▸ Hospital · CA · CCN 052055
CENTRAL VALLEY SPECIALTY HOSPITAL
730 17TH STREET, MODESTO, CA, 95354-1209
96 beds4
Compliance grade
A
100/100
Procedures tracked
126
of 209 target codes
Payers
14
with negotiated rates
Rates published
14,456
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 6 | $340.77 | $340.77 | $85.19 | $255.58 | $289.65 |
| ED visit level 2 | CPT | 99282 | 6 | $617.09 | $617.09 | $154.27 | $462.82 | $524.53 |
| ED visit level 3 | CPT | 99283 | 6 | $1,087.21 | $1,087.21 | $271.8 | $815.41 | $924.13 |
| ED visit level 4 | CPT | 99284 | 6 | $1,708.99 | $1,708.99 | $427.25 | $1,281.74 | $1,452.64 |
| ED visit level 5 | CPT | 99285 | 6 | $2,451.8 | $2,451.8 | $612.95 | $1,838.85 | $2,084.03 |
| Critical care, first hour | CPT | 99291 | 6 | $3,499.4 | $3,499.4 | $874.85 | $2,624.55 | $2,974.49 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 6 | $2,141 | $2,141 | $535.25 | $1,605.75 | $1,819.85 |
| CT head with contrast | CPT | 70460 | 6 | $821.33 | $821.33 | $205.33 | $616 | $698.13 |
| CT head with and without contrast | CPT | 70470 | 6 | $4,973 | $4,973 | $1,243.25 | $3,729.75 | $4,227.05 |
| CT neck with contrast | CPT | 70491 | 6 | $1,477 | $1,477 | $369.25 | $1,107.75 | $1,255.45 |
| MRI brain without contrast | CPT | 70551 | 6 | $8,215 | $8,215 | $2,053.75 | $6,161.25 | $6,982.75 |
| MRI brain with contrast | CPT | 70552 | 6 | $1,693.35 | $1,693.35 | $423.34 | $1,270.01 | $1,439.35 |
| MRI brain with and without contrast | CPT | 70553 | 6 | $6,636 | $6,636 | $1,659 | $4,977 | $5,640.6 |
| Chest X-ray single view | CPT | 71045 | 6 | $782 | $782 | $195.5 | $586.5 | $664.7 |
| Chest X-ray 2 views | CPT | 71046 | 6 | $408 | $408 | $102 | $306 | $346.8 |
| Chest X-ray 3 views | CPT | 71047 | 6 | $372.14 | $372.14 | $93.04 | $279.11 | $316.32 |
| CT chest without contrast | CPT | 71250 | 6 | $2,211 | $2,211 | $552.75 | $1,658.25 | $1,879.35 |
| CT chest with contrast | CPT | 71260 | 6 | $3,006 | $3,006 | $751.5 | $2,254.5 | $2,555.1 |
| CT chest with and without contrast | CPT | 71270 | 6 | $821.33 | $821.33 | $205.33 | $616 | $698.13 |
| MRI chest without contrast | CPT | 71550 | 6 | $1,058.6 | $1,058.6 | $264.65 | $793.95 | $899.81 |
| MRI chest with and without contrast | CPT | 71552 | 6 | $1,693.35 | $1,693.35 | $423.34 | $1,270.01 | $1,439.35 |
| Lumbosacral spine X-ray | CPT | 72100 | 6 | $369 | $369 | $92.25 | $276.75 | $313.65 |
| CT cervical spine without contrast | CPT | 72125 | 6 | $5,731 | $5,731 | $1,432.75 | $4,298.25 | $4,871.35 |
| CT thoracic spine without contrast | CPT | 72128 | 6 | $501.26 | $501.26 | $125.32 | $375.95 | $426.07 |
| CT lumbar spine without contrast | CPT | 72131 | 6 | $501.26 | $501.26 | $125.32 | $375.95 | $426.07 |
| MRI cervical spine without contrast | CPT | 72141 | 6 | $2,014 | $2,014 | $503.5 | $1,510.5 | $1,711.9 |
| MRI thoracic spine without contrast | CPT | 72146 | 6 | $1,058.6 | $1,058.6 | $264.65 | $793.95 | $899.81 |
| MRI lumbar spine without contrast | CPT | 72148 | 6 | $3,490 | $3,490 | $872.5 | $2,617.5 | $2,966.5 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 6 | $1,693.35 | $1,693.35 | $423.34 | $1,270.01 | $1,439.35 |
| MRI cervical spine with and without contrast | CPT | 72156 | 6 | $3,532.2 | $3,532.2 | $883.05 | $2,649.15 | $3,002.37 |
| MRI lumbar spine with contrast | CPT | 72158 | 6 | $4,008 | $4,008 | $1,002 | $3,006 | $3,406.8 |
| CT pelvis without contrast | CPT | 72192 | 6 | $1,372 | $1,372 | $343 | $1,029 | $1,166.2 |
| CT pelvis with contrast | CPT | 72193 | 6 | $2,091 | $2,091 | $522.75 | $1,568.25 | $1,777.35 |
| Shoulder X-ray | CPT | 73030 | 6 | $362 | $362 | $90.5 | $271.5 | $307.7 |
| Humerus X-ray | CPT | 73060 | 6 | $372.14 | $372.14 | $93.04 | $279.11 | $316.32 |
| Hand X-ray 3 views | CPT | 73130 | 6 | $192 | $192 | $48 | $144 | $163.2 |
| MRI upper extremity joint without contrast | CPT | 73221 | 6 | $1,058.6 | $1,058.6 | $264.65 | $793.95 | $899.81 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 6 | $1,693.35 | $1,693.35 | $423.34 | $1,270.01 | $1,439.35 |
| Knee X-ray 1-2 views | CPT | 73560 | 6 | $372.14 | $372.14 | $93.04 | $279.11 | $316.32 |
| Ankle X-ray 3 views | CPT | 73610 | 6 | $183 | $183 | $45.75 | $137.25 | $155.55 |
| MRI lower extremity joint without contrast | CPT | 73721 | 6 | $1,058.6 | $1,058.6 | $264.65 | $793.95 | $899.81 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 6 | $1,693.35 | $1,693.35 | $423.34 | $1,270.01 | $1,439.35 |
| CT abdomen without contrast | CPT | 74150 | 6 | $1,380 | $1,380 | $345 | $1,035 | $1,173 |
| CT abdomen with contrast | CPT | 74160 | 6 | $3,694 | $3,694 | $923.5 | $2,770.5 | $3,139.9 |
| CT abdomen with and without contrast | CPT | 74170 | 6 | $3,392 | $3,392 | $848 | $2,544 | $2,883.2 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 6 | $2,848 | $2,848 | $712 | $2,136 | $2,420.8 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 6 | $3,549 | $3,549 | $887.25 | $2,661.75 | $3,016.65 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 6 | $2,998 | $2,998 | $749.5 | $2,248.5 | $2,548.3 |
| MRI abdomen without contrast | CPT | 74181 | 6 | $2,200 | $2,200 | $550 | $1,650 | $1,870 |
| MRI abdomen with and without contrast | CPT | 74183 | 6 | $1,693.35 | $1,693.35 | $423.34 | $1,270.01 | $1,439.35 |
| Abdominal ultrasound complete | CPT | 76700 | 6 | $1,045 | $1,045 | $261.25 | $783.75 | $888.25 |
| Abdominal ultrasound limited | CPT | 76705 | 6 | $759 | $759 | $189.75 | $569.25 | $645.15 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 6 | $1,415.51 | $1,415.51 | $125.32 | $401.01 | $1,203.18 |
| Transvaginal ultrasound | CPT | 76830 | 6 | $110 | $110 | $27.5 | $82.5 | $93.5 |
| Pelvic ultrasound complete | CPT | 76856 | 6 | $501.26 | $501.26 | $125.32 | $375.95 | $426.07 |
| Scrotal ultrasound | CPT | 76870 | 6 | $501.26 | $501.26 | $125.32 | $375.95 | $426.07 |
| Screening mammography bilateral | CPT | 77067 | 6 | $444.59 | $444.59 | $111.15 | $333.44 | $377.9 |
| EKG tracing only | CPT | 93005 | 6 | $230 | $230 | $57.5 | $172.5 | $195.5 |
| Transthoracic echocardiogram complete | CPT | 93306 | 6 | $1,510 | $1,510 | $377.5 | $1,132.5 | $1,283.5 |
| Transthoracic echocardiogram | CPT | 93307 | 6 | $1,058.6 | $1,058.6 | $264.65 | $793.95 | $899.81 |
| Stress echocardiogram | CPT | 93350 | 6 | $2,221.29 | $2,221.29 | $555.32 | $1,665.97 | $1,888.1 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 11 | — | — | $56,573 | $56,573 | $85,218 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 11 | — | — | $29,639 | $29,639 | $44,647 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 11 | — | — | $20,789 | $20,789 | $31,315 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $35,254 | $35,254 | $53,104 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $28,421 | $28,421 | $42,812 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $28,421 | $28,421 | $42,812 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $28,421 | $28,421 | $42,812 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $23,198 | $23,198 | $34,944 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $20,789 | $20,789 | $31,315 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $35,658 | $35,658 | $53,714 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $27,778 | $27,778 | $41,843 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $20,789 | $20,789 | $31,315 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $33,466 | $33,466 | $50,412 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $23,763 | $23,763 | $35,796 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $20,789 | $20,789 | $31,315 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $36,411 | $36,411 | $54,847 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $20,789 | $20,789 | $31,315 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $20,789 | $20,789 | $31,315 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $27,778 | $27,778 | $41,843 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $27,778 | $27,778 | $41,843 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $27,243 | $27,243 | $41,037 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $31,548 | $31,548 | $47,523 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $27,478 | $27,478 | $41,391 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $20,441 | $20,441 | $30,791 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $36,919 | $36,919 | $55,613 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $24,738 | $24,738 | $37,263 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 6 | $84.6 | $84.6 | $21.15 | $63.45 | $71.91 |
| Electrolyte panel | CPT | 80051 | 6 | $147 | $147 | $36.75 | $110.25 | $124.95 |
| Comprehensive metabolic panel | CPT | 80053 | 6 | $357 | $357 | $89.25 | $267.75 | $303.45 |
| Lipid panel | CPT | 80061 | 6 | $191 | $191 | $47.75 | $143.25 | $162.35 |
| Renal function panel | CPT | 80069 | 6 | $200 | $200 | $50 | $150 | $170 |
| Hepatic function panel | CPT | 80076 | 6 | $190 | $190 | $47.5 | $142.5 | $161.5 |
| Urinalysis non-automated | CPT | 81002 | 6 | $34.8 | $34.8 | $8.7 | $26.1 | $29.58 |
| Urinalysis automated | CPT | 81003 | 6 | $49 | $49 | $12.25 | $36.75 | $41.65 |
| Glucose quantitative | CPT | 82947 | 6 | $39.3 | $39.3 | $9.83 | $29.48 | $33.41 |
| Hemoglobin A1c | CPT | 83036 | 6 | $112 | $112 | $28 | $84 | $95.2 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 6 | $215 | $215 | $53.75 | $161.25 | $182.75 |
| Complete blood count with automated differential | CPT | 85025 | 6 | $89 | $89 | $22.25 | $66.75 | $75.65 |
| Complete blood count without differential | CPT | 85027 | 6 | $98 | $98 | $24.5 | $73.5 | $83.3 |
| Urine culture bacterial | CPT | 87086 | 6 | $98 | $98 | $24.5 | $73.5 | $83.3 |
| Urine culture identification | CPT | 87088 | 6 | $80.9 | $80.9 | $20.23 | $60.68 | $68.77 |
| Tissue exam by pathologist level IV | CPT | 88305 | 6 | $228.9 | $228.9 | $57.23 | $171.68 | $194.57 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 6 | $2,592 | $2,592 | $648 | $1,944 | $2,203.2 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 6 | $3,801.39 | $3,801.39 | $950.35 | $2,851.04 | $3,231.18 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 6 | $4,287 | $4,287 | $1,071.75 | $3,215.25 | $3,643.95 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 6 | $3,728.21 | $3,728.21 | $932.05 | $2,796.16 | $3,168.98 |
| Colonoscopy diagnostic | CPT | 45378 | 6 | $3,728.21 | $3,728.21 | $932.05 | $2,796.16 | $3,168.98 |
| Colonoscopy with biopsy | CPT | 45380 | 6 | $2,592 | $2,592 | $648 | $1,944 | $2,203.2 |
| Colonoscopy with polyp removal | CPT | 45385 | 6 | $4,871.68 | $4,871.68 | $1,217.92 | $3,653.76 | $4,140.93 |
| surgery | ||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 11 | — | — | $54,899 | $54,899 | $82,696 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 11 | — | — | $27,778 | $27,778 | $41,843 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 11 | — | — | $27,778 | $27,778 | $41,843 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 11 | — | — | $31,548 | $31,548 | $47,523 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 11 | — | — | $31,548 | $31,548 | $47,523 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 11 | — | — | $31,274 | $31,274 | $47,110 |
| Major joint replacement w MCC | MS-DRG | 469 | 11 | — | — | $54,899 | $54,899 | $82,696 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 11 | — | — | $29,639 | $29,639 | $44,647 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 11 | — | — | $29,639 | $29,639 | $44,647 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 11 | — | — | $29,639 | $29,639 | $44,647 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 11 | — | — | $29,639 | $29,639 | $44,647 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 11 | — | — | $56,869 | $56,869 | $85,664 |
| OR procedure for obesity w CC | MS-DRG | 620 | 11 | — | — | $41,260 | $41,260 | $62,151 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 11 | — | — | $29,639 | $29,639 | $44,647 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 11 | — | — | $54,899 | $54,899 | $82,696 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 11 | — | — | $54,899 | $54,899 | $82,696 |
Payer mix (top 14)
| Payer | Codes covered | Median rate |
|---|---|---|
| Molina | 126 | $2,053.75 |
| prime health services | 126 | $6,982.75 |
| velocity provider ppo network | 126 | $1,838.85 |
| quik trip | 84 | $793.95 |
| america's choice | 84 | $741.02 |
| usa managed care organization | 84 | $793.95 |
| Aetna | 42 | $29,639 |
| the health plan | 42 | $29,639 |
| Humana | 42 | $29,639 |
| amerihealth caritas pennsylvania | 42 | $29,639 |
| Blue Cross Blue Shield | 42 | $36,759 |
| Centene | 42 | $29,639 |
| gateway health plan | 42 | $29,639 |
| geisinger | 42 | $30,232 |