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Acute Care Hospital

Riverside Community Hospital

Riverside, California · Riverside County · Emergency services listed

Riverside Community Hospital is an acute care hospital at 4445 Magnolia Avenue, Riverside, CA 92501. Phone: (951) 788-3000. It has an emergency department. Medicare overall rating: 2 of 5 stars (CMS, October 2026).

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

Summary

Riverside Community Hospital is an acute care hospital in Riverside, California. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 154 services, specialties and programs. Medicare lists 414 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is an acute care hospital?

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

Call(951) 788‑3000 Directions Website Medicare profile
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Profile from official sources

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

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
YesBirthing-friendly (CMS)
542Beds (hospital website)
414Doctors and clinicians
154Services listed

Quick answers

Does Riverside Community Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Riverside Community Hospital. In a medical emergency, call 911.
Where is Riverside Community Hospital?
4445 Magnolia Avenue, Riverside, CA 92501, in Riverside County, California.
What is the phone number of Riverside Community Hospital?
(951) 788-3000, as listed by Medicare (CMS).
What is the Medicare star rating of Riverside Community Hospital?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Riverside Community Hospital for hospital-acquired conditions?
No. For fiscal year 2026, CMS lists no Medicare payment reduction for Riverside Community Hospital under the Hospital-Acquired Condition Reduction Program (Total HAC Score: 0.3381; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas[4][8][9][10][11][18]

Conditions treated[7][9][10][13][14][18][19]

Treatments[7][8][10][13][14][19]

Procedures[8][9][10][11][13][14][15][16][17][18][19]

Programs and centers[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]

  • Level III NICU
  • STEMI receiving center
  • Robot-assisted surgery
  • Hip and knee joint replacement
  • Comprehensive Stroke Center
  • Level I Trauma Center
  • Chest Pain Center
  • HeartCare Institute
  • Labor and delivery
  • Southern California Institute for Robotic Surgery
  • Center for Surgical Weight Loss
  • Orthopedic and Spine Center
  • Neuroscience Center (spine care)
  • Stroke and brain injury support group
  • Grief support group
  • Breast imaging center
  • Preadmission testing
  • Consult-A-Nurse (24/7 nurse advice line)

Emergency care (hospital website)[4][6][9][12]

Emergency roomYes
Open 24/7Yes
Trauma designationLevel I
Stroke designationComprehensive Stroke Center

Visiting and practical information

VisitingVisiting hours 9 a.m. to 9 p.m., seven days a week; visitors must be at least 16[5]
ParkingParking garage at 4550 Brockton Avenue; dedicated pickup parking by the main entrance[5]
Patient portalMyHealthONE

Recognition[4][6][7][8][9][11][12][13][14][15]

  • Accredited cancer program (American College of Surgeons)
  • Advanced Primary Heart Attack Center (The Joint Commission)
  • Center of Excellence for Robot-Assisted Surgery (Surgical Review Corporation)
  • Hip and knee joint replacement certification (The Joint Commission)
  • Accredited Level I Trauma Center (American College of Surgeons)
  • Comprehensive Stroke Center (DNV)
  • Accredited Level I Trauma Center by the American College of Surgeons
  • Designated Level I Trauma Center by Riverside County EMS Agency (REMSA)
  • Comprehensive Stroke Certification by DNV
  • Designated Comprehensive Stroke Center by Riverside County EMS Agency (REMSA)
  • Advanced Primary Heart Attack Center certification (Joint Commission and American Heart Association)
  • Designated STEMI Receiving Center by Riverside County EMS Agency (REMSA)
  • Joint Commission Gold Seal of Approval
  • Accredited Chest Pain Center (American College of Cardiology)
  • Accredited Bariatric Surgery Center (ASMBS MBSAQIP)
  • Certified Joint Replacement, Hip and Knee (Joint Commission)
  • Advanced Certification in Perinatal Care (Joint Commission)
  • Laboratory accredited by the College of American Pathologists
  • Imaging accredited by the American College of Radiology (CT, MRI, nuclear medicine, ultrasound)
  • Top 5% of hospitals nationwide for overall clinical performance (Healthgrades, 2023-2026)

Doctors and clinicians (414)

414 doctors and other clinicians list Riverside 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 (414)

And 390 more: the button below opens the full list.

Other emergency rooms nearby

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

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

Other hospitals near Riverside

All hospitals in Riverside · Hospitals in Riverside County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

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

About the Medicare star rating

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

Medicare quality data

What Riverside 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.

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) 2 of 5 stars
Overall rating of the hospital2 of 5 stars
Would recommend the hospital3 of 5 stars
Nurses communicated well2 of 5 stars
Doctors communicated well2 of 5 stars
Patients got help quickly from staff1 of 5 stars
Staff explained medicines2 of 5 stars
Information about recovery at home2 of 5 stars
Room and bathroom kept clean3 of 5 stars
Restfulness of Environment1 of 5 stars
Care Coordination1 of 5 stars
Symptoms After Stay1 of 5 stars
Rated the hospital 9 or 10 out of 1061%National average: 72%
Would definitely recommend the hospital63%National average: 71%
Nurses “always” communicated well73%National average: 80%
Doctors “always” communicated well71%National average: 80%
“Always” got help as soon as they wanted49%National average: 64%
Staff “always” explained medicines before giving them56%National average: 62%
Were given information about recovery at home81%National average: 86%
Room and bathroom “always” clean62%National average: 73%
Completed surveys661Response rate: 16%

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

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)0.827No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)1.042No different from the national benchmark
Surgical site infections after colon surgery1.163No different from the national benchmark
Surgical site infections after abdominal hysterectomy0No different from the national benchmark
MRSA bloodstream infections0.978No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections0.985No different from the national benchmark

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

Complications and deaths

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

Deaths within 30 days: heart attack patients11.7%
Deaths within 30 days: heart failure patients8.1%
Deaths within 30 days: pneumonia patients11.3%
Deaths within 30 days: COPD patients7.6%
Deaths within 30 days: stroke patients11.9%
Deaths within 30 days: coronary bypass surgery (CABG)1.9%
Serious complications (patient safety indicator PSI-90)1.06No different from the national rate
Complications after hip or knee replacement3.8%

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

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)16.9%
Readmitted within 30 days: heart attack14.8%
Readmitted within 30 days: heart failure22.1%
Readmitted within 30 days: pneumonia19.2%
Readmitted within 30 days: COPD19.8%
Readmitted within 30 days: coronary bypass surgery8%
Readmitted within 30 days: hip or knee replacement6.8%

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

Emergency room times and sepsis care

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

Emergency room volume (patients per year)Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)193 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)63%National average: 66%

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

See every measure on Medicare Care Compare →

Medicare payment programs

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

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

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

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

Medicare payment reduction, fiscal year 2026NoCMS lists no payment reduction for this hospital.
Total HAC Score0.3381Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

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

Hospital Readmissions Reduction Program

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

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

Heart attack1.0248More readmissions than expected
Heart failure1.0893More readmissions than expected
Pneumonia1.0855More readmissions than expected
COPD (chronic lung disease)1.0501More readmissions than expected
Hip or knee replacement1.0913More readmissions than expected
Coronary bypass surgery (CABG)1.0115More readmissions than expected

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

Hospital Value-Based Purchasing Program

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

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

Total Performance Score25.17 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)45.00 out of 100
Person and community engagement (patient survey)19.00 out of 100
Safety (infections and sepsis care)36.67 out of 100
Efficiency and cost reduction (Medicare spending)0.00 out of 100

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

Medicare spending per patient (MSPB)

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

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

Medicare spending per patient, ratio1.12Above the national median hospital (1.00): Medicare spent more

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

ER wait times and Medicare ratings nearby

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

ER wait times in RiversideBest hospitals in Riverside

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 82 common services exactly as Riverside 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 82 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 NP $494.25 $494.25 $49.42 – $444.82
New patient office visit (about 30–44 minutes): 10 of 23 insurance plan rates
  • Aetna — HMO: $88.97
  • Aetna — MCRHMO: $49.42
  • Aetna — MCRPOS: $49.42
  • Aetna — MCRPPO: $49.42
  • Aetna — PPO: $88.97
  • American Health System — HIX: $222.41
  • Blue Shield — COMM: $253.45
  • Blue Shield — EPN: $157.17
  • First Health — COMM: $217.47
  • First Health — WCOMP: $444.82
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP $717.75 $717.75 $71.78 – $645.98
New patient office visit (about 45–59 minutes): 10 of 23 insurance plan rates
  • Aetna — HMO: $129.19
  • Aetna — MCRHMO: $71.78
  • Aetna — MCRPOS: $71.78
  • Aetna — MCRPPO: $71.78
  • Aetna — PPO: $129.19
  • American Health System — HIX: $322.99
  • Blue Shield — COMM: $368.06
  • Blue Shield — EPN: $228.24
  • First Health — COMM: $315.81
  • First Health — WCOMP: $645.98
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP $717.75 $717.75 $71.78 – $645.98
New patient office visit (about 60–74 minutes): 10 of 23 insurance plan rates
  • Aetna — HMO: $129.19
  • Aetna — MCRHMO: $71.78
  • Aetna — MCRPOS: $71.78
  • Aetna — MCRPPO: $71.78
  • Aetna — PPO: $129.19
  • American Health System — HIX: $322.99
  • Blue Shield — COMM: $368.06
  • Blue Shield — EPN: $228.24
  • First Health — COMM: $315.81
  • First Health — WCOMP: $645.98
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST $494.25 $494.25 $49.42 – $444.82
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates
  • Aetna — HMO: $88.97
  • Aetna — MCRHMO: $49.42
  • Aetna — MCRPOS: $49.42
  • Aetna — MCRPPO: $49.42
  • Aetna — PPO: $88.97
  • American Health System — HIX: $222.41
  • Blue Shield — COMM: $253.45
  • Blue Shield — EPN: $157.17
  • First Health — COMM: $217.47
  • First Health — WCOMP: $444.82
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST $717.75 $717.75 $71.78 – $645.98
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates
  • Aetna — HMO: $129.19
  • Aetna — MCRHMO: $71.78
  • Aetna — MCRPOS: $71.78
  • Aetna — MCRPPO: $71.78
  • Aetna — PPO: $129.19
  • American Health System — HIX: $322.99
  • Blue Shield — COMM: $368.06
  • Blue Shield — EPN: $228.24
  • First Health — COMM: $315.81
  • First Health — WCOMP: $645.98
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin Not listed in the file Not listed in the file $66.82 – $70.34
Preventive checkup, new patient, age 18–39: rates for 2 insurance plans
  • Blue Shield — TRICARE: $66.82
  • Health Net — Tricare: $70.34
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin Not listed in the file Not listed in the file $81.16 – $85.43
Preventive checkup, new patient, age 40–64: rates for 2 insurance plans
  • Blue Shield — TRICARE: $81.16
  • Health Net — Tricare: $85.43
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $6,007 $6,007 $2,530
Emergency room visit (moderate): 10 of 12 insurance plan rates
  • Aetna — HMO: $2,397
  • Aetna — PPO: $2,397
  • Anthem — COMM: $1,832
  • Anthem — ExchangeHMO: $1,736
  • Blue Shield — COMM: $3,890
  • Blue Shield — EPN: $2,408
  • Bright Health — COMM: $2,837
  • Cigna — HMO: $2,989
  • Cigna — PPO: $2,989
  • Heritage Provider Network — COMM: $2,530
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT $6,007 $6,007 $1,579.84 – $5,406.30
Emergency room visit (moderate): rates for 8 insurance plans
  • American Health System — HIX: $2,703.15
  • First Health — COMM: $2,643.08
  • First Health — WCOMP: $5,406.30
  • HealthSmart — COMM: $4,805.60
  • Multiplan — COMMCOMPLEMENTARYPPO: $4,805.60
  • Multiplan — COMMPRIMARYPPO: $5,105.95
  • United — GlobalBenefitPlan: $2,703.15
  • United — OptionsPPO: $1,579.84
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $10,526.50 $10,526.50 $3,573 – $8,910
Emergency room visit (moderately high): 10 of 12 insurance plan rates
  • Aetna — HMO: $3,160
  • Aetna — PPO: $3,160
  • Anthem — COMM: $5,918
  • Anthem — ExchangeHMO: $5,608
  • Blue Shield — COMM: $5,761
  • Blue Shield — EPN: $3,573
  • Bright Health — COMM: $4,101
  • Cigna — HMO: $8,910
  • Cigna — PPO: $8,910
  • Heritage Provider Network — COMM: $3,622
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT $10,526.50 $10,526.50 $2,768.47 – $9,473.85
Emergency room visit (moderately high): rates for 8 insurance plans
  • American Health System — HIX: $4,736.93
  • First Health — COMM: $4,631.66
  • First Health — WCOMP: $9,473.85
  • HealthSmart — COMM: $8,421.20
  • Multiplan — COMMCOMPLEMENTARYPPO: $8,421.20
  • Multiplan — COMMPRIMARYPPO: $8,947.52
  • United — GlobalBenefitPlan: $4,736.93
  • United — OptionsPPO: $2,768.47
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination $15,824 $15,824 $3,573 – $16,117
Emergency room visit (high): 10 of 12 insurance plan rates
  • Aetna — HMO: $3,160
  • Aetna — PPO: $3,160
  • Anthem — COMM: $5,918
  • Anthem — ExchangeHMO: $5,608
  • Blue Shield — COMM: $5,761
  • Blue Shield — EPN: $3,573
  • Bright Health — COMM: $4,101
  • Cigna — HMO: $9,899
  • Cigna — PPO: $9,899
  • Heritage Provider Network — COMM: $9,335
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT $15,824 $15,824 $4,161.71 – $14,241.60
Emergency room visit (high): rates for 8 insurance plans
  • American Health System — HIX: $7,120.80
  • First Health — COMM: $6,962.56
  • First Health — WCOMP: $14,241.60
  • HealthSmart — COMM: $12,659.20
  • Multiplan — COMMCOMPLEMENTARYPPO: $12,659.20
  • Multiplan — COMMPRIMARYPPO: $13,450.40
  • United — GlobalBenefitPlan: $7,120.80
  • United — OptionsPPO: $4,161.71

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM $1,753 $1,753 $262.95 – $1,577.70
Basic metabolic panel (blood test): 10 of 13 insurance plan rates
  • Aetna — HMO: $315.54
  • Aetna — PPO: $315.54
  • American Health System — HIX: $788.85
  • First Health — COMM: $771.32
  • First Health — WCOMP: $1,577.70
  • Health Net — COMM: $383.91
  • HealthSmart — COMM: $1,402.40
  • MedCare Partners — MGMCR: $262.95
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,402.40
  • Multiplan — COMMPRIMARYPPO: $1,490.05
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch Not listed in the file Not listed in the file $8.46 – $99.37
Basic metabolic panel (blood test): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $8.38
  • Aetna — MCRPOS: $8.38
  • Aetna — MCRPPO: $8.38
  • Aetna Senior Health Plan — MCR: $8.46
  • Alignment Health Plan — MGMCR: $8.46
  • Anthem — COMM: $43.99
  • Anthem — ExchangeHMO: $41.71
  • Anthem — MCR: $8.46
  • Astiva Health — MGMCR: $9.31
  • Blue Shield — COMM: $99.37
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon $2,266.25 $2,266.25 $10.56 – $124.07
Comprehensive metabolic panel (blood test): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $10.45
  • Aetna — MCRPOS: $10.45
  • Aetna — MCRPPO: $10.45
  • Aetna Senior Health Plan — MCR: $10.56
  • Alignment Health Plan — MGMCR: $10.56
  • Anthem — COMM: $54.91
  • Anthem — ExchangeHMO: $52.06
  • Anthem — MCR: $10.56
  • Astiva Health — MGMCR: $11.62
  • Blue Shield — COMM: $124.07
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL $2,266.25 $2,266.25 $339.94 – $2,039.63
Comprehensive metabolic panel (blood test): 10 of 13 insurance plan rates
  • Aetna — HMO: $407.93
  • Aetna — PPO: $407.93
  • American Health System — HIX: $1,019.81
  • First Health — COMM: $997.15
  • First Health — WCOMP: $2,039.63
  • Health Net — COMM: $496.31
  • HealthSmart — COMM: $1,813
  • MedCare Partners — MGMCR: $339.94
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,813
  • Multiplan — COMMPRIMARYPPO: $1,926.31
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or $1,043.25 $1,043.25 $212.90 – $342.82
Obstetric blood test panel: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $47.33
  • Aetna — MCRPOS: $47.33
  • Aetna — MCRPPO: $47.33
  • Aetna Senior Health Plan — MCR: $47.81
  • Alignment Health Plan — MGMCR: $47.81
  • Anthem — COMM: $248.61
  • Anthem — ExchangeHMO: $235.70
  • Anthem — MCR: $47.81
  • Astiva Health — MGMCR: $52.59
  • Blue Shield — COMM: $342.82
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: OB PANEL $1,043.25 $1,043.25 $156.49 – $938.92
Obstetric blood test panel: 10 of 13 insurance plan rates
  • Aetna — HMO: $187.78
  • Aetna — PPO: $187.78
  • American Health System — HIX: $469.46
  • First Health — COMM: $459.03
  • First Health — WCOMP: $938.92
  • Health Net — COMM: $228.47
  • HealthSmart — COMM: $834.60
  • MedCare Partners — MGMCR: $156.49
  • Multiplan — COMMCOMPLEMENTARYPPO: $834.60
  • Multiplan — COMMPRIMARYPPO: $886.76
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester $1,261.75 $1,261.75 $10.71 – $37.11
Cholesterol panel (lipid panel): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $13.26
  • Aetna — MCRPOS: $13.26
  • Aetna — MCRPPO: $13.26
  • Aetna Senior Health Plan — MCR: $13.39
  • Alignment Health Plan — MGMCR: $13.39
  • Anthem — COMM: $69.63
  • Anthem — ExchangeHMO: $66.01
  • Anthem — MCR: $13.39
  • Astiva Health — MGMCR: $14.73
  • Blue Shield — COMM: $157.25
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL $1,261.75 $1,261.75 $189.26 – $1,135.58
Cholesterol panel (lipid panel): 10 of 13 insurance plan rates
  • Aetna — HMO: $227.12
  • Aetna — PPO: $227.12
  • American Health System — HIX: $567.79
  • First Health — COMM: $555.17
  • First Health — WCOMP: $1,135.58
  • Health Net — COMM: $276.32
  • HealthSmart — COMM: $1,009.40
  • MedCare Partners — MGMCR: $189.26
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,009.40
  • Multiplan — COMMPRIMARYPPO: $1,072.49
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo $1,991.75 $1,991.75 $8.68 – $101.89
Kidney function panel: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $8.59
  • Aetna — MCRPOS: $8.59
  • Aetna — MCRPPO: $8.59
  • Aetna Senior Health Plan — MCR: $8.68
  • Alignment Health Plan — MGMCR: $8.68
  • Anthem — COMM: $45.14
  • Anthem — ExchangeHMO: $42.79
  • Anthem — MCR: $8.68
  • Astiva Health — MGMCR: $9.55
  • Blue Shield — COMM: $101.89
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL $1,991.75 $1,991.75 $298.76 – $1,792.58
Kidney function panel: 10 of 13 insurance plan rates
  • Aetna — HMO: $358.51
  • Aetna — PPO: $358.51
  • American Health System — HIX: $896.29
  • First Health — COMM: $876.37
  • First Health — WCOMP: $1,792.58
  • Health Net — COMM: $436.19
  • HealthSmart — COMM: $1,593.40
  • MedCare Partners — MGMCR: $298.76
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,593.40
  • Multiplan — COMMPRIMARYPPO: $1,692.99
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase $1,689 $1,689 $8.17 – $95.93
Liver function panel: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $8.09
  • Aetna — MCRPOS: $8.09
  • Aetna — MCRPPO: $8.09
  • Aetna Senior Health Plan — MCR: $8.17
  • Alignment Health Plan — MGMCR: $8.17
  • Anthem — COMM: $42.48
  • Anthem — ExchangeHMO: $40.28
  • Anthem — MCR: $8.17
  • Astiva Health — MGMCR: $8.99
  • Blue Shield — COMM: $95.93
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL $1,689 $1,689 $253.35 – $1,520.10
Liver function panel: 10 of 13 insurance plan rates
  • Aetna — HMO: $304.02
  • Aetna — PPO: $304.02
  • American Health System — HIX: $760.05
  • First Health — COMM: $743.16
  • First Health — WCOMP: $1,520.10
  • Health Net — COMM: $369.89
  • HealthSmart — COMM: $1,351.20
  • MedCare Partners — MGMCR: $253.35
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,351.20
  • Multiplan — COMMPRIMARYPPO: $1,435.65
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $477.25 $477.25 $3.17 – $37.21
Urine test (automated, with microscope): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $3.14
  • Aetna — MCRPOS: $3.14
  • Aetna — MCRPPO: $3.14
  • Aetna Senior Health Plan — MCR: $3.17
  • Alignment Health Plan — MGMCR: $3.17
  • Anthem — COMM: $16.48
  • Anthem — ExchangeHMO: $15.63
  • Anthem — MCR: $3.17
  • Astiva Health — MGMCR: $3.49
  • Blue Shield — COMM: $37.21
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO $477.25 $477.25 $71.59 – $429.52
Urine test (automated, with microscope): 10 of 13 insurance plan rates
  • Aetna — HMO: $85.91
  • Aetna — PPO: $85.91
  • American Health System — HIX: $214.76
  • First Health — COMM: $209.99
  • First Health — WCOMP: $429.52
  • Health Net — COMM: $104.52
  • HealthSmart — COMM: $381.80
  • MedCare Partners — MGMCR: $71.59
  • Multiplan — COMMCOMPLEMENTARYPPO: $381.80
  • Multiplan — COMMPRIMARYPPO: $405.66
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, Not listed in the file Not listed in the file $18.56 – $29.99
Urine test (manual, without microscope): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $3.45
  • Aetna — MCRPOS: $3.45
  • Aetna — MCRPPO: $3.45
  • Aetna Senior Health Plan — MCR: $3.48
  • Alignment Health Plan — MGMCR: $3.48
  • Anthem — COMM: $18.10
  • Anthem — ExchangeHMO: $17.16
  • Anthem — MCR: $3.48
  • Astiva Health — MGMCR: $3.83
  • Blue Shield — COMM: $29.99
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $374.25 $374.25 $2.25 – $26.38
Urine test (automated, without microscope): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $2.23
  • Aetna — MCRPOS: $2.23
  • Aetna — MCRPPO: $2.23
  • Aetna Senior Health Plan — MCR: $2.25
  • Alignment Health Plan — MGMCR: $2.25
  • Anthem — COMM: $11.70
  • Anthem — ExchangeHMO: $11.09
  • Anthem — MCR: $2.25
  • Astiva Health — MGMCR: $2.48
  • Blue Shield — COMM: $26.38
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO $374.25 $374.25 $56.14 – $336.82
Urine test (automated, without microscope): 10 of 13 insurance plan rates
  • Aetna — HMO: $67.36
  • Aetna — PPO: $67.36
  • American Health System — HIX: $168.41
  • First Health — COMM: $164.67
  • First Health — WCOMP: $336.82
  • Health Net — COMM: $81.96
  • HealthSmart — COMM: $299.40
  • MedCare Partners — MGMCR: $56.14
  • Multiplan — COMMCOMPLEMENTARYPPO: $299.40
  • Multiplan — COMMPRIMARYPPO: $318.11
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL $1,261.75 $1,261.75 $189.26 – $1,135.58
PSA (prostate specific antigen) blood test: 10 of 13 insurance plan rates
  • Aetna — HMO: $227.12
  • Aetna — PPO: $227.12
  • American Health System — HIX: $567.79
  • First Health — COMM: $555.17
  • First Health — WCOMP: $1,135.58
  • Health Net — COMM: $276.32
  • HealthSmart — COMM: $1,009.40
  • MedCare Partners — MGMCR: $189.26
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,009.40
  • Multiplan — COMMPRIMARYPPO: $1,072.49
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total Not listed in the file Not listed in the file $18.39 – $215.88
PSA (prostate specific antigen) blood test: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $18.21
  • Aetna — MCRPOS: $18.21
  • Aetna — MCRPPO: $18.21
  • Aetna Senior Health Plan — MCR: $18.39
  • Alignment Health Plan — MGMCR: $18.39
  • Anthem — COMM: $95.63
  • Anthem — ExchangeHMO: $90.66
  • Anthem — MCR: $18.39
  • Astiva Health — MGMCR: $20.23
  • Blue Shield — COMM: $215.88
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH $1,261.75 $1,261.75 $189.26 – $1,135.58
Thyroid stimulating hormone (TSH) test: 10 of 13 insurance plan rates
  • Aetna — HMO: $227.12
  • Aetna — PPO: $227.12
  • American Health System — HIX: $567.79
  • First Health — COMM: $555.17
  • First Health — WCOMP: $1,135.58
  • Health Net — COMM: $276.32
  • HealthSmart — COMM: $1,009.40
  • MedCare Partners — MGMCR: $189.26
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,009.40
  • Multiplan — COMMPRIMARYPPO: $1,072.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) Not listed in the file Not listed in the file $16.80 – $197.15
Thyroid stimulating hormone (TSH) test: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $16.63
  • Aetna — MCRPOS: $16.63
  • Aetna — MCRPPO: $16.63
  • Aetna Senior Health Plan — MCR: $16.80
  • Alignment Health Plan — MGMCR: $16.80
  • Anthem — COMM: $87.36
  • Anthem — ExchangeHMO: $82.82
  • Anthem — MCR: $16.80
  • Astiva Health — MGMCR: $18.48
  • Blue Shield — COMM: $197.15
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count Not listed in the file Not listed in the file $56.47 – $91.22
Complete blood count (CBC) with differential: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $7.69
  • Aetna — MCRPOS: $7.69
  • Aetna — MCRPPO: $7.69
  • Aetna Senior Health Plan — MCR: $7.77
  • Alignment Health Plan — MGMCR: $7.77
  • Anthem — COMM: $40.40
  • Anthem — ExchangeHMO: $38.31
  • Anthem — MCR: $7.77
  • Astiva Health — MGMCR: $8.55
  • Blue Shield — COMM: $91.22
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) $513.50 $513.50 $47.01 – $75.94
Complete blood count (CBC), automated: 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $6.41
  • Aetna — MCRPOS: $6.41
  • Aetna — MCRPPO: $6.41
  • Aetna Senior Health Plan — MCR: $6.47
  • Alignment Health Plan — MGMCR: $6.47
  • Anthem — COMM: $33.64
  • Anthem — ExchangeHMO: $31.90
  • Anthem — MCR: $6.47
  • Astiva Health — MGMCR: $7.12
  • Blue Shield — COMM: $75.94
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED $513.50 $513.50 $77.03 – $462.15
Complete blood count (CBC), automated: 10 of 13 insurance plan rates
  • Aetna — HMO: $92.43
  • Aetna — PPO: $92.43
  • American Health System — HIX: $231.07
  • First Health — COMM: $225.94
  • First Health — WCOMP: $462.15
  • Health Net — COMM: $112.46
  • HealthSmart — COMM: $410.80
  • MedCare Partners — MGMCR: $77.03
  • Multiplan — COMMCOMPLEMENTARYPPO: $410.80
  • Multiplan — COMMPRIMARYPPO: $436.48
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; $606.50 $606.50 $4.29 – $46.12
Blood clotting time test (prothrombin time, PT): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $4.25
  • Aetna — MCRPOS: $4.25
  • Aetna — MCRPPO: $4.25
  • Aetna Senior Health Plan — MCR: $4.29
  • Alignment Health Plan — MGMCR: $4.29
  • Anthem — COMM: $22.31
  • Anthem — ExchangeHMO: $21.15
  • Anthem — MCR: $4.29
  • Astiva Health — MGMCR: $4.72
  • Blue Shield — COMM: $46.12
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME $606.50 $606.50 $90.97 – $545.85
Blood clotting time test (prothrombin time, PT): 10 of 13 insurance plan rates
  • Aetna — HMO: $109.17
  • Aetna — PPO: $109.17
  • American Health System — HIX: $272.93
  • First Health — COMM: $266.86
  • First Health — WCOMP: $545.85
  • Health Net — COMM: $132.82
  • HealthSmart — COMM: $485.20
  • MedCare Partners — MGMCR: $90.97
  • Multiplan — COMMCOMPLEMENTARYPPO: $485.20
  • Multiplan — COMMPRIMARYPPO: $515.52
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT $735.25 $735.25 $110.29 – $661.73
Blood clotting test (partial thromboplastin time, PTT): 10 of 13 insurance plan rates
  • Aetna — HMO: $132.34
  • Aetna — PPO: $132.34
  • American Health System — HIX: $330.86
  • First Health — COMM: $323.51
  • First Health — WCOMP: $661.73
  • Health Net — COMM: $161.02
  • HealthSmart — COMM: $588.20
  • MedCare Partners — MGMCR: $110.29
  • Multiplan — COMMCOMPLEMENTARYPPO: $588.20
  • Multiplan — COMMPRIMARYPPO: $624.96
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood Not listed in the file Not listed in the file $43.58 – $70.39
Blood clotting test (partial thromboplastin time, PTT): 10 of 41 insurance plan rates
  • Aetna — MCRHMO: $5.95
  • Aetna — MCRPOS: $5.95
  • Aetna — MCRPPO: $5.95
  • Aetna Senior Health Plan — MCR: $6.01
  • Alignment Health Plan — MGMCR: $6.01
  • Anthem — COMM: $31.25
  • Anthem — ExchangeHMO: $29.63
  • Anthem — MCR: $6.01
  • Astiva Health — MGMCR: $6.61
  • Blue Shield — COMM: $70.39

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

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONT $14,900 $14,900 $2,235 – $13,410
CT scan of the head or brain, without contrast: rates for 10 insurance plans
  • American Health System — HIX: $6,705
  • First Health — COMM: $6,556
  • First Health — WCOMP: $13,410
  • HealthSmart — COMM: $11,920
  • MedCare Partners — MGMCR: $2,235
  • Multiplan — COMMCOMPLEMENTARYPPO: $11,920
  • Multiplan — COMMPRIMARYPPO: $12,665
  • Next — COMMPPO: $11,920
  • United — GlobalBenefitPlan: $6,705
  • United — OptionsPPO: $3,918.70
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material $14,900 $14,900 $770.02 – $1,239.90
CT scan of the head or brain, without contrast: rates for 7 insurance plans
  • Aetna — HMO: $1,359
  • Aetna — PPO: $1,359
  • Anthem — COMM: $579.07
  • Anthem — ExchangeHMO: $549
  • Blue Shield — COMM: $1,239.90
  • Blue Shield — EPN: $770.02
  • United — AllPayerAppendix: $245.18
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography, head or brain; without contrast material Not listed in the file Not listed in the file $351.71 – $370.97
CT scan of the head or brain, without contrast: rates for 2 insurance plans
  • Anthem — COMM: $370.97
  • Anthem — ExchangeHMO: $351.71
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT $24,629.75 $24,629.75 $3,694.46 – $22,166.78
MRI of the brain, before and after contrast: rates for 10 insurance plans
  • American Health System — HIX: $11,083.39
  • First Health — COMM: $10,837.09
  • First Health — WCOMP: $22,166.78
  • HealthSmart — COMM: $19,703.80
  • MedCare Partners — MGMCR: $3,694.46
  • Multiplan — COMMCOMPLEMENTARYPPO: $19,703.80
  • Multiplan — COMMPRIMARYPPO: $20,935.29
  • Next — COMMPPO: $19,703.80
  • United — GlobalBenefitPlan: $11,083.39
  • United — OptionsPPO: $6,477.62
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth Not listed in the file Not listed in the file $4,057.22 – $6,532.99
MRI of the brain, before and after contrast: rates for 7 insurance plans
  • Aetna — HMO: $1,920
  • Aetna — PPO: $1,920
  • Anthem — COMM: $1,725.78
  • Anthem — ExchangeHMO: $1,636.17
  • Blue Shield — COMM: $6,532.99
  • Blue Shield — EPN: $4,057.22
  • United — AllPayerAppendix: $828.27
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth Not listed in the file Not listed in the file $1,109.40 – $1,170.16
MRI of the brain, before and after contrast: rates for 2 insurance plans
  • Anthem — COMM: $1,170.16
  • Anthem — ExchangeHMO: $1,109.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V $1,428.75 $1,428.75 $214.31 – $1,285.88
Chest X-ray, 2 views: 10 of 14 insurance plan rates
  • Aetna — HMO: $257.18
  • Aetna — PPO: $257.18
  • American Health System — HIX: $642.94
  • First Health — COMM: $628.65
  • First Health — WCOMP: $1,285.88
  • Health Net — COMM: $312.90
  • HealthSmart — COMM: $1,143
  • MedCare Partners — MGMCR: $214.31
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,143
  • Multiplan — COMMPRIMARYPPO: $1,214.44
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views Not listed in the file Not listed in the file $85.65 – $137.92
Chest X-ray, 2 views: rates for 7 insurance plans
  • Anthem — COMM: $180.08
  • Anthem — ExchangeHMO: $170.73
  • Blue Shield — COMM: $137.92
  • Blue Shield — EPN: $85.65
  • Cigna — HMO: $350.49
  • Cigna — PPO: $350.49
  • United — AllPayerAppendix: $182.03
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, chest; 2 views Not listed in the file Not listed in the file $120.44 – $127.04
Chest X-ray, 2 views: rates for 2 insurance plans
  • Anthem — COMM: $127.04
  • Anthem — ExchangeHMO: $120.44
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS $2,963.25 $2,963.25 $444.49 – $2,666.93
X-ray of the lower spine, at least 4 views: 10 of 14 insurance plan rates
  • Aetna — HMO: $533.38
  • Aetna — PPO: $533.38
  • American Health System — HIX: $1,333.46
  • First Health — COMM: $1,303.83
  • First Health — WCOMP: $2,666.93
  • Health Net — COMM: $648.95
  • HealthSmart — COMM: $2,370.60
  • MedCare Partners — MGMCR: $444.49
  • Multiplan — COMMCOMPLEMENTARYPPO: $2,370.60
  • Multiplan — COMMPRIMARYPPO: $2,518.76
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views Not listed in the file Not listed in the file $149.18 – $240.21
X-ray of the lower spine, at least 4 views: rates for 7 insurance plans
  • Anthem — COMM: $291.93
  • Anthem — ExchangeHMO: $276.77
  • Blue Shield — COMM: $240.21
  • Blue Shield — EPN: $149.18
  • Cigna — HMO: $424.05
  • Cigna — PPO: $424.05
  • United — AllPayerAppendix: $245.18
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views Not listed in the file Not listed in the file $213.27 – $224.95
X-ray of the lower spine, at least 4 views: rates for 2 insurance plans
  • Anthem — COMM: $224.95
  • Anthem — ExchangeHMO: $213.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT $13,281 $13,281 $1,992.15 – $11,952.90
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans
  • American Health System — HIX: $5,976.45
  • First Health — COMM: $5,843.64
  • First Health — WCOMP: $11,952.90
  • HealthSmart — COMM: $10,624.80
  • MedCare Partners — MGMCR: $1,992.15
  • Multiplan — COMMCOMPLEMENTARYPPO: $10,624.80
  • Multiplan — COMMPRIMARYPPO: $11,288.85
  • Next — COMMPPO: $10,624.80
  • United — GlobalBenefitPlan: $5,976.45
  • United — OptionsPPO: $3,492.90
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material $13,281 $13,281 $2,025.36 – $3,261.27
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans
  • Aetna — HMO: $1,920
  • Aetna — PPO: $1,920
  • Anthem — COMM: $1,042.86
  • Anthem — ExchangeHMO: $988.71
  • Blue Shield — COMM: $3,261.27
  • Blue Shield — EPN: $2,025.36
  • United — AllPayerAppendix: $517.79
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Not listed in the file Not listed in the file $645.58 – $680.94
MRI of the lower back (lumbar spine), without contrast: rates for 2 insurance plans
  • Anthem — COMM: $680.94
  • Anthem — ExchangeHMO: $645.58
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST $17,358 $17,358 $2,603.70 – $15,622.20
CT scan of the pelvis, with contrast: rates for 10 insurance plans
  • American Health System — HIX: $7,811.10
  • First Health — COMM: $7,637.52
  • First Health — WCOMP: $15,622.20
  • HealthSmart — COMM: $13,886.40
  • MedCare Partners — MGMCR: $2,603.70
  • Multiplan — COMMCOMPLEMENTARYPPO: $13,886.40
  • Multiplan — COMMPRIMARYPPO: $14,754.30
  • Next — COMMPPO: $13,886.40
  • United — GlobalBenefitPlan: $7,811.10
  • United — OptionsPPO: $4,565.15
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s) $17,358 $17,358 $1,115.78 – $1,796.65
CT scan of the pelvis, with contrast: rates for 7 insurance plans
  • Aetna — HMO: $1,359
  • Aetna — PPO: $1,359
  • Anthem — COMM: $1,234.64
  • Anthem — ExchangeHMO: $1,170.53
  • Blue Shield — COMM: $1,796.65
  • Blue Shield — EPN: $1,115.78
  • United — AllPayerAppendix: $401.74
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography, pelvis; with contrast material(s) Not listed in the file Not listed in the file $903.13 – $952.59
CT scan of the pelvis, with contrast: rates for 2 insurance plans
  • Anthem — COMM: $952.59
  • Anthem — ExchangeHMO: $903.13
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material Not listed in the file Not listed in the file $1,803.24 – $2,903.60
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans
  • Aetna — HMO: $1,920
  • Aetna — PPO: $1,920
  • Anthem — COMM: $1,114.62
  • Anthem — ExchangeHMO: $1,056.75
  • Blue Shield — COMM: $2,903.60
  • Blue Shield — EPN: $1,803.24
  • United — AllPayerAppendix: $517.79
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: MRI LW JNT W/O CONT RT $13,281 $13,281 $1,992.15 – $11,952.90
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • American Health System — HIX: $5,976.45
  • First Health — COMM: $5,843.64
  • First Health — WCOMP: $11,952.90
  • HealthSmart — COMM: $10,624.80
  • MedCare Partners — MGMCR: $1,992.15
  • Multiplan — COMMCOMPLEMENTARYPPO: $10,624.80
  • Multiplan — COMMPRIMARYPPO: $11,288.85
  • Next — COMMPPO: $10,624.80
  • United — GlobalBenefitPlan: $5,976.45
  • United — OptionsPPO: $3,492.90
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: MRI LW JNT W/O CONT LT $13,281 $13,281 $1,992.15 – $11,952.90
MRI of a leg joint (such as the knee), without contrast: rates for 10 insurance plans
  • American Health System — HIX: $5,976.45
  • First Health — COMM: $5,843.64
  • First Health — WCOMP: $11,952.90
  • HealthSmart — COMM: $10,624.80
  • MedCare Partners — MGMCR: $1,992.15
  • Multiplan — COMMCOMPLEMENTARYPPO: $10,624.80
  • Multiplan — COMMPRIMARYPPO: $11,288.85
  • Next — COMMPPO: $10,624.80
  • United — GlobalBenefitPlan: $5,976.45
  • United — OptionsPPO: $3,492.90
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT $26,036.75 $26,036.75 $3,905.51 – $23,433.08
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans
  • American Health System — HIX: $11,716.54
  • First Health — COMM: $11,456.17
  • First Health — WCOMP: $23,433.08
  • HealthSmart — COMM: $20,829.40
  • MedCare Partners — MGMCR: $3,905.51
  • Multiplan — COMMCOMPLEMENTARYPPO: $20,829.40
  • Multiplan — COMMPRIMARYPPO: $22,131.24
  • Next — COMMPPO: $20,829.40
  • United — GlobalBenefitPlan: $11,716.54
  • United — OptionsPPO: $6,847.67
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s) $26,036.75 $26,036.75 $1,157.97 – $1,864.58
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans
  • Aetna — HMO: $1,359
  • Aetna — PPO: $1,359
  • Anthem — COMM: $1,638.99
  • Anthem — ExchangeHMO: $1,553.89
  • Blue Shield — COMM: $1,864.58
  • Blue Shield — EPN: $1,157.97
  • United — AllPayerAppendix: $828.27
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography, abdomen and pelvis; with contrast material(s) Not listed in the file Not listed in the file $1,134.39 – $1,196.52
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans
  • Anthem — COMM: $1,196.52
  • Anthem — ExchangeHMO: $1,134.39
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE $4,221.50 $4,221.50 $633.23 – $3,799.35
Ultrasound of the abdomen, complete: 10 of 13 insurance plan rates
  • Aetna — HMO: $759.87
  • Aetna — PPO: $759.87
  • American Health System — HIX: $1,899.67
  • First Health — COMM: $1,857.46
  • First Health — WCOMP: $3,799.35
  • HealthSmart — COMM: $3,377.20
  • MedCare Partners — MGMCR: $633.23
  • Multiplan — COMMCOMPLEMENTARYPPO: $3,377.20
  • Multiplan — COMMPRIMARYPPO: $3,588.28
  • Next — COMMPPO: $3,377.20
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete Not listed in the file Not listed in the file $322.28 – $518.93
Ultrasound of the abdomen, complete: rates for 7 insurance plans
  • Anthem — COMM: $621.92
  • Anthem — ExchangeHMO: $589.63
  • Blue Shield — COMM: $518.93
  • Blue Shield — EPN: $322.28
  • Cigna — HMO: $424.05
  • Cigna — PPO: $424.05
  • United — AllPayerAppendix: $245.18
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, abdominal, real time with image documentation; complete Not listed in the file Not listed in the file $402.04 – $424.06
Ultrasound of the abdomen, complete: rates for 2 insurance plans
  • Anthem — COMM: $424.06
  • Anthem — ExchangeHMO: $402.04
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI $5,716.50 $5,716.50 $857.48 – $5,144.85
Pregnancy ultrasound (after the first trimester): 10 of 13 insurance plan rates
  • Aetna — HMO: $1,028.97
  • Aetna — PPO: $1,028.97
  • American Health System — HIX: $2,572.43
  • First Health — COMM: $2,515.26
  • First Health — WCOMP: $5,144.85
  • HealthSmart — COMM: $4,573.20
  • MedCare Partners — MGMCR: $857.48
  • Multiplan — COMMCOMPLEMENTARYPPO: $4,573.20
  • Multiplan — COMMPRIMARYPPO: $4,859.02
  • Next — COMMPPO: $4,573.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $5,716.50 $5,716.50 $342.19 – $550.99
Pregnancy ultrasound (after the first trimester): rates for 7 insurance plans
  • Anthem — COMM: $739.96
  • Anthem — ExchangeHMO: $701.54
  • Blue Shield — COMM: $550.99
  • Blue Shield — EPN: $342.19
  • Cigna — HMO: $424.05
  • Cigna — PPO: $424.05
  • United — AllPayerAppendix: $245.18
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day $5,716.50 $5,716.50 $236.39 – $249.34
Pregnancy ultrasound (after the first trimester): rates for 2 insurance plans
  • Anthem — COMM: $249.34
  • Anthem — ExchangeHMO: $236.39
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL $3,650.25 $3,650.25 $547.54 – $3,285.22
Transvaginal ultrasound: 10 of 13 insurance plan rates
  • Aetna — HMO: $657.04
  • Aetna — PPO: $657.04
  • American Health System — HIX: $1,642.61
  • First Health — COMM: $1,606.11
  • First Health — WCOMP: $3,285.22
  • HealthSmart — COMM: $2,920.20
  • MedCare Partners — MGMCR: $547.54
  • Multiplan — COMMCOMPLEMENTARYPPO: $2,920.20
  • Multiplan — COMMPRIMARYPPO: $3,102.71
  • Next — COMMPPO: $2,920.20
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file $249.15 – $401.18
Transvaginal ultrasound: rates for 7 insurance plans
  • Anthem — COMM: $641.47
  • Anthem — ExchangeHMO: $608.16
  • Blue Shield — COMM: $401.18
  • Blue Shield — EPN: $249.15
  • Cigna — HMO: $424.05
  • Cigna — PPO: $424.05
  • United — AllPayerAppendix: $245.18
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file $445.82 – $470.24
Transvaginal ultrasound: rates for 2 insurance plans
  • Anthem — COMM: $470.24
  • Anthem — ExchangeHMO: $445.82
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral Not listed in the file Not listed in the file $322.94 – $675.53
Diagnostic mammogram, one breast: 10 of 40 insurance plan rates
  • Aetna — MCRHMO: $93.43
  • Aetna — MCRPOS: $93.43
  • Aetna — MCRPPO: $93.43
  • Aetna Senior Health Plan — MCR: $94.37
  • Alignment Health Plan — MGMCR: $94.37
  • Anthem — COMM: $675.53
  • Anthem — ExchangeHMO: $640.46
  • Anthem — MCR: $94.37
  • Astiva Health — MGMCR: $103.81
  • Blue Shield — COMM: $520
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT $1,344.50 $1,344.50 $201.68 – $1,210.05
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates
  • Aetna — HMO: $242.01
  • Aetna — PPO: $242.01
  • American Health System — HIX: $605.02
  • First Health — COMM: $591.58
  • First Health — WCOMP: $1,210.05
  • Health Net — COMM: $294.45
  • HealthSmart — COMM: $1,075.60
  • MedCare Partners — MGMCR: $201.68
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,075.60
  • Multiplan — COMMPRIMARYPPO: $1,142.83
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT $1,344.50 $1,344.50 $201.68 – $1,210.05
Diagnostic mammogram, one breast: 10 of 14 insurance plan rates
  • Aetna — HMO: $242.01
  • Aetna — PPO: $242.01
  • American Health System — HIX: $605.02
  • First Health — COMM: $591.58
  • First Health — WCOMP: $1,210.05
  • Health Net — COMM: $294.45
  • HealthSmart — COMM: $1,075.60
  • MedCare Partners — MGMCR: $201.68
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,075.60
  • Multiplan — COMMPRIMARYPPO: $1,142.83
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral $1,607 $1,607 $472.91 – $761.49
Diagnostic mammogram, both breasts: 10 of 40 insurance plan rates
  • Aetna — MCRHMO: $119.80
  • Aetna — MCRPOS: $119.80
  • Aetna — MCRPPO: $119.80
  • Aetna Senior Health Plan — MCR: $121.01
  • Alignment Health Plan — MGMCR: $121.01
  • Anthem — COMM: $855.76
  • Anthem — ExchangeHMO: $811.33
  • Anthem — MCR: $121.01
  • Astiva Health — MGMCR: $133.11
  • Blue Shield — COMM: $761.49
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI $1,607 $1,607 $241.05 – $1,446.30
Diagnostic mammogram, both breasts: 10 of 14 insurance plan rates
  • Aetna — HMO: $289.26
  • Aetna — PPO: $289.26
  • American Health System — HIX: $723.15
  • First Health — COMM: $707.08
  • First Health — WCOMP: $1,446.30
  • Health Net — COMM: $351.93
  • HealthSmart — COMM: $1,285.60
  • MedCare Partners — MGMCR: $241.05
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,285.60
  • Multiplan — COMMPRIMARYPPO: $1,365.95
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier 26 In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Not listed in the file Not listed in the file $232.35 – $245.08
Diagnostic mammogram, both breasts: rates for 2 insurance plans
  • Anthem — COMM: $245.08
  • Anthem — ExchangeHMO: $232.35
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed $1,299.75 $1,299.75 $479.17 – $771.57
Screening mammogram, both breasts: 10 of 40 insurance plan rates
  • Aetna — MCRHMO: $98.86
  • Aetna — MCRPOS: $98.86
  • Aetna — MCRPPO: $98.86
  • Aetna Senior Health Plan — MCR: $99.86
  • Alignment Health Plan — MGMCR: $99.86
  • Anthem — COMM: $689.42
  • Anthem — ExchangeHMO: $653.62
  • Anthem — MCR: $99.86
  • Astiva Health — MGMCR: $109.85
  • Blue Shield — COMM: $771.57
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI $1,299.75 $1,299.75 $194.96 – $1,169.78
Screening mammogram, both breasts: 10 of 13 insurance plan rates
  • Aetna — HMO: $233.96
  • Aetna — PPO: $233.96
  • American Health System — HIX: $584.89
  • First Health — COMM: $571.89
  • First Health — WCOMP: $1,169.78
  • HealthSmart — COMM: $1,039.80
  • MedCare Partners — MGMCR: $194.96
  • Multiplan — COMMCOMPLEMENTARYPPO: $1,039.80
  • Multiplan — COMMPRIMARYPPO: $1,104.79
  • Next — COMMPPO: $1,039.80
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Not listed in the file Not listed in the file $477.86 – $504.04
Screening mammogram, both breasts: rates for 2 insurance plans
  • Anthem — COMM: $504.04
  • Anthem — ExchangeHMO: $477.86

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report Not listed in the file Not listed in the file $83.20 – $133.96
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans
  • Blue Shield — COMM: $133.96
  • Blue Shield — EPN: $83.20
  • Blue Shield — TRICARE: $12.93
  • Health Net — Tricare: $13.61
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe Not listed in the file Not listed in the file $1,292 – $13,748
Left heart catheterization (diagnostic): 10 of 14 insurance plan rates
  • Aetna — HMO: $22,540
  • Aetna — PPO: $22,540
  • Aetna Senior Health Plan — MCR: $1,292
  • Anthem — COMM: $13,748
  • Anthem — ExchangeHMO: $13,027
  • Blue Shield — COMM: $13,377
  • Blue Shield — EPN: $8,302
  • Bright Health — COMM: $8,810
  • Cigna — HMO: $11,653
  • Cigna — PPO: $11,653
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor $14,014.25 $14,014.25 $1,264.30 – $2,035.80
Heart rhythm study (electrophysiology evaluation): 10 of 14 insurance plan rates
  • Aetna — HMO: $32,767
  • Aetna — PPO: $32,767
  • Aetna Senior Health Plan — MCR: $1,292
  • Anthem — COMM: $13,378
  • Anthem — ExchangeHMO: $12,677
  • Blue Shield — COMM: $2,035.80
  • Blue Shield — EPN: $1,264.30
  • Bright Health — COMM: $14,286
  • Cigna — HMO: $25,784
  • Cigna — PPO: $25,784
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: EP W/O ARRHYTHMIA $14,014.25 $14,014.25 $2,102.14 – $12,612.83
Heart rhythm study (electrophysiology evaluation): rates for 8 insurance plans
  • American Health System — HIX: $6,306.41
  • First Health — WCOMP: $12,612.83
  • HealthSmart — COMM: $11,211.40
  • MedCare Partners — MGMCR: $2,102.14
  • Multiplan — COMMCOMPLEMENTARYPPO: $11,211.40
  • Multiplan — COMMPRIMARYPPO: $11,912.11
  • United — GlobalBenefitPlan: $6,306.41
  • United — OptionsPPO: $3,685.75
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, $120,346 $120,346 $1,292 – $27,712
Heart rhythm study with ablation for atrial fibrillation: 10 of 13 insurance plan rates
  • Aetna — HMO: $32,505
  • Aetna — PPO: $32,505
  • Aetna Senior Health Plan — MCR: $1,292
  • Anthem — COMM: $16,954
  • Anthem — ExchangeHMO: $16,065
  • Blue Shield — COMM: $13,377
  • Blue Shield — EPN: $8,302
  • Bright Health — COMM: $10,375
  • Cigna — HMO: $19,166
  • Cigna — PPO: $19,166
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COM EP REPO CTH TX AFIB $120,346 $120,346 $18,051.90 – $108,311.40
Heart rhythm study with ablation for atrial fibrillation: rates for 9 insurance plans
  • American Health System — HIX: $54,155.70
  • First Health — COMM: $52,952.24
  • First Health — WCOMP: $108,311.40
  • HealthSmart — COMM: $96,276.80
  • MedCare Partners — MGMCR: $18,051.90
  • Multiplan — COMMCOMPLEMENTARYPPO: $96,276.80
  • Multiplan — COMMPRIMARYPPO: $102,294.10
  • United — GlobalBenefitPlan: $54,155.70
  • United — OptionsPPO: $31,651
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist Not listed in the file Not listed in the file $2,526.70 – $4,068.53
Sleep study (overnight, in a sleep lab): rates for 5 insurance plans
  • Anthem — COMM: $5,196
  • Anthem — ExchangeHMO: $4,924
  • Blue Shield — COMM: $4,068.53
  • Blue Shield — EPN: $2,526.70
  • United — AllPayerAppendix: $5,017

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib Not listed in the file Not listed in the file $52.33 – $84.27
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 35 insurance plan rates
  • Aetna — MCRHMO: $30.28
  • Aetna — MCRPOS: $30.28
  • Aetna — MCRPPO: $30.28
  • Aetna Senior Health Plan — MCR: $30.59
  • Alignment Health Plan — MGMCR: $30.59
  • Anthem — MCR: $30.59
  • Astiva Health — MGMCR: $33.65
  • Blue Shield — COMM: $84.27
  • Blue Shield — EPN: $52.33
  • Blue Shield — TRICARE: $28.96
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO|CO In the file: THER EXERCIS 15 MIN OTCO $618.25 $618.25 $92.74 – $556.42
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates
  • Aetna — HMO: $111.28
  • Aetna — PPO: $111.28
  • American Health System — HIX: $278.21
  • Bright Health — COMM: $244.95
  • First Health — COMM: $272.03
  • First Health — WCOMP: $556.42
  • Health Net — COMM: $135.40
  • HealthSmart — COMM: $494.60
  • MedCare Partners — MGMCR: $92.74
  • Multiplan — COMMCOMPLEMENTARYPPO: $494.60
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP|CQ In the file: THER EXERCIS 15 MIN PTCQ $618.25 $618.25 $92.74 – $556.42
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 14 insurance plan rates
  • Aetna — HMO: $111.28
  • Aetna — PPO: $111.28
  • American Health System — HIX: $278.21
  • Bright Health — COMM: $244.95
  • First Health — COMM: $272.03
  • First Health — WCOMP: $556.42
  • Health Net — COMM: $135.40
  • HealthSmart — COMM: $494.60
  • MedCare Partners — MGMCR: $92.74
  • Multiplan — COMMCOMPLEMENTARYPPO: $494.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $721 $721 $103.17
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates
  • Aetna — MCRHMO: $102.14
  • Aetna — MCRPOS: $102.14
  • Aetna — MCRPPO: $102.14
  • Aetna Senior Health Plan — MCR: $103.17
  • Alignment Health Plan — MGMCR: $103.17
  • Anthem — MCR: $103.17
  • Astiva Health — MGMCR: $113.49
  • Blue Shield — TRICARE: $97.85
  • Brand New Day — MCR: $103.17
  • Bristol Hospice — MGMCR: $82.54
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $721 $721 $90.79
Physical therapy evaluation (low complexity): 10 of 31 insurance plan rates
  • Aetna — MCRHMO: $89.88
  • Aetna — MCRPOS: $89.88
  • Aetna — MCRPPO: $89.88
  • Aetna Senior Health Plan — MCR: $90.79
  • Alignment Health Plan — MGMCR: $90.79
  • Anthem — MCR: $90.79
  • Astiva Health — MGMCR: $99.87
  • Brand New Day — MCR: $90.79
  • Bristol Hospice — MGMCR: $72.63
  • Care1st Health Plan — MCR: $92.61
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX $721 $721 $108.15 – $648.90
Physical therapy evaluation (low complexity): 10 of 14 insurance plan rates
  • Aetna — HMO: $129.78
  • Aetna — PPO: $129.78
  • American Health System — HIX: $324.45
  • Bright Health — COMM: $285.66
  • First Health — COMM: $317.24
  • First Health — WCOMP: $648.90
  • Health Net — COMM: $157.90
  • HealthSmart — COMM: $576.80
  • MedCare Partners — MGMCR: $108.15
  • Multiplan — COMMCOMPLEMENTARYPPO: $576.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $897.25 $897.25 $103.17
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates
  • Aetna — MCRHMO: $102.14
  • Aetna — MCRPOS: $102.14
  • Aetna — MCRPPO: $102.14
  • Aetna Senior Health Plan — MCR: $103.17
  • Alignment Health Plan — MGMCR: $103.17
  • Anthem — MCR: $103.17
  • Astiva Health — MGMCR: $113.49
  • Blue Shield — TRICARE: $97.85
  • Brand New Day — MCR: $103.17
  • Bristol Hospice — MGMCR: $82.54
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $897.25 $897.25 $90.79
Physical therapy evaluation (moderate complexity): 10 of 31 insurance plan rates
  • Aetna — MCRHMO: $89.88
  • Aetna — MCRPOS: $89.88
  • Aetna — MCRPPO: $89.88
  • Aetna Senior Health Plan — MCR: $90.79
  • Alignment Health Plan — MGMCR: $90.79
  • Anthem — MCR: $90.79
  • Astiva Health — MGMCR: $99.87
  • Brand New Day — MCR: $90.79
  • Bristol Hospice — MGMCR: $72.63
  • Care1st Health Plan — MCR: $92.61
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX $897.25 $897.25 $134.59 – $807.52
Physical therapy evaluation (moderate complexity): 10 of 14 insurance plan rates
  • Aetna — HMO: $161.50
  • Aetna — PPO: $161.50
  • American Health System — HIX: $403.76
  • Bright Health — COMM: $355.49
  • First Health — COMM: $394.79
  • First Health — WCOMP: $807.52
  • Health Net — COMM: $196.50
  • HealthSmart — COMM: $717.80
  • MedCare Partners — MGMCR: $134.59
  • Multiplan — COMMCOMPLEMENTARYPPO: $717.80
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $1,074 $1,074 $103.17
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates
  • Aetna — MCRHMO: $102.14
  • Aetna — MCRPOS: $102.14
  • Aetna — MCRPPO: $102.14
  • Aetna Senior Health Plan — MCR: $103.17
  • Alignment Health Plan — MGMCR: $103.17
  • Anthem — MCR: $103.17
  • Astiva Health — MGMCR: $113.49
  • Blue Shield — TRICARE: $97.85
  • Brand New Day — MCR: $103.17
  • Bristol Hospice — MGMCR: $82.54
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $1,074 $1,074 $72.63 – $154.34
Physical therapy evaluation (high complexity): 10 of 31 insurance plan rates
  • Aetna — MCRHMO: $89.88
  • Aetna — MCRPOS: $89.88
  • Aetna — MCRPPO: $89.88
  • Aetna Senior Health Plan — MCR: $90.79
  • Alignment Health Plan — MGMCR: $90.79
  • Anthem — MCR: $90.79
  • Astiva Health — MGMCR: $99.87
  • Brand New Day — MCR: $90.79
  • Bristol Hospice — MGMCR: $72.63
  • Care1st Health Plan — MCR: $92.61
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX $1,074 $1,074 $161.10 – $966.60
Physical therapy evaluation (high complexity): 10 of 14 insurance plan rates
  • Aetna — HMO: $193.32
  • Aetna — PPO: $193.32
  • American Health System — HIX: $483.30
  • Bright Health — COMM: $425.52
  • First Health — COMM: $472.56
  • First Health — WCOMP: $966.60
  • Health Net — COMM: $235.21
  • HealthSmart — COMM: $859.20
  • MedCare Partners — MGMCR: $161.10
  • Multiplan — COMMCOMPLEMENTARYPPO: $859.20
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes Not listed in the file Not listed in the file $71.79 – $115.60
Family psychotherapy, without the patient: rates for 2 insurance plans
  • Blue Shield — COMM: $115.60
  • Blue Shield — EPN: $71.79
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes Not listed in the file Not listed in the file $82.31 – $132.54
Family psychotherapy, with the patient: rates for 2 insurance plans
  • Blue Shield — COMM: $132.54
  • Blue Shield — EPN: $82.31
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group) Not listed in the file Not listed in the file $32.43 – $52.22
Group psychotherapy: rates for 2 insurance plans
  • Blue Shield — COMM: $52.22
  • Blue Shield — EPN: $32.43

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19 Not listed in the file Not listed in the file $663 – $7,161
Removal of breast growth (open surgery): 10 of 13 insurance plan rates
  • Aetna — HMO: $5,071
  • Aetna — PPO: $5,071
  • Aetna Senior Health Plan — MCR: $663
  • Anthem — COMM: $5,981
  • Anthem — ExchangeHMO: $5,668
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft Not listed in the file Not listed in the file $1,072 – $41,569
Total hip replacement: 10 of 14 insurance plan rates
  • Aetna — HMO: $9,667
  • Aetna — PPO: $9,667
  • Aetna Senior Health Plan — MCR: $1,072
  • Anthem — COMM: $37,261
  • Anthem — ExchangeHMO: $35,308
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Bright Health — COMM: $31,058
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) Not listed in the file Not listed in the file $1,072 – $41,569
Total knee replacement: 10 of 14 insurance plan rates
  • Aetna — HMO: $9,667
  • Aetna — PPO: $9,667
  • Aetna Senior Health Plan — MCR: $1,072
  • Anthem — COMM: $37,261
  • Anthem — ExchangeHMO: $35,308
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Bright Health — COMM: $31,058
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele Not listed in the file Not listed in the file $4,253 – $6,853
Shoulder arthroscopy: shaving of shoulder bone: 10 of 11 insurance plan rates
  • Aetna — HMO: $5,071
  • Aetna — PPO: $5,071
  • Aetna Senior Health Plan — MCR: $663
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
  • United — AllPayerAppendix: $2,163
  • Health Net — COMM: 18.1% (a percentage in the contract, not a dollar amount)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula Not listed in the file Not listed in the file $818 – $8,485
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 13 insurance plan rates
  • Aetna — HMO: $4,781
  • Aetna — PPO: $4,781
  • Aetna Senior Health Plan — MCR: $818
  • Anthem — COMM: $5,981
  • Anthem — ExchangeHMO: $5,668
  • Blue Shield — COMM: $8,474
  • Blue Shield — EPN: $5,260
  • Bright Health — COMM: $5,466
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12 Not listed in the file Not listed in the file $5,892
Removal of tonsils and adenoids (under age 12): 10 of 13 insurance plan rates
  • Aetna — HMO: $5,071
  • Aetna — PPO: $5,071
  • Aetna Senior Health Plan — MCR: $663
  • Anthem — COMM: $6,979
  • Anthem — ExchangeHMO: $6,614
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep Not listed in the file Not listed in the file $432 – $6,150
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates
  • Aetna — HMO: $2,215
  • Aetna — PPO: $2,215
  • Aetna Senior Health Plan — MCR: $432
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $4,481
  • Blue Shield — EPN: $2,781
  • Bright Health — COMM: $2,820
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple Not listed in the file Not listed in the file $5,892
Upper GI endoscopy with biopsy: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) Not listed in the file Not listed in the file $579 – $6,150
Colonoscopy (diagnostic): 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple Not listed in the file Not listed in the file $579 – $6,150
Colonoscopy with biopsy: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Not listed in the file Not listed in the file $579 – $6,150
Colonoscopy with removal of polyps (snare): 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and Not listed in the file Not listed in the file $579 – $6,150
Ultrasound of the lower bowel by endoscope: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $4,481
  • Blue Shield — EPN: $2,781
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk Not listed in the file Not listed in the file $2,804
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $1,384
  • Blue Shield — EPN: $859
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $3,936
  • Cigna — PPO: $3,936
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy Not listed in the file Not listed in the file $5,892
Gallbladder removal by laparoscope: 10 of 13 insurance plan rates
  • Aetna — HMO: $5,713
  • Aetna — PPO: $5,713
  • Aetna Senior Health Plan — MCR: $931
  • Anthem — COMM: $7,949
  • Anthem — ExchangeHMO: $7,533
  • Blue Shield — COMM: $13,377
  • Blue Shield — EPN: $8,302
  • Bright Health — COMM: $5,558
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible Not listed in the file Not listed in the file $4,604.99
Groin (inguinal) hernia repair, age 5 or older: 10 of 13 insurance plan rates
  • Aetna — HMO: $4,781
  • Aetna — PPO: $4,781
  • Aetna Senior Health Plan — MCR: $818
  • Anthem — COMM: $5,981
  • Anthem — ExchangeHMO: $5,668
  • Blue Shield — COMM: $8,474
  • Blue Shield — EPN: $5,260
  • Bright Health — COMM: $5,466
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach Not listed in the file Not listed in the file $579 – $5,997
Prostate biopsy: rates for 6 insurance plans
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; Not listed in the file Not listed in the file $931 – $21,361
Prostate removal by laparoscope (radical prostatectomy): 10 of 13 insurance plan rates
  • Aetna — HMO: $5,713
  • Aetna — PPO: $5,713
  • Aetna Senior Health Plan — MCR: $931
  • Anthem — COMM: $10,298
  • Anthem — ExchangeHMO: $9,758
  • Blue Shield — COMM: $4,481
  • Blue Shield — EPN: $2,781
  • Bright Health — COMM: $8,489
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C Not listed in the file Not listed in the file $663 – $7,161
Hysteroscopy with biopsy of the uterus lining: 10 of 13 insurance plan rates
  • Aetna — HMO: $5,071
  • Aetna — PPO: $5,071
  • Aetna Senior Health Plan — MCR: $663
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur Not listed in the file Not listed in the file $5,892
Spinal injection, lower back (epidural), with imaging guidance: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,215
  • Aetna — PPO: $2,215
  • Aetna Senior Health Plan — MCR: $432
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $4,481
  • Blue Shield — EPN: $2,781
  • Bright Health — COMM: $2,820
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing Not listed in the file Not listed in the file $2,215 – $4,481
Nerve root injection, lower back, with imaging guidance: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,215
  • Aetna — PPO: $2,215
  • Aetna Senior Health Plan — MCR: $432
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $4,481
  • Blue Shield — EPN: $2,781
  • Bright Health — COMM: $2,820
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel Not listed in the file Not listed in the file $2,804
Carpal tunnel release: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or Not listed in the file Not listed in the file $3,722 – $5,997
Laser treatment of clouding after cataract surgery: 10 of 13 insurance plan rates
  • Aetna — HMO: $2,804
  • Aetna — PPO: $2,804
  • Aetna Senior Health Plan — MCR: $579
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Bright Health — COMM: $4,748
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga Not listed in the file Not listed in the file $5,892
Cataract removal with lens implant: 10 of 13 insurance plan rates
  • Aetna — HMO: $5,713
  • Aetna — PPO: $5,713
  • Aetna Senior Health Plan — MCR: $1,264
  • Anthem — COMM: $3,684
  • Anthem — ExchangeHMO: $3,491
  • Blue Shield — COMM: $13,035
  • Blue Shield — EPN: $8,090
  • Bright Health — COMM: $11,181
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892

Pregnancy and childbirth

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care Not listed in the file Not listed in the file $3,722 – $5,997
Vaginal delivery, with care before and after: rates for 8 insurance plans
  • Anthem — COMM: $5,981
  • Anthem — ExchangeHMO: $5,668
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
  • Health Net — COMM: 18.1% (a percentage in the contract, not a dollar amount)
  • MedCare Partners — MGMCR: 100% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care Not listed in the file Not listed in the file $4,253 – $6,853
Cesarean delivery (C-section), with care before and after: rates for 8 insurance plans
  • Anthem — COMM: $5,981
  • Anthem — ExchangeHMO: $5,668
  • Blue Shield — COMM: $6,853
  • Blue Shield — EPN: $4,253
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
  • Health Net — COMM: 18.1% (a percentage in the contract, not a dollar amount)
  • MedCare Partners — MGMCR: 100% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p Not listed in the file Not listed in the file $3,722 – $5,997
Vaginal delivery after a previous C-section, with care before and after: rates for 8 insurance plans
  • Anthem — COMM: $5,981
  • Anthem — ExchangeHMO: $5,668
  • Blue Shield — COMM: $5,997
  • Blue Shield — EPN: $3,722
  • Cigna — HMO: $5,892
  • Cigna — PPO: $5,892
  • Health Net — COMM: 18.1% (a percentage in the contract, not a dollar amount)
  • MedCare Partners — MGMCR: 100% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Not listed in the file Not listed in the file $89,342.96
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 55 insurance plan rates
  • Aetna — HMO: $119,918
  • Aetna — MCRHMO: $117,868.50
  • Aetna — MCRPOS: $117,868.50
  • Aetna — MCRPPO: $117,868.50
  • Aetna — PPO: $119,918
  • Aetna Senior Health Plan — MCR: $2,800
  • Alignment Health Plan — MGMCR: $117,868.50
  • Anthem — COMM: $144,230
  • Anthem — ExchangeHMO: $136,672
  • Anthem — MCR: $117,868.50
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Not listed in the file Not listed in the file $22,989 – $52,934.90
Spinal fusion (not neck), without major complications: rates for 2 insurance plans
  • Bright Health — COMM: $52,934.90
  • Redlands Community — COMM: $22,989
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Not listed in the file Not listed in the file $17,534.03
Hip or knee replacement (major joint of the leg), without major complications: 10 of 55 insurance plan rates
  • Aetna — HMO: $51,634
  • Aetna — MCRHMO: $24,213.15
  • Aetna — MCRPOS: $24,213.15
  • Aetna — MCRPPO: $24,213.15
  • Aetna — PPO: $51,634
  • Aetna Senior Health Plan — MCR: $1,022
  • Alignment Health Plan — MGMCR: $24,213.15
  • Anthem — COMM: $42,169
  • Anthem — ExchangeHMO: $39,985
  • Anthem — MCR: $24,213.15
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Trauma or Burn Not listed in the file Not listed in the file $36,319.73
Hip or knee replacement (major joint of the leg), without major complications: rates for 3 insurance plans
  • Brand New Day — MCR: $36,319.73
  • Imperial Insurance — MCR: $25,423.81
  • MedCare Partners — MGMCR: $25,423.81
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $1,022
Neck (cervical) spinal fusion, without complications: 10 of 55 insurance plan rates
  • Aetna — HMO: $65,893
  • Aetna — MCRHMO: $30,323.36
  • Aetna — MCRPOS: $30,323.36
  • Aetna — MCRPPO: $30,323.36
  • Aetna — PPO: $65,893
  • Aetna Senior Health Plan — MCR: $1,022
  • Alignment Health Plan — MGMCR: $30,323.36
  • Anthem — COMM: $22,578
  • Anthem — ExchangeHMO: $21,395
  • Anthem — MCR: $30,323.36
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Trauma Not listed in the file Not listed in the file $31,839.53
Neck (cervical) spinal fusion, without complications: rates for 2 insurance plans
  • Imperial Insurance — MCR: $31,839.53
  • MedCare Partners — MGMCR: $31,839.53
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Trauma or Burn Not listed in the file Not listed in the file $45,485.04
Neck (cervical) spinal fusion, without complications: rates for 1 insurance plan
  • Brand New Day — MCR: $45,485.04
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $10,735.57
Uterus and ovary surgery (not for cancer), without complications: 10 of 53 insurance plan rates
  • Aetna — MCRHMO: $16,006.58
  • Aetna — MCRPOS: $16,006.58
  • Aetna — MCRPPO: $16,006.58
  • Aetna Senior Health Plan — MCR: $1,022
  • Alignment Health Plan — MGMCR: $16,006.58
  • Anthem — COMM: $7,579
  • Anthem — ExchangeHMO: $7,182
  • Anthem — MCR: $16,006.58
  • Astiva Health — MGMCR: $17,607.24
  • Blue Shield — COMM: $9,730
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Trauma Not listed in the file Not listed in the file $16,806.91
Uterus and ovary surgery (not for cancer), without complications: rates for 2 insurance plans
  • Imperial Insurance — MCR: $16,806.91
  • MedCare Partners — MGMCR: $16,806.91
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Trauma or Burn Not listed in the file Not listed in the file $24,009.87
Uterus and ovary surgery (not for cancer), without complications: rates for 1 insurance plan
  • Brand New Day — MCR: $24,009.87

Source: Riverside Community Hospital’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 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 typeAcute Care Hospital
Address4445 Magnolia Avenue, Riverside, CA 92501
CountyRiverside County
StateCalifornia
Phone(951) 788‑3000
Emergency servicesYes
OwnershipProprietary
Medicare overall rating2 of 5 stars
Birthing-friendly designationYes (meets CMS criteria)
CMS Certification Number050022
Name in Medicare recordsRIVERSIDE COMMUNITY HOSPITAL
Profile levelMedicare data + hospital website
Official websiteriversidecommunityhospital.com
CorrectionsReport an error or suggest an update →

Sources

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

From the hospital’s website

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

  1. Riverside Community Hospital — riversidecommunityhospital.com
  2. For Visitors — riversidecommunityhospital.com
  3. Riverside Community Hospital — riversidecommunityhospital.com
  4. Stroke Center | Riverside Community Hospital — riversidecommunityhospital.com
  5. Radiology | Riverside Community Hospital — riversidecommunityhospital.com
  6. Emergency care | Riverside Community Hospital — riversidecommunityhospital.com
  7. Neurology | Riverside Community Hospital — riversidecommunityhospital.com
  8. Laboratory Services | Riverside Community Hospital — riversidecommunityhospital.com
  9. Awards and Recognition | Riverside Community Hospital — riversidecommunityhospital.com
  10. Cardiology | Riverside Community Hospital — riversidecommunityhospital.com
  11. Spine Care | Riverside Community Hospital — riversidecommunityhospital.com
  12. Surgical Care | Riverside Community Hospital — riversidecommunityhospital.com
  13. Weight Loss Surgery | Riverside Community Hospital — riversidecommunityhospital.com
  14. Minimally Invasive Surgery | Riverside Community Hospital — riversidecommunityhospital.com
  15. Women's Care | Riverside Community Hospital — riversidecommunityhospital.com
  16. Spine care | Riverside Community Hospital — riversidecommunityhospital.com