▸ Hospital · CA · CCN 050152
Saint Francis Memorial Hospital
900 HYDE STREET, SAN FRANCISCO, CA, 94109
171 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
185
of 209 target codes
Payers
20
with negotiated rates
Rates published
7,834
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 9 | — | — | $15,363 | $15,363 | $46,550 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 17 | $379 | $265.3 | $40.8 | $162.44 | $546.1 |
| Psychotherapy 45 minutes | CPT | 90834 | 16 | $462 | $323.4 | $85.18 | $203.11 | $546.1 |
| Psychotherapy 60 minutes | CPT | 90837 | 16 | $557 | $389.9 | $124.32 | $203.11 | $557 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 20 | $1,049 | $734.3 | $21.77 | $669.27 | $4,123 |
| ED visit level 2 | CPT | 99282 | 20 | $1,703 | $1,192.1 | $34.97 | $1,086.52 | $7,834 |
| ED visit level 3 | CPT | 99283 | 20 | $2,923 | $2,046.1 | $63.97 | $1,864.88 | $10,310 |
| ED visit level 4 | CPT | 99284 | 20 | $4,325 | $3,027.5 | $98.04 | $2,759.35 | $16,495 |
| ED visit level 5 | CPT | 99285 | 20 | $9,093 | $6,365.1 | $155.03 | $5,801.34 | $21,856 |
| Critical care, first hour | CPT | 99291 | 20 | $14,354 | $10,048 | $211.05 | $9,640 | $24,743 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 18 | $5,181 | $3,626.7 | $149.03 | $210.29 | $5,181 |
| CT head with contrast | CPT | 70460 | 18 | $8,638 | $6,046.6 | $209.04 | $1,148.55 | $8,638 |
| CT head with and without contrast | CPT | 70470 | 18 | $7,484 | $5,238.8 | $247.23 | $346.93 | $7,484 |
| CT neck with contrast | CPT | 70491 | 18 | $6,355 | $4,448.5 | $262.9 | $368.82 | $6,355 |
| MRI brain without contrast | CPT | 70551 | 18 | $6,566 | $4,596.2 | $283.78 | $397.29 | $7,012 |
| MRI brain with contrast | CPT | 70552 | 18 | $9,522 | $6,665.4 | $396.44 | $611.28 | $9,522 |
| MRI brain with and without contrast | CPT | 70553 | 18 | $10,966 | $7,676.2 | $467.23 | $654.12 | $10,966 |
| Chest X-ray single view | CPT | 71045 | 18 | $757 | $529.9 | $17.67 | $161.21 | $757 |
| Chest X-ray 2 views | CPT | 71046 | 18 | $984 | $688.8 | $27.48 | $222.32 | $984 |
| Chest X-ray 3 views | CPT | 71047 | 18 | $1,212 | $848.4 | $35.27 | $222.32 | $1,212 |
| CT chest without contrast | CPT | 71250 | 18 | $5,575 | $3,902.5 | $164.29 | $272.17 | $5,575 |
| CT chest with contrast | CPT | 71260 | 18 | $5,797 | $4,057.9 | $238.02 | $353.94 | $5,797 |
| CT chest with and without contrast | CPT | 71270 | 18 | $6,690 | $4,683 | $269.56 | $414.33 | $6,690 |
| MRI chest without contrast | CPT | 71550 | 18 | $7,216 | $5,051.2 | $347.24 | $633.67 | $7,216 |
| MRI chest with contrast | CPT | 71551 | 18 | $7,819 | $5,473.3 | $395.33 | $1,187.6 | $7,819 |
| MRI chest with and without contrast | CPT | 71552 | 18 | $8,657 | $6,059.9 | $501.11 | $701.55 | $8,657 |
| Lumbosacral spine X-ray | CPT | 72100 | 19 | $1,330 | $931 | $43.45 | $267.95 | $1,330 |
| CT cervical spine without contrast | CPT | 72125 | 18 | $5,575 | $3,902.5 | $164.29 | $273.15 | $5,575 |
| CT thoracic spine without contrast | CPT | 72128 | 18 | $5,575 | $3,902.5 | $164.29 | $269.56 | $5,575 |
| CT lumbar spine without contrast | CPT | 72131 | 18 | $6,293 | $4,405.1 | $164.29 | $268.39 | $6,293 |
| MRI cervical spine without contrast | CPT | 72141 | 18 | $6,028 | $4,219.6 | $277.53 | $388.54 | $7,012 |
| MRI thoracic spine without contrast | CPT | 72146 | 18 | $6,881 | $4,816.7 | $277.53 | $388.54 | $7,012 |
| MRI lumbar spine without contrast | CPT | 72148 | 18 | $6,636 | $4,645.2 | $277.97 | $389.16 | $7,012 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 18 | $9,621 | $6,734.7 | $399.67 | $611.28 | $9,621 |
| MRI cervical spine with and without contrast | CPT | 72156 | 18 | $10,067 | $7,046.9 | $471.83 | $660.56 | $10,067 |
| MRI lumbar spine with contrast | CPT | 72158 | 18 | $11,083 | $7,758.1 | $470.9 | $659.26 | $11,083 |
| CT pelvis without contrast | CPT | 72192 | 18 | $5,667 | $3,966.9 | $164.29 | $246.57 | $5,667 |
| CT pelvis with contrast | CPT | 72193 | 18 | $5,667 | $3,966.9 | $269.56 | $385.64 | $5,667 |
| Shoulder X-ray | CPT | 73030 | 19 | $1,172 | $820.4 | $37.09 | $211.88 | $1,172 |
| Humerus X-ray | CPT | 73060 | 19 | $916 | $641.2 | $29.81 | $211.88 | $916 |
| Hand X-ray 3 views | CPT | 73130 | 19 | $876 | $613.2 | $36.06 | $204.82 | $876 |
| MRI upper extremity joint without contrast | CPT | 73221 | 18 | $5,070 | $3,549 | $295.44 | $413.62 | $7,012 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 18 | $8,467 | $5,926.9 | $408.36 | $611.28 | $8,467 |
| Knee X-ray 1-2 views | CPT | 73560 | 19 | $2,557 | $1,789.9 | $27.28 | $599.04 | $2,557 |
| Ankle X-ray 3 views | CPT | 73610 | 19 | $1,085 | $759.5 | $36.06 | $204.82 | $1,085 |
| MRI lower extremity joint without contrast | CPT | 73721 | 18 | $4,354 | $3,047.8 | $294.53 | $412.34 | $7,012 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 18 | $7,271 | $5,089.7 | $407.06 | $611.28 | $7,271 |
| CT abdomen without contrast | CPT | 74150 | 18 | $5,576 | $3,903.2 | $164.29 | $252.71 | $5,576 |
| CT abdomen with contrast | CPT | 74160 | 18 | $5,576 | $3,903.2 | $269.56 | $393.78 | $5,576 |
| CT abdomen with and without contrast | CPT | 74170 | 18 | $6,690 | $4,683 | $269.56 | $433.2 | $6,690 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 18 | $11,150 | $7,805 | $178.43 | $366.65 | $11,150 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 18 | $11,150 | $7,805 | $281.8 | $586.78 | $11,150 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 18 | $13,381 | $9,366.7 | $319.24 | $586.78 | $13,381 |
| MRI abdomen without contrast | CPT | 74181 | 18 | $10,539 | $7,377.3 | $287.28 | $1,492.85 | $10,539 |
| MRI abdomen with and without contrast | CPT | 74183 | 18 | $9,897 | $6,927.9 | $351.25 | $611.28 | $9,897 |
| Abdominal ultrasound complete | CPT | 76700 | 19 | $1,948 | $1,363.6 | $119.34 | $211.93 | $1,948 |
| Abdominal ultrasound limited | CPT | 76705 | 19 | $1,500 | $1,050 | $87.13 | $211.93 | $1,500 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 19 | $2,249 | $1,574.3 | $115.78 | $211.93 | $2,249 |
| Obstetric ultrasound first trimester | CPT | 76801 | 19 | $2,175 | $1,522.5 | $78.42 | $211.93 | $2,175 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 19 | $2,526 | $1,768.2 | $135.29 | $211.93 | $2,526 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 19 | $2,474 | $1,731.8 | $159.03 | $447.94 | $2,474 |
| Transvaginal ultrasound | CPT | 76830 | 19 | $2,249 | $1,574.3 | $97.04 | $211.93 | $2,249 |
| Pelvic ultrasound complete | CPT | 76856 | 19 | $2,530 | $1,771 | $97.04 | $211.93 | $2,530 |
| Scrotal ultrasound | CPT | 76870 | 19 | $1,601 | $1,120.7 | $85.75 | $211.93 | $1,601 |
| Diagnostic mammography unilateral | CPT | 77065 | 12 | $1,030 | $721 | $117.89 | $698.39 | $1,030 |
| Diagnostic mammography bilateral | CPT | 77066 | 12 | $1,236 | $865.2 | $149.36 | $865.4 | $1,236 |
| Screening mammography bilateral | CPT | 77067 | 12 | $1,362 | $953.4 | $120.94 | $817.2 | $1,362 |
| EKG tracing only | CPT | 93005 | 17 | $655 | $458.5 | $28.92 | $84.99 | $655 |
| Transthoracic echocardiogram complete | CPT | 93306 | 17 | $4,893 | $3,425.1 | $239.76 | $737.78 | $4,893 |
| Transthoracic echocardiogram | CPT | 93307 | 17 | $2,562 | $1,793.4 | $215.3 | $351.34 | $2,562 |
| Stress echocardiogram | CPT | 93350 | 17 | $4,707 | $3,294.9 | $137.87 | $737.78 | $4,707 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $22,146 | $22,146 | $67,101 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $14,091 | $14,091 | $42,697 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $11,413 | $11,413 | $34,580 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $9,313.5 | $9,313.5 | $28,220 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $11,186 | $11,186 | $33,893 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $8,981.99 | $8,981.99 | $27,215 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $19,451 | $19,451 | $58,937 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $11,928 | $11,928 | $36,141 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $9,652.8 | $9,652.8 | $29,248 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $15,684 | $15,684 | $47,524 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $11,181 | $11,181 | $33,879 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $8,137.65 | $8,137.65 | $24,657 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $14,935 | $14,935 | $45,252 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $9,924.23 | $9,924.23 | $30,070 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $7,796.13 | $7,796.13 | $23,622 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $12,627 | $12,627 | $38,261 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $8,663.83 | $8,663.83 | $26,251 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $10,094 | $10,094 | $30,586 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $17,330 | $17,330 | $52,509 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $13,970 | $13,970 | $42,330 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $10,408 | $10,408 | $31,537 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $22,402 | $22,402 | $67,880 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $12,992 | $12,992 | $39,367 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 18 | $1,184 | $828.8 | $8.46 | $13.61 | $1,184 |
| General health panel | CPT | 80050 | 10 | $741 | $518.7 | $185.99 | $381.97 | $741 |
| Electrolyte panel | CPT | 80051 | 18 | $1,184 | $828.8 | $7.01 | $11.24 | $1,184 |
| Comprehensive metabolic panel | CPT | 80053 | 18 | $1,184 | $828.8 | $10.56 | $17.19 | $1,184 |
| Lipid panel | CPT | 80061 | 18 | $592 | $414.4 | $6.66 | $15.36 | $592 |
| Renal function panel | CPT | 80069 | 18 | $918 | $642.6 | $8.68 | $13.96 | $918 |
| Hepatic function panel | CPT | 80076 | 18 | $450 | $315 | $8.17 | $13.11 | $450 |
| Urinalysis non-automated | CPT | 81002 | 18 | $173 | $121.1 | $3.08 | $4.49 | $173 |
| Urinalysis automated | CPT | 81003 | 18 | $374 | $261.8 | $2.25 | $3.61 | $374 |
| Glucose quantitative | CPT | 82947 | 18 | $416 | $291.2 | $3.93 | $16.35 | $416 |
| Hemoglobin A1c | CPT | 83036 | 18 | $763 | $534.1 | $9.71 | $15.72 | $763 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 18 | $947 | $662.9 | $16.8 | $27.77 | $947 |
| Complete blood count with automated differential | CPT | 85025 | 18 | $596 | $417.2 | $7.77 | $12.47 | $596 |
| Complete blood count without differential | CPT | 85027 | 18 | $251 | $175.7 | $6.47 | $10.39 | $251 |
| Urine culture bacterial | CPT | 87086 | 18 | $730 | $511 | $8.07 | $12.95 | $730 |
| Urine culture identification | CPT | 87088 | 18 | $40 | $28 | $7.48 | $12.21 | $40 |
| Tissue exam by pathologist level IV | CPT | 88305 | 19 | $624 | $436.8 | $58.8 | $157.1 | $624 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 14 | — | — | $32.7 | $271.47 | $20,938 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 6 | — | — | $1,919.8 | $6,196.04 | $20,938 |
| Vaginal delivery only | CPT | 59409 | 14 | — | — | $780.72 | $4,047 | $20,938 |
| Vaginal delivery with postpartum | CPT | 59410 | 6 | — | — | $4,047 | $8,890.48 | $20,938 |
| Routine obstetric care with C-section | CPT | 59510 | 6 | — | — | $1,919.91 | $7,081.2 | $20,938 |
| C-section delivery only | CPT | 59514 | 6 | — | — | $781.35 | $7,081.2 | $20,938 |
| C-section with postpartum | CPT | 59515 | 6 | — | — | $6,474.07 | $9,713.5 | $20,938 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 8 | $689 | $482.3 | $49.2 | $205.33 | $689 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 8 | $933 | $653.1 | $82.05 | $237 | $933 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 8 | $1,206 | $844.2 | $98.83 | $373 | $1,206 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 8 | $1,537 | $1,075.9 | $118.62 | $405 | $1,537 |
| Office visit, established patient, 5 min | CPT | 99211 | 8 | $359 | $251.3 | $17.21 | $140 | $359 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 8 | $455 | $318.5 | $16.37 | $205.33 | $455 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 8 | $686 | $480.2 | $34.43 | $237 | $686 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 8 | $987 | $690.9 | $53.79 | $373 | $987 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 8 | $1,288 | $901.6 | $82.05 | $405 | $1,288 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $395.26 | $1,459.18 | $8,443 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $413.01 | $1,459.18 | $9,384 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | — | — | $96.52 | $1,431.1 | $7,009 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 15 | — | — | $127.39 | $1,431.1 | $7,009 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $520.67 | $1,431.1 | $9,384 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | — | $582.4 | $1,870.02 | $9,384 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $705.84 | $1,870.02 | $9,384 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 12 | — | — | $1,526.79 | $18,608 | $33,890 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 9 | — | — | $36,331 | $38,148 | $110,084 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 9 | — | — | $23,526 | $24,702 | $85,800 |
| Hip hemiarthroplasty | CPT | 27125 | 9 | — | — | $1,838.47 | $10,696 | $20,938 |
| Total hip replacement | CPT | 27130 | 13 | — | — | $2,626.38 | $18,608 | $33,890 |
| Total knee replacement | CPT | 27447 | 13 | — | — | $2,626.38 | $18,608 | $33,890 |
| Knee revision arthroplasty single component | CPT | 27486 | 7 | — | — | $1,687.81 | $13,291 | $21,213 |
| Knee revision arthroplasty all components | CPT | 27487 | 9 | — | — | $2,519.36 | $10,012 | $21,213 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 9 | — | — | $605.06 | $6,204 | $14,471 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 14 | — | — | $607.33 | $9,563.97 | $22,630 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 14 | — | — | $790.35 | $5,512.98 | $13,360 |
| ACL reconstruction | CPT | 29888 | 14 | — | — | $1,189.76 | $9,452.28 | $22,630 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $55,931 | $55,931 | $169,472 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $29,935 | $29,935 | $90,703 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $20,604 | $20,604 | $62,429 |
| CABG single arterial graft | CPT | 33533 | 8 | — | — | $3,301.35 | $12,394 | $20,938 |
| CABG 2 arterial grafts | CPT | 33534 | 8 | — | — | $3,712.38 | $12,414 | $26,502 |
| CABG 3 arterial grafts | CPT | 33535 | 8 | — | — | $4,122.75 | $12,414 | $26,502 |
| CABG 4+ arterial grafts | CPT | 33536 | 8 | — | — | $4,534.45 | $12,414 | $26,502 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $20,365 | $20,365 | $61,704 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $16,207 | $16,207 | $49,108 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $40,694 | $40,694 | $123,304 |
| Open appendectomy | CPT | 44950 | 14 | — | — | $706.49 | $5,026.98 | $20,938 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | — | — | $481.95 | $7,726.01 | $18,689 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 9 | — | — | $76,482 | $76,482 | $231,739 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 9 | — | — | $45,302 | $45,302 | $137,265 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $35,904 | $35,904 | $108,790 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $22,715 | $22,715 | $68,827 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | — | — | $822.06 | $8,731 | $28,173 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $946.16 | $8,731 | $28,173 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $35,236 | $35,236 | $106,764 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $24,893 | $24,893 | $75,427 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $19,884 | $19,884 | $60,248 |
| Open umbilical hernia repair | CPT | 49560 | 14 | — | — | $818.12 | $6,193.6 | $13,360 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 14 | — | — | $520.67 | $6,193.6 | $13,360 |
| Lap inguinal hernia repair | CPT | 49650 | 14 | — | — | $379.7 | $7,726.01 | $18,689 |
| Lap incisional hernia repair | CPT | 49652 | 14 | — | — | $524.57 | $7,726.01 | $28,173 |
| Total abdominal hysterectomy | CPT | 58150 | 9 | — | — | $1,162.9 | $10,386 | $20,938 |
| Vaginal hysterectomy | CPT | 58260 | 14 | — | — | $1,162.9 | $6,732.99 | $28,173 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 14 | — | — | $838.74 | $9,816 | $28,173 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 14 | — | — | $616.65 | $13,600 | $30,206 |
| Lap salpingo-oophorectomy | CPT | 58661 | 14 | — | — | $701.38 | $8,731 | $18,689 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $35,635 | $35,635 | $107,974 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $21,184 | $21,184 | $64,189 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $19,342 | $19,342 | $58,607 |
| Complex cataract surgery | CPT | 66982 | 14 | — | — | $1,240.5 | $4,042.58 | $20,474 |
| Cataract surgery with lens implant | CPT | 66984 | 14 | — | — | $1,772.8 | $4,042.58 | $20,474 |
| Intravitreal injection | CPT | 67028 | 15 | — | — | $481.17 | $843.22 | $7,009 |
| Vitrectomy mechanical | CPT | 67042 | 14 | — | — | $1,157.18 | $6,500.77 | $28,173 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $14,177 | $14,177 | $42,957 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $21,548 | $21,548 | $65,291 |
Payer mix (top 20)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 185 | $1,037.09 |
| Kaiser Permanente | 181 | $347.24 |
| Cigna | 176 | $1,438.09 |
| Aetna | 173 | $1,437.48 |
| Blue Cross Blue Shield | 169 | $5,026.98 |
| Health Net | 158 | $1,441.32 |
| Medicare | 158 | $562.28 |
| Humana | 158 | $555.71 |
| commercial | oscar | exchange | 152 | $1,848.48 |
| Medicaid | 136 | $261.24 |
| First Health | 121 | $2,006.65 |
| UnitedHealthcare | 118 | $4,210.32 |
| commercial | mhn | all plans | 114 | $351.34 |
| commercial | us behavioral health| all plans | 96 | $999.5 |
| commercial | healthsmart | all plans | 96 | $699.65 |
| Multiplan | 96 | $786.61 |
| commercial | magellan | all plans | 96 | $599.7 |
| commercial | jade medical group | all plans | 92 | $232.22 |
| commercial | connected care intel | all plans | 89 | $7,009 |
| commercial | chinese community | all plans | 6 | $2,533.54 |