▸ Hospital · CA · CCN 050378
Pacifica Hospital Of The Valley
9449 SAN FERNANDO ROAD, SUN VALLEY, CA, 91352-1421
133 bedsAcute Care Hospitals4
Compliance grade
A
100/100
Procedures tracked
96
of 209 target codes
Payers
16
with negotiated rates
Rates published
1,893
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 | 13 | $477 | $477 | $118 | $151.5 | $477 |
| Psychiatric eval with medical services | CPT | 90792 | 13 | $545 | $545 | $118 | $151.5 | $545 |
| Psychotherapy 30 minutes | CPT | 90832 | 13 | $257 | $257 | $107 | $155 | $257 |
| Psychotherapy 45 minutes | CPT | 90834 | 13 | $342 | $342 | $118 | $171 | $342 |
| Psychotherapy 60 minutes | CPT | 90837 | 13 | $511 | $511 | $118 | $206 | $511 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 13 | $489 | $489 | $118 | $151.5 | $489 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 13 | $549 | $549 | $66 | $159 | $549 |
| ED visit level 2 | CPT | 99282 | 13 | $902 | $902 | $121 | $155.5 | $902 |
| ED visit level 3 | CPT | 99283 | 13 | $1,431 | $1,431 | $212 | $271 | $1,431 |
| ED visit level 4 | CPT | 99284 | 13 | $1,822 | $1,822 | $328 | $420.5 | $1,822 |
| ED visit level 5 | CPT | 99285 | 13 | $3,877 | $3,877 | $476 | $610 | $3,877 |
| Critical care, first hour | CPT | 99291 | 13 | $5,422 | $5,422 | $658 | $843 | $5,422 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $1,235 | $1,235 | $82 | $104.5 | $1,235 |
| CT head with contrast | CPT | 70460 | 13 | $1,375 | $1,375 | $136 | $174.5 | $1,375 |
| CT head with and without contrast | CPT | 70470 | 13 | $1,979 | $1,979 | $136 | $174.5 | $1,979 |
| CT neck with contrast | CPT | 70491 | 13 | $1,590 | $1,590 | $136 | $174.5 | $1,590 |
| MRI brain without contrast | CPT | 70551 | 13 | $2,714 | $2,714 | $182 | $232.5 | $2,714 |
| MRI brain with contrast | CPT | 70552 | 13 | $2,985 | $2,985 | $285 | $365 | $2,985 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $3,390 | $3,390 | $285 | $365 | $3,390 |
| Chest X-ray single view | CPT | 71045 | 13 | $260 | $260 | $67 | $86 | $260 |
| Chest X-ray 2 views | CPT | 71046 | 13 | $336 | $336 | $67 | $120 | $336 |
| Chest X-ray 3 views | CPT | 71047 | 13 | $395 | $395 | $67 | $86 | $395 |
| CT chest without contrast | CPT | 71250 | 13 | $1,590 | $1,590 | $82 | $104.5 | $1,590 |
| CT chest with contrast | CPT | 71260 | 13 | $1,750 | $1,750 | $136 | $174.5 | $1,750 |
| CT chest with and without contrast | CPT | 71270 | 13 | $2,211 | $2,211 | $136 | $174.5 | $2,211 |
| MRI chest without contrast | CPT | 71550 | 13 | $2,511 | $2,511 | $182 | $232.5 | $2,511 |
| Lumbosacral spine X-ray | CPT | 72100 | 13 | $458 | $458 | $82 | $104.5 | $458 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $1,635 | $1,635 | $82 | $104.5 | $1,635 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $2,948 | $2,948 | $82 | $104.5 | $2,948 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $3,010 | $3,010 | $82 | $104.5 | $3,010 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $2,714 | $2,714 | $182 | $232.5 | $2,714 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $3,390 | $3,390 | $182 | $232.5 | $3,390 |
| MRI lumbar spine without contrast | CPT | 72148 | 13 | $2,714 | $2,714 | $182 | $232.5 | $2,714 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 13 | $2,969 | $2,969 | $285 | $365 | $2,969 |
| MRI cervical spine with and without contrast | CPT | 72156 | 13 | $3,446 | $3,446 | $285 | $365 | $3,446 |
| MRI lumbar spine with contrast | CPT | 72158 | 13 | $3,390 | $3,390 | $285 | $365 | $3,390 |
| CT pelvis without contrast | CPT | 72192 | 13 | $1,413 | $1,413 | $82 | $104.5 | $1,413 |
| Shoulder X-ray | CPT | 73030 | 13 | $487 | $487 | $67 | $86 | $487 |
| Humerus X-ray | CPT | 73060 | 13 | $299 | $299 | $67 | $86 | $299 |
| Hand X-ray 3 views | CPT | 73130 | 13 | $273 | $273 | $11 | $84 | $273 |
| MRI upper extremity joint without contrast | CPT | 73221 | 13 | $1,764 | $1,764 | $182 | $232.5 | $1,764 |
| Knee X-ray 1-2 views | CPT | 73560 | 13 | $247 | $247 | $67 | $86 | $247 |
| Ankle X-ray 3 views | CPT | 73610 | 13 | $273 | $273 | $67 | $105 | $273 |
| MRI lower extremity joint without contrast | CPT | 73721 | 13 | $1,764 | $1,764 | $182 | $232.5 | $1,764 |
| CT abdomen without contrast | CPT | 74150 | 13 | $1,431 | $1,431 | $82 | $104.5 | $1,431 |
| CT abdomen with contrast | CPT | 74160 | 13 | $2,441 | $2,441 | $136 | $174.5 | $2,441 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $3,196 | $3,196 | $136 | $174.5 | $3,196 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $6,378 | $6,378 | $182 | $232.5 | $6,378 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $8,379 | $8,379 | $285 | $365 | $8,379 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $4,233 | $4,233 | $285 | $365 | $4,233 |
| MRI abdomen without contrast | CPT | 74181 | 13 | $3,356 | $3,356 | $182 | $232.5 | $3,356 |
| MRI abdomen with and without contrast | CPT | 74183 | 13 | $3,356 | $3,356 | $285 | $365 | $3,356 |
| Abdominal ultrasound complete | CPT | 76700 | 13 | $1,147 | $1,147 | $82 | $104.5 | $1,147 |
| Abdominal ultrasound limited | CPT | 76705 | 13 | $1,033 | $1,033 | $82 | $559.5 | $1,033 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 13 | $964 | $964 | $82 | $104.5 | $964 |
| Obstetric ultrasound first trimester | CPT | 76801 | 13 | $918 | $918 | $82 | $104.5 | $918 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 13 | $1,099 | $1,099 | $182 | $232.5 | $1,099 |
| Transvaginal ultrasound | CPT | 76830 | 13 | $907 | $907 | $82 | $104.5 | $907 |
| Pelvic ultrasound complete | CPT | 76856 | 13 | $944 | $944 | $82 | $104.5 | $944 |
| Scrotal ultrasound | CPT | 76870 | 13 | $716 | $716 | $82 | $104.5 | $716 |
| EKG tracing only | CPT | 93005 | 13 | $183 | $183 | $45 | $58.5 | $183 |
| Transthoracic echocardiogram | CPT | 93307 | 13 | $937 | $937 | $182 | $232.5 | $937 |
| Stress echocardiogram | CPT | 93350 | 13 | $1,866 | $1,866 | $409 | $524 | $1,866 |
| inpatient | ||||||||
| Initial hospital care, high complexity | CPT | 99223 | 5 | $460 | $460 | $230 | $460 | $460 |
| Hospital discharge, <30 min | CPT | 99238 | 5 | $460 | $460 | $230 | $460 | $460 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 5 | $269 | $269 | $48 | $115.5 | $269 |
| Electrolyte panel | CPT | 80051 | 5 | $249 | $249 | $125 | $249 | $249 |
| Comprehensive metabolic panel | CPT | 80053 | 5 | $443 | $443 | $80 | $190.5 | $443 |
| Lipid panel | CPT | 80061 | 5 | $310 | $310 | $7 | $84.5 | $310 |
| Renal function panel | CPT | 80069 | 5 | $387 | $387 | $194 | $387 | $387 |
| Hepatic function panel | CPT | 80076 | 5 | $378 | $378 | $59 | $153.5 | $378 |
| Urinalysis automated | CPT | 81003 | 5 | $33 | $33 | $14 | $27 | $33 |
| Glucose quantitative | CPT | 82947 | 5 | $329 | $329 | $34 | $75 | $329 |
| Hemoglobin A1c | CPT | 83036 | 5 | $128 | $128 | $37 | $73 | $128 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 5 | $137 | $137 | $26 | $60 | $137 |
| Complete blood count with automated differential | CPT | 85025 | 5 | $94 | $94 | $36 | $72 | $94 |
| Urine culture bacterial | CPT | 87086 | 5 | $158 | $158 | $79 | $158 | $158 |
| Urine culture identification | CPT | 87088 | 5 | $117 | $117 | $59 | $117 | $117 |
| Tissue exam by pathologist level IV | CPT | 88305 | 5 | $435 | $435 | $96 | $205 | $435 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 13 | $106 | $106 | $53 | $185 | $231 |
| office | ||||||||
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 5 | $395 | $395 | $131 | $262 | $395 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 5 | $604 | $604 | $212 | $424 | $604 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 5 | $763 | $763 | $288 | $575 | $763 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | $61,772 | $61,772 | $672 | $861 | $61,772 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | $8,190 | $8,190 | $672 | $861 | $8,190 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 13 | $1,166 | $1,166 | $583 | $847 | $1,166 |
| Colonoscopy diagnostic | CPT | 45378 | 13 | $5,873 | $5,873 | $678 | $868 | $5,873 |
| Colonoscopy with biopsy | CPT | 45380 | 13 | $61,772 | $61,772 | $875 | $1,121 | $61,772 |
| Colonoscopy with polyp removal | CPT | 45385 | 13 | $61,772 | $61,772 | $875 | $1,121 | $61,772 |
| surgery | ||||||||
| Total hip replacement | CPT | 27130 | 13 | $5,646 | $5,646 | $2,823 | $12,198 | $15,247 |
| Total knee replacement | CPT | 27447 | 13 | $7,087 | $7,087 | $3,544 | $12,198 | $15,247 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | $18,342 | $18,342 | $9,171 | $18,342 | $18,342 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 13 | $18,342 | $18,342 | $2,400 | $3,075 | $18,342 |
| Laparoscopic cholecystectomy | CPT | 47562 | 13 | $25,236 | $25,236 | $4,278 | $5,481.5 | $25,236 |
| Cataract surgery with lens implant | CPT | 66984 | 13 | $27,945 | $27,945 | $1,728 | $2,214 | $27,945 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | $25,272 | $25,272 | $1,200 | $15,163 | $25,272 |
Payer mix (top 16)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 96 | $330 |
| altamed | 96 | $660 |
| Blue Cross Blue Shield | 96 | $660 |
| heritage provider network | 96 | $660 |
| Molina | 96 | $660 |
| Health Net | 75 | $213 |
| Anthem BCBS | 75 | $170 |
| Bright Health | 75 | $179 |
| Self-Pay (Cash) | 75 | $170 |
| Humana | 75 | $170 |
| care 1st health plan | 75 | $170 |
| la health care | 75 | $170 |
| alignment health | 75 | $136 |
| scan health plan | 1 | $17,690 |
| Kaiser Permanente | 1 | $1,200 |
| UnitedHealthcare | 1 | $2,336 |