▸ Hospital · CA · CCN 050026
Grossmont Hospital
5555 GROSSMONT CENTER DRIVE, LA MESA, CA, 050026
Compliance grade
C
70/100
Procedures tracked
135
of 209 target codes
Payers
30
with negotiated rates
Rates published
0
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 2 | $1,000 | $750 | $491 | $630 | $750 |
| Psychiatric eval with medical services | CPT | 90792 | 3 | $1,500 | $1,125 | $1 | $420 | $1,200 |
| Psychotherapy 30 minutes | CPT | 90832 | 6 | $360 | $270 | $144 | $257.4 | $288 |
| Psychotherapy 45 minutes | CPT | 90834 | 1 | $471 | $353.25 | $1.15 | $181.91 | $362.67 |
| Psychotherapy 60 minutes | CPT | 90837 | 6 | $1,106 | $829.5 | $154.84 | $733.72 | $995.4 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 6 | $999 | $749.25 | $75 | $350 | $699.3 |
| ED visit level 2 | CPT | 99282 | 6 | $1,805 | $1,353.75 | $270.75 | $1,005.39 | $1,263.5 |
| ED visit level 3 | CPT | 99283 | 5 | $2,917 | $2,187.75 | $991.78 | $1,543.1 | $2,391.94 |
| ED visit level 4 | CPT | 99284 | 7 | $10,400 | $7,800 | $657.28 | $3,900 | $10,192 |
| ED visit level 5 | CPT | 99285 | 10 | $15,200 | $11,400 | $1.1 | $5,510 | $14,896 |
| Critical care, first hour | CPT | 99291 | 8 | $29,586 | $22,190 | $5,029.62 | $11,169 | $19,823 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 2 | $3,714 | $2,785.5 | $2,488.38 | $3,064.05 | $3,639.72 |
| CT head with contrast | CPT | 70460 | 4 | $3,827 | $2,870.25 | $574.05 | $1,492.53 | $2,162.25 |
| CT head with and without contrast | CPT | 70470 | 4 | $4,121 | $3,090.75 | $2,513.81 | $2,695.14 | $2,884.7 |
| CT neck with contrast | CPT | 70491 | 5 | $3,646 | $2,734.5 | $1.15 | $2,169.37 | $2,442.82 |
| MRI brain without contrast | CPT | 70551 | 24 | $4,048 | $3,036 | $161.8 | $1,870.16 | $3,878.84 |
| MRI brain with contrast | CPT | 70552 | 5 | $5,069 | $3,801.75 | $887.07 | $3,801.75 | $4,055.2 |
| MRI brain with and without contrast | CPT | 70553 | 25 | $6,086 | $4,562.25 | $271.82 | $3,043 | $5,964.28 |
| Chest X-ray single view | CPT | 71045 | 3 | $609 | $456.75 | $207.06 | $243.6 | $456.75 |
| Chest X-ray 2 views | CPT | 71046 | 4 | $710 | $532.5 | $280.52 | $355 | $532.5 |
| Chest X-ray 3 views | CPT | 71047 | 4 | $755 | $566.25 | $317.1 | $460.55 | $528.5 |
| CT chest without contrast | CPT | 71250 | 4 | $2,851 | $2,138.25 | $180.18 | $1,639.33 | $2,195.27 |
| CT chest with contrast | CPT | 71260 | 4 | $4,108 | $3,081 | $1 | $2,505.88 | $3,081 |
| CT chest with and without contrast | CPT | 71270 | 4 | $4,759 | $3,569.25 | $832.82 | $2,141.55 | $3,212.33 |
| MRI chest without contrast | CPT | 71550 | 4 | $3,959 | $2,969.25 | $2,205.16 | $2,771.3 | $3,167.2 |
| MRI chest with and without contrast | CPT | 71552 | 4 | $6,123 | $4,592.25 | $3,410.51 | $4,286.1 | $6,000.54 |
| CT cervical spine without contrast | CPT | 72125 | 5 | $4,228 | $3,171 | $1.15 | $3,065.3 | $18,827 |
| CT thoracic spine without contrast | CPT | 72128 | 4 | $2,814 | $2,110.5 | $393.96 | $1,547.7 | $2,251.2 |
| CT lumbar spine without contrast | CPT | 72131 | 5 | $3,216 | $2,412 | $900.48 | $1,910.31 | $2,251.2 |
| MRI cervical spine without contrast | CPT | 72141 | 2 | $5,533 | $4,149.75 | $1,881.22 | $2,503.68 | $3,126.14 |
| MRI thoracic spine without contrast | CPT | 72146 | 3 | $4,269 | $3,201.75 | $1,676.44 | $2,411.98 | $2,988.3 |
| MRI lumbar spine without contrast | CPT | 72148 | 24 | $4,191 | $3,111.75 | $156.18 | $1,991.52 | $4,107.18 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 3 | $5,517 | $4,137.75 | $2,708.85 | $3,519.85 | $4,965.3 |
| MRI cervical spine with and without contrast | CPT | 72156 | 3 | $7,832 | $5,874 | $5,129.96 | $5,325.76 | $7,675.36 |
| MRI lumbar spine with contrast | CPT | 72158 | 4 | $6,150 | $4,612.5 | $922.5 | $2,767.5 | $4,612.5 |
| CT pelvis without contrast | CPT | 72192 | 5 | $2,615 | $1,961.25 | $1,734.79 | $1,961.25 | $2,562.7 |
| CT pelvis with contrast | CPT | 72193 | 6 | $3,256 | $2,442 | $1,559.95 | $2,344.32 | $2,604.8 |
| Shoulder X-ray | CPT | 73030 | 3 | $753 | $564.75 | $105.42 | $442.39 | $466.86 |
| Humerus X-ray | CPT | 73060 | 6 | $536 | $402 | $1 | $268 | $428.8 |
| Hand X-ray 3 views | CPT | 73130 | 3 | $678 | $508.5 | $1 | $427.14 | $474.6 |
| MRI upper extremity joint without contrast | CPT | 73221 | 1 | $3,287 | $2,465.25 | $2,054.38 | $2,177.64 | $2,300.9 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 4 | $5,734 | $4,300.5 | $2,293.6 | $3,841.78 | $4,300.5 |
| Knee X-ray 1-2 views | CPT | 73560 | 2 | $505 | $378.75 | $9.82 | $211.96 | $414.1 |
| Ankle X-ray 3 views | CPT | 73610 | 4 | $719 | $539.25 | $201.32 | $406.23 | $704.62 |
| MRI lower extremity joint without contrast | CPT | 73721 | 26 | $4,329 | $3,246.75 | $176.26 | $2,034.46 | $3,902.36 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 4 | $6,161 | $4,620.75 | $1,725.08 | $4,312.7 | $4,620.75 |
| CT abdomen without contrast | CPT | 74150 | 5 | $2,545 | $1,908.75 | $381.75 | $1,272.5 | $2,036 |
| CT abdomen with contrast | CPT | 74160 | 5 | $3,736 | $2,802 | $1,494.4 | $2,745.96 | $3,661.28 |
| CT abdomen with and without contrast | CPT | 74170 | 5 | $4,159 | $3,119.25 | $1.15 | $2,828.12 | $3,410.38 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 24 | $4,640 | $3,480 | $128.67 | $2,383.17 | $4,547.2 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 3 | $6,658 | $4,993.5 | $1.1 | $3,661.9 | $4,247.8 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 4 | $7,116 | $5,337 | $1,067.4 | $4,589.82 | $5,692.8 |
| MRI abdomen without contrast | CPT | 74181 | 4 | $4,223 | $3,167.25 | $1.15 | $3,251.71 | $4,138.54 |
| MRI abdomen with and without contrast | CPT | 74183 | 2 | $5,691 | $4,268.25 | $2,276.4 | $3,002.01 | $3,727.61 |
| Abdominal ultrasound complete | CPT | 76700 | 3 | $1,866 | $1,399.5 | $1.15 | $1,039.36 | $1,306.2 |
| Abdominal ultrasound limited | CPT | 76705 | 6 | $1,172 | $879 | $35.57 | $879 | $1,148.56 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 3 | $1,095 | $821.25 | $657 | $736.39 | $766.5 |
| Obstetric ultrasound first trimester | CPT | 76801 | 3 | $1,592 | $1,194 | $796 | $1,044.35 | $1,194 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 3 | $1,425 | $1,068.75 | $484.5 | $969 | $1,396.5 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 5 | $1,549 | $1,161.75 | $232.35 | $1,084.3 | $1,192.73 |
| Transvaginal ultrasound | CPT | 76830 | 4 | $1,178 | $883.5 | $665.57 | $839.33 | $1,154.44 |
| Pelvic ultrasound complete | CPT | 76856 | 4 | $1,749 | $1,311.75 | $1 | $1,171.83 | $1,311.75 |
| Scrotal ultrasound | CPT | 76870 | 4 | $1,674 | $1,255.5 | $1.15 | $803.52 | $1,255.5 |
| Diagnostic mammography unilateral | CPT | 77065 | 5 | $560 | $420 | $190.4 | $352.8 | $420 |
| Diagnostic mammography bilateral | CPT | 77066 | 5 | $701 | $525.75 | $294.42 | $497.71 | $560.8 |
| Screening mammography bilateral | CPT | 77067 | 7 | $580 | $435 | $81.2 | $327.7 | $475.6 |
| EKG tracing only | CPT | 93005 | 5 | $838 | $628.5 | $234.64 | $511.18 | $23,240 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $6,019 | $4,514.25 | $1 | $3,310.45 | $4,213.3 |
| Stress echocardiogram | CPT | 93350 | 2 | $3,611 | $2,708.25 | $1,011.08 | $2,094.55 | $2,153.65 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 1 | $98,961 | $74,221 | $61,356 | $61,356 | $61,356 |
| COPD w MCC | MS-DRG | 190 | 4 | $88,259 | $66,195 | $13,239 | $30,008 | $30,008 |
| COPD w CC | MS-DRG | 191 | 2 | $59,771 | $44,829 | $39,210 | $42,019 | $44,829 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 1 | $61,563 | $46,173 | $36,938 | $36,938 | $36,938 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | $120,409 | $90,307 | $40,939 | $84,286 | $118,001 |
| AMI discharged alive w CC | MS-DRG | 281 | 2 | $83,186 | $62,389 | $11,646 | $23,292 | $64,053 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 4 | $61,503 | $46,127 | $20,911 | $28,292 | $50,433 |
| Heart failure & shock w MCC | MS-DRG | 291 | 1 | $89,247 | $66,935 | $60,688 | $60,688 | $60,688 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | $60,050 | $45,037 | $48,040 | $53,444 | $58,849 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 1 | $42,123 | $31,592 | $14,322 | $14,322 | $14,322 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | $101,878 | $76,409 | $40,751 | $73,862 | $81,503 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 4 | $57,982 | $43,487 | $19,714 | $39,718 | $46,386 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 4 | $44,298 | $33,224 | $18,605 | $24,674 | $31,009 |
| GI hemorrhage w CC | MS-DRG | 378 | 4 | $72,239 | $54,180 | $10,114 | $45,872 | $55,624 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 3 | $50,189 | $37,642 | $21,079 | $33,878 | $37,642 |
| Kidney/UTI w MCC | MS-DRG | 689 | 1 | $80,013 | $60,010 | $44,567 | $44,567 | $44,567 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 2 | $52,218 | $39,164 | $29,503 | $31,070 | $32,636 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 6 | $352 | $264 | $1.1 | $211.2 | $271.04 |
| Electrolyte panel | CPT | 80051 | 6 | $143 | $107.25 | $40.04 | $85.8 | $114.4 |
| Comprehensive metabolic panel | CPT | 80053 | 17 | $452 | $339 | $11.19 | $284.85 | $725 |
| Lipid panel | CPT | 80061 | 19 | $194 | $145.5 | $1 | $24.64 | $725 |
| Renal function panel | CPT | 80069 | 6 | $180 | $135 | $1 | $121.5 | $144 |
| Hepatic function panel | CPT | 80076 | 3 | $260 | $195 | $104 | $162.5 | $208 |
| Urinalysis non-automated | CPT | 81002 | 4 | $29 | $21.75 | $1.15 | $19.72 | $20.3 |
| Urinalysis automated | CPT | 81003 | 3 | $86 | $64.5 | $47.3 | $58.31 | $60.2 |
| Glucose quantitative | CPT | 82947 | 8 | $70 | $52.5 | $1.3 | $43.4 | $56 |
| Hemoglobin A1c | CPT | 83036 | 3 | $87 | $65.25 | $60.9 | $67.43 | $78.3 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 7 | $207 | $155.25 | $2.02 | $116.95 | $155.25 |
| Complete blood count with automated differential | CPT | 85025 | 19 | $197 | $147.75 | $8.24 | $133.96 | $725 |
| Complete blood count without differential | CPT | 85027 | 2 | $159 | $119.25 | $88.56 | $95 | $101.44 |
| Urine culture bacterial | CPT | 87086 | 5 | $260 | $195 | $1.3 | $146.9 | $182 |
| Tissue exam by pathologist level IV | CPT | 88305 | 6 | $345 | $258.75 | $1 | $219.66 | $276 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 4 | $1,558 | $1,168.5 | $1 | $779 | $965.96 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 8 | $368 | $276 | $1 | $230 | $294.4 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 22 | $952 | $353.25 | $61.88 | $537.88 | $932.96 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 8 | $635 | $476.25 | $177.8 | $416.56 | $496.92 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 6 | $817 | $612.75 | $264.52 | $523.73 | $622.4 |
| Office visit, established patient, 5 min | CPT | 99211 | 17 | $742 | $556.5 | $1 | $199.8 | $727.16 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $344 | $258 | $111.52 | $214.14 | $295.2 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 22 | $853 | $311.25 | $24.44 | $290.02 | $835.94 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 22 | $942 | $370.5 | $1.15 | $340.86 | $923.16 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 9 | $742 | $556.5 | $1 | $445.41 | $667.8 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 3 | $3,558 | $2,668.5 | $1,779 | $2,535.08 | $2,917.56 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 10 | $4,019 | $3,014.25 | $602.85 | $2,612.36 | $3,617.1 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 5 | $2,753 | $2,064.75 | $1 | $1,651.8 | $2,202.4 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 3 | $3,502 | $2,626.5 | $1,950.61 | $2,171.24 | $2,451.4 |
| Colonoscopy diagnostic | CPT | 45378 | 28 | $3,383 | $2,537.25 | $195.42 | $1,993.13 | $4,366 |
| Colonoscopy with biopsy | CPT | 45380 | 24 | $3,675 | $2,756.25 | $1.3 | $2,163.13 | $5,178.63 |
| Colonoscopy with polyp removal | CPT | 45385 | 24 | $4,649 | $3,486.75 | $1.3 | $2,486 | $5,178.63 |
| surgery | ||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 1 | $385,111 | $288,834 | $231,067 | $231,067 | $231,067 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 1 | $206,220 | $154,665 | $144,354 | $144,354 | $144,354 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | $158,711 | $119,033 | $63,484 | $87,291 | $111,098 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 2 | $324,819 | $243,614 | $159,486 | $193,429 | $227,373 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | $213,466 | $160,099 | $117,406 | $125,411 | $133,416 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 2 | $150,562 | $112,922 | $100,877 | $103,135 | $105,394 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 1 | $116,531 | $87,398 | $81,572 | $81,572 | $81,572 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 1 | $114,198 | $85,648 | $54,815 | $54,815 | $54,815 |
| OR procedure for obesity w CC | MS-DRG | 620 | 1 | $126,962 | $95,221 | $104,109 | $104,109 | $104,109 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 5 | $111,452 | $83,589 | $7,043.77 | $67,986 | $83,589 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 5 | $106,686 | $80,014 | $72,546 | $80,014 | $87,482 |
| PCI single major coronary artery | CPT | 92920 | 5 | $17,091 | $12,818 | $7,178.22 | $11,451 | $13,673 |
| PCI with drug-eluting stent | CPT | 92928 | 7 | $35,802 | $26,852 | $1 | $17,333 | $25,061 |
| PCI bypass graft | CPT | 92937 | 5 | $17,869 | $13,402 | $7,147.6 | $12,062 | $16,082 |
| Left heart catheterization | CPT | 93452 | 2 | $19,565 | $14,674 | $1,236.51 | $5,313.86 | $9,391.2 |
| Coronary angiography with cath | CPT | 93455 | 4 | $21,609 | $16,207 | $13,614 | $16,747 | $19,448 |
| Coronary angiography with bypass cath | CPT | 93458 | 5 | $22,097 | $16,573 | $1,396.53 | $13,479 | $15,468 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 84 | $729.7 |
| Aetna | 81 | $820.4 |
| Health Net | 80 | $588.75 |
| Molina | 52 | $370.5 |
| Cigna | 51 | $1,649.46 |
| UnitedHealthcare | 45 | $533.13 |
| Kaiser Permanente | 32 | $725 |
| Multiplan | 30 | $733.04 |
| Medicare | 28 | $662.9 |
| san diego pace | 27 | $831.9 |
| california health and wellness | 26 | $280.52 |
| interplan | 24 | $963.95 |
| medi-cal | 23 | $246.4 |
| community health group | 23 | $463.75 |
| Humana | 21 | $991.78 |
| indian health council | 21 | $781.3 |
| allianz global assistance | 16 | $2,505.88 |
| axa assistance | 14 | $666.4 |
| First Health | 14 | $662.9 |
| managed health network | 14 | $788.45 |
| maximum negotiated charge | 14 | $932.96 |
| azga services canada | 14 | $647.36 |
| minimum negotiated charge | 14 | $269.52 |
| community health group medi-cal | 14 | $133.28 |
| choice care network | 14 | $761.6 |
| epic americas | 12 | $622.38 |
| county of san diego | 11 | $161.8 |
| county medical services | 11 | $2,094.55 |
| community health group cal mediconnect | 8 | $354.59 |
| optum health commercial | 8 | $1,418.34 |