▸ Hospital · CA · CCN 051332
Mark Twain Medical Center
768 MOUNTAIN RANCH ROAD, SAN ANDREAS, CA, 95249
25 bedsCritical Access Hospitals2
Compliance grade
A
100/100
Procedures tracked
127
of 209 target codes
Payers
12
with negotiated rates
Rates published
6,035
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 | 12 | $275 | $192.5 | $63.25 | $195.66 | $269.5 |
| Psychotherapy 30 minutes | CPT | 90832 | 12 | $207 | $144.9 | $36.8 | $127.56 | $202.86 |
| Psychotherapy 45 minutes | CPT | 90834 | 12 | $275 | $192.5 | $63.25 | $195.66 | $269.5 |
| Psychotherapy 60 minutes | CPT | 90837 | 12 | $445 | $311.5 | $101.43 | $316.8 | $436.1 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 12 | $324 | $226.8 | $13.8 | $57 | $453 |
| ED visit level 2 | CPT | 99282 | 12 | $568 | $397.6 | $26.91 | $111.15 | $556.64 |
| ED visit level 3 | CPT | 99283 | 12 | $924 | $646.8 | $40.02 | $165.3 | $905.52 |
| ED visit level 4 | CPT | 99284 | 12 | $1,622 | $1,135.4 | $78.66 | $324.9 | $1,589.56 |
| ED visit level 5 | CPT | 99285 | 12 | $2,335 | $1,634.5 | $118.68 | $463.86 | $2,288.3 |
| Critical care, first hour | CPT | 99291 | 12 | $4,343 | $3,040.1 | $172.68 | $3,089.84 | $4,256.14 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $1,071 | $749.7 | $147.54 | $761.97 | $1,049.58 |
| CT head with contrast | CPT | 70460 | 12 | $1,401 | $980.7 | $206.94 | $996.75 | $1,372.98 |
| CT head with and without contrast | CPT | 70470 | 12 | $1,721 | $1,204.7 | $244.76 | $1,224.41 | $1,686.58 |
| CT neck with contrast | CPT | 70491 | 12 | $1,736 | $1,215.2 | $260.27 | $1,235.08 | $1,701.28 |
| MRI brain without contrast | CPT | 70551 | 12 | $2,682 | $1,877.4 | $280.94 | $1,652.65 | $2,628.36 |
| MRI brain with contrast | CPT | 70552 | 12 | $2,946 | $2,062.2 | $392.48 | $2,095.94 | $2,887.08 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $3,352 | $2,346.4 | $462.55 | $2,384.79 | $3,284.96 |
| Chest X-ray single view | CPT | 71045 | 12 | $109 | $76.3 | $25.07 | $77.55 | $106.82 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $149 | $104.3 | $34.27 | $106.01 | $146.02 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $188 | $131.6 | $43.24 | $133.76 | $184.24 |
| CT chest without contrast | CPT | 71250 | 12 | $1,386 | $970.2 | $185.25 | $986.08 | $1,358.28 |
| CT chest with contrast | CPT | 71260 | 12 | $1,743 | $1,220.1 | $235.64 | $1,240.07 | $1,708.14 |
| CT chest with and without contrast | CPT | 71270 | 12 | $2,177 | $1,523.9 | $280.02 | $1,548.83 | $2,133.46 |
| MRI chest without contrast | CPT | 71550 | 12 | $2,905 | $2,033.5 | $510.03 | $2,066.77 | $2,846.9 |
| MRI chest with contrast | CPT | 71551 | 12 | $3,275 | $2,292.5 | $561.39 | $2,330.01 | $3,209.5 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $4,013 | $2,809.1 | $711.6 | $2,855.06 | $3,932.74 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $258 | $180.6 | $43.01 | $173.12 | $252.84 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $1,403 | $982.1 | $181.94 | $998.17 | $1,374.94 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $1,401 | $980.7 | $181.45 | $996.75 | $1,372.98 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $1,393 | $975.1 | $181.01 | $991.06 | $1,365.14 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $2,280 | $1,596 | $274.75 | $1,404.94 | $2,234.4 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $2,288 | $1,601.6 | $274.75 | $1,409.87 | $2,242.24 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $2,278 | $1,594.6 | $275.19 | $1,403.71 | $2,232.44 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $2,915 | $2,040.5 | $395.67 | $2,073.88 | $2,856.7 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $3,280 | $2,296 | $467.11 | $2,021.14 | $3,214.4 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $3,262 | $2,283.4 | $466.19 | $2,010.05 | $3,196.76 |
| CT pelvis without contrast | CPT | 72192 | 12 | $1,300 | $910 | $185.63 | $924.89 | $1,274 |
| CT pelvis with contrast | CPT | 72193 | 12 | $1,651 | $1,155.7 | $290.33 | $1,174.61 | $1,617.98 |
| Shoulder X-ray | CPT | 73030 | 12 | $319 | $223.3 | $36.72 | $134.81 | $312.62 |
| Humerus X-ray | CPT | 73060 | 12 | $221 | $154.7 | $29.21 | $109.16 | $216.58 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $361 | $252.7 | $35.7 | $153.06 | $353.78 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $4,395 | $3,076.5 | $292.49 | $2,026.38 | $4,307.1 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $5,695 | $3,986.5 | $579.89 | $2,625.98 | $5,581.1 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $330 | $231 | $27.01 | $141.17 | $323.4 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $377 | $263.9 | $35.7 | $160.49 | $369.46 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $4,514 | $3,159.8 | $554.5 | $2,081.26 | $4,423.72 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $5,695 | $3,986.5 | $748.42 | $2,625.98 | $5,581.1 |
| CT abdomen without contrast | CPT | 74150 | 12 | $1,296 | $907.2 | $190.24 | $922.05 | $1,270.08 |
| CT abdomen with contrast | CPT | 74160 | 12 | $1,926 | $1,348.2 | $296.45 | $1,370.26 | $1,887.48 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $2,675 | $1,872.5 | $337.46 | $1,903.14 | $2,621.5 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $1,174 | $821.8 | $253.38 | $835.25 | $1,150.52 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $2,242 | $1,569.4 | $400.17 | $1,595.08 | $2,197.16 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $2,961 | $2,072.7 | $453.34 | $2,106.61 | $2,901.78 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $2,428 | $1,699.6 | $284.41 | $1,702.96 | $2,379.44 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $3,715 | $2,600.5 | $498.79 | $2,604.22 | $3,640.7 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $749 | $524.3 | $118.15 | $532.88 | $734.02 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $582 | $407.4 | $86.25 | $414.07 | $570.36 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $712 | $498.4 | $44.16 | $163.76 | $697.76 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $582 | $407.4 | $111.36 | $414.07 | $570.36 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $739 | $517.3 | $133.94 | $525.77 | $724.22 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $653 | $457.1 | $150.19 | $464.59 | $639.94 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $684 | $478.8 | $96.07 | $486.64 | $670.32 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $678 | $474.6 | $19.78 | $96.07 | $664.44 |
| Scrotal ultrasound | CPT | 76870 | 12 | $686 | $480.2 | $84.89 | $488.06 | $672.28 |
| Diagnostic mammography unilateral | CPT | 77065 | 12 | $351 | $245.7 | $51.75 | $181.58 | $343.98 |
| Diagnostic mammography bilateral | CPT | 77066 | 12 | $351 | $245.7 | $67.39 | $217.7 | $343.98 |
| Screening mammography bilateral | CPT | 77067 | 12 | $306 | $214.2 | $63.48 | $205.07 | $299.88 |
| EKG tracing only | CPT | 93005 | 12 | $493 | $345.1 | $18.63 | $289.72 | $483.14 |
| EKG interpretation only | CPT | 93010 | 12 | $34 | $23.8 | $7.82 | $24.2 | $33.32 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $1,960 | $1,372 | $340.47 | $1,352.26 | $1,920.8 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $1,625 | $1,137.5 | $213.15 | $1,156.11 | $1,592.5 |
| inpatient | ||||||||
| Initial hospital care, low complexity | CPT | 99221 | 12 | $277 | $193.9 | $48.71 | $197.08 | $271.46 |
| Initial hospital care, moderate complexity | CPT | 99222 | 12 | $377 | $263.9 | $86.71 | $268.22 | $369.46 |
| Initial hospital care, high complexity | CPT | 99223 | 12 | $554 | $387.8 | $113.75 | $394.15 | $542.92 |
| Hospital discharge, <30 min | CPT | 99238 | 12 | $184 | $128.8 | $42.32 | $130.91 | $180.32 |
| Hospital discharge, >30 min | CPT | 99239 | 12 | $281 | $196.7 | $64.63 | $199.93 | $275.38 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 12 | $204 | $142.8 | $2.16 | $10.32 | $199.92 |
| Electrolyte panel | CPT | 80051 | 12 | $130 | $91 | $8.85 | $92.49 | $127.4 |
| Comprehensive metabolic panel | CPT | 80053 | 12 | $219 | $153.3 | $2.69 | $13.18 | $214.62 |
| Lipid panel | CPT | 80061 | 12 | $139 | $97.3 | $3.24 | $13.4 | $136.22 |
| Renal function panel | CPT | 80069 | 12 | $186 | $130.2 | $10.79 | $132.34 | $182.28 |
| Hepatic function panel | CPT | 80076 | 12 | $217 | $151.9 | $2.08 | $9.06 | $212.66 |
| Urinalysis non-automated | CPT | 81002 | 12 | $13 | $9.1 | $2.99 | $9.26 | $12.74 |
| Urinalysis automated | CPT | 81003 | 12 | $84 | $58.8 | $2.78 | $51.77 | $82.32 |
| Glucose quantitative | CPT | 82947 | 12 | $68 | $47.6 | $1 | $15.64 | $66.64 |
| Hemoglobin A1c | CPT | 83036 | 12 | $149 | $104.3 | $3.1 | $34.27 | $146.02 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 12 | $190 | $133 | $20.96 | $135.18 | $186.2 |
| Complete blood count with automated differential | CPT | 85025 | 12 | $135 | $94.5 | $9.59 | $96.05 | $132.3 |
| Complete blood count without differential | CPT | 85027 | 12 | $100 | $70 | $8.11 | $59.69 | $98 |
| Urine culture bacterial | CPT | 87086 | 12 | $58 | $40.6 | $1.75 | $10.15 | $56.84 |
| Urine culture identification | CPT | 87088 | 12 | $173 | $121.1 | $1.9 | $8.63 | $169.54 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $175 | $122.5 | $8.26 | $40.25 | $171.5 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 12 | $169 | $118.3 | $28.75 | $100.88 | $165.62 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 12 | $242 | $169.4 | $45.54 | $149.13 | $237.16 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 12 | $369 | $258.3 | $55.66 | $195.3 | $361.62 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 12 | $458 | $320.6 | $70.15 | $246.14 | $448.84 |
| Office visit, established patient, 5 min | CPT | 99211 | 12 | $66 | $46.2 | $2.76 | $15.18 | $64.68 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 12 | $100 | $70 | $5.75 | $23 | $98 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 12 | $163 | $114.1 | $9.43 | $37.49 | $159.74 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 12 | $241 | $168.7 | $13.8 | $55.2 | $236.18 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 12 | $323 | $226.1 | $18.63 | $74.29 | $316.54 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $889 | $622.3 | $204.47 | $632.48 | $871.22 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $1,026 | $718.2 | $235.98 | $729.95 | $1,005.48 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | $180 | $126 | $41.4 | $128.07 | $176.4 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | $218 | $152.6 | $50.14 | $155.1 | $213.64 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | $616 | $431.2 | $141.68 | $438.26 | $603.68 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | $739 | $517.3 | $169.97 | $525.77 | $724.22 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | $875 | $612.5 | $201.25 | $622.53 | $857.5 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 11 | $3,759 | $2,631.3 | $864.57 | $2,774.15 | $3,683.82 |
| Hip hemiarthroplasty | CPT | 27125 | 12 | $4,495 | $3,146.5 | $1,033.85 | $3,197.98 | $4,405.1 |
| Total hip replacement | CPT | 27130 | 12 | $3,610 | $2,527 | $830.3 | $2,568.34 | $3,537.8 |
| Total knee replacement | CPT | 27447 | 12 | $3,855 | $2,698.5 | $886.65 | $2,742.65 | $3,777.9 |
| Knee revision arthroplasty single component | CPT | 27486 | 11 | $3,527 | $2,468.9 | $811.21 | $2,602.93 | $3,456.46 |
| Knee revision arthroplasty all components | CPT | 27487 | 12 | $4,405 | $3,083.5 | $1,013.15 | $3,133.94 | $4,316.9 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 12 | $439 | $307.3 | $100.97 | $340.23 | $599.01 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | $2,695 | $1,886.5 | $619.85 | $1,917.37 | $2,641.1 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | $1,366 | $956.2 | $314.18 | $971.85 | $1,338.68 |
| ACL reconstruction | CPT | 29888 | 12 | $2,481 | $1,736.7 | $570.63 | $1,765.12 | $2,431.38 |
| Open appendectomy | CPT | 44950 | 12 | $1,632 | $1,142.4 | $375.36 | $1,161.1 | $1,599.36 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | $1,525 | $1,067.5 | $350.75 | $1,084.97 | $1,494.5 |
| Laparoscopic cholecystectomy | CPT | 47562 | 12 | $1,660 | $1,162 | $381.8 | $1,181.01 | $1,626.8 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | $1,800 | $1,260 | $414 | $1,280.61 | $1,764 |
| Open umbilical hernia repair | CPT | 49560 | 12 | $1,878 | $1,314.6 | $431.94 | $1,336.11 | $1,840.44 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 12 | $1,120 | $784 | $257.6 | $796.83 | $1,097.6 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | $1,080 | $756 | $248.4 | $768.37 | $1,058.4 |
| Lap incisional hernia repair | CPT | 49652 | 12 | $1,894 | $1,325.8 | $435.62 | $1,347.49 | $1,856.12 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | $1,638 | $1,146.6 | $376.74 | $1,165.36 | $1,605.24 |
Payer mix (top 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 127 | $304.32 |
| Anthem BCBS | 127 | $217.85 |
| Blue Cross Blue Shield | 127 | $210.75 |
| Cigna | 127 | $322.65 |
| First Health | 127 | $343.16 |
| Health Net | 127 | $301.02 |
| Humana | 127 | $85.79 |
| Kaiser Permanente | 127 | $190.24 |
| Aetna | 127 | $207.63 |
| Medicare | 127 | $85.79 |
| Multiplan | 127 | $365.54 |
| Medicaid | 125 | $181.67 |