAL
Profile level	Medicare data + hospital website
Official website	mchcares.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau ZIP code areas (Gazetteer) — approximate position (center of the ZIP code area) used for distances

From the hospital’s website

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

Mountains Community Hospital — mchcares.com
24/7 Emergency Care Services | Mountains Community Hospital — mchcares.com
General & Orthopedic Surgery | Mountains Community Hospital — mchcares.com
Radiology & Laboratory | Mountains Community Hospital — mchcares.com
Physical Therapy & Rehabilitation | Mountains Community Hospital — mchcares.com
Additional Resources | Mountains Community Hospital — mchcares.com