▸ Hospital · CA · CCN 050089
Community Hospital Of San Bernardino
1805 MEDICAL CENTER DRIVE, SAN BERNARDINO, CA, 92411
185 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
189
of 209 target codes
Payers
20
with negotiated rates
Rates published
8,431
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 8 | — | — | $12,937 | $12,937 | $25,228 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 14 | $313 | $219.1 | $151.88 | $192.12 | $313 |
| Psychotherapy 30 minutes | CPT | 90832 | 13 | $178 | $124.6 | $67.05 | $155.4 | $309.87 |
| Psychotherapy 45 minutes | CPT | 90834 | 13 | $235 | $164.5 | $85.18 | $158.91 | $309.87 |
| Psychotherapy 60 minutes | CPT | 90837 | 13 | $349 | $244.3 | $124.32 | $176.79 | $349 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 20 | $674 | $471.8 | $1.11 | $167.99 | $3,706 |
| ED visit level 2 | CPT | 99282 | 20 | $1,380 | $966 | $34.97 | $790.74 | $3,706 |
| ED visit level 3 | CPT | 99283 | 20 | $2,063 | $1,444.1 | $63.97 | $1,182.1 | $7,276 |
| ED visit level 4 | CPT | 99284 | 20 | $3,358 | $2,350.6 | $98.04 | $1,444.1 | $7,276 |
| ED visit level 5 | CPT | 99285 | 20 | $4,936 | $3,455.2 | $155.03 | $2,350.6 | $9,233 |
| Critical care, first hour | CPT | 99291 | 20 | $10,814 | $7,569.8 | $358.55 | $4,129.88 | $10,814 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 16 | $3,606 | $2,524.2 | $113.97 | $223.68 | $2,884.8 |
| CT head with contrast | CPT | 70460 | 16 | $4,939 | $3,457.3 | $167.16 | $313.35 | $3,951.2 |
| CT head with and without contrast | CPT | 70470 | 16 | $5,912 | $4,138.4 | $200.2 | $370.96 | $4,729.6 |
| CT neck with contrast | CPT | 70491 | 16 | $4,120 | $2,884 | $209.16 | $405.93 | $3,296 |
| MRI brain without contrast | CPT | 70551 | 16 | $5,822 | $4,075.4 | $232.97 | $435.16 | $4,657.6 |
| MRI brain with contrast | CPT | 70552 | 16 | $8,442 | $5,909.4 | $344.4 | $605.38 | $6,753.6 |
| MRI brain with and without contrast | CPT | 70553 | 16 | $9,723 | $6,806.1 | $392.56 | $643.09 | $7,778.4 |
| Chest X-ray single view | CPT | 71045 | 17 | $457 | $319.9 | $16.27 | $96.07 | $382.37 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $594 | $415.8 | $27.48 | $96.07 | $475.2 |
| Chest X-ray 3 views | CPT | 71047 | 17 | $740 | $518 | $35.27 | $96.07 | $592 |
| CT chest without contrast | CPT | 71250 | 16 | $2,522 | $1,765.4 | $129.3 | $248.66 | $2,017.6 |
| CT chest with contrast | CPT | 71260 | 16 | $4,944 | $3,460.8 | $209.71 | $386.53 | $3,955.2 |
| CT chest with and without contrast | CPT | 71270 | 16 | $5,588 | $3,911.6 | $210.68 | $407.72 | $4,470.4 |
| MRI chest without contrast | CPT | 71550 | 16 | $1,629 | $1,140.3 | $269.44 | $540.64 | $2,429 |
| MRI chest with contrast | CPT | 71551 | 16 | $1,882 | $1,317.4 | $395.33 | $849.7 | $2,429 |
| MRI chest with and without contrast | CPT | 71552 | 16 | $2,394 | $1,675.8 | $437.36 | $693.55 | $2,429 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $784 | $548.8 | $41.75 | $129.56 | $627.2 |
| CT cervical spine without contrast | CPT | 72125 | 16 | $4,879 | $3,415.3 | $129.3 | $248.66 | $3,903.2 |
| CT thoracic spine without contrast | CPT | 72128 | 16 | $3,836 | $2,685.2 | $129.3 | $248.66 | $3,068.8 |
| CT lumbar spine without contrast | CPT | 72131 | 16 | $3,836 | $2,685.2 | $129.3 | $248.66 | $3,068.8 |
| MRI cervical spine without contrast | CPT | 72141 | 16 | $1,969 | $1,378.3 | $223.72 | $423.83 | $2,429 |
| MRI thoracic spine without contrast | CPT | 72146 | 16 | $4,338 | $3,036.6 | $223.72 | $423.83 | $3,470.4 |
| MRI lumbar spine without contrast | CPT | 72148 | 16 | $1,969 | $1,378.3 | $224.27 | $423.14 | $2,429 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 16 | $2,855 | $1,998.5 | $347.2 | $605.14 | $2,429 |
| MRI cervical spine with and without contrast | CPT | 72156 | 16 | $3,288 | $2,301.6 | $397.04 | $643.09 | $2,630.4 |
| MRI lumbar spine with contrast | CPT | 72158 | 16 | $3,288 | $2,301.6 | $395.92 | $643.09 | $2,630.4 |
| CT pelvis without contrast | CPT | 72192 | 16 | $4,329 | $3,030.3 | $129.3 | $248.66 | $3,463.2 |
| CT pelvis with contrast | CPT | 72193 | 16 | $8,525 | $5,967.5 | $210.68 | $407.72 | $6,820 |
| Shoulder X-ray | CPT | 73030 | 17 | $891 | $623.7 | $31.98 | $149.56 | $712.8 |
| Humerus X-ray | CPT | 73060 | 17 | $612 | $428.4 | $29.81 | $98.13 | $489.6 |
| Hand X-ray 3 views | CPT | 73130 | 17 | $857 | $599.9 | $36.06 | $139.07 | $685.6 |
| MRI upper extremity joint without contrast | CPT | 73221 | 16 | $2,795 | $1,956.5 | $252.58 | $521.84 | $2,429 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 16 | $3,111 | $2,177.7 | $408.36 | $654.86 | $2,488.8 |
| Knee X-ray 1-2 views | CPT | 73560 | 17 | $770 | $539 | $27.28 | $136.85 | $616 |
| Ankle X-ray 3 views | CPT | 73610 | 17 | $855 | $598.5 | $36.06 | $139.07 | $684 |
| MRI lower extremity joint without contrast | CPT | 73721 | 16 | $6,903 | $4,832.1 | $252.58 | $521.03 | $5,522.4 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 16 | $6,903 | $4,832.1 | $407.06 | $653.85 | $5,522.4 |
| CT abdomen without contrast | CPT | 74150 | 16 | $687 | $480.9 | $129.3 | $248.66 | $1,021 |
| CT abdomen with contrast | CPT | 74160 | 16 | $1,073 | $751.1 | $210.68 | $407.72 | $1,021 |
| CT abdomen with and without contrast | CPT | 74170 | 16 | $1,247 | $872.9 | $210.68 | $413.07 | $1,021 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 16 | $967 | $676.9 | $176.68 | $276.09 | $1,021 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 16 | $1,451 | $1,015.7 | $281.8 | $446.92 | $1,160.8 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 16 | $1,692 | $1,184.4 | $319.24 | $489.56 | $1,353.6 |
| MRI abdomen without contrast | CPT | 74181 | 16 | $5,156 | $3,609.2 | $238.28 | $525.35 | $4,124.8 |
| MRI abdomen with and without contrast | CPT | 74183 | 16 | $8,612 | $6,028.4 | $351.25 | $644.15 | $6,889.6 |
| Abdominal ultrasound complete | CPT | 76700 | 17 | $3,133 | $2,193.1 | $119.34 | $176.6 | $2,506.4 |
| Abdominal ultrasound limited | CPT | 76705 | 17 | $2,410 | $1,687 | $87.13 | $164.68 | $1,928 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 17 | $451 | $315.7 | $115.78 | $173.67 | $451 |
| Obstetric ultrasound first trimester | CPT | 76801 | 17 | $2,343 | $1,640.1 | $78.42 | $129.58 | $1,874.4 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 17 | $2,253 | $1,577.1 | $129.3 | $181.38 | $1,802.4 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 17 | $2,343 | $1,640.1 | $129.95 | $273.28 | $1,874.4 |
| Transvaginal ultrasound | CPT | 76830 | 17 | $1,419 | $993.3 | $97.04 | $145.56 | $1,135.2 |
| Pelvic ultrasound complete | CPT | 76856 | 17 | $2,218 | $1,552.6 | $97.04 | $145.56 | $1,774.4 |
| Scrotal ultrasound | CPT | 76870 | 17 | $2,343 | $1,640.1 | $85.75 | $141.17 | $1,874.4 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $270 | $189 | $117.89 | $183.08 | $270 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $318 | $222.6 | $149.36 | $223.77 | $318 |
| Screening mammography bilateral | CPT | 77067 | 11 | $256 | $179.2 | $120.94 | $182.91 | $256 |
| EKG tracing only | CPT | 93005 | 14 | $813 | $569.1 | $29.84 | $92.74 | $801.62 |
| Transthoracic echocardiogram complete | CPT | 93306 | 15 | $4,370 | $3,059 | $239.76 | $573.87 | $4,308.82 |
| Transthoracic echocardiogram | CPT | 93307 | 15 | $1,648 | $1,153.6 | $215.3 | $383.23 | $1,624.93 |
| Stress echocardiogram | CPT | 93350 | 14 | $7,235 | $5,064.5 | $137.87 | $573.87 | $7,133.71 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $18,330 | $18,330 | $35,744 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $11,926 | $11,926 | $23,256 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $9,796.29 | $9,796.29 | $19,103 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $8,127.2 | $8,127.2 | $15,848 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $9,615.85 | $9,615.85 | $18,751 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $7,863.61 | $7,863.61 | $15,334 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $16,188 | $16,188 | $31,566 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $10,206 | $10,206 | $19,901 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $8,396.98 | $8,396.98 | $16,374 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $13,193 | $13,193 | $25,726 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $9,612.31 | $9,612.31 | $18,744 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $7,192.26 | $7,192.26 | $14,025 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $12,597 | $12,597 | $24,564 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $8,612.8 | $8,612.8 | $16,795 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $6,920.71 | $6,920.71 | $13,495 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $10,762 | $10,762 | $20,986 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $7,610.64 | $7,610.64 | $14,841 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $8,748.13 | $8,748.13 | $17,059 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $14,501 | $14,501 | $28,277 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $11,830 | $11,830 | $23,068 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $8,997.57 | $8,997.57 | $17,545 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $18,534 | $18,534 | $36,142 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $11,052 | $11,052 | $21,552 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 16 | $709 | $496.3 | $8.46 | $16.5 | $567.2 |
| General health panel | CPT | 80050 | 9 | $1,154 | $807.8 | $54.43 | $309.39 | $923.2 |
| Electrolyte panel | CPT | 80051 | 16 | $387 | $270.9 | $7.01 | $13.59 | $309.6 |
| Comprehensive metabolic panel | CPT | 80053 | 16 | $838 | $586.6 | $10.56 | $20.59 | $670.4 |
| Lipid panel | CPT | 80061 | 16 | $921 | $644.7 | $13.39 | $23.96 | $736.8 |
| Renal function panel | CPT | 80069 | 16 | $62 | $43.4 | $8.68 | $15.52 | $62 |
| Hepatic function panel | CPT | 80076 | 16 | $688 | $481.6 | $8.17 | $15.93 | $550.4 |
| Urinalysis non-automated | CPT | 81002 | 16 | $104 | $72.8 | $1.11 | $4.31 | $83.2 |
| Urinalysis automated | CPT | 81003 | 16 | $124 | $86.8 | $2.25 | $4.49 | $99.2 |
| Glucose quantitative | CPT | 82947 | 16 | $153 | $107.1 | $3.93 | $7.83 | $122.4 |
| Hemoglobin A1c | CPT | 83036 | 16 | $205 | $143.5 | $1.11 | $14.08 | $164 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 16 | $722 | $505.4 | $1.11 | $10.44 | $577.6 |
| Complete blood count with automated differential | CPT | 85025 | 16 | $74 | $51.8 | $7.77 | $15.15 | $74 |
| Complete blood count without differential | CPT | 85027 | 16 | $39 | $27.3 | $6.47 | $11.58 | $39 |
| Urine culture bacterial | CPT | 87086 | 16 | $164 | $114.8 | $8.07 | $14.43 | $131.2 |
| Urine culture identification | CPT | 87088 | 16 | $28.35 | $19.85 | $5.93 | $11.73 | $28.35 |
| Tissue exam by pathologist level IV | CPT | 88305 | 16 | $255 | $178.5 | $15.6 | $59.08 | $204 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 15 | $566 | $396.2 | $32.7 | $326.88 | $5,035 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | — | $1,994.02 | $2,989.04 | $7,603 |
| Vaginal delivery only | CPT | 59409 | 11 | — | — | $780.72 | $3,116.06 | $9,464 |
| Vaginal delivery with postpartum | CPT | 59410 | 3 | — | — | $1,894 | $2,962.67 | $7,603 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | — | $1,995.21 | $2,990.83 | $7,603 |
| C-section delivery only | CPT | 59514 | 4 | — | — | $781.35 | $1,304.86 | $7,603 |
| C-section with postpartum | CPT | 59515 | 3 | — | — | $2,681.54 | $4,498 | $7,603 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $474 | $331.8 | $49.2 | $154.94 | $467.37 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 4 | $1.11 | — | $1.1 | $1.11 | $117.99 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $2,492 | $1,744.4 | $98.83 | $186.79 | $2,457.12 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $474 | $331.8 | $17.21 | $154.94 | $467.37 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 4 | $1.11 | — | $1.1 | $1.11 | $49.51 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $2,492 | $1,744.4 | $53.79 | $101.67 | $2,457.12 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | — | — | $405.42 | $961.95 | $9,063 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | — | — | $423.61 | $961.95 | $9,063 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 13 | — | — | $99 | $943.44 | $8,054 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 13 | — | — | $130.65 | $943.44 | $8,054 |
| Colonoscopy diagnostic | CPT | 45378 | 13 | — | — | $534.04 | $993.68 | $9,063 |
| Colonoscopy with biopsy | CPT | 45380 | 13 | — | — | $597.36 | $1,232.79 | $9,063 |
| Colonoscopy with polyp removal | CPT | 45385 | 13 | — | — | $723.96 | $1,321.7 | $9,063 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 10 | — | — | $1,862.67 | $14,645 | $28,557 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 8 | — | — | $29,610 | $29,610 | $57,739 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 8 | — | — | $19,428 | $19,428 | $37,884 |
| Hip hemiarthroplasty | CPT | 27125 | 6 | — | — | $1,885.66 | $3,467.73 | $12,082 |
| Total hip replacement | CPT | 27130 | 11 | — | — | $2,681.54 | $7,206.5 | $28,557 |
| Total knee replacement | CPT | 27447 | 11 | — | — | $2,681.54 | $10,954 | $28,557 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | — | — | $2,059.11 | $5,877 | $13,088 |
| Knee revision arthroplasty all components | CPT | 27487 | 6 | — | — | $2,584.03 | $4,828.69 | $13,088 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $605.06 | $2,681.54 | $7,346 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | — | — | $623.03 | $7,439.13 | $14,506 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | — | — | $790.35 | $3,363.43 | $10,068 |
| ACL reconstruction | CPT | 29888 | 12 | — | — | $1,220.29 | $7,439.13 | $14,506 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $45,194 | $45,194 | $88,128 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $24,524 | $24,524 | $47,821 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $17,104 | $17,104 | $33,353 |
| CABG single arterial graft | CPT | 33533 | 7 | — | — | $3,386.12 | $6,399.77 | $29,649 |
| CABG 2 arterial grafts | CPT | 33534 | 7 | — | — | $3,807.69 | $6,793.85 | $29,649 |
| CABG 3 arterial grafts | CPT | 33535 | 7 | — | — | $4,228.6 | $7,168.46 | $29,649 |
| CABG 4+ arterial grafts | CPT | 33536 | 7 | — | — | $4,650.86 | $7,699.17 | $29,649 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $16,914 | $16,914 | $32,982 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $13,609 | $13,609 | $26,537 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $33,079 | $33,079 | $64,503 |
| Open appendectomy | CPT | 44950 | 11 | — | — | $724.63 | $3,778.67 | $10,068 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | — | — | $494.31 | $6,009.51 | $12,082 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 8 | — | — | $61,534 | $61,534 | $119,991 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 8 | — | — | $36,742 | $36,742 | $71,648 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $29,270 | $29,270 | $57,076 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $18,783 | $18,783 | $36,627 |
| Laparoscopic cholecystectomy | CPT | 47562 | 13 | — | — | $843.15 | $6,009.51 | $12,964 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | — | — | $970.44 | $6,009.51 | $12,964 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $28,738 | $28,738 | $56,040 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $20,515 | $20,515 | $40,004 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $16,532 | $16,532 | $32,237 |
| Open umbilical hernia repair | CPT | 49560 | 12 | — | — | $839.12 | $3,778.67 | $10,068 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 12 | — | — | $534.04 | $3,778.67 | $10,068 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | — | — | $379.7 | $6,009.51 | $12,082 |
| Lap incisional hernia repair | CPT | 49652 | 12 | — | — | $524.57 | $6,009.51 | $12,082 |
| Total abdominal hysterectomy | CPT | 58150 | 6 | — | — | $1,162.9 | $2,197.88 | $10,068 |
| Vaginal hysterectomy | CPT | 58260 | 12 | — | — | $1,162.9 | $5,237.11 | $10,212 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | — | — | $838.74 | $6,009.51 | $12,082 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | — | — | $616.65 | $9,319 | $20,628 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | — | — | $701.38 | $6,009.51 | $12,082 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $29,056 | $29,056 | $56,659 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $17,566 | $17,566 | $34,254 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $16,101 | $16,101 | $31,397 |
| Complex cataract surgery | CPT | 66982 | 12 | — | — | $1,272.35 | $2,544.7 | $9,464 |
| Cataract surgery with lens implant | CPT | 66984 | 12 | — | — | $1,818.32 | $3,236.61 | $9,464 |
| Intravitreal injection | CPT | 67028 | 13 | — | — | $357.95 | $790.18 | $5,801 |
| Vitrectomy mechanical | CPT | 67042 | 12 | — | — | $1,186.9 | $4,651.12 | $11,076 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $11,994 | $11,994 | $23,389 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $17,855 | $17,855 | $34,818 |
| PCI single major coronary artery | CPT | 92920 | 15 | $10,106 | $7,074.2 | $435.12 | $5,892.24 | $12,964 |
| PCI with drug-eluting stent | CPT | 92928 | 15 | $18,977 | $13,284 | $483.05 | $11,848 | $23,263 |
| PCI bypass graft | CPT | 92937 | 15 | $18,977 | $13,284 | $482.46 | $11,848 | $23,263 |
| Left heart catheterization | CPT | 93452 | 17 | $8,679 | $6,075.3 | $967.53 | $4,309.66 | $11,076 |
| Coronary angiography with cath | CPT | 93455 | 17 | $8,679 | $6,075.3 | $1,166.18 | $4,309.66 | $12,964 |
| Coronary angiography with bypass cath | CPT | 93458 | 17 | $26,154 | $18,308 | $1,204.89 | $4,309.66 | $20,923 |
Payer mix (top 20)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 189 | $817 |
| Kaiser Permanente | 186 | $436.24 |
| Blue Cross Blue Shield | 176 | $1,838.73 |
| Medicare | 172 | $507.91 |
| commercial | epic health | all plans | 165 | $613.49 |
| commercial | ballards rehab | all plans | 165 | $481.1 |
| Humana | 165 | $437.36 |
| commercial | naphcare | all plans | 165 | $852.85 |
| Medicaid | 140 | $335.84 |
| UnitedHealthcare | 137 | $2,928 |
| Aetna | 127 | $597.91 |
| commercial | magellan | all plans | 99 | $528.9 |
| First Health | 99 | $617.05 |
| Multiplan | 99 | $705.2 |
| commercial | redlands | all plans | 87 | $176.68 |
| commercial | sbmg | all plans | 78 | $210.68 |
| Cigna | 70 | $468.82 |
| commercial | hpn | all plans | 12 | $5,265 |
| commercial | primecare | all plans | 10 | $2,973.6 |
| Health Net | 7 | $1,895.59 |