▸ Hospital · CA · CCN 050300

St Mary Medical Center

18300 HIGHWAY 18, APPLE VALLEY, CA, 92307

214 bedsAcute Care Hospitals2

Compliance grade

100/100

Procedures tracked

191

of 209 target codes

Payers

with negotiated rates

Rates published

9,942

last crawl 2026-05-22

▸ Compare with other hospitals All CA hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://www.dignityhealth.org/content/dam/dignity-health/documents/pricing-procedure-spreadsheets-2020/price-transparency-4-30-2022/southern-california/941196203_St-Mary-Medical-Center_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	8	—	—	$12,414	$12,414	$19,862
Psychiatric diagnostic evaluation	CPT	90791	11	$450	$315	$67.25	$161.42	$416.7
Psychotherapy 30 minutes	CPT	90832	10	$249	$174.3	$67.05	$159.96	$737
Psychotherapy 45 minutes	CPT	90834	10	$327	$228.9	$85.18	$159.96	$737
Psychotherapy 60 minutes	CPT	90837	10	$484	$338.8	$124.32	$159.96	$737
emergency
ED visit level 1	CPT	99281	15	$475	$332.5	$1.11	$106.23	$2,820
ED visit level 2	CPT	99282	15	$1,163	$814.1	$34.97	$251.25	$4,814
ED visit level 3	CPT	99283	15	$2,209	$1,546.3	$63.97	$442.67	$6,417
ED visit level 4	CPT	99284	15	$3,351	$2,345.7	$98.04	$695.82	$10,313
ED visit level 5	CPT	99285	15	$5,946	$4,162.2	$155.03	$887	$14,315
Critical care, first hour	CPT	99291	15	$4,855	$3,398.5	$174.42	$2,442.07	$15,274
imaging
CT head without contrast	CPT	70450	13	$2,713	$1,899.1	$127.9	$166.02	$2,512.24
CT head with contrast	CPT	70460	13	$3,717	$2,601.9	$209.04	$313.56	$3,441.95
CT head with and without contrast	CPT	70470	13	$4,450	$3,115	$209.56	$308.55	$4,120.7
CT neck with contrast	CPT	70491	13	$4,946	$3,462.2	$209.56	$323.56	$4,580
MRI brain without contrast	CPT	70551	13	$3,922	$2,745.4	$270.1	$343.86	$3,898
MRI brain with contrast	CPT	70552	13	$5,685	$3,979.5	$396.44	$550.3	$5,077.28
MRI brain with and without contrast	CPT	70553	13	$5,241	$3,668.7	$432.06	$550.3	$4,680.74
Chest X-ray single view	CPT	71045	13	$485	$339.5	$17.67	$96.7	$433.16
Chest X-ray 2 views	CPT	71046	13	$630	$441	$27.48	$112.54	$562.66
Chest X-ray 3 views	CPT	71047	13	$775	$542.5	$35.27	$116.04	$692.16
CT chest without contrast	CPT	71250	13	$2,525	$1,767.5	$127.9	$208.45	$2,338.15
CT chest with contrast	CPT	71260	13	$4,946	$3,462.2	$209.56	$319.66	$4,580
CT chest with and without contrast	CPT	71270	13	$5,588	$3,911.6	$209.56	$349.63	$5,174.49
MRI chest without contrast	CPT	71550	13	$3,212	$2,248.4	$270.1	$542.4	$3,898
MRI chest with contrast	CPT	71551	13	$4,657	$3,259.9	$395.33	$855.31	$4,159.17
MRI chest with and without contrast	CPT	71552	13	$5,362	$3,753.4	$432.06	$558.24	$4,788.81
Lumbosacral spine X-ray	CPT	72100	13	$725	$507.5	$43.45	$167.67	$647.5
CT cervical spine without contrast	CPT	72125	13	$2,890	$2,023	$127.9	$208.26	$2,676.14
CT thoracic spine without contrast	CPT	72128	13	$2,890	$2,023	$127.9	$208.26	$2,676.14
CT lumbar spine without contrast	CPT	72131	13	$1,779	$1,245.3	$127.9	$208.26	$1,647.36
MRI cervical spine without contrast	CPT	72141	13	$4,726	$3,308.2	$270.1	$343.86	$4,220.8
MRI thoracic spine without contrast	CPT	72146	13	$2,889	$2,022.3	$270.1	$343.86	$3,898
MRI lumbar spine without contrast	CPT	72148	13	$3,110	$2,177	$270.1	$343.86	$3,898
MRI lumbar spine with and without contrast	CPT	72149	13	$4,510	$3,157	$399.67	$550.3	$4,027.89
MRI cervical spine with and without contrast	CPT	72156	13	$7,892	$5,524.4	$432.06	$550.3	$7,048.35
MRI lumbar spine with contrast	CPT	72158	13	$5,195	$3,636.5	$432.06	$550.3	$4,639.66
CT pelvis without contrast	CPT	72192	13	$3,128	$2,189.6	$127.9	$208.26	$2,896.53
CT pelvis with contrast	CPT	72193	13	$3,993	$2,795.1	$209.56	$341.68	$3,697.52
Shoulder X-ray	CPT	73030	13	$941	$658.7	$37.09	$337.14	$840.41
Humerus X-ray	CPT	73060	13	$555	$388.5	$29.81	$121.55	$495.68
Hand X-ray 3 views	CPT	73130	13	$786	$550.2	$36.06	$284.72	$701.98
MRI upper extremity joint without contrast	CPT	73221	13	$7,106	$4,974.2	$270.1	$452.03	$6,346.37
MRI upper extremity joint with and without contrast	CPT	73223	13	$11,865	$8,305.5	$408.36	$642.02	$10,597
Knee X-ray 1-2 views	CPT	73560	13	$1,006	$704.2	$27.28	$258.63	$898.46
Ankle X-ray 3 views	CPT	73610	13	$989	$692.3	$36.06	$354.23	$883.28
MRI lower extremity joint without contrast	CPT	73721	13	$3,314	$2,319.8	$270.1	$450.63	$3,898
MRI lower extremity joint with and without contrast	CPT	73723	13	$5,759	$4,031.3	$407.06	$641.01	$5,143.37
CT abdomen without contrast	CPT	74150	13	$1,543	$1,080.1	$127.9	$208.26	$1,528
CT abdomen with contrast	CPT	74160	13	$2,379	$1,665.3	$209.56	$341.68	$2,202.96
CT abdomen with and without contrast	CPT	74170	13	$2,763	$1,934.1	$209.56	$379.73	$2,558.54
CT abdomen and pelvis without contrast	CPT	74176	13	$2,153	$1,507.1	$178.43	$278.35	$1,993.68
CT abdomen and pelvis with contrast	CPT	74177	13	$3,214	$2,249.8	$281.8	$472.35	$2,976.17
CT abdomen and pelvis with and without contrast	CPT	74178	13	$3,760	$2,632	$319.24	$496	$3,481.76
MRI abdomen without contrast	CPT	74181	13	$3,160	$2,212	$270.1	$444.15	$3,898
MRI abdomen with and without contrast	CPT	74183	13	$5,266	$3,686.2	$351.25	$547.95	$4,703.07
Abdominal ultrasound complete	CPT	76700	12	$1,155	$808.5	$119.34	$162.7	$1,031.54
Abdominal ultrasound limited	CPT	76705	12	$889	$622.3	$87.13	$135.92	$793.97
Retroperitoneal ultrasound complete	CPT	76770	12	$640	$448	$115.78	$162.7	$640
Obstetric ultrasound first trimester	CPT	76801	13	$472	$330.4	$78.42	$143.95	$472
Obstetric ultrasound after first trimester	CPT	76805	13	$548	$383.6	$127.9	$162.7	$548
Obstetric ultrasound with fetal anatomy	CPT	76811	13	$873	$611.1	$159.03	$275.82	$873
Transvaginal ultrasound	CPT	76830	12	$662	$463.4	$97.04	$151.38	$619.31
Pelvic ultrasound complete	CPT	76856	12	$941	$658.7	$97.04	$151.38	$840.41
Scrotal ultrasound	CPT	76870	12	$954	$667.8	$85.75	$133.77	$852.02
Diagnostic mammography unilateral	CPT	77065	9	$587	$410.9	$117.89	$377.97	$587
Diagnostic mammography bilateral	CPT	77066	9	$714	$499.8	$148	$461.57	$714
Screening mammography bilateral	CPT	77067	9	$681	$476.7	$116	$385.6	$681
EKG tracing only	CPT	93005	11	$344	$240.8	$28.22	$66.55	$307.23
Transthoracic echocardiogram complete	CPT	93306	11	$4,356	$3,049.2	$239.76	$577.66	$3,890.35
Transthoracic echocardiogram	CPT	93307	12	$2,237	$1,565.9	$215.3	$330.11	$2,034.24
Stress echocardiogram	CPT	93350	11	$4,949	$3,464.3	$137.87	$577.66	$4,419.96
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	8	—	—	$17,977	$17,977	$28,763
COPD w MCC	MS-DRG	190	8	—	—	$11,371	$11,371	$18,193
COPD w CC	MS-DRG	191	8	—	—	$9,173.27	$9,173.27	$14,677
COPD w/o CC/MCC	MS-DRG	192	8	—	—	$7,451.37	$7,451.37	$11,922
Simple pneumonia & pleurisy w CC	MS-DRG	194	8	—	—	$8,987.12	$8,987.12	$14,379
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	8	—	—	$7,179.44	$7,179.44	$11,487
AMI discharged alive w MCC	MS-DRG	280	8	—	—	$15,767	$15,767	$25,227
AMI discharged alive w CC	MS-DRG	281	8	—	—	$9,595.77	$9,595.77	$15,353
AMI discharged alive w/o CC/MCC	MS-DRG	282	8	—	—	$7,729.68	$7,729.68	$12,367
Heart failure & shock w MCC	MS-DRG	291	8	—	—	$12,677	$12,677	$20,284
Heart failure & shock w CC	MS-DRG	292	8	—	—	$8,983.47	$8,983.47	$14,374
Heart failure & shock w/o CC/MCC	MS-DRG	293	8	—	—	$6,486.84	$6,486.84	$10,379
Cardiac arrhythmia w MCC	MS-DRG	308	8	—	—	$12,062	$12,062	$19,300
Cardiac arrhythmia w CC	MS-DRG	309	8	—	—	$7,952.34	$7,952.34	$12,724
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	8	—	—	$6,206.7	$6,206.7	$9,930.72
GI hemorrhage w CC	MS-DRG	378	8	—	—	$10,170	$10,170	$16,272
GI hemorrhage w/o CC/MCC	MS-DRG	379	8	—	—	$6,918.46	$6,918.46	$11,070
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	8	—	—	$8,091.95	$8,091.95	$12,947
Fractures of femur w/o MCC	MS-DRG	533	8	—	—	$14,027	$14,027	$22,443
Kidney/UTI w MCC	MS-DRG	689	8	—	—	$11,271	$11,271	$18,034
Kidney/UTI w/o MCC	MS-DRG	690	8	—	—	$8,349.28	$8,349.28	$13,359
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	8	—	—	$18,188	$18,188	$29,101
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	8	—	—	$10,469	$10,469	$16,750
lab
Basic metabolic panel (BMP)	CPT	80048	11	$391	$273.7	$8.46	$13.28	$312.8
General health panel	CPT	80050	6	$1,091	$763.7	$93.07	$423.51	$872.8
Electrolyte panel	CPT	80051	11	$275	$192.5	$7.01	$10.87	$220
Comprehensive metabolic panel	CPT	80053	11	$602	$421.4	$10.56	$16.78	$481.6
Lipid panel	CPT	80061	11	$437	$305.9	$13.39	$17.11	$349.6
Renal function panel	CPT	80069	11	$20	$14	$8.05	$10.85	$20
Hepatic function panel	CPT	80076	11	$539	$377.3	$8.17	$12.79	$431.2
Urinalysis non-automated	CPT	81002	11	$55	$38.5	$1.03	$5.61	$44
Urinalysis automated	CPT	81003	11	$90	$63	$1.03	$2.76	$72
Glucose quantitative	CPT	82947	11	$115	$80.5	$3.93	$6.75	$92
Hemoglobin A1c	CPT	83036	11	$195	$136.5	$1.03	$11.9	$156
Thyroid stimulating hormone (TSH)	CPT	84443	11	$293	$205.1	$1.03	$9.26	$237.12
Complete blood count with automated differential	CPT	85025	11	$184	$128.8	$7.77	$12.13	$147.2
Complete blood count without differential	CPT	85027	11	$162	$113.4	$6.47	$9.91	$129.6
Urine culture bacterial	CPT	87086	11	$223	$156.1	$8.07	$10.3	$178.4
Tissue exam by pathologist level IV	CPT	88305	12	$1,144	$800.8	$13.81	$59.41	$1,021.71
maternity
Fetal non-stress test	CPT	59025	12	$906	$634.2	$1.03	$264.28	$3,439
Routine obstetric care including vaginal delivery	CPT	59400	5	—	—	$1,873.72	$3,110.67	$9,630
Vaginal delivery only	CPT	59409	11	—	—	$780.72	$3,136.64	$9,630
Vaginal delivery with postpartum	CPT	59410	3	—	—	$2,967	$5,665.1	$9,630
Routine obstetric care with C-section	CPT	59510	5	—	—	$1,873.82	$3,112.53	$9,630
C-section delivery only	CPT	59514	5	—	—	$781.35	$1,218.91	$9,630
C-section with postpartum	CPT	59515	3	—	—	$4,512	$6,196	$9,630
office
Office visit, new patient, 15-29 min	CPT	99202	7	$348	$243.6	$19.16	$135.36	$322.25
Office visit, new patient, 30-44 minutes	CPT	99203	6	$273	$191.1	$67.46	$125.54	$243.82
Office visit, new patient, 45-59 min	CPT	99204	6	$1,845	$1,291.5	$98.83	$248.07	$1,708.47
Office visit, new patient, 60-74 min	CPT	99205	6	$570	$399	$118.62	$181.49	$509.07
Office visit, established patient, 5 min	CPT	99211	7	$320	$224	$17.21	$126.41	$296.32
Office visit, established patient, 10-19 min	CPT	99212	7	$210	$147	$16.37	$29.77	$187.56
Office visit, established patient, 20-29 minutes	CPT	99213	6	$247	$172.9	$34.43	$57.38	$220.6
Office visit, established patient, 30-39 minutes	CPT	99214	6	$1,845	$1,291.5	$53.79	$171	$1,708.47
Office visit, established patient, 40-54 min	CPT	99215	6	$366	$256.2	$82.05	$125.54	$326.88
preventive
Upper GI endoscopy diagnostic	CPT	43235	11	—	—	$337.55	$968.65	$7,322
Upper GI endoscopy with biopsy	CPT	43239	11	—	—	$337.55	$968.65	$7,322
Sigmoidoscopy diagnostic	CPT	45330	11	—	—	$94.2	$951.26	$5,237
Sigmoidoscopy with biopsy	CPT	45331	11	—	—	$124.33	$951.26	$5,237
Colonoscopy diagnostic	CPT	45378	11	—	—	$328.08	$950	$6,529.48
Colonoscopy with biopsy	CPT	45380	11	—	—	$431.31	$1,241.37	$6,529.48
Colonoscopy with polyp removal	CPT	45385	11	—	—	$431.31	$1,241.37	$6,529.48
surgery
Total shoulder arthroplasty	CPT	23472	10	—	—	$1,490.14	$14,741	$23,586
PCI w drug-eluting stent w MCC	MS-DRG	246	8	—	—	$29,614	$29,614	$47,382
PCI w drug-eluting stent w/o MCC	MS-DRG	247	8	—	—	$19,110	$19,110	$30,575
Hip hemiarthroplasty	CPT	27125	7	—	—	$1,794.34	$6,584.74	$14,454
Total hip replacement	CPT	27130	11	—	—	$2,563.33	$13,758	$23,586
Total knee replacement	CPT	27447	11	—	—	$2,563.33	$14,454	$24,116
Knee revision arthroplasty single component	CPT	27486	5	—	—	$1,647.29	$8,815	$14,454
Knee revision arthroplasty all components	CPT	27487	7	—	—	$2,458.88	$7,942.77	$14,454
Shoulder arthroscopy with decompression	CPT	29826	8	—	—	$605.06	$3,024.5	$13,663
Shoulder arthroscopy with rotator cuff repair	CPT	29827	11	—	—	$592.75	$7,488.26	$16,289
Knee arthroscopy with meniscectomy	CPT	29881	11	—	—	$790.35	$3,728.73	$12,612
ACL reconstruction	CPT	29888	11	—	—	$1,161.19	$7,488.26	$17,331
Major small/large bowel procedures w MCC	MS-DRG	329	8	—	—	$45,691	$45,691	$73,106
Major small/large bowel procedures w CC	MS-DRG	330	8	—	—	$24,367	$24,367	$38,987
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	8	—	—	$16,712	$16,712	$26,740
CABG single arterial graft	CPT	33533	6	—	—	$3,222.1	$6,882	$17,331
CABG 2 arterial grafts	CPT	33534	6	—	—	$3,623.26	$6,882	$24,116
CABG 3 arterial grafts	CPT	33535	6	—	—	$4,023.78	$6,882	$24,116
CABG 4+ arterial grafts	CPT	33536	6	—	—	$4,425.59	$7,255.34	$24,116
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	8	—	—	$16,516	$16,516	$26,426
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	8	—	—	$13,106	$13,106	$20,970
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	8	—	—	$33,192	$33,192	$53,108
Open appendectomy	CPT	44950	11	—	—	$689.53	$3,813.76	$13,663
Laparoscopic appendectomy	CPT	44970	11	—	—	$470.38	$6,049.19	$12,054
Spinal fusion (non-cervical) w MCC	MS-DRG	459	8	—	—	$62,548	$62,548	$100,077
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	8	—	—	$36,972	$36,972	$59,155
Major joint replacement w MCC	MS-DRG	469	8	—	—	$29,263	$29,263	$46,821
Major joint replacement w/o MCC	MS-DRG	470	8	—	—	$18,444	$18,444	$29,511
Laparoscopic cholecystectomy	CPT	47562	11	—	—	$802.32	$6,122.16	$24,116
Lap cholecystectomy with cholangiography	CPT	47563	11	—	—	$923.44	$6,122.16	$24,116
Hip & femur procedures except major joint w MCC	MS-DRG	480	8	—	—	$28,715	$28,715	$45,943
Hip & femur procedures except major joint w CC	MS-DRG	481	8	—	—	$20,231	$20,231	$32,370
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	8	—	—	$16,122	$16,122	$25,795
Open umbilical hernia repair	CPT	49560	11	—	—	$798.48	$4,189.05	$12,612
Umbilical hernia repair age 5+	CPT	49585	11	—	—	$508.18	$4,189.05	$12,612
Lap inguinal hernia repair	CPT	49650	11	—	—	$379.7	$6,049.19	$12,612
Lap incisional hernia repair	CPT	49652	11	—	—	$524.57	$6,049.19	$12,612
Total abdominal hysterectomy	CPT	58150	7	—	—	$1,162.9	$4,879.17	$17,331
Vaginal hysterectomy	CPT	58260	11	—	—	$1,162.9	$5,271.7	$17,331
Lap-assisted vaginal hysterectomy	CPT	58550	11	—	—	$838.74	$6,493.66	$19,603
Lap-assisted vaginal hysterectomy >250g	CPT	58552	11	—	—	$616.65	$10,648	$19,603
Lap salpingo-oophorectomy	CPT	58661	11	—	—	$701.38	$6,122.16	$14,173
OR procedure for obesity w MCC	MS-DRG	619	8	—	—	$29,042	$29,042	$46,468
OR procedure for obesity w CC	MS-DRG	620	8	—	—	$17,189	$17,189	$27,502
OR procedure for obesity w/o CC/MCC	MS-DRG	621	8	—	—	$15,678	$15,678	$25,084
Complex cataract surgery	CPT	66982	11	—	—	$860.81	$2,489.25	$16,289
Cataract surgery with lens implant	CPT	66984	11	—	—	$860.81	$2,836.58	$16,289
Intravitreal injection	CPT	67028	11	—	—	$40.19	$618.32	$5,237
Vitrectomy mechanical	CPT	67042	11	—	—	$1,129.4	$5,156.27	$12,612
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	8	—	—	$11,441	$11,441	$18,305
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	8	—	—	$17,487	$17,487	$27,979
PCI single major coronary artery	CPT	92920	14	$19,236	$13,465	$435.12	$7,406.69	$24,116
PCI with drug-eluting stent	CPT	92928	14	$27,673	$19,371	$483.05	$12,008	$24,116
PCI bypass graft	CPT	92937	14	$27,673	$19,371	$482.46	$12,008	$24,116
Left heart catheterization	CPT	93452	14	$7,704	$5,392.8	$824.33	$3,875.12	$17,331
Coronary angiography with cath	CPT	93455	14	$14,563	$10,194	$1,103.39	$4,246.71	$24,116
Coronary angiography with bypass cath	CPT	93458	14	$23,019	$16,113	$1,140.01	$4,333.38	$24,116

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 15)

Payer	Codes covered	Median rate
Anthem BCBS	191	$798.15
Medicare	188	$435.12
Kaiser Permanente	188	$440.24
Blue Cross Blue Shield	178	$1,183.41
Cigna	169	$440.24
commercial \| hcla \| preferred ipa	164	$550.3
Humana	164	$440.24
commercial \| la care \| all plans	164	$528.29
Medicaid	142	$277.53
Aetna	126	$1,739.65
UnitedHealthcare	124	$1,998.69
Multiplan	103	$552.4
commercial \| healthcare partners \| all plans	58	$496
commercial \| hpn \| all plans	18	$2,224
Health Net	7	$644.58