Does Shriners Hospitals for Children Northern Calif have an emergency room?

Medicare (CMS) data does not list emergency services at Shriners Hospitals for Children Northern Calif. The closest hospitals that do: University of California Davis Medical Center (0.1 mi), Mercy General Hospital (1.2 mi) and Sutter Medical Center, Sacramento (1.4 mi). In a medical emergency, call 911.

Where is Shriners Hospitals for Children Northern Calif?

2425 Stockton Boulevard, Sacramento, CA 95817, in Sacramento County, California.

What is the phone number of Shriners Hospitals for Children Northern Calif?

(916) 453-2000, as listed by Medicare (CMS).

What is the Medicare star rating of Shriners Hospitals for Children Northern Calif?

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

Shriners Hospitals for Children Northern Calif

Quick answers

Does Shriners Hospitals for Children Northern Calif have an emergency room?: Medicare (CMS) data does not list emergency services at Shriners Hospitals for Children Northern Calif. The closest hospitals that do: University of California Davis Medical Center (0.1 mi), Mercy General Hospital (1.2 mi) and Sutter Medical Center, Sacramento (1.4 mi). In a medical emergency, call 911.
Where is Shriners Hospitals for Children Northern Calif?: 2425 Stockton Boulevard, Sacramento, CA 95817, in Sacramento County, California.
What is the phone number of Shriners Hospitals for Children Northern Calif?: (916) 453-2000, as listed by Medicare (CMS).
What is the Medicare star rating of Shriners Hospitals for Children Northern Calif?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][11][14]

Conditions treated^{[4][10][11][14]}

Idiopathic scoliosis
Congenital scoliosis
Scheuermann's kyphosis
Spondylolisthesis
Spinal fractures and tumors
Brachial plexus
Cerebral palsy
Clubfoot
Hand or limb deficiencies
Spina bifida
Spinal disorders
Sports injuries
Spinal cord injuries
Burn injuries
Cleft lip
Cleft palate
Anorectal disorders
Chest wall malformations
Spinal tumors

Treatments^[4][7][11]

Fusionless treatments for the growing spine
Spinal fusion
Minimally invasive (nonfusion) spine surgery
Fusionless scoliosis treatment
Orthotic and prosthetic services
Gait analysis before surgery

Procedures^[4][11]

Minimally invasive (nonfusion) spine surgery
Spinal fusion for children
Cleft lip and cleft palate repair

Programs and centers^{[4][8][10][11][12]}

Neil Reitman Burn Institute
Pediatric Spine Center
Young Adult Transition in Care Program
Patient Alumni Network
Pediatric Orthopedic Surgery Fellowship
Neil Reitman Pediatric Burn Institute
Pediatric Orthotic and Prosthetic Services (POPS)
Pediatric Colorectal Center
Institute of Pediatric Regenerative Medicine (with UC Davis Health)
On-site public school (with Sacramento City Unified School District)
Therapeutic recreation and child life
Pet therapy
Service dog program
BikeFit adaptive bicycle program
School re-entry program

Visiting and practical information

Visiting	Visitors must be 18+ or accompanied by a parent/guardian; wear badges; ICU limited to two visitors at a time^[6]
Parking	Free 24-hour visitor parking in the garage directly behind the hospital^[9]
Interpreters and languages	Interpreter Services listed as a patient resource^[4]
Patient portal	Patient Portal

Recognition^[11]

Burn program verified by the American Burn Association and American College of Surgeons

Nearest emergency rooms

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

University of California Davis Medical Center0.1 mi · Sacramento, CA · Acute Care Hospital
Mercy General Hospital1.2 mi · Sacramento, CA · Acute Care Hospital
Sutter Medical Center, Sacramento1.4 mi · Sacramento, CA · Acute Care Hospital
Kaiser Foundation Hospital - Sacramento4.8 mi · Sacramento, CA · Acute Care Hospital
Kaiser Foundation Hosp So Sacramento5.9 mi · Sacramento, CA · Acute Care Hospital

Other hospitals nearby

UC Davis Rehabilitation Hospital0.5 mi · Sacramento, CA · Inpatient Rehabilitation Hospital
Sutter Center for Psychiatry2.2 mi · Sacramento, CA · Psychiatric Hospital
Sacramento Behavioral Healthcare Hospital, LLC3.2 mi · North Sacramento, 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

University Post-Acute Rehab0.4 mi · Sacramento, CA · 5 of 5 stars
Saylor Lane Healthcare Center1.0 mi · Sacramento, CA · 4 of 5 stars
McKinley Park Care Center1.4 mi · Sacramento, CA · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Blossom Ridge Hospice2.9 mi · Sacramento, CA · 3 of 5 stars
AHC Home Care of Sacramento3.7 mi · North Sacramento, CA
American River Hospice Services3.7 mi · Sacramento, CA · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Blossom Ridge Home Health Agency2.9 mi · Sacramento, CA · 2 of 5 stars
Clinicians Connect Care Home Health3.2 mi · Sacramento, CA · 2 of 5 stars
AHC Home Health of Sacramento3.7 mi · Sacramento, CA · 4 of 5 stars

All home health agencies in the state →

Dialysis facilities

DaVita Broadway Dialysis0.2 mi · Sacramento, CA · 3 of 5 stars
UC Davis Medical Center Pediatric0.2 mi · Sacramento, CA
DaVita Alhambra Dialysis Center1.6 mi · Sacramento, CA · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Sutter Alhambra Surgery Center, LP0.2 mi · Sacramento, CA
Sacramento Midtown Endoscopy Center1.4 mi · Sacramento, CA
Fort Sutter Surgery Center1.6 mi · Sacramento, 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

Mobile Medical Center0.5 mi · Sacramento, CA · Community health center
Sacramento County Primary Care Center0.5 mi · Sacramento, CA · Community health center
WellSpace Health - Oak Park Community Health Center0.8 mi · Sacramento, CA · Community health center

Clinics and urgent care

Turning Point Community Programs0.2 mi · Sacramento, CA · Urgent care center
Kumar Health Solutions Inc2.6 mi · Sacramento, CA · Urgent care center
MDR Care LLC3.4 mi · Sacramento, CA · Urgent care center

Pharmacies

Regents of the University of California0.2 mi · Sacramento, CA · Community/retail pharmacy
Regents of the University of California0.2 mi · Sacramento, CA · Community/retail pharmacy
Regents of the University of California0.2 mi · Sacramento, CA · Community/retail pharmacy

Assisted living nearby

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

Oakmont of East Sacramento1.4 mi · East Sacramen, CA
Wholesome Elderly on T1.4 mi · Sacramento, CA
Abounding Peace Elderly Care II1.4 mi · Sacramento, CA
Pavilion Sunrise Assisted Living1.4 mi · Sacramento, 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 Shriners Hospitals for Children Northern Calif 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.

Not reported to Medicare

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)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

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	Not reported to Medicare
Deaths within 30 days: heart failure patients	Not reported to Medicare
Deaths within 30 days: pneumonia patients	Not reported to Medicare
Deaths within 30 days: COPD patients	Not reported to Medicare
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

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	Not reported to Medicare
Readmitted within 30 days: heart failure	Not reported to Medicare
Readmitted within 30 days: pneumonia	Not reported to Medicare
Readmitted within 30 days: COPD	Not reported to Medicare
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

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.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

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 Sacramento Best hospitals in Sacramento

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 45 common services exactly as Shriners Hospitals for Children Northern Calif 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 →

$ 3 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN	$574.01	$574.01	$21.32 – $536
New patient office visit (about 30–44 minutes): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $65.64 Aetna Better Health of MI — Managed Medicaid: $71.13 Amerigroup NV — Managed Medicaid: $63.79 Anthem - Medi — Cal: $65.64 Centene — AZ Complete Health: $21.32 Centene — Care 1st Health Plan AZ: $21.32 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $81.80 Centene California Health and Wellness — Mgd Mcaid: $65.64 Centene Calviva Health — Managed Medicaid: $65.64 Centene Health Net of CA - Managed Medi — Cal: $65.64
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$388	$388	$21.32 – $110.14
New patient office visit (about 30–44 minutes): 10 of 35 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $65.64 Aetna Better Health of MI — Managed Medicaid: $71.13 Amerigroup NV — Managed Medicaid: $63.79 Centene — AZ Complete Health: $21.32 Centene — Care 1st Health Plan AZ: $21.32 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $81.80 Centene California Health and Wellness — Mgd Mcaid: $65.64 Centene Calviva Health — Managed Medicaid: $65.64 Centene Health Net of CA - Managed Medi — Cal: $65.64 Centene SilverSummitt Healthplan — Medicaid: $70.88
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN	$931.39	$931.39	$24.43 – $536
New patient office visit (about 45–59 minutes): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $79.06 Aetna Better Health of MI — Managed Medicaid: $116.78 Amerigroup NV — Managed Medicaid: $109.18 Anthem - Medi — Cal: $79.06 Centene — AZ Complete Health: $24.43 Centene — Care 1st Health Plan AZ: $24.43 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $134.30 Centene California Health and Wellness — Mgd Mcaid: $79.06 Centene Calviva Health — Managed Medicaid: $79.06 Centene Health Net of CA - Managed Medi — Cal: $79.06
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$493.80	$493.80	$24.43 – $167.97
New patient office visit (about 45–59 minutes): 10 of 35 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $79.06 Aetna Better Health of MI — Managed Medicaid: $116.78 Amerigroup NV — Managed Medicaid: $109.18 Centene — AZ Complete Health: $24.43 Centene — Care 1st Health Plan AZ: $24.43 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $134.30 Centene California Health and Wellness — Mgd Mcaid: $79.06 Centene Calviva Health — Managed Medicaid: $79.06 Centene Health Net of CA - Managed Medi — Cal: $79.06 Centene SilverSummitt Healthplan — Medicaid: $121.31
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN	$1,266.85	$1,266.85	$28.50 – $536
New patient office visit (about 60–74 minutes): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $94.90 Aetna Better Health of MI — Managed Medicaid: $159.75 Amerigroup NV — Managed Medicaid: $140.83 Anthem - Medi — Cal: $94.90 Centene — AZ Complete Health: $28.50 Centene — Care 1st Health Plan AZ: $28.50 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $183.71 Centene California Health and Wellness — Mgd Mcaid: $94.90 Centene Calviva Health — Managed Medicaid: $94.90 Centene Health Net of CA - Managed Medi — Cal: $94.90
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$730.90	$730.90	$28.50 – $223.65
New patient office visit (about 60–74 minutes): 10 of 35 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $94.90 Aetna Better Health of MI — Managed Medicaid: $159.75 Amerigroup NV — Managed Medicaid: $140.83 Centene — AZ Complete Health: $28.50 Centene — Care 1st Health Plan AZ: $28.50 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $183.71 Centene California Health and Wellness — Mgd Mcaid: $94.90 Centene Calviva Health — Managed Medicaid: $94.90 Centene Health Net of CA - Managed Medi — Cal: $94.90 Centene SilverSummitt Healthplan — Medicaid: $156.48
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 57 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$730.90	$730.90	$159.75 – $223.65
New patient office visit (about 60–74 minutes): 10 of 21 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $159.75 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $183.71 Centene SilverSummitt Healthplan — Medicare: $183.71 Centene Trillium Community Health Plan — Mgd Mcd: $181.91 Health Net of CA — Commercial: $183.71 Northbay Healthcare — Medicare Advantage: $159.75 Sana Benefits — Commercial: $223.65 Sutter Medical Foundation — Commercial: $175.72 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$345.50	$345.50	$17.97 – $80.99
Established patient office visit (about 20–29 minutes): 10 of 35 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $27.54 Aetna Better Health of MI — Managed Medicaid: $57.85 Amerigroup NV — Managed Medicaid: $42.67 Centene — AZ Complete Health: $17.97 Centene — Care 1st Health Plan AZ: $17.97 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $66.53 Centene California Health and Wellness — Mgd Mcaid: $27.54 Centene Calviva Health — Managed Medicaid: $27.54 Centene Health Net of CA - Managed Medi — Cal: $27.54 Centene SilverSummitt Healthplan — Medicaid: $47.41
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN	$337.10	$337.10	$1,384.20 – $3,783
Established patient office visit (about 20–29 minutes): 10 of 16 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Centene Trillium Community Health Plan — Mgd Mcd: 87% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$345.50	$345.50	$57.85 – $80.99
Established patient office visit (about 20–29 minutes): 10 of 21 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $57.85 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $66.53 Centene SilverSummitt Healthplan — Medicare: $66.53 Centene Trillium Community Health Plan — Mgd Mcd: $65.87 Health Net of CA — Commercial: $66.53 Northbay Healthcare — Medicare Advantage: $57.85 Sana Benefits — Commercial: $80.99 Sutter Medical Foundation — Commercial: $63.64 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$345.50	$345.50	$22.28 – $118.90
Established patient office visit (about 30–39 minutes): 10 of 35 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $43.03 Aetna Better Health of MI — Managed Medicaid: $84.93 Amerigroup NV — Managed Medicaid: $65.46 Centene — AZ Complete Health: $22.28 Centene — Care 1st Health Plan AZ: $22.28 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $97.67 Centene California Health and Wellness — Mgd Mcaid: $43.03 Centene Calviva Health — Managed Medicaid: $43.03 Centene Health Net of CA - Managed Medi — Cal: $43.03 Centene SilverSummitt Healthplan — Medicaid: $72.73
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN	$337.10	$337.10	$1,384.20 – $3,783
Established patient office visit (about 30–39 minutes): 10 of 16 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Centene Trillium Community Health Plan — Mgd Mcd: 87% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 24 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$345.50	$345.50	$84.93 – $118.90
Established patient office visit (about 30–39 minutes): 10 of 21 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $84.93 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $97.67 Centene SilverSummitt Healthplan — Medicare: $97.67 Centene Trillium Community Health Plan — Mgd Mcd: $96.71 Health Net of CA — Commercial: $97.67 Northbay Healthcare — Medicare Advantage: $84.93 Sana Benefits — Commercial: $118.90 Sutter Medical Foundation — Commercial: $93.42 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	$708	$708	$23.87 – $219.83
Office consultation with a specialist (moderate to high): 10 of 27 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $93.41 Amerigroup NV — Managed Medicaid: $129.36 Centene — AZ Complete Health: $23.87 Centene — Care 1st Health Plan AZ: $23.87 Centene California Health and Wellness — Mgd Mcaid: $93.41 Centene Calviva Health — Managed Medicaid: $93.41 Centene Health Net of CA - Managed Medi — Cal: $93.41 Centene SilverSummitt Healthplan — Medicaid: $143.73 Centene Western Sky Community Care — Mgd. Medicaid: $219.83 Central California Alliance for Health — Mgd Mcd: $93.41

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$87.90	$87.90	$5.19 – $536
Basic metabolic panel (blood test): 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $10.43 Amerigroup NV — Managed Medicaid: $5.19 Anthem — Commercial: $12.57 Anthem - Medi — Cal: $10.43 Centene California Health and Wellness — Mgd Mcaid: $10.43 Centene Calviva Health — Managed Medicaid: $10.43 Centene Health Net of CA - Managed Medi — Cal: $10.43 Centene SilverSummitt Healthplan — Medicaid: $5.77 Centene Western Sky Community Care — Mgd. Medicaid: $7.95 Central California Alliance for Health — Mgd Mcd: $10.43
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$87.90	$87.90	$9.40 – $536
Basic metabolic panel (blood test): 10 of 14 insurance plan rates Dignity Health — Commercial: $536 Kaiser Permanente — Commercial: $100 Providence Health Plan — Commercial: $9.40 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Anthem — Commercial: 50% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CA — Commercial: 60% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$110	$110	$6.49 – $536
Comprehensive metabolic panel (blood test): 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $13.18 Amerigroup NV — Managed Medicaid: $6.49 Anthem — Commercial: $15.72 Anthem - Medi — Cal: $13.18 Centene California Health and Wellness — Mgd Mcaid: $13.18 Centene Calviva Health — Managed Medicaid: $13.18 Centene Health Net of CA - Managed Medi — Cal: $13.18 Centene SilverSummitt Healthplan — Medicaid: $7.21 Centene Western Sky Community Care — Mgd. Medicaid: $9.93 Central California Alliance for Health — Mgd Mcd: $13.18
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$110	$110	$100 – $536
Comprehensive metabolic panel (blood test): 10 of 14 insurance plan rates Dignity Health — Commercial: $536 Kaiser Permanente — Commercial: $100 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Anthem — Commercial: 50% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CA — Commercial: 60% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Providence Health Plan — Commercial: 72% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$110	$110	$11.74 – $536
Comprehensive metabolic panel (blood test): 10 of 14 insurance plan rates Dignity Health — Commercial: $536 Kaiser Permanente — Commercial: $100 Providence Health Plan — Commercial: $11.74 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Anthem — Commercial: 50% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CA — Commercial: 60% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$139.40	$139.40	$8.23 – $536
Cholesterol panel (lipid panel): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $16.55 Aetna Better Health of MI — Managed Medicaid: $13.39 Amerigroup NV — Managed Medicaid: $8.23 Anthem — Commercial: $19.89 Anthem - Medi — Cal: $16.55 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $15.40 Centene California Health and Wellness — Mgd Mcaid: $16.55 Centene Calviva Health — Managed Medicaid: $16.55 Centene Health Net of CA - Managed Medi — Cal: $16.55 Centene SilverSummitt Healthplan — Medicaid: $9.14
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$90.30	$90.30	$5.34 – $536
Kidney function panel: 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $10.90 Amerigroup NV — Managed Medicaid: $5.34 Anthem — Commercial: $12.89 Anthem - Medi — Cal: $10.90 Centene California Health and Wellness — Mgd Mcaid: $10.90 Centene Calviva Health — Managed Medicaid: $10.90 Centene Health Net of CA - Managed Medi — Cal: $10.90 Centene SilverSummitt Healthplan — Medicaid: $5.93 Centene Western Sky Community Care — Mgd. Medicaid: $8.16 Central California Alliance for Health — Mgd Mcd: $10.90
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$90.30	$90.30	$9.65 – $536
Kidney function panel: 10 of 14 insurance plan rates Dignity Health — Commercial: $536 Kaiser Permanente — Commercial: $100 Providence Health Plan — Commercial: $9.65 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Anthem — Commercial: 50% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CA — Commercial: 60% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$85	$85	$5.01 – $536
Liver function panel: 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $9.15 Amerigroup NV — Managed Medicaid: $5.01 Anthem — Commercial: $12.14 Anthem - Medi — Cal: $9.15 Centene California Health and Wellness — Mgd Mcaid: $9.15 Centene Calviva Health — Managed Medicaid: $9.15 Centene Health Net of CA - Managed Medi — Cal: $9.15 Centene SilverSummitt Healthplan — Medicaid: $5.57 Centene Western Sky Community Care — Mgd. Medicaid: $7.68 Central California Alliance for Health — Mgd Mcd: $9.15
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$32.90	$32.90	$1.94 – $536
Urine test (automated, with microscope): 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $3.97 Amerigroup NV — Managed Medicaid: $1.94 Anthem — Commercial: $4.54 Anthem - Medi — Cal: $3.97 Centene California Health and Wellness — Mgd Mcaid: $3.97 Centene Calviva Health — Managed Medicaid: $3.97 Centene Health Net of CA - Managed Medi — Cal: $3.97 Centene SilverSummitt Healthplan — Medicaid: $2.16 Centene Western Sky Community Care — Mgd. Medicaid: $2.98 Central California Alliance for Health — Mgd Mcd: $3.97
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$26.60	$26.60	$1.58 – $536
Urine test (manual, without microscope): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $3.08 Aetna Better Health of MI — Managed Medicaid: $3.48 Amerigroup NV — Managed Medicaid: $1.58 Anthem — Commercial: $3.53 Anthem - Medi — Cal: $3.08 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $4 Centene California Health and Wellness — Mgd Mcaid: $3.08 Centene Calviva Health — Managed Medicaid: $3.08 Centene Health Net of CA - Managed Medi — Cal: $3.08 Centene SilverSummitt Healthplan — Medicaid: $1.75
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$23.40	$23.40	$1.38 – $536
Urine test (automated, without microscope): 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $2.81 Amerigroup NV — Managed Medicaid: $1.38 Anthem — Commercial: $3.34 Anthem - Medi — Cal: $2.81 Centene California Health and Wellness — Mgd Mcaid: $2.81 Centene Calviva Health — Managed Medicaid: $2.81 Centene Health Net of CA - Managed Medi — Cal: $2.81 Centene SilverSummitt Healthplan — Medicaid: $1.53 Centene Western Sky Community Care — Mgd. Medicaid: $2.12 Central California Alliance for Health — Mgd Mcd: $2.81
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$175	$175	$10.32 – $536
Thyroid stimulating hormone (TSH) test: 10 of 28 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $21.17 Amerigroup NV — Managed Medicaid: $10.32 Anthem — Commercial: $24.96 Anthem - Medi — Cal: $21.17 Centene California Health and Wellness — Mgd Mcaid: $21.17 Centene Calviva Health — Managed Medicaid: $21.17 Centene Health Net of CA - Managed Medi — Cal: $21.17 Centene SilverSummitt Healthplan — Medicaid: $11.47 Centene Western Sky Community Care — Mgd. Medicaid: $15.79 Central California Alliance for Health — Mgd Mcd: $21.17
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$80.90	$80.90	$4.78 – $536
Complete blood count (CBC) with differential: 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $9.68 Aetna Better Health of MI — Managed Medicaid: $7.77 Amerigroup NV — Managed Medicaid: $4.78 Anthem — Commercial: $11.55 Anthem - Medi — Cal: $9.68 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $8.94 Centene California Health and Wellness — Mgd Mcaid: $9.68 Centene Calviva Health — Managed Medicaid: $9.68 Centene Health Net of CA - Managed Medi — Cal: $9.68 Centene SilverSummitt Healthplan — Medicaid: $5.31
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$106.10	$106.10	$3.98 – $536
Complete blood count (CBC), automated: 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $8.19 Aetna Better Health of MI — Managed Medicaid: $6.47 Amerigroup NV — Managed Medicaid: $3.98 Anthem — Commercial: $9.61 Anthem - Medi — Cal: $8.19 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $7.44 Centene California Health and Wellness — Mgd Mcaid: $8.19 Centene Calviva Health — Managed Medicaid: $8.19 Centene Health Net of CA - Managed Medi — Cal: $8.19 Centene SilverSummitt Healthplan — Medicaid: $4.42
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$67.30	$67.30	$3.98 – $536
Complete blood count (CBC), automated: 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $8.19 Aetna Better Health of MI — Managed Medicaid: $6.47 Amerigroup NV — Managed Medicaid: $3.98 Anthem — Commercial: $9.61 Anthem - Medi — Cal: $8.19 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $7.44 Centene California Health and Wellness — Mgd Mcaid: $8.19 Centene Calviva Health — Managed Medicaid: $8.19 Centene Health Net of CA - Managed Medi — Cal: $8.19 Centene SilverSummitt Healthplan — Medicaid: $4.42
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$40.90	$40.90	$2.42 – $536
Blood clotting time test (prothrombin time, PT): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $5.01 Aetna Better Health of MI — Managed Medicaid: $4.29 Amerigroup NV — Managed Medicaid: $2.42 Anthem — Commercial: $5.85 Anthem - Medi — Cal: $5.01 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $4.93 Centene California Health and Wellness — Mgd Mcaid: $5.01 Centene Calviva Health — Managed Medicaid: $5.01 Centene Health Net of CA - Managed Medi — Cal: $5.01 Centene SilverSummitt Healthplan — Medicaid: $2.69
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$62.50	$62.50	$3.69 – $536
Blood clotting test (partial thromboplastin time, PTT): 10 of 36 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $7.66 Aetna Better Health of MI — Managed Medicaid: $6.01 Amerigroup NV — Managed Medicaid: $3.69 Anthem — Commercial: $8.92 Anthem - Medi — Cal: $7.66 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $6.91 Centene California Health and Wellness — Mgd Mcaid: $7.66 Centene Calviva Health — Managed Medicaid: $7.66 Centene Health Net of CA - Managed Medi — Cal: $7.66 Centene SilverSummitt Healthplan — Medicaid: $4.10

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

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$1,430.40	$1,430.40	$100 – $199.10
CT scan of the head or brain, without contrast: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $145.26 Aetna Better Health of MI — Managed Medicaid: $135.68 Aetna National — Commercial: $165.77 Amerigroup NV — Managed Medicaid: $117.32 Anthem — Commercial: $199.10 Anthem - Medi — Cal: $145.26 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $156.03 Centene California Health and Wellness — Mgd Mcaid: $145.26 Centene Calviva Health — Managed Medicaid: $145.26 Centene Health Net of CA - Managed Medi — Cal: $145.26
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$3,926.10	$3,926.10	$100 – $926.42
MRI of the brain, before and after contrast: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $446.18 Aetna Better Health of MI — Managed Medicaid: $452.77 Aetna National — Commercial: $500.87 Amerigroup NV — Managed Medicaid: $373.46 Anthem — Commercial: $926.42 Anthem - Medi — Cal: $446.18 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $520.69 Centene California Health and Wellness — Mgd Mcaid: $446.18 Centene Calviva Health — Managed Medicaid: $446.18 Centene Health Net of CA - Managed Medi — Cal: $446.18
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS	$395.10	$395.10	$28.02 – $158.12
Chest X-ray, 2 views: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $39.40 Aetna Better Health of MI — Managed Medicaid: $112.94 Aetna National — Commercial: $51.48 Amerigroup NV — Managed Medicaid: $28.02 Anthem — Commercial: $32.94 Anthem - Medi — Cal: $39.40 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $129.88 Centene California Health and Wellness — Mgd Mcaid: $39.40 Centene Calviva Health — Managed Medicaid: $39.40 Centene Health Net of CA - Managed Medi — Cal: $39.40
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF CHEST; 2 VIEWS	$395.10	$395.10	$17.99 – $158.12
Chest X-ray, 2 views: 10 of 26 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $112.94 Aetna National — Commercial: $36.63 Amerigroup NV — Managed Medicaid: $17.99 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $129.88 Centene SilverSummitt Healthplan — Medicaid: $19.99 Centene SilverSummitt Healthplan — Medicare: $129.88 Centene Trillium Community Health Plan — Mgd Mcd: $128.60 Centene Western Sky Community Care — Mgd. Medicaid: $19.74 Health Net of CA — Commercial: $129.88 Health Plan of NV — Managed Medicaid: $19.99
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$551.70	$551.70	$38.90 – $189.95
X-ray of the lower spine, at least 4 views: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $62.90 Aetna Better Health of MI — Managed Medicaid: $135.68 Aetna National — Commercial: $80.25 Amerigroup NV — Managed Medicaid: $47.48 Anthem — Commercial: $38.90 Anthem - Medi — Cal: $62.90 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $156.03 Centene California Health and Wellness — Mgd Mcaid: $62.90 Centene Calviva Health — Managed Medicaid: $62.90 Centene Health Net of CA - Managed Medi — Cal: $62.90
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$551.70	$551.70	$32.33 – $189.95
X-ray of the lower spine, at least 4 views: 10 of 26 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $135.68 Aetna National — Commercial: $62.46 Amerigroup NV — Managed Medicaid: $32.33 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $156.03 Centene SilverSummitt Healthplan — Medicaid: $35.92 Centene SilverSummitt Healthplan — Medicare: $156.03 Centene Trillium Community Health Plan — Mgd Mcd: $154.50 Centene Western Sky Community Care — Mgd. Medicaid: $32.69 Health Net of CA — Commercial: $156.03 Health Plan of NV — Managed Medicaid: $35.92
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$7,144.40	$7,144.40	$100 – $521.55
MRI of the lower back (lumbar spine), without contrast: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $266.80 Aetna Better Health of MI — Managed Medicaid: $309.66 Aetna National — Commercial: $300.08 Amerigroup NV — Managed Medicaid: $231.28 Anthem — Commercial: $521.55 Anthem - Medi — Cal: $266.80 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $356.11 Centene California Health and Wellness — Mgd Mcaid: $266.80 Centene Calviva Health — Managed Medicaid: $266.80 Centene Health Net of CA - Managed Medi — Cal: $266.80
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$2,178	$2,178	$100 – $363.03
CT scan of the pelvis, with contrast: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $293.26 Aetna Better Health of MI — Managed Medicaid: $227.64 Aetna National — Commercial: $363.03 Amerigroup NV — Managed Medicaid: $223.96 Anthem — Commercial: $287.81 Anthem - Medi — Cal: $293.26 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $261.79 Centene California Health and Wellness — Mgd Mcaid: $293.26 Centene Calviva Health — Managed Medicaid: $293.26 Centene Health Net of CA - Managed Medi — Cal: $293.26
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$2,563	$2,563	$100 – $468.71
MRI of a leg joint (such as the knee), without contrast: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $282.46 Aetna Better Health of MI — Managed Medicaid: $309.66 Aetna National — Commercial: $319.53 Amerigroup NV — Managed Medicaid: $242.40 Anthem — Commercial: $468.71 Anthem - Medi — Cal: $282.46 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $356.11 Centene California Health and Wellness — Mgd Mcaid: $282.46 Centene Calviva Health — Managed Medicaid: $282.46 Centene Health Net of CA - Managed Medi — Cal: $282.46
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$4,129.90	$4,129.90	$100 – $633.88
CT scan of the abdomen and pelvis, with contrast: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $404.21 Aetna Better Health of MI — Managed Medicaid: $452.77 Aetna National — Commercial: $479.27 Amerigroup NV — Managed Medicaid: $307.90 Anthem — Commercial: $283.37 Anthem - Medi — Cal: $404.21 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $520.69 Centene California Health and Wellness — Mgd Mcaid: $404.21 Centene Calviva Health — Managed Medicaid: $404.21 Centene Health Net of CA - Managed Medi — Cal: $404.21
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$856.20	$856.20	$83.98 – $189.95
Ultrasound of the abdomen, complete: 10 of 37 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $119.34 Aetna Better Health of MI — Managed Medicaid: $135.68 Aetna National — Commercial: $177.85 Amerigroup NV — Managed Medicaid: $134.39 Anthem — Commercial: $83.98 Anthem - Medi — Cal: $119.34 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $156.03 Centene California Health and Wellness — Mgd Mcaid: $119.34 Centene Calviva Health — Managed Medicaid: $119.34 Centene Health Net of CA - Managed Medi — Cal: $119.34
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$856.20	$856.20	$78.67 – $189.95
Ultrasound of the abdomen, complete: 10 of 26 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $135.68 Aetna National — Commercial: $123.87 Amerigroup NV — Managed Medicaid: $96.62 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $156.03 Centene SilverSummitt Healthplan — Medicaid: $107.35 Centene SilverSummitt Healthplan — Medicare: $156.03 Centene Trillium Community Health Plan — Mgd Mcd: $154.50 Centene Western Sky Community Care — Mgd. Medicaid: $78.67 Health Net of CA — Commercial: $156.03 Health Plan of NV — Managed Medicaid: $107.35

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPEUTIC EXERCISES	$202.40	$202.40	$30.48 – $307
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $30.48 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $35.05 Centene SilverSummitt Healthplan — Medicare: $35.05 Centene Trillium Community Health Plan — Mgd Mcd: $34.71 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $35.05 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $30.48
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPEUTIC EXERCISES	$202.40	$202.40	$30.48 – $307
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $30.48 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $35.05 Centene SilverSummitt Healthplan — Medicare: $35.05 Centene Trillium Community Health Plan — Mgd Mcd: $34.71 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $35.05 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $30.48
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GN In the file: THERAPEUTIC EXERCISES	$197.50	$197.50	$30.48 – $307
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $30.48 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $35.05 Centene SilverSummitt Healthplan — Medicare: $35.05 Centene Trillium Community Health Plan — Mgd Mcd: $34.71 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $35.05 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $30.48
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$261.20	$261.20	$26.06 – $307
Physical therapy evaluation (low complexity): 10 of 26 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $103.01 Aetna National — Commercial: $149.03 Amerigroup NV — Managed Medicaid: $63.50 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $118.46 Centene SilverSummitt Healthplan — Medicaid: $70.55 Centene SilverSummitt Healthplan — Medicare: $118.46 Centene Trillium Community Health Plan — Mgd Mcd: $117.30 Centene Western Sky Community Care — Mgd. Medicaid: $26.06 Cigna — Commercial: $130
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$261.20	$261.20	$100 – $307
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $103.01 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $118.46 Centene SilverSummitt Healthplan — Medicare: $118.46 Centene Trillium Community Health Plan — Mgd Mcd: $117.30 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $118.46 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $103.01
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$261.20	$261.20	$100 – $307
Physical therapy evaluation (low complexity): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $103.01 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $118.46 Centene SilverSummitt Healthplan — Medicare: $118.46 Centene Trillium Community Health Plan — Mgd Mcd: $117.30 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $118.46 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $103.01
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$391.80	$391.80	$52.11 – $307
Physical therapy evaluation (moderate complexity): 10 of 26 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $103.01 Aetna National — Commercial: $149.03 Amerigroup NV — Managed Medicaid: $63.50 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $118.46 Centene SilverSummitt Healthplan — Medicaid: $70.55 Centene SilverSummitt Healthplan — Medicare: $118.46 Centene Trillium Community Health Plan — Mgd Mcd: $117.30 Centene Western Sky Community Care — Mgd. Medicaid: $52.11 Cigna — Commercial: $130
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$391.80	$391.80	$100 – $307
Physical therapy evaluation (moderate complexity): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $103.01 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $118.46 Centene SilverSummitt Healthplan — Medicare: $118.46 Centene Trillium Community Health Plan — Mgd Mcd: $117.30 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $118.46 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $103.01
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$587.60	$587.60	$100 – $307
Physical therapy evaluation (high complexity): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $103.01 Anthem — Commercial: $307 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $118.46 Centene SilverSummitt Healthplan — Medicare: $118.46 Centene Trillium Community Health Plan — Mgd Mcd: $117.30 Cigna — Commercial: $130 Dignity Health — Commercial: $233 Health Net of CA — Commercial: $118.46 Kaiser Permanente — Commercial: $100 Northbay Healthcare — Medicare Advantage: $103.01

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$18,400.55	$18,400.55	$1,664 – $6,120
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4,246.45 Aetna National — Commercial: $1,924 Anthem — Commercial: $2,941 Blue Cross Blue Shield of CA — Commercial: $5,794.77 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $4,883.42 Centene SilverSummitt Healthplan — Medicare: $4,883.42 Centene Trillium Community Health Plan — Mgd Mcd: $4,835.43 Cigna — Commercial: $1,664 Health Net of CA — Commercial: $4,883.42 Kaiser Permanente — Commercial: $4,246.45
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$10,746.97	$10,746.97	$1,664 – $6,120
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4,246.45 Aetna National — Commercial: $1,924 Anthem — Commercial: $2,941 Blue Cross Blue Shield of CA — Commercial: $5,794.77 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $4,883.42 Centene SilverSummitt Healthplan — Medicare: $4,883.42 Centene Trillium Community Health Plan — Mgd Mcd: $4,835.43 Cigna — Commercial: $1,664 Health Net of CA — Commercial: $4,883.42 Kaiser Permanente — Commercial: $4,246.45
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT_XS In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$6,391.30	$6,391.30	$1,664 – $6,120
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4,246.45 Aetna National — Commercial: $1,924 Anthem — Commercial: $2,941 Blue Cross Blue Shield of CA — Commercial: $5,794.77 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $4,883.42 Centene SilverSummitt Healthplan — Medicare: $4,883.42 Centene Trillium Community Health Plan — Mgd Mcd: $4,835.43 Cigna — Commercial: $1,664 Health Net of CA — Commercial: $4,883.42 Kaiser Permanente — Commercial: $4,246.45
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$5,333.52	$5,333.52	$113.43 – $3,064.10
Upper GI endoscopy (diagnostic): 10 of 39 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $321.48 Aetna Better Health of MI — Managed Medicaid: $1,177.10 Aetna National — Commercial: $988 Amerigroup NV — Managed Medicaid: $113.43 Anthem — Commercial: $2,266 Anthem - Medi — Cal: $321.48 Blue Cross Blue Shield of CA — Commercial: $3,064.10 Centene — AZ Complete Health: $174.52 Centene — Care 1st Health Plan AZ: $174.52 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,353.66
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$3,813.48	$3,813.48	$126.75 – $4,501
Upper GI endoscopy with biopsy: 10 of 39 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $335.91 Aetna Better Health of MI — Managed Medicaid: $1,177.10 Aetna National — Commercial: $1,486 Amerigroup NV — Managed Medicaid: $126.75 Anthem — Commercial: $2,266 Anthem - Medi — Cal: $335.91 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene — AZ Complete Health: $250.33 Centene — Care 1st Health Plan AZ: $250.33 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,353.66
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$8,717.19	$8,717.19	$1,177.10 – $4,501
Upper GI endoscopy with biopsy: 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $1,177.10 Aetna National — Commercial: $1,486 Anthem — Commercial: $2,266 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,353.66 Centene SilverSummitt Healthplan — Medicare: $1,353.66 Centene Trillium Community Health Plan — Mgd Mcd: $1,340.36 Cigna — Commercial: $1,248 Health Net of CA — Commercial: $1,353.66 Kaiser Permanente — Commercial: $1,177.10
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$5,333.53	$5,333.53	$165.57 – $4,501
Colonoscopy (diagnostic): 10 of 39 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $423.48 Aetna Better Health of MI — Managed Medicaid: $1,206.91 Aetna National — Commercial: $1,486 Amerigroup NV — Managed Medicaid: $184.55 Anthem — Commercial: $1,814 Anthem - Medi — Cal: $423.48 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene — AZ Complete Health: $165.57 Centene — Care 1st Health Plan AZ: $165.57 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,387.95
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$7,803.73	$7,803.73	$1,206.91 – $4,501
Colonoscopy (diagnostic): 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $1,206.91 Aetna National — Commercial: $1,486 Anthem — Commercial: $1,814 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,387.95 Centene SilverSummitt Healthplan — Medicare: $1,387.95 Centene Trillium Community Health Plan — Mgd Mcd: $1,374.31 Cigna — Commercial: $1,248 Health Net of CA — Commercial: $1,387.95 Kaiser Permanente — Commercial: $1,206.91
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$4,329.03	$4,329.03	$220.25 – $4,501
Colonoscopy with biopsy: 10 of 39 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $473.68 Aetna Better Health of MI — Managed Medicaid: $1,553.02 Aetna National — Commercial: $1,486 Amerigroup NV — Managed Medicaid: $220.25 Anthem — Commercial: $1,814 Anthem - Medi — Cal: $473.68 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene — AZ Complete Health: $246.39 Centene — Care 1st Health Plan AZ: $246.39 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,785.97
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$12,213.75	$12,213.75	$1,664 – $6,505.37
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4,646.69 Aetna National — Commercial: $1,924 Anthem — Commercial: $2,941 Blue Cross Blue Shield of CA — Commercial: $5,794.77 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $5,343.69 Centene SilverSummitt Healthplan — Medicare: $5,343.69 Centene Trillium Community Health Plan — Mgd Mcd: $5,291.19 Cigna — Commercial: $1,664 Health Net of CA — Commercial: $5,343.69 Kaiser Permanente — Commercial: $4,646.69
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$5,720.20	$5,720.20	$1,664 – $6,505.37
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4,646.69 Aetna National — Commercial: $1,924 Anthem — Commercial: $2,941 Blue Cross Blue Shield of CA — Commercial: $5,794.77 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $5,343.69 Centene SilverSummitt Healthplan — Medicare: $5,343.69 Centene Trillium Community Health Plan — Mgd Mcd: $5,291.19 Cigna — Commercial: $1,664 Health Net of CA — Commercial: $5,343.69 Kaiser Permanente — Commercial: $4,646.69
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier UB In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$14,688.49	$14,688.49	$1,664 – $6,505.37
Groin (inguinal) hernia repair, age 5 or older: 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4,646.69 Aetna National — Commercial: $1,924 Anthem — Commercial: $2,941 Blue Cross Blue Shield of CA — Commercial: $5,794.77 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $5,343.69 Centene SilverSummitt Healthplan — Medicare: $5,343.69 Centene Trillium Community Health Plan — Mgd Mcd: $5,291.19 Cigna — Commercial: $1,664 Health Net of CA — Commercial: $5,343.69 Kaiser Permanente — Commercial: $4,646.69
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$5,527.24	$5,527.24	$96.74 – $3,064.10
Nerve root injection, lower back, with imaging guidance: 10 of 39 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $205.61 Aetna Better Health of MI — Managed Medicaid: $1,147.88 Aetna National — Commercial: $988 Amerigroup NV — Managed Medicaid: $96.74 Anthem — Commercial: $1,814 Anthem - Medi — Cal: $205.61 Blue Cross Blue Shield of CA — Commercial: $3,064.10 Centene — AZ Complete Health: $142.33 Centene — Care 1st Health Plan AZ: $142.33 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $1,320.06
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	$11,658.71	$11,658.71	$7.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,100.50
Carpal tunnel release: 10 of 39 insurance plan rates Aetna Better Health of CA — Managed Medicaid: $454.46 Aetna Better Health of MI — Managed Medicaid: $2,534.27 Aetna National — Commercial: $1,486 Amerigroup NV — Managed Medicaid: $363.74 Anthem — Commercial: $2,266 Anthem - Medi — Cal: $454.46 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene — AZ Complete Health: $7.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Centene — Care 1st Health Plan AZ: $7.87 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $2,914.41
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$4,586.81	$4,586.81	$1,248 – $4,501
Carpal tunnel release: 10 of 23 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $2,534.27 Aetna National — Commercial: $1,486 Anthem — Commercial: $2,266 Blue Cross Blue Shield of CA — Commercial: $4,100.50 Centene Ambttr Slvr Smmit Hlth Pln — Commercial: $2,914.41 Centene SilverSummitt Healthplan — Medicare: $2,914.41 Centene Trillium Community Health Plan — Mgd Mcd: $2,885.77 Cigna — Commercial: $1,248 Health Net of CA — Commercial: $2,914.41 Kaiser Permanente — Commercial: $2,534.27

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$1,384.20 – $106,162.10
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 20 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Centene SilverSummitt Healthplan — Medicare: $106,162.10 Centene Trillium Community Health Plan — Mgd Mcd: $75,336.49 Centene Western Sky Community Care — Mgd. Medicaid: $42,852.53 Health Net of CA — Commercial: $106,162.10 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal fusion except cervical without major comorbid conditions or complications	Not listed in the file	Not listed in the file	$1,384.20 – $29,047.38
Spinal fusion (not neck), without major complications: 10 of 16 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428 Providence Health Plan — Managed Medicaid: $29,047.38 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Centene Trillium Community Health Plan — Mgd Mcd: 87% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$1,384.20 – $20,740.50
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Centene SilverSummitt Healthplan — Medicare: $20,740.50 Centene Trillium Community Health Plan — Mgd Mcd: $14,718.21 Centene Western Sky Community Care — Mgd. Medicaid: $11,852.87 Health Net of CA — Commercial: $20,740.50 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,384.20 – $26,041.40
Neck (cervical) spinal fusion, without complications: 10 of 20 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Centene SilverSummitt Healthplan — Medicare: $26,041.40 Centene Trillium Community Health Plan — Mgd Mcd: $18,479.92 Centene Western Sky Community Care — Mgd. Medicaid: $6,452.73 Health Net of CA — Commercial: $26,041.40 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,384.20 – $13,185.70
Uterus and ovary surgery (not for cancer), without complications: 10 of 20 insurance plan rates Amerigroup NV — Managed Medicaid: $1,384.20 Anthem — Commercial: $3,500.97 Blue Cross Blue Shield of CA — Commercial: $3,783 Centene SilverSummitt Healthplan — Medicaid: $1,538 Centene SilverSummitt Healthplan — Medicare: $13,185.70 Centene Trillium Community Health Plan — Mgd Mcd: $9,357.05 Centene Western Sky Community Care — Mgd. Medicaid: $3,614.51 Health Net of CA — Commercial: $13,185.70 Health Plan of NV — Managed Medicaid: $1,538 Health Plan of San Joaquin — Managed Medicaid: $2,428

Source: Shriners Hospitals for Children Northern Calif’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 19, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

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

Hospital information

Hospital type	Children's Hospital
Address	2425 Stockton Boulevard, Sacramento, CA 95817
County	Sacramento County
State	California
Phone	(916) 453‑2000
Emergency services	Not listed
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	053311
Name in Medicare records	SHRINERS HOSPITALS FOR CHILDREN NORTHERN CALIF
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(916) 453‑2191^[4]
Name on the hospital’s website	Shriners Children's Northern California
Official website	shrinerschildrens.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.

Shriners Children's Northern California — shrinerschildrens.org
Visiting Us | Shriners Children's Northern California — shrinerschildrens.org
Pediatric Orthopedic Surgery Fellowship | Shriners Children's Northern California — shrinerschildrens.org
Patient Programs | Shriners Children's Northern California — shrinerschildrens.org
Getting Here | Shriners Children’s Northern California — shrinerschildrens.org
About Us | Shriners Children's Northern California — shrinerschildrens.org
Our Treatment Approach | Shriners Children’s Northern California — shrinerschildrens.org
Affiliations and Partners | Shriners Children's Northern California — shrinerschildrens.org
our-care — shrinerschildrens.org