▸ Hospital · CA · CCN 050016
Arroyo Grande Community Hospital
345 SOUTH HALCYON ROAD, ARROYO GRANDE, CA, 93420
1
Compliance grade
A
100/100
Procedures tracked
181
of 209 target codes
Payers
15
with negotiated rates
Rates published
6,307
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 6 | — | — | $12,009 | $12,009 | $12,009 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 14 | $604 | $422.8 | $21.77 | $409.82 | $8,401 |
| ED visit level 2 | CPT | 99282 | 14 | $845 | $591.5 | $34.97 | $573.34 | $8,401 |
| ED visit level 3 | CPT | 99283 | 14 | $1,387 | $970.9 | $63.97 | $941.08 | $18,001 |
| ED visit level 4 | CPT | 99284 | 14 | $1,901 | $1,330.7 | $98.04 | $1,382.03 | $18,001 |
| ED visit level 5 | CPT | 99285 | 14 | $2,663 | $1,864.1 | $155.03 | $1,936.01 | $18,001 |
| Critical care, first hour | CPT | 99291 | 13 | $5,315 | $3,720.5 | $945.69 | $4,232.99 | $18,001 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $2,737 | $1,915.9 | $138.22 | $492.09 | $2,687.74 |
| CT head with contrast | CPT | 70460 | 12 | $5,316 | $3,721.2 | $209.04 | $705.48 | $5,220.32 |
| CT head with and without contrast | CPT | 70470 | 12 | $5,795 | $4,056.5 | $226.78 | $822.35 | $5,690.69 |
| CT neck with contrast | CPT | 70491 | 12 | $5,123 | $3,586.1 | $226.78 | $808.71 | $5,030.79 |
| MRI brain without contrast | CPT | 70551 | 12 | $8,252 | $5,776.4 | $283.78 | $2,004.52 | $8,103.47 |
| MRI brain with contrast | CPT | 70552 | 12 | $8,829 | $6,180.3 | $396.44 | $1,224.17 | $8,670.08 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $9,596 | $6,717.2 | $467.23 | $2,216.8 | $9,423.28 |
| Chest X-ray single view | CPT | 71045 | 13 | $626 | $438.2 | $17.67 | $158.54 | $614.74 |
| Chest X-ray 2 views | CPT | 71046 | 13 | $971 | $679.7 | $27.48 | $182.03 | $953.53 |
| Chest X-ray 3 views | CPT | 71047 | 13 | $1,198 | $838.6 | $35.27 | $182.03 | $1,176.44 |
| CT chest without contrast | CPT | 71250 | 12 | $4,442 | $3,109.4 | $138.22 | $2,113.88 | $4,362.05 |
| CT chest with contrast | CPT | 71260 | 12 | $5,123 | $3,586.1 | $226.78 | $1,410.61 | $5,030.79 |
| CT chest with and without contrast | CPT | 71270 | 12 | $5,738 | $4,016.6 | $226.78 | $919.87 | $5,634.72 |
| MRI chest without contrast | CPT | 71550 | 12 | $3,652 | $2,556.4 | $292.13 | $804.71 | $3,586.27 |
| MRI chest with contrast | CPT | 71551 | 12 | $5,373 | $3,761.1 | $395.33 | $1,529.94 | $5,276.29 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $5,939 | $4,157.3 | $467.53 | $1,215.9 | $5,832.1 |
| Lumbosacral spine X-ray | CPT | 72100 | 13 | $1,036 | $725.2 | $43.45 | $240.94 | $1,017.36 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $5,930 | $4,151 | $138.22 | $609.29 | $5,823.26 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $5,834 | $4,083.8 | $138.22 | $609.29 | $5,728.99 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $6,338 | $4,436.6 | $138.22 | $609.29 | $6,223.92 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $4,671 | $3,269.7 | $277.53 | $1,700.53 | $4,586.93 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $4,671 | $3,269.7 | $277.53 | $1,700.53 | $4,586.93 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $4,671 | $3,269.7 | $277.97 | $1,700.53 | $4,586.93 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $5,891 | $4,123.7 | $399.67 | $1,209.42 | $5,784.97 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $7,185 | $5,029.5 | $467.53 | $1,860.48 | $7,055.67 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $6,984 | $4,888.8 | $467.53 | $1,833.34 | $6,858.29 |
| CT pelvis without contrast | CPT | 72192 | 12 | $3,931 | $2,751.7 | $138.22 | $599.06 | $3,860.25 |
| CT pelvis with contrast | CPT | 72193 | 12 | $5,123 | $3,586.1 | $226.78 | $796.76 | $5,030.79 |
| Shoulder X-ray | CPT | 73030 | 13 | $1,514 | $1,059.8 | $37.09 | $274.88 | $1,486.75 |
| Humerus X-ray | CPT | 73060 | 13 | $626 | $438.2 | $29.81 | $205.07 | $614.74 |
| Hand X-ray 3 views | CPT | 73130 | 13 | $1,068 | $747.6 | $36.06 | $255.6 | $1,048.78 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $6,289 | $4,402.3 | $292.13 | $1,739.52 | $6,175.8 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $8,670 | $6,069 | $408.36 | $2,060.95 | $8,513.94 |
| Knee X-ray 1-2 views | CPT | 73560 | 13 | $1,394 | $975.8 | $27.28 | $251.52 | $1,368.91 |
| Ankle X-ray 3 views | CPT | 73610 | 13 | $1,394 | $975.8 | $36.06 | $255.6 | $1,368.91 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $5,931 | $4,151.7 | $292.13 | $1,700.53 | $5,824.25 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $8,655 | $6,058.5 | $407.06 | $2,058.93 | $8,499.21 |
| CT abdomen without contrast | CPT | 74150 | 12 | $4,576 | $3,203.2 | $138.22 | $1,336.76 | $4,493.64 |
| CT abdomen with contrast | CPT | 74160 | 12 | $4,815 | $3,370.5 | $226.78 | $850.9 | $4,728.33 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $4,893 | $3,425.1 | $226.78 | $866.78 | $4,804.93 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $7,892 | $5,524.4 | $178.43 | $589.49 | $7,749.95 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $8,285 | $5,799.5 | $281.8 | $1,044.99 | $8,135.87 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $8,602 | $6,021.4 | $319.24 | $1,133.14 | $8,447.17 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $4,671 | $3,269.7 | $287.28 | $889.48 | $4,586.93 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $6,403 | $4,482.1 | $351.25 | $1,224.17 | $6,287.75 |
| Abdominal ultrasound complete | CPT | 76700 | 13 | $2,216 | $1,551.2 | $119.34 | $462.49 | $2,176.12 |
| Abdominal ultrasound limited | CPT | 76705 | 13 | $1,578 | $1,104.6 | $87.13 | $391.62 | $1,549.6 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 13 | $1,578 | $1,104.6 | $115.78 | $482.05 | $1,549.6 |
| Obstetric ultrasound first trimester | CPT | 76801 | 13 | $1,896 | $1,327.2 | $78.42 | $394.49 | $1,861.88 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 13 | $1,592 | $1,114.4 | $135.29 | $429.84 | $1,563.35 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 13 | $2,918 | $2,042.6 | $159.03 | $517.79 | $2,865.48 |
| Transvaginal ultrasound | CPT | 76830 | 13 | $1,578 | $1,104.6 | $97.04 | $426.06 | $1,549.6 |
| Pelvic ultrasound complete | CPT | 76856 | 13 | $1,635 | $1,144.5 | $97.04 | $441.45 | $1,605.57 |
| Scrotal ultrasound | CPT | 76870 | 13 | $1,683 | $1,178.1 | $85.75 | $454.41 | $1,652.71 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $742 | $519.4 | $117.89 | $469.2 | $742 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $929 | $650.3 | $149.36 | $597.55 | $929 |
| Screening mammography bilateral | CPT | 77067 | 10 | $868 | $607.6 | $120.94 | $623.32 | $868 |
| EKG tracing only | CPT | 93005 | 12 | $874 | $611.8 | $29.84 | $512.28 | $874 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $3,197 | $2,237.9 | $239.76 | $2,329.81 | $3,197 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $1,743 | $1,220.1 | $215.3 | $784.35 | $1,743 |
| Stress echocardiogram | CPT | 93350 | 12 | $2,407 | $1,684.9 | $137.87 | $722.69 | $2,407 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | — | — | $17,707 | $17,707 | $17,707 |
| COPD w MCC | MS-DRG | 190 | 6 | — | — | $10,940 | $10,940 | $10,940 |
| COPD w CC | MS-DRG | 191 | 6 | — | — | $8,689.82 | $8,689.82 | $8,689.82 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | — | — | $6,926.22 | $6,926.22 | $6,926.22 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 6 | — | — | $8,499.16 | $8,499.16 | $8,499.16 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 6 | — | — | $6,647.71 | $6,647.71 | $6,647.71 |
| AMI discharged alive w MCC | MS-DRG | 280 | 6 | — | — | $15,443 | $15,443 | $15,443 |
| AMI discharged alive w CC | MS-DRG | 281 | 6 | — | — | $9,122.54 | $9,122.54 | $9,122.54 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | — | — | $7,211.28 | $7,211.28 | $7,211.28 |
| Heart failure & shock w MCC | MS-DRG | 291 | 6 | — | — | $12,279 | $12,279 | $12,279 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | — | — | $8,495.42 | $8,495.42 | $8,495.42 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 6 | — | — | $5,938.35 | $5,938.35 | $5,938.35 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 6 | — | — | $11,649 | $11,649 | $11,649 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 6 | — | — | $7,439.32 | $7,439.32 | $7,439.32 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 6 | — | — | $5,651.42 | $5,651.42 | $5,651.42 |
| GI hemorrhage w CC | MS-DRG | 378 | 6 | — | — | $9,710.4 | $9,710.4 | $9,710.4 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | — | — | $6,380.41 | $6,380.41 | $6,380.41 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 6 | — | — | $7,582.31 | $7,582.31 | $7,582.31 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 6 | — | — | $13,661 | $13,661 | $13,661 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | — | — | $10,838 | $10,838 | $10,838 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 6 | — | — | $7,845.87 | $7,845.87 | $7,845.87 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 6 | — | — | $17,923 | $17,923 | $17,923 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 6 | — | — | $10,017 | $10,017 | $10,017 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $688 | $481.6 | $8.46 | $37.71 | $675.62 |
| General health panel | CPT | 80050 | 10 | $1,784 | $1,248.8 | $54.43 | $752.29 | $1,751.89 |
| Electrolyte panel | CPT | 80051 | 13 | $311 | $217.7 | $7.01 | $31.27 | $305.41 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $945 | $661.5 | $3.02 | $11.18 | $927.99 |
| Lipid panel | CPT | 80061 | 13 | $1,021 | $714.7 | $3.12 | $15.31 | $1,002.63 |
| Renal function panel | CPT | 80069 | 13 | $805 | $563.5 | $8.68 | $38.7 | $790.51 |
| Hepatic function panel | CPT | 80076 | 13 | $650 | $455 | $8.17 | $36.41 | $638.3 |
| Urinalysis non-automated | CPT | 81002 | 13 | $146 | $102.2 | $3.08 | $41.72 | $143.38 |
| Urinalysis automated | CPT | 81003 | 13 | $247 | $172.9 | $2.25 | $38.88 | $242.56 |
| Glucose quantitative | CPT | 82947 | 13 | $255 | $178.5 | $3.93 | $26.81 | $250.41 |
| Hemoglobin A1c | CPT | 83036 | 13 | $484 | $338.8 | $1.35 | $9.71 | $475.29 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $286 | $200.2 | $2.16 | $20.39 | $283.05 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $403 | $282.1 | $7.77 | $34.65 | $395.75 |
| Complete blood count without differential | CPT | 85027 | 13 | $233 | $163.1 | $6.47 | $28.85 | $228.81 |
| Urine culture identification | CPT | 87088 | 13 | $193 | $135.1 | $8.09 | $90.44 | $189.53 |
| Tissue exam by pathologist level IV | CPT | 88305 | 13 | $346 | $242.2 | $9.02 | $64.09 | $346 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 9 | — | — | $32.7 | $405.97 | $14,083 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | — | $1,994.02 | $7,139.82 | $14,083 |
| Vaginal delivery only | CPT | 59409 | 9 | — | — | $780.72 | $4,258 | $14,821 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $4,849.17 | $7,685.41 | $14,083 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | — | $1,995.21 | $8,159.8 | $14,083 |
| C-section delivery only | CPT | 59514 | 4 | — | — | $781.35 | $8,159.8 | $14,083 |
| C-section with postpartum | CPT | 59515 | 4 | — | — | $5,541.9 | $8,974 | $14,083 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $318 | $222.6 | $49.2 | $249.33 | $318 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $400 | $280 | $82.05 | $326.4 | $400 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $500 | $350 | $98.83 | $392.03 | $500 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | $625 | $437.5 | $118.62 | $490.04 | $625 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $313 | $219.1 | $17.21 | $231.97 | $313 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $318 | $222.6 | $16.37 | $249.33 | $318 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $369 | $258.3 | $34.43 | $289.32 | $369 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $500 | $350 | $53.79 | $392.03 | $500 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $625 | $437.5 | $82.05 | $490.04 | $625 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | — | — | $405.42 | $3,137 | $10,920 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | — | — | $423.61 | $3,137 | $10,920 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | — | — | $99 | $2,802 | $9,750 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | — | — | $130.65 | $2,802 | $9,750 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | — | — | $534.04 | $3,137 | $10,920 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | — | — | $597.36 | $3,137 | $10,920 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | — | — | $723.96 | $3,137 | $10,920 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 8 | — | — | $5,541.9 | $15,559 | $31,200 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 6 | — | — | $29,625 | $29,625 | $29,625 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 6 | — | — | $18,867 | $18,867 | $18,867 |
| Hip hemiarthroplasty | CPT | 27125 | 6 | — | — | $1,885.66 | $9,500 | $27,301 |
| Total hip replacement | CPT | 27130 | 9 | — | — | $2,693.8 | $12,730 | $31,200 |
| Total knee replacement | CPT | 27447 | 9 | — | — | $2,693.8 | $15,655 | $31,200 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | — | $5,541.9 | $11,876 | $31,200 |
| Knee revision arthroplasty all components | CPT | 27487 | 6 | — | — | $2,584.03 | $10,090 | $31,200 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 6 | — | — | $605.06 | $6,822 | $12,268 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | — | — | $623.03 | $8,078.96 | $27,301 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 9 | — | — | $790.35 | $5,379 | $18,719 |
| ACL reconstruction | CPT | 29888 | 9 | — | — | $1,220.29 | $8,078.96 | $27,301 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 6 | — | — | $46,092 | $46,092 | $46,092 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 6 | — | — | $24,251 | $24,251 | $24,251 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 6 | — | — | $16,412 | $16,412 | $16,412 |
| CABG single arterial graft | CPT | 33533 | 5 | — | — | $3,386.12 | $11,611 | $22,621 |
| CABG 2 arterial grafts | CPT | 33534 | 5 | — | — | $3,807.69 | $13,555 | $22,621 |
| CABG 3 arterial grafts | CPT | 33535 | 5 | — | — | $4,228.6 | $13,555 | $22,621 |
| CABG 4+ arterial grafts | CPT | 33536 | 5 | — | — | $4,650.86 | $13,555 | $22,621 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 6 | — | — | $16,211 | $16,211 | $16,211 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 6 | — | — | $12,718 | $12,718 | $12,718 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 6 | — | — | $33,290 | $33,290 | $33,290 |
| Open appendectomy | CPT | 44950 | 9 | — | — | $724.63 | $4,103.67 | $18,719 |
| Laparoscopic appendectomy | CPT | 44970 | 9 | — | — | $494.31 | $6,526.38 | $27,301 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 6 | — | — | $63,357 | $63,357 | $63,357 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 6 | — | — | $37,162 | $37,162 | $37,162 |
| Major joint replacement w MCC | MS-DRG | 469 | 6 | — | — | $29,266 | $29,266 | $29,266 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 6 | — | — | $18,185 | $18,185 | $18,185 |
| Laparoscopic cholecystectomy | CPT | 47562 | 9 | — | — | $843.15 | $7,844 | $27,301 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 9 | — | — | $970.44 | $7,844 | $27,301 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 6 | — | — | $28,704 | $28,704 | $28,704 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 6 | — | — | $20,015 | $20,015 | $20,015 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 6 | — | — | $15,807 | $15,807 | $15,807 |
| Open umbilical hernia repair | CPT | 49560 | 9 | — | — | $839.12 | $5,379 | $18,719 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 9 | — | — | $534.04 | $5,379 | $18,719 |
| Lap inguinal hernia repair | CPT | 49650 | 9 | — | — | $379.7 | $6,852.78 | $27,301 |
| Lap incisional hernia repair | CPT | 49652 | 9 | — | — | $524.57 | $7,844 | $27,301 |
| Total abdominal hysterectomy | CPT | 58150 | 6 | — | — | $1,162.9 | $7,125 | $18,719 |
| Vaginal hysterectomy | CPT | 58260 | 9 | — | — | $1,162.9 | $5,687.55 | $18,719 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 9 | — | — | $838.74 | $7,844 | $27,301 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 9 | — | — | $616.65 | $11,488 | $27,301 |
| Lap salpingo-oophorectomy | CPT | 58661 | 9 | — | — | $701.38 | $7,790.63 | $27,301 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 6 | — | — | $29,040 | $29,040 | $29,040 |
| OR procedure for obesity w CC | MS-DRG | 620 | 6 | — | — | $16,899 | $16,899 | $16,899 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 6 | — | — | $15,352 | $15,352 | $15,352 |
| Complex cataract surgery | CPT | 66982 | 9 | — | — | $1,272.35 | $4,258 | $15,519 |
| Cataract surgery with lens implant | CPT | 66984 | 9 | — | — | $1,818.32 | $4,258 | $15,519 |
| Intravitreal injection | CPT | 67028 | 9 | — | — | $404.81 | $2,240 | $7,800 |
| Vitrectomy mechanical | CPT | 67042 | 9 | — | — | $1,186.9 | $5,541.9 | $22,621 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 6 | — | — | $11,012 | $11,012 | $11,012 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 6 | — | — | $17,205 | $17,205 | $17,205 |
Payer mix (top 15)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 172 | $1,438 |
| Aetna | 169 | $1,023.57 |
| Kaiser Permanente | 167 | $652.68 |
| Blue Cross Blue Shield | 165 | $1,043.66 |
| Humana | 154 | $474.97 |
| Medicare | 154 | $467.53 |
| UnitedHealthcare | 132 | $2,941.84 |
| Medicaid | 131 | $222.08 |
| First Health | 92 | $1,178.95 |
| commercial | mhs hspcc | all plans | 92 | $374.49 |
| commercial | healthsmart | all plans | 92 | $1,276.04 |
| Multiplan | 92 | $1,362.04 |
| Cigna | 82 | $496.12 |
| commercial | western growers | all plans | 6 | $1,254 |
| Health Net | 6 | $2,075.8 |