Does Scripps Memorial Hospital La Jolla have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Scripps Memorial Hospital La Jolla. In a medical emergency, call 911.

Where is Scripps Memorial Hospital La Jolla?

9888 Genesee Avenue, La Jolla, CA 92037, in San Diego County, California.

What is the phone number of Scripps Memorial Hospital La Jolla?

(858) 626-4123, as listed by Medicare (CMS).

What is the Medicare star rating of Scripps Memorial Hospital La Jolla?

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

Scripps Memorial Hospital La Jolla

Quick answers

Does Scripps Memorial Hospital La Jolla have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Scripps Memorial Hospital La Jolla. In a medical emergency, call 911.
Where is Scripps Memorial Hospital La Jolla?: 9888 Genesee Avenue, La Jolla, CA 92037, in San Diego County, California.
What is the phone number of Scripps Memorial Hospital La Jolla?: (858) 626-4123, as listed by Medicare (CMS).
What is the Medicare star rating of Scripps Memorial Hospital La Jolla?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5][12]

Conditions treated^{[7][8][9][10][11]}

Stroke
Heart attack (STEMI)
Traumatic injuries

Treatments^[8][9]

Thrombolytic (clot-busting) therapy for stroke
Endovascular stroke treatment (thrombectomy)

Procedures^[4][13]

Heart surgery
Orthopedic surgery
PFO closure

Programs and centers^{[4][7][9][13]}

Level III NICU
Barbey Family Emergency and Trauma Center
Comprehensive stroke center
Scripps Cryptogenic Stroke Program
Labor and delivery
Neonatal intensive care unit (Level III)
Interventional radiology

Emergency care (hospital website)^{[4][7][9][10]}

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level I
Stroke designation	Comprehensive Stroke Center

Visiting and practical information

Visiting	Visiting 8 a.m.-8:30 p.m., adjustable to patient needs^[4]
Parking	Paid parking in Structures A, B, D; first 30 min free, max $12/day, valet $8^[4]
Interpreters and languages	Language/medical interpreter services listed^[4]
Patient portal	MyScripps Patient Portal

Recognition^[4][7]

Level I Trauma Center
Comprehensive Stroke Center
Geriatric emergency department accreditation (American College of Emergency Physicians)

Doctors and clinicians (1,309)

1,309 doctors and other clinicians list Scripps Memorial Hospital La Jolla as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 1,285 more: the button below opens the full list.

Other emergency rooms nearby

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

VA San Diego Healthcare System0.9 mi · San Diego, CA · Federal/VA Acute Care Hospital
Sharp Memorial Hospital7.0 mi · San Diego, CA · Acute Care Hospital
Rady Children's Hospital - San Diego7.3 mi · San Diego, CA · Children's Hospital
UC San Diego Health Hillcrest - Hillcrest Med Ctr9.7 mi · San Diego, CA · Acute Care Hospital
Kaiser Foundation Hospital - San Diego9.8 mi · San Diego, CA · Acute Care Hospital

Other hospitals nearby

Scripps Green Hospital1.4 mi · La Jolla, CA · Acute Care Hospital
Sharp Mesa Vista Hospital7.4 mi · San Diego, CA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

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

Nursing homes

VI at La Jolla Village1.1 mi · San Diego, CA · 5 of 5 stars
The Springs at Pacific Regent1.2 mi · San Diego, CA · 5 of 5 stars
La Jolla Post-Acute2.8 mi · La Jolla, CA · 3 of 5 stars

All nursing homes in the state →

Outpatient surgery centers nearby

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

Innovative Surgery Center LLC1.5 mi · San Diego, CA
UCSD Surgical Center of San Diego LLC1.5 mi · San Diego, CA
University Ambulatory Surgery Center2.1 mi · San Diego, CA

All outpatient surgery centers in the state →

Community care nearby

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

Community health centers

OPSAM HEALTH: 10737 Camino Ruiz Ste. 1405.0 mi · San Diego, CA · Community health center
OPSAM HEALTH: 10737 Camino Ruiz Ste. 2355.0 mi · San Diego, CA · Community health center
HCHC-San Diego5.4 mi · San Diego, CA · Community health center

Clinics and urgent care

Cue Health Ca, PC1.5 mi · San Diego, CA · Urgent care center
Cue Health Ct PLLC1.5 mi · San Diego, CA · Urgent care center
Cue Health Inc.1.5 mi · San Diego, CA · Urgent care center

Pharmacies

Regents of the University of California0.9 mi · La Jolla, CA · Pharmacy
UCSD Medical Center0.9 mi · La Jolla, CA · Pharmacy
1st Choice Pharmacy Management, LLC1.5 mi · San Diego, CA · Community/retail pharmacy

Assisted living nearby

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

Autumn Villas on Honors Drive LLC2.1 mi · San Diego, CA
Baron's Loving Care - UC2.1 mi · San Diego, CA
Right Choice Senior Living2.1 mi · San Diego, CA
Right Choice Senior Living University C2.1 mi · San Diego, CA

About the Medicare star rating

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

Medicare quality data

What Scripps Memorial Hospital La Jolla 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)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	81%National average: 72%
Would definitely recommend the hospital	85%National average: 71%
Nurses “always” communicated well	82%National average: 80%
Doctors “always” communicated well	82%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	89%National average: 86%
Room and bathroom “always” clean	76%National average: 74%
Area around the room “always” quiet at night	60%National average: 60%
Completed surveys	4,573Response rate: 30%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

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

Central line bloodstream infections (CLABSI)	0.435Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.677No different from the national benchmark
Surgical site infections after colon surgery	0.745No different from the national benchmark
Surgical site infections after abdominal hysterectomy	0.418No different from the national benchmark
MRSA bloodstream infections	0.315No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.292Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

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

Deaths within 30 days: heart attack patients	8.9%
Deaths within 30 days: heart failure patients	7.7%
Deaths within 30 days: pneumonia patients	11.2%
Deaths within 30 days: COPD patients	8.9%
Deaths within 30 days: stroke patients	10.2%
Deaths within 30 days: coronary bypass surgery (CABG)	2%
Serious complications (patient safety indicator PSI-90)	1.38Worse than the national rate
Complications after hip or knee replacement	3.3%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

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

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	13.4%
Readmitted within 30 days: heart failure	20.4%
Readmitted within 30 days: pneumonia	15.8%
Readmitted within 30 days: COPD	19.3%
Readmitted within 30 days: coronary bypass surgery	11.1%
Readmitted within 30 days: hip or knee replacement	5.2%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

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

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	186 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)	85%National average: 65%

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

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

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

ER wait times in California Best hospitals in California

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 58 common services exactly as Scripps Memorial Hospital La Jolla 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 →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC G-Tube Removal Only	$293.71	$73.43	$23.50 – $428.09
Established patient office visit (about 20–29 minutes): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $74.01 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $97.81 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $171.24 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $88.11 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $176.37 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $171.24 BC [814] — BLUE CROSS HMO: $61.97 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $171.24 BLUE CROSS [220] — BLUE CROSS HMO: $61.97 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $61.97
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC ER Level III	$2,414.77	$603.69	$69.85 – $2,173.29
Emergency room visit (moderate): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $2,069.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $2,069.46 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $351.09 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $69.85 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $361.63 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $351.09 BC [814] — BLUE CROSS HMO: $1,970.45 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $351.09 BLUE CROSS [220] — BLUE CROSS HMO: $1,970.45 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,970.45
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER Level IV	$3,884.63	$971.16	$118.58 – $3,496.17
Emergency room visit (moderately high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,329.13 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,329.13 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $536.67 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $118.58 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $552.77 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $536.67 BC [814] — BLUE CROSS HMO: $3,169.86 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $536.67 BLUE CROSS [220] — BLUE CROSS HMO: $3,169.86 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $3,169.86
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER Level IV Trauma	$19,633.13	$4,908.28	$118.58 – $17,669.82
Emergency room visit (moderately high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $16,825.59 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $16,825.59 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $536.67 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $118.58 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $552.77 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $536.67 BC [814] — BLUE CROSS HMO: $16,020.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $536.67 BLUE CROSS [220] — BLUE CROSS HMO: $16,020.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $16,020.63
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER Level V	$7,874.25	$1,968.56	$172.27 – $7,086.83
Emergency room visit (high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $6,748.23 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $6,748.23 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $765.95 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $172.27 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $788.93 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $765.95 BC [814] — BLUE CROSS HMO: $6,425.39 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $765.95 BLUE CROSS [220] — BLUE CROSS HMO: $6,425.39 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $6,425.39
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER Level V Trauma	$23,622.75	$5,905.69	$172.27 – $21,260.48
Emergency room visit (high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $20,244.70 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $20,244.70 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $765.95 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $172.27 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $788.93 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $765.95 BC [814] — BLUE CROSS HMO: $19,276.16 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $765.95 BLUE CROSS [220] — BLUE CROSS HMO: $19,276.16 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $19,276.16

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC Basic Metabolic Panel	$244	$61	$8.46 – $195.20
Basic metabolic panel (blood test): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $110.78 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $122.98 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $8.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $8.46 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $8.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $8.46 BC [814] — BLUE CROSS HMO: $53.92 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $8.46 BLUE CROSS [220] — BLUE CROSS HMO: $53.92 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $51.48
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Comprehensive Panel	$391.99	$98	$10.56 – $313.59
Comprehensive metabolic panel (blood test): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $177.96 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $197.56 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $10.56 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $10.56 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $10.88 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $10.56 BC [814] — BLUE CROSS HMO: $86.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $10.56 BLUE CROSS [220] — BLUE CROSS HMO: $86.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $82.71
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Metabolic Pnl,Comp, Wb	$391.99	$98	$10.56 – $313.59
Comprehensive metabolic panel (blood test): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $177.96 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $197.56 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $10.56 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $10.56 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $10.88 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $10.56 BC [814] — BLUE CROSS HMO: $86.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $10.56 BLUE CROSS [220] — BLUE CROSS HMO: $86.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $82.71
Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: HC Obstetric Panel	$348.08	$87.02	$27.85 – $278.46
Obstetric blood test panel: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $158.03 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $175.43 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $47.81 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $47.81 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $49.24 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $47.81 BC [814] — BLUE CROSS HMO: $76.93 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $47.81 BLUE CROSS [220] — BLUE CROSS HMO: $76.93 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $73.44
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC Renal Function Panel	$88	$22	$7.04 – $70.40
Kidney function panel: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $39.95 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $44.35 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $8.68 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $8.68 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $8.94 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $8.68 BC [814] — BLUE CROSS HMO: $19.45 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $8.68 BLUE CROSS [220] — BLUE CROSS HMO: $19.45 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $18.57
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC Hepatic Fx Panel	$284.84	$71.21	$8.17 – $227.87
Liver function panel: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $129.32 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $143.56 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $8.17 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $8.17 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $8.42 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $8.17 BC [814] — BLUE CROSS HMO: $62.95 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $8.17 BLUE CROSS [220] — BLUE CROSS HMO: $62.95 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $60.10
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: HC Urinalysis-Complete	$141.43	$35.36	$3.17 – $113.14
Urine test (automated, with microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $64.21 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $71.28 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $3.17 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.17 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $3.27 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $3.17 BC [814] — BLUE CROSS HMO: $31.26 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $3.17 BLUE CROSS [220] — BLUE CROSS HMO: $31.26 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $29.84
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Urinalysis Dipstick/Reducing/Sub/Ph	$19.08	$4.77	$1.53 – $15.26
Urine test (manual, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $8.66 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $9.62 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $3.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.48 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $3.58 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $3.48 BC [814] — BLUE CROSS HMO: $4.22 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $3.48 BLUE CROSS [220] — BLUE CROSS HMO: $4.22 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4.03
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Dipstick Urine	$21.09	$5.27	$1.69 – $16.87
Urine test (manual, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $9.57 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $10.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $3.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.48 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $3.58 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $3.48 BC [814] — BLUE CROSS HMO: $4.66 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $3.48 BLUE CROSS [220] — BLUE CROSS HMO: $4.66 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4.45
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Phurine	$19.08	$4.77	$1.53 – $15.26
Urine test (manual, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $8.66 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $9.62 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $3.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.48 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $3.58 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $3.48 BC [814] — BLUE CROSS HMO: $4.22 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $3.48 BLUE CROSS [220] — BLUE CROSS HMO: $4.22 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4.03
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Sp Gravity	$65.03	$16.26	$2.25 – $52.02
Urine test (automated, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $29.52 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $32.78 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $2.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $2.25 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $2.32 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $2.25 BC [814] — BLUE CROSS HMO: $14.37 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $2.25 BLUE CROSS [220] — BLUE CROSS HMO: $14.37 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $13.72
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis Macro/Sp Gravity	$84.77	$21.19	$2.25 – $67.82
Urine test (automated, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $38.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $42.72 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $2.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $2.25 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $2.32 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $2.25 BC [814] — BLUE CROSS HMO: $18.73 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $2.25 BLUE CROSS [220] — BLUE CROSS HMO: $18.73 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $17.89
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urine Screen	$65.03	$16.26	$2.25 – $52.02
Urine test (automated, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $29.52 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $32.78 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $2.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $2.25 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $2.32 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $2.25 BC [814] — BLUE CROSS HMO: $14.37 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $2.25 BLUE CROSS [220] — BLUE CROSS HMO: $14.37 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $13.72
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Psa Antigen (Psa Screen)	$126	$31.50	$10.08 – $100.80
PSA (prostate specific antigen) blood test: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $57.20 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $63.50 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $18.39 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $18.39 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $18.94 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $18.39 BC [814] — BLUE CROSS HMO: $27.85 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $18.39 BLUE CROSS [220] — BLUE CROSS HMO: $27.85 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $26.59
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Tsh	$134.32	$33.58	$10.75 – $107.46
Thyroid stimulating hormone (TSH) test: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $60.98 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $67.70 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $16.80 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $16.80 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $17.30 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $16.80 BC [814] — BLUE CROSS HMO: $29.68 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $16.80 BLUE CROSS [220] — BLUE CROSS HMO: $29.68 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $28.34
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC Cbc	$110	$27.50	$7.77 – $88
Complete blood count (CBC) with differential: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $49.94 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $55.44 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $7.77 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $7.77 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $8 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $7.77 BC [814] — BLUE CROSS HMO: $24.31 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7.77 BLUE CROSS [220] — BLUE CROSS HMO: $24.31 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $23.21
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC Hemogram	$151.63	$37.91	$6.47 – $121.30
Complete blood count (CBC), automated: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $68.84 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $76.42 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $6.47 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $6.47 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $6.66 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $6.47 BC [814] — BLUE CROSS HMO: $33.51 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $6.47 BLUE CROSS [220] — BLUE CROSS HMO: $33.51 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $31.99
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier TC In the file: HC Hemogram\|TECHNICAL COMPONENT	$151.63	$37.91	$6.47 – $121.30
Complete blood count (CBC), automated: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHLJ: $22.74 MC BLUE CROSS [901] — SHPS SHLJ: $22.74 MC BLUE SHIELD [902] — SHPS SHLJ: $22.74 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHLJ: $22.74 MC CIGNA [903] — SHPS SHLJ: $22.74 MC HEALTH NET [904] — SHPS SHLJ: $22.74 MC SCAN [905] — SHPS SHLJ: $22.74 MC UNITED [906] — SHPS SHLJ: $22.74
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Prothrombin Time	$103	$25.75	$4.29 – $82.40
Blood clotting time test (prothrombin time, PT): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $46.76 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $51.91 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $4.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $4.29 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $4.42 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $4.29 BC [814] — BLUE CROSS HMO: $22.76 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $4.29 BLUE CROSS [220] — BLUE CROSS HMO: $22.76 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $21.73
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Aptt	$135	$33.75	$6.01 – $108
Blood clotting test (partial thromboplastin time, PTT): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $61.29 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $68.04 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $6.01 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $6.01 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $6.19 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $6.01 BC [814] — BLUE CROSS HMO: $29.84 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $6.01 BLUE CROSS [220] — BLUE CROSS HMO: $29.84 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $28.49

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: HC CT Head WO	$3,457.62	$864.40	$62.46 – $2,766.10
CT scan of the head or brain, without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $698.44 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $698.44 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $80.08 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $134.46 BC [814] — BLUE CROSS HMO: $598.17 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $598.17 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $598.17
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: HC MR Brain W/WO	$5,902.98	$1,475.74	$197.04 – $4,722.38
MRI of the brain, before and after contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,192.40 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,192.40 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $448.71 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $252.61 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $462.17 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $448.71 BC [814] — BLUE CROSS HMO: $1,021.22 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $448.71 BLUE CROSS [220] — BLUE CROSS HMO: $1,021.22 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,021.22
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: HC Chest 2 Views	$974.59	$243.65	$27.35 – $779.67
Chest X-ray, 2 views: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $442.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $491.19 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $111.93 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $27.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $115.29 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $111.93 BC [814] — BLUE CROSS HMO: $215.38 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $111.93 BLUE CROSS [220] — BLUE CROSS HMO: $215.38 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $205.64
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier TC In the file: HC Chest 2 Views\|TECHNICAL COMPONENT	$974.59	$243.65	$27.35 – $779.67
Chest X-ray, 2 views: rates for 4 insurance plans MPMG [800] — MPMG: $111.93 MPMG MCR ADV [836] — MPMG: $111.93 OCN MCR ADV [890] — PCAMG/OPTUM CARE NETWORK: $111.93 OPTUM CARE NETWORK NORTH COUNTY SD [808] — PCAMG/OPTUM CARE NETWORK: $111.93
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC Spine L-S Min 4vw	$1,168.13	$292.03	$48.52 – $934.50
X-ray of the lower spine, at least 4 views: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $530.33 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $588.74 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $48.52 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $134.46 BC [814] — BLUE CROSS HMO: $258.16 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $258.16 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $246.48
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier TC In the file: HC Spine L-S Min 4vw\|TECHNICAL COMPONENT	$1,168.13	$292.03	$48.52 – $934.50
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans MPMG [800] — MPMG: $134.46 MPMG MCR ADV [836] — MPMG: $134.46 OCN MCR ADV [890] — PCAMG/OPTUM CARE NETWORK: $134.46 OPTUM CARE NETWORK NORTH COUNTY SD [808] — PCAMG/OPTUM CARE NETWORK: $134.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MR Lumbar WO	$3,013	$753.25	$114.64 – $2,410.40
MRI of the lower back (lumbar spine), without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $608.63 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $608.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $306.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $146.97 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $316.09 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $306.88 BC [814] — BLUE CROSS HMO: $521.25 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $306.88 BLUE CROSS [220] — BLUE CROSS HMO: $521.25 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $521.25
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC CT Pelvis W	$2,920.22	$730.05	$160.44 – $2,336.18
CT scan of the pelvis, with contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $589.88 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $589.88 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $225.59 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $205.69 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $232.36 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $225.59 BC [814] — BLUE CROSS HMO: $505.20 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $225.59 BLUE CROSS [220] — BLUE CROSS HMO: $505.20 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $505.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MR Jnt Low Ext WO Unilat	$3,780.92	$945.23	$131.77 – $3,024.74
MRI of a leg joint (such as the knee), without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $763.75 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $763.75 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $306.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $168.94 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $316.09 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $306.88 BC [814] — BLUE CROSS HMO: $654.10 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $306.88 BLUE CROSS [220] — BLUE CROSS HMO: $654.10 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $654.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MRI Any Jt Lower Extrem W/O Contrast Matrl Bilateral	$6,628.43	$1,657.11	$131.77 – $5,302.74
MRI of a leg joint (such as the knee), without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,338.94 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,338.94 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $306.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $168.94 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $316.09 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $306.88 BC [814] — BLUE CROSS HMO: $1,146.72 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $306.88 BLUE CROSS [220] — BLUE CROSS HMO: $1,146.72 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,146.72
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier 50 In the file: HC MRI Any Jt Lower Extrem W/O Contrast Matrl Bilateral\|BILATERAL PROCEDURE	$6,628.43	$1,657.11	$131.77 – $5,302.74
MRI of a leg joint (such as the knee), without contrast: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHLJ: $530.27 MC BLUE CROSS [901] — SHPS SHLJ: $530.27 MC BLUE SHIELD [902] — SHPS SHLJ: $530.27 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHLJ: $530.27 MC CIGNA [903] — SHPS SHLJ: $530.27 MC HEALTH NET [904] — SHPS SHLJ: $530.27 MC SCAN [905] — SHPS SHLJ: $530.27 MC UNITED [906] — SHPS SHLJ: $530.27
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC CT Abdomen & Pelvis W	$9,000	$2,250	$201.57 – $7,200
CT scan of the abdomen and pelvis, with contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,818 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,818 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $448.71 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $258.42 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $462.17 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $448.71 BC [814] — BLUE CROSS HMO: $1,557 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $448.71 BLUE CROSS [220] — BLUE CROSS HMO: $1,557 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,557
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC US Abdomen Complete	$1,369.44	$342.36	$91.44 – $1,095.55
Ultrasound of the abdomen, complete: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $621.73 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $690.20 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $91.44 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $134.46 BC [814] — BLUE CROSS HMO: $302.65 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $302.65 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $288.95
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · modifier TC In the file: HC US Abdomen Complete\|TECHNICAL COMPONENT	$1,369.44	$342.36	$91.44 – $1,095.55
Ultrasound of the abdomen, complete: rates for 4 insurance plans MPMG [800] — MPMG: $134.46 MPMG MCR ADV [836] — MPMG: $134.46 OCN MCR ADV [890] — PCAMG/OPTUM CARE NETWORK: $134.46 OPTUM CARE NETWORK NORTH COUNTY SD [808] — PCAMG/OPTUM CARE NETWORK: $134.46
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC US Preg>14 Wks Sgl Ges	$909.04	$227.26	$72.72 – $727.23
Pregnancy ultrasound (after the first trimester): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $412.70 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $458.16 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.82 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $134.46 BC [814] — BLUE CROSS HMO: $200.90 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $200.90 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $191.81
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC US Transvaginal	$1,615.79	$403.95	$101.43 – $1,292.63
Transvaginal ultrasound: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $733.57 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $814.36 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $101.43 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $134.46 BC [814] — BLUE CROSS HMO: $357.09 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $357.09 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $340.93
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier TC In the file: HC US Transvaginal\|TECHNICAL COMPONENT	$1,615.79	$403.95	$101.43 – $1,292.63
Transvaginal ultrasound: rates for 4 insurance plans MPMG [800] — MPMG: $134.46 MPMG MCR ADV [836] — MPMG: $134.46 OCN MCR ADV [890] — PCAMG/OPTUM CARE NETWORK: $134.46 OPTUM CARE NETWORK NORTH COUNTY SD [808] — PCAMG/OPTUM CARE NETWORK: $134.46
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: HC Dx Uni Mammo Incl Cad	$671.99	$168	$53.76 – $537.59
Diagnostic mammogram, one breast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $305.08 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $338.68 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $102.85 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $102.85 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $105.94 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $102.85 BC [814] — BLUE CROSS HMO: $148.51 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $102.85 BLUE CROSS [220] — BLUE CROSS HMO: $148.51 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $141.79
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: HC Dx Bilat Mammo Incl Cad	$897.82	$224.45	$71.83 – $718.26
Diagnostic mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $407.61 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $452.50 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $131.79 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $131.79 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $135.74 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $131.79 BC [814] — BLUE CROSS HMO: $198.42 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $131.79 BLUE CROSS [220] — BLUE CROSS HMO: $198.42 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $189.44
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier TC In the file: HC Dx Bilat Mammo Incl Cad\|TECHNICAL COMPONENT	$897.82	$224.45	$71.83 – $718.26
Diagnostic mammogram, both breasts: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHLJ: $188.54 MC BLUE CROSS [901] — SHPS SHLJ: $188.54 MC BLUE SHIELD [902] — SHPS SHLJ: $188.54 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHLJ: $188.54 MC CIGNA [903] — SHPS SHLJ: $188.54 MC HEALTH NET [904] — SHPS SHLJ: $188.54 MC SCAN [905] — SHPS SHLJ: $188.54 MC UNITED [906] — SHPS SHLJ: $188.54
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scrn Uni Mammo Ximg W/Cad	$723.47	$180.87	$57.88 – $578.78
Screening mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $328.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $364.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $108.84 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $108.84 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $112.11 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $108.84 BC [814] — BLUE CROSS HMO: $159.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $108.84 BLUE CROSS [220] — BLUE CROSS HMO: $159.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $152.65
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scrn Uni Mammo Incl Cad	$723.47	$180.87	$57.88 – $578.78
Screening mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $328.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $364.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $108.84 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $108.84 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $112.11 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $108.84 BC [814] — BLUE CROSS HMO: $159.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $108.84 BLUE CROSS [220] — BLUE CROSS HMO: $159.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $152.65
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scrn Bilat Mammo Incl Cad	$723.47	$180.87	$57.88 – $578.78
Screening mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $328.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $364.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $108.84 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $108.84 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $112.11 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $108.84 BC [814] — BLUE CROSS HMO: $159.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $108.84 BLUE CROSS [220] — BLUE CROSS HMO: $159.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $152.65

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: HC Poly 4 or More Para Atted	$2,313.49	$578.37	$185.08 – $2,761.21
Sleep study (overnight, in a sleep lab): 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,050.32 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,166 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,104.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $659.45 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,137.62 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,104.48 BC [814] — BLUE CROSS HMO: $511.28 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,104.48 BLUE CROSS [220] — BLUE CROSS HMO: $511.28 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $488.15

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Ther Ex 15 Min	$172.80	$43.20	$13.82 – $138.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $78.45 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $87.09 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $32.04 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $33 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $32.04 BC [814] — BLUE CROSS HMO: $38.19 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE CROSS [220] — BLUE CROSS HMO: $38.19 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $36.46
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier CO In the file: HC Ther Ex 15 Min\|OP OCCUPATIONAL THERAPY SERV BY COTA	$172.80	$43.20	$13.82 – $138.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 71 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $32.04 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $33 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $32.04 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHLJ: $32.04
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier CQ In the file: HC Ther Ex 15 Min\|OP PT SERVICES BY PTA	$172.80	$43.20	$13.82 – $138.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 63 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $32.04 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $33 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $32.04 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHLJ: $32.04 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHLJ: $32.04
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: HC Pt Eval Low Complexity	$218.88	$54.72	$17.51 – $295
Physical therapy evaluation (low complexity): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $99.37 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $110.32 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $108.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $111.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $108.29 BC [814] — BLUE CROSS HMO: $48.37 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $108.29 BLUE CROSS [220] — BLUE CROSS HMO: $48.37 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $46.18
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: HC Pt Eval Mod Complexity	$248.26	$62.06	$19.86 – $295
Physical therapy evaluation (moderate complexity): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $112.71 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $125.12 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $108.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $111.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $108.29 BC [814] — BLUE CROSS HMO: $54.87 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $108.29 BLUE CROSS [220] — BLUE CROSS HMO: $54.87 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $52.38
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: HC Pt Eval High Complexity	$279.36	$69.84	$22.35 – $295
Physical therapy evaluation (high complexity): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $126.83 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $140.80 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $108.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $111.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $108.29 BC [814] — BLUE CROSS HMO: $61.74 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $108.29 BLUE CROSS [220] — BLUE CROSS HMO: $61.74 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $58.94

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: HC Excise Brst Les =>1 Uni	$15,935.77	$3,983.94	$424.09 – $12,748.62
Removal of breast growth (open surgery): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,219.03 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,219.03 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $5,035.90 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $424.09 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $5,186.98 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $5,035.90 BC [814] — BLUE CROSS HMO: $2,756.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $5,035.90 BLUE CROSS [220] — BLUE CROSS HMO: $2,756.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,756.89
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: HC Excise Brst Les =>1 Bil	$23,958.14	$5,989.53	$424.09 – $19,166.51
Removal of breast growth (open surgery): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $4,839.54 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $4,839.54 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $5,035.90 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $424.09 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $5,186.98 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $5,035.90 BC [814] — BLUE CROSS HMO: $4,144.76 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $5,035.90 BLUE CROSS [220] — BLUE CROSS HMO: $4,144.76 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4,144.76
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: HC Arthroscopy Shldr Decomp	$17,253	$4,313.25	$147.65 – $13,802.40
Shoulder arthroscopy: shaving of shoulder bone: 10 of 70 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,485.11 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,485.11 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $147.65 BC [814] — BLUE CROSS HMO: $2,984.77 BLUE CROSS [220] — BLUE CROSS HMO: $2,984.77 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,984.77 BLUE CROSS [220] — BLUE CROSS PPO MCS: $3,278.07 BLUE CROSS [220] — BLUE CROSS PPO NON-MCS: $2,984.77 BLUE CROSS BLUE SHIELD [233] — BLUE CROSS HMO: $2,984.77 BLUE CROSS BLUE SHIELD [233] — BLUE CROSS PPO NON-MCS: $2,984.77
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: HC Knee Meniscec Med or Lat	$11,855.97	$2,963.99	$548.23 – $10,520.85
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $2,394.91 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $2,394.91 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $4,208.34 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $548.23 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $4,334.59 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $4,208.34 BC [814] — BLUE CROSS HMO: $2,051.08 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $4,208.34 BLUE CROSS [220] — BLUE CROSS HMO: $2,051.08 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,051.08
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: HC Egd Diag Brush/Wash	$2,901.60	$725.40	$115.67 – $2,916.34
Upper GI endoscopy (diagnostic): 10 of 136 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $2,486.67 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $2,486.67 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,166.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $115.67 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,201.53 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,166.53 BC [814] — BLUE CROSS HMO: $2,367.71 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,166.53 BLUE CROSS [220] — BLUE CROSS HMO: $2,367.71 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,367.71
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: HC Egd Diag W/Fmt	$2,901.60	$725.40	$115.67 – $2,916.34
Upper GI endoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $731.20 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $966.23 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,166.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $115.67 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,201.53 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,166.53 BC [814] — BLUE CROSS HMO: $641.25 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,166.53 BLUE CROSS [220] — BLUE CROSS HMO: $641.25 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $612.24
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: HC Egd W/Biopsy Sgl/Mult	$2,597.40	$649.35	$128.99 – $2,916.34
Upper GI endoscopy with biopsy: 10 of 136 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $654.54 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $864.93 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,166.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $128.99 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,201.53 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,166.53 BC [814] — BLUE CROSS HMO: $574.03 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,166.53 BLUE CROSS [220] — BLUE CROSS HMO: $574.03 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $548.05
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: HC Colonoscpy	$2,997.98	$749.49	$170.35 – $2,990.20
Colonoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $755.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $998.33 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,196.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $170.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,231.96 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,196.08 BC [814] — BLUE CROSS HMO: $662.55 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,196.08 BLUE CROSS [220] — BLUE CROSS HMO: $662.55 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $632.57
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: HC Diagnostic Colonoscopy	$2,997.98	$749.49	$170.35 – $2,990.20
Colonoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $605.59 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $605.59 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,196.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $170.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,231.96 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,196.08 BC [814] — BLUE CROSS HMO: $518.65 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,196.08 BLUE CROSS [220] — BLUE CROSS HMO: $518.65 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $518.65
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: HC Colonoscopy W/Fmt	$2,997.98	$749.49	$170.35 – $2,990.20
Colonoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $755.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $998.33 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,196.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $170.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,231.96 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,196.08 BC [814] — BLUE CROSS HMO: $662.55 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,196.08 BLUE CROSS [220] — BLUE CROSS HMO: $662.55 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $632.57
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: HC Colonoscopy W/Biopsy	$3,887.40	$971.85	$184.11 – $3,847.70
Colonoscopy with biopsy: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $979.62 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,294.50 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,539.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $184.11 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,585.25 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,539.08 BC [814] — BLUE CROSS HMO: $859.12 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,539.08 BLUE CROSS [220] — BLUE CROSS HMO: $859.12 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $820.24
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: HC Colonoscpy Tum/Pol/Les Sr	$3,385.34	$846.33	$231.38 – $3,847.70
Colonoscopy with removal of polyps (snare): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $853.11 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,127.32 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,539.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $231.38 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,585.25 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,539.08 BC [814] — BLUE CROSS HMO: $748.16 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,539.08 BLUE CROSS [220] — BLUE CROSS HMO: $748.16 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $714.31
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: HC Colonscopy Endo US Exam	$3,691.96	$922.99	$234.68 – $3,847.70
Ultrasound of the lower bowel by endoscope: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $930.37 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,229.42 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,539.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $234.68 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,585.25 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,539.08 BC [814] — BLUE CROSS HMO: $815.92 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,539.08 BLUE CROSS [220] — BLUE CROSS HMO: $815.92 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $779
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: HC Laparoscopy Surg Cholecystectomy	$49,754.53	$12,438.63	$640.87 – $39,803.62
Gallbladder removal by laparoscope: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $10,050.42 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $10,050.42 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $7,775.56 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $640.87 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $8,008.82 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $7,775.56 BC [814] — BLUE CROSS HMO: $8,607.53 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,775.56 BLUE CROSS [220] — BLUE CROSS HMO: $8,607.53 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $8,607.53
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: HC Prp I/Hern Init Reduc>5 R	$13,329.79	$3,332.45	$519.79 – $19,520.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $11,423.63 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $11,423.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $4,604.99 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $519.79 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $4,743.14 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $4,604.99 BC [814] — BLUE CROSS HMO: $10,877.11 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $4,604.99 BLUE CROSS [220] — BLUE CROSS HMO: $10,877.11 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $10,877.11
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: HC Rpr I/Hern Init Redc >5yr	$15,636.67	$3,909.17	$519.79 – $19,520.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,158.61 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,158.61 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $4,604.99 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $519.79 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $4,743.14 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $4,604.99 BC [814] — BLUE CROSS HMO: $2,705.14 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $4,604.99 BLUE CROSS [220] — BLUE CROSS HMO: $2,705.14 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,705.14
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier 50 In the file: HC Prp I/Hern Init Reduc>5 R\|BILATERAL PROCEDURE	$13,329.79	$3,332.45	$519.79 – $19,520.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 59 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $7,808.19 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $8,042.43 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $7,808.19 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,808.19 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,808.19 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,808.19 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,808.19 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,808.19 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHLJ: $7,808.19 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHLJ: $7,808.19
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HC Hysteroscopy Biopsy	$28,325.92	$7,081.48	$206.18 – $22,660.74
Hysteroscopy with biopsy of the uterus lining: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $5,721.84 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $5,721.84 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $4,163.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $206.18 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $4,288.39 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $4,163.48 BC [814] — BLUE CROSS HMO: $4,900.38 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $4,163.48 BLUE CROSS [220] — BLUE CROSS HMO: $4,900.38 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4,900.38
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC Inj Lumbr/Sacrl W Image	$2,071.74	$517.93	$93.19 – $2,269.70
Spinal injection, lower back (epidural), with imaging guidance: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $418.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $418.49 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $907.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $93.19 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $935.12 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $907.88 BC [814] — BLUE CROSS HMO: $358.41 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $907.88 BLUE CROSS [220] — BLUE CROSS HMO: $358.41 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $358.41
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Foramn Epi L/S 1lev	$2,277.28	$569.32	$105.07 – $2,843.95
Nerve root injection, lower back, with imaging guidance: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $460.01 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $460.01 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,137.58 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.07 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,171.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,137.58 BC [814] — BLUE CROSS HMO: $393.97 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,137.58 BLUE CROSS [220] — BLUE CROSS HMO: $393.97 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $393.97
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Foramen Epi L/S 1 Lev, Bilateral	$4,554.55	$1,138.64	$105.07 – $3,643.64
Nerve root injection, lower back, with imaging guidance: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $920.02 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $920.02 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,137.58 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.07 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,171.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,137.58 BC [814] — BLUE CROSS HMO: $787.94 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,137.58 BLUE CROSS [220] — BLUE CROSS HMO: $787.94 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $787.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$2,277.28	$569.32	$105.07 – $2,843.95
Nerve root injection, lower back, with imaging guidance: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $460.01 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $460.01 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $1,137.58 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.07 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $1,171.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $1,137.58 BC [814] — BLUE CROSS HMO: $393.97 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $1,137.58 BLUE CROSS [220] — BLUE CROSS HMO: $393.97 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $393.97
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: HC Neuroplasty Med Nrv Carp	$4,255.65	$1,063.91	$340.45 – $6,278.83
Carpal tunnel release: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $859.64 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $859.64 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $2,511.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $457.62 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $2,586.88 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $2,511.53 BC [814] — BLUE CROSS HMO: $736.23 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $2,511.53 BLUE CROSS [220] — BLUE CROSS HMO: $736.23 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $736.23
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: HC Discisn 2nd Cataract Lasr	$1,006.20	$251.55	$80.50 – $1,768.47
Laser treatment of clouding after cataract surgery: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $203.25 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $203.25 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $707.39 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $305.24 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $728.61 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $707.39 BC [814] — BLUE CROSS HMO: $174.07 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $707.39 BLUE CROSS [220] — BLUE CROSS HMO: $174.07 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $174.07
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: HC Discisn 2nd Cataract Lasr V	$1,006.20	$251.55	$80.50 – $1,768.47
Laser treatment of clouding after cataract surgery: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $203.25 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $203.25 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $707.39 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $305.24 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $728.61 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $707.39 BC [814] — BLUE CROSS HMO: $174.07 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $707.39 BLUE CROSS [220] — BLUE CROSS HMO: $174.07 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $174.07
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: HC Cataract Rml W/Iol 1 Stg	$7,774.02	$1,943.50	$501.72 – $7,420.62
Cataract removal with lens implant: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,570.35 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,570.35 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $2,968.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $501.72 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $3,057.29 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $2,968.25 BC [814] — BLUE CROSS HMO: $1,344.91 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $2,968.25 BLUE CROSS [220] — BLUE CROSS HMO: $1,344.91 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,344.91

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	$877,065.18	$219,266.29	$94,000.21 – $185,119.92
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 125 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $94,000.21 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $96,820.22 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $94,000.21 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $94,000.21 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHLJ: $94,000.21 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHLJ: $94,000.21 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHLJ: $94,000.21 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHLJ: $94,000.21 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHLJ: $94,000.21 CIGNA [280] — CIGNA HMO PPO: $161,122.72
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$193,685.57	$48,421.39	$16,164.18 – $52,946.38
Hip or knee replacement (major joint of the leg), without major complications: 10 of 123 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $22,430 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $22,430 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $18,725.85 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $19,287.63 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $18,725.85 BC [814] — BLUE CROSS HMO: $27,600.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $18,725.85 BLUE CROSS [220] — BLUE CROSS HMO: $27,600.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $16,164.18 BLUE CROSS [220] — BLUE CROSS PPO MCS: $52,946.38
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	$260,701.22	$65,175.30	$20,458.09 – $67,011.24
Neck (cervical) spinal fusion, without complications: 10 of 123 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $26,984 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $26,984 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $23,636.86 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $24,345.97 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $23,636.86 BC [814] — BLUE CROSS HMO: $34,932.56 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $23,636.86 BLUE CROSS [220] — BLUE CROSS HMO: $34,932.56 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $20,458.09 BLUE CROSS [220] — BLUE CROSS PPO MCS: $67,011.24
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	$185,349.27	$46,337.32	$10,397.07 – $45,914.58
Uterus and ovary surgery (not for cancer), without complications: 10 of 123 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $32,060.93 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $45,914.58 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHLJ: $12,129.91 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHLJ: $12,493.81 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHLJ: $12,129.91 BC [814] — BLUE CROSS HMO: $17,753.18 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHLJ: $12,129.91 BLUE CROSS [220] — BLUE CROSS HMO: $17,753.18 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $10,397.07 BLUE CROSS [220] — BLUE CROSS PPO MCS: $34,055.97

Source: Scripps Memorial Hospital La Jolla’s standard charges file (apps.scripps.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 30, 2026; retrieved October 31, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Acute Care Hospital
Address	9888 Genesee Avenue, La Jolla, CA 92037
County	San Diego County
State	California
Phone	(858) 626‑4123
Emergency services	Yes
Ownership	Physician
Medicare overall rating	5 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	050324
Name in Medicare records	SCRIPPS MEMORIAL HOSPITAL LA JOLLA
Profile level	Medicare data + hospital website
Official website	scripps.org
Corrections	Report an error or suggest an update →

Sources

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

From the hospital’s website

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

Scripps Memorial Hospital La Jolla — scripps.org
International Patient Services - Scripps - San Diego — scripps.org
Scripps Emergency Room - La Jolla - Address and Parking — scripps.org
Emergency Care in San Diego - Scripps Health — scripps.org
Stroke Quality Measures and Outcomes - Scripps Health — scripps.org
Trauma Centers - San Diego - Scripps Health — scripps.org
Stroke Treatment and Recovery - Scripps Health — scripps.org
Out-of-Town Patients - San Diego - Scripps Health — scripps.org
Care for Underlying Conditions of Cryptogenic Stroke — scripps.org