▸ Hospital · CA · CCN 050516
Mercy San Juan Medical Center
6501 COYLE AVENUE, CARMICHAEL, CA, 95608
384 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
192
of 209 target codes
Payers
18
with negotiated rates
Rates published
7,995
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 | — | — | $7,705.65 | $12,899 | $16,124 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 14 | $1,242 | $869.4 | $35.19 | $262.56 | $1,242 |
| Psychiatric eval with medical services | CPT | 90792 | 14 | $1,242 | $869.4 | $35.19 | $236.6 | $1,242 |
| Psychotherapy 30 minutes | CPT | 90832 | 14 | $1,237 | $865.9 | $67.05 | $194.61 | $1,023 |
| Psychotherapy 45 minutes | CPT | 90834 | 14 | $663 | $464.1 | $85.18 | $188.94 | $548.31 |
| Psychotherapy 60 minutes | CPT | 90837 | 14 | $990 | $693 | $124.32 | $206.62 | $818.73 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 17 | $491 | $343.7 | $21.77 | $309.13 | $6,939 |
| ED visit level 2 | CPT | 99282 | 17 | $1,224 | $856.8 | $34.97 | $834.55 | $12,266 |
| ED visit level 3 | CPT | 99283 | 17 | $2,268 | $1,587.6 | $63.97 | $1,199.48 | $14,200 |
| ED visit level 4 | CPT | 99284 | 17 | $18,542 | $12,979 | $98.04 | $2,355.36 | $20,609 |
| ED visit level 5 | CPT | 99285 | 17 | $34,425 | $24,098 | $76.5 | $3,985.99 | $34,459 |
| Critical care, first hour | CPT | 99291 | 17 | $48,238 | $33,767 | $293 | $6,535.78 | $48,286 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| CT head with contrast | CPT | 70460 | 14 | $6,697 | $4,687.9 | $209.04 | $376.14 | $5,538.42 |
| CT head with and without contrast | CPT | 70470 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| CT neck with contrast | CPT | 70491 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| MRI brain without contrast | CPT | 70551 | 14 | $5,092 | $3,564.4 | $283.78 | $445.35 | $4,211.09 |
| MRI brain with contrast | CPT | 70552 | 14 | $7,800 | $5,460 | $396.44 | $683.78 | $6,450.6 |
| MRI brain with and without contrast | CPT | 70553 | 14 | $7,800 | $5,460 | $467.23 | $712.73 | $6,450.6 |
| Chest X-ray single view | CPT | 71045 | 15 | $1,054 | $737.8 | $17.67 | $121.28 | $871.66 |
| Chest X-ray 2 views | CPT | 71046 | 15 | $1,054 | $737.8 | $27.48 | $121.28 | $871.66 |
| Chest X-ray 3 views | CPT | 71047 | 15 | $1,054 | $737.8 | $35.27 | $121.28 | $871.66 |
| CT chest without contrast | CPT | 71250 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| CT chest with contrast | CPT | 71260 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| CT chest with and without contrast | CPT | 71270 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| MRI chest without contrast | CPT | 71550 | 14 | $5,092 | $3,564.4 | $306.4 | $516.49 | $4,211.09 |
| MRI chest with contrast | CPT | 71551 | 14 | $8,000 | $5,600 | $395.33 | $1,072.68 | $6,616 |
| MRI chest with and without contrast | CPT | 71552 | 14 | $7,800 | $5,460 | $490.35 | $712.73 | $6,450.6 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | $1,175 | $822.5 | $43.45 | $163.23 | $971.73 |
| CT cervical spine without contrast | CPT | 72125 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| CT thoracic spine without contrast | CPT | 72128 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| CT lumbar spine without contrast | CPT | 72131 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| MRI cervical spine without contrast | CPT | 72141 | 14 | $5,092 | $3,564.4 | $277.53 | $445.35 | $4,211.09 |
| MRI thoracic spine without contrast | CPT | 72146 | 14 | $5,092 | $3,564.4 | $277.53 | $445.35 | $4,211.09 |
| MRI lumbar spine without contrast | CPT | 72148 | 14 | $5,092 | $3,564.4 | $277.97 | $445.35 | $4,211.09 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 14 | $7,800 | $5,460 | $399.67 | $686.7 | $6,450.6 |
| MRI cervical spine with and without contrast | CPT | 72156 | 14 | $7,800 | $5,460 | $471.83 | $712.73 | $6,450.6 |
| MRI lumbar spine with contrast | CPT | 72158 | 14 | $7,800 | $5,460 | $470.9 | $712.73 | $6,450.6 |
| CT pelvis without contrast | CPT | 72192 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| CT pelvis with contrast | CPT | 72193 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| Shoulder X-ray | CPT | 73030 | 15 | $1,054 | $737.8 | $37.09 | $121.28 | $871.66 |
| Humerus X-ray | CPT | 73060 | 15 | $1,054 | $737.8 | $29.81 | $121.28 | $871.66 |
| Hand X-ray 3 views | CPT | 73130 | 15 | $1,054 | $737.8 | $36.06 | $121.28 | $871.66 |
| MRI upper extremity joint without contrast | CPT | 73221 | 14 | $5,092 | $3,564.4 | $295.44 | $445.35 | $4,211.09 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 14 | $7,800 | $5,460 | $408.36 | $694.56 | $6,450.6 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | $1,054 | $737.8 | $27.28 | $121.28 | $871.66 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | $1,054 | $737.8 | $36.06 | $121.28 | $871.66 |
| MRI lower extremity joint without contrast | CPT | 73721 | 14 | $7,091 | $4,963.7 | $294.53 | $525.45 | $5,864.26 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 14 | $7,800 | $5,460 | $407.06 | $693.39 | $6,450.6 |
| CT abdomen without contrast | CPT | 74150 | 14 | $4,465 | $3,125.5 | $144.97 | $229.26 | $3,692.56 |
| CT abdomen with contrast | CPT | 74160 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| CT abdomen with and without contrast | CPT | 74170 | 14 | $6,697 | $4,687.9 | $237.85 | $376.14 | $5,538.42 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 14 | $5,921 | $4,144.7 | $178.43 | $355.33 | $4,896.67 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 14 | $8,837 | $6,185.9 | $281.8 | $566.42 | $7,308.2 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 14 | $8,837 | $6,185.9 | $319.24 | $606.56 | $7,308.2 |
| MRI abdomen without contrast | CPT | 74181 | 14 | $5,092 | $3,564.4 | $287.28 | $445.35 | $4,211.09 |
| MRI abdomen with and without contrast | CPT | 74183 | 14 | $7,800 | $5,460 | $351.25 | $642.88 | $6,450.6 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $1,874 | $1,311.8 | $119.34 | $228.01 | $1,549.8 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $1,874 | $1,311.8 | $87.13 | $183.65 | $1,549.8 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $1,874 | $1,311.8 | $115.78 | $224.62 | $1,549.8 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $1,874 | $1,311.8 | $78.42 | $180.14 | $1,549.8 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $1,250 | $875 | $135.29 | $237.07 | $1,250 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 15 | $2,793 | $1,955.1 | $159.03 | $345 | $2,793 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $1,874 | $1,311.8 | $97.04 | $193.61 | $1,549.8 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $1,874 | $1,311.8 | $97.04 | $193.61 | $1,549.8 |
| Scrotal ultrasound | CPT | 76870 | 15 | $1,874 | $1,311.8 | $85.75 | $185.26 | $1,549.8 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $557 | $389.9 | $91.12 | $417.75 | $557 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $716 | $501.2 | $117.13 | $537 | $716 |
| EKG tracing only | CPT | 93005 | 14 | $529 | $370.3 | $29.84 | $98.25 | $529 |
| Transthoracic echocardiogram complete | CPT | 93306 | 15 | $3,050 | $2,135 | $239.76 | $1,017.5 | $3,050 |
| Transthoracic echocardiogram | CPT | 93307 | 14 | $1,068 | $747.6 | $181.56 | $397.92 | $1,068 |
| Stress echocardiogram | CPT | 93350 | 14 | $4,164 | $2,914.8 | $137.87 | $692.54 | $4,164 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $11,990 | $18,967 | $23,709 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $7,252.96 | $11,761 | $14,702 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $5,660.36 | $9,364.75 | $11,706 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $4,496.34 | $7,486.65 | $9,358.31 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $5,633.73 | $9,161.71 | $11,452 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $4,324.51 | $7,190.05 | $8,987.56 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $10,340 | $16,557 | $20,696 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $6,141.57 | $9,825.57 | $12,282 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $4,678.3 | $7,790.21 | $9,737.76 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $8,532.38 | $13,187 | $16,483 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $5,740.88 | $9,157.73 | $11,447 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $4,154.61 | $6,434.63 | $8,043.29 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $7,530.03 | $12,516 | $15,645 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $4,794.94 | $8,033.06 | $10,041 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $3,545.96 | $6,129.08 | $7,661.35 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $6,264.55 | $10,452 | $13,065 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $4,093.74 | $6,905.4 | $8,631.75 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $4,827.92 | $8,185.34 | $10,232 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $9,252.6 | $14,659 | $18,323 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $7,091.92 | $11,653 | $14,566 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $5,013.67 | $8,466.01 | $10,583 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $11,832 | $19,197 | $23,996 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $6,589.17 | $10,778 | $13,473 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | $479 | $335.3 | $7.98 | $21.03 | $396.14 |
| General health panel | CPT | 80050 | 10 | $481 | $336.7 | $54.43 | $257.34 | $481 |
| Electrolyte panel | CPT | 80051 | 15 | $371 | $259.7 | $6.61 | $17.21 | $306.82 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | $953 | $667.1 | $9.96 | $26.56 | $788.14 |
| Lipid panel | CPT | 80061 | 15 | $325 | $227.5 | $1.36 | $11.63 | $325 |
| Renal function panel | CPT | 80069 | 15 | $248 | $173.6 | $8.19 | $21.58 | $233.7 |
| Hepatic function panel | CPT | 80076 | 15 | $234 | $163.8 | $7.7 | $20.25 | $220.1 |
| Urinalysis non-automated | CPT | 81002 | 15 | $39 | $27.3 | $3.08 | $6.71 | $39 |
| Urinalysis automated | CPT | 81003 | 15 | $90 | $63 | $2.12 | $21.63 | $74.43 |
| Glucose quantitative | CPT | 82947 | 15 | $130 | $91 | $3.71 | $13.02 | $107.51 |
| Hemoglobin A1c | CPT | 83036 | 15 | $544 | $380.8 | $9.16 | $91.83 | $449.89 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | $231 | $161.7 | $15.84 | $39.27 | $231 |
| Complete blood count with automated differential | CPT | 85025 | 15 | $185 | $129.5 | $7.33 | $19.21 | $185 |
| Complete blood count without differential | CPT | 85027 | 15 | $148 | $103.6 | $6.1 | $15.69 | $148 |
| Urine culture bacterial | CPT | 87086 | 15 | $143 | $100.1 | $7.61 | $18.59 | $143 |
| Urine culture identification | CPT | 87088 | 15 | $147 | $102.9 | $7.63 | $24.99 | $147 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | $620 | $434 | $5.66 | $66.17 | $512.74 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 17 | $861 | $602.7 | $32.7 | $410.94 | $23,269 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 6 | — | — | $1,994.02 | $6,884.19 | $23,269 |
| Vaginal delivery only | CPT | 59409 | 11 | — | — | $780.72 | $4,595.51 | $253,188 |
| Vaginal delivery with postpartum | CPT | 59410 | 5 | — | — | $4,052.09 | $7,511.13 | $23,269 |
| Routine obstetric care with C-section | CPT | 59510 | 6 | — | — | $1,995.21 | $7,867.65 | $23,269 |
| C-section delivery only | CPT | 59514 | 6 | — | — | $781.35 | $7,751.46 | $23,269 |
| C-section with postpartum | CPT | 59515 | 5 | — | — | $4,630.96 | $8,892.89 | $23,269 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 10 | $1,856 | $1,299.2 | $49.2 | $312.28 | $7,969 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 9 | $397 | $277.9 | $60.86 | $268.5 | $397 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 10 | $3,410 | $2,387 | $68 | $358.1 | $7,969 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 9 | $505 | $353.5 | $77.86 | $372.58 | $505 |
| Office visit, established patient, 5 min | CPT | 99211 | 10 | $1,856 | $1,299.2 | $17.21 | $240.82 | $7,969 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 9 | $316 | $221.2 | $16.37 | $152 | $316 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 9 | $358 | $250.6 | $34.43 | $152 | $358 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 10 | $3,410 | $2,387 | $53.79 | $330.8 | $7,969 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 9 | $486 | $340.2 | $77.86 | $328.19 | $486 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | — | — | $405.42 | $2,365.92 | $252,199 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | — | — | $423.61 | $2,878 | $252,199 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | — | — | $99 | $2,349.52 | $23,486 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 11 | — | — | $130.65 | $2,349.52 | $23,486 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | — | — | $534.04 | $2,407.46 | $252,199 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | — | — | $597.36 | $2,652.32 | $252,199 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | — | — | $723.96 | $2,708.65 | $252,199 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 11 | — | — | $2,359.38 | $17,412 | $48,140 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 9 | — | — | $20,116 | $31,659 | $39,574 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 9 | — | — | $12,900 | $20,202 | $25,253 |
| Hip hemiarthroplasty | CPT | 27125 | 7 | — | — | $1,885.66 | $7,455.46 | $42,475 |
| Total hip replacement | CPT | 27130 | 11 | — | — | $2,693.8 | $16,865 | $48,140 |
| Total knee replacement | CPT | 27447 | 11 | — | — | $2,693.8 | $17,361 | $48,140 |
| Knee revision arthroplasty single component | CPT | 27486 | 6 | — | — | $2,608.21 | $11,423 | $48,140 |
| Knee revision arthroplasty all components | CPT | 27487 | 7 | — | — | $2,584.03 | $10,013 | $48,140 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $605.06 | $7,751 | $17,966 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 11 | — | — | $623.03 | $9,708.42 | $42,475 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 11 | — | — | $790.35 | $5,844.93 | $29,354 |
| ACL reconstruction | CPT | 29888 | 11 | — | — | $1,220.29 | $8,430.53 | $42,475 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $31,112 | $49,195 | $61,494 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $16,020 | $25,936 | $32,420 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $10,710 | $17,588 | $21,985 |
| CABG single arterial graft | CPT | 33533 | 6 | — | — | $3,386.12 | $16,587 | $33,981 |
| CABG 2 arterial grafts | CPT | 33534 | 6 | — | — | $3,807.69 | $20,361 | $43,418 |
| CABG 3 arterial grafts | CPT | 33535 | 6 | — | — | $4,228.6 | $20,361 | $43,418 |
| CABG 4+ arterial grafts | CPT | 33536 | 6 | — | — | $4,650.86 | $20,361 | $43,418 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $10,581 | $17,374 | $21,717 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $8,285.12 | $13,654 | $17,068 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $21,777 | $35,563 | $44,453 |
| Open appendectomy | CPT | 44950 | 11 | — | — | $724.63 | $4,770.27 | $29,354 |
| Laparoscopic appendectomy | CPT | 44970 | 11 | — | — | $494.31 | $7,595.87 | $42,475 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 9 | — | — | $43,442 | $67,581 | $84,476 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 9 | — | — | $25,109 | $39,685 | $49,606 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $19,907 | $31,277 | $39,096 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $12,480 | $19,477 | $24,346 |
| Laparoscopic cholecystectomy | CPT | 47562 | 11 | — | — | $843.15 | $10,344 | $43,418 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 11 | — | — | $970.44 | $10,344 | $43,418 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $19,137 | $30,679 | $38,349 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $13,237 | $21,426 | $26,782 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $10,431 | $16,944 | $21,180 |
| Open umbilical hernia repair | CPT | 49560 | 11 | — | — | $839.12 | $6,187.18 | $29,354 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 11 | — | — | $534.04 | $6,187.18 | $29,354 |
| Lap inguinal hernia repair | CPT | 49650 | 11 | — | — | $379.7 | $7,329.6 | $42,475 |
| Lap incisional hernia repair | CPT | 49652 | 11 | — | — | $524.57 | $9,236.37 | $42,475 |
| Total abdominal hysterectomy | CPT | 58150 | 7 | — | — | $1,162.9 | $5,571.11 | $29,354 |
| Vaginal hysterectomy | CPT | 58260 | 11 | — | — | $1,162.9 | $6,226.62 | $29,354 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 11 | — | — | $838.74 | $11,668 | $42,475 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 11 | — | — | $616.65 | $13,354 | $42,475 |
| Lap salpingo-oophorectomy | CPT | 58661 | 11 | — | — | $701.38 | $8,570.6 | $42,475 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $19,518 | $31,036 | $38,795 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $11,378 | $18,107 | $22,634 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $9,966.49 | $16,459 | $20,574 |
| Complex cataract surgery | CPT | 66982 | 11 | — | — | $1,272.35 | $7,689.98 | $253,188 |
| Cataract surgery with lens implant | CPT | 66984 | 11 | — | — | $1,818.32 | $8,387.26 | $253,188 |
| Intravitreal injection | CPT | 67028 | 11 | — | — | $424.58 | $2,558.53 | $14,679 |
| Vitrectomy mechanical | CPT | 67042 | 11 | — | — | $1,186.9 | $5,975.52 | $33,981 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $7,281.5 | $11,838 | $14,798 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $11,035 | $18,433 | $23,041 |
| PCI single major coronary artery | CPT | 92920 | 15 | $17,500 | $12,250 | $435.12 | $8,441.99 | $43,418 |
| PCI with drug-eluting stent | CPT | 92928 | 15 | $36,094 | $25,266 | $483.05 | $14,224 | $43,418 |
| PCI bypass graft | CPT | 92937 | 14 | $36,094 | $25,266 | $482.46 | $14,184 | $43,418 |
| Left heart catheterization | CPT | 93452 | 15 | $36,933 | $25,853 | $967.53 | $8,787.5 | $33,981 |
| Coronary angiography with cath | CPT | 93455 | 15 | $34,066 | $23,846 | $1,166.18 | $8,701.33 | $43,418 |
| Coronary angiography with bypass cath | CPT | 93458 | 15 | $41,919 | $29,343 | $1,204.89 | $9,211.31 | $43,418 |
Payer mix (top 18)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 192 | $1,397 |
| Humana | 190 | $1,120.59 |
| Aetna | 180 | $1,011.13 |
| Blue Cross Blue Shield | 177 | $4,188.78 |
| Bright Health | 166 | $657.42 |
| Medicare | 166 | $601.15 |
| commercial | hill physicians | all plans | 166 | $601.15 |
| Kaiser Permanente | 166 | $678.33 |
| UnitedHealthcare | 146 | $1,224.38 |
| Medicaid | 144 | $358.69 |
| First Health | 104 | $790.5 |
| Multiplan | 104 | $871.66 |
| commercial | wcmg | all plans | 104 | $179.18 |
| commercial | sutter health | all plans | 104 | $843.2 |
| Cigna | 95 | $2,067.9 |
| commercial | western health advantage | all plans | 44 | $8,892.49 |
| commercial | connected care intel | all plans | 17 | $4,828.33 |
| Health Net | 7 | $1,186.72 |