▸ Hospital · · CCN 059804

Lucile Salter Packard Children's Hospital At Stanf

Compliance grade

97/100

Rates published

4,001

last crawl 2026-05-22

Procedures tracked

141

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals JSON

Source MRF: https://www.stanfordchildrens.org/content/dam/sch/config-public/charges/770003859-lucile-salter-packard-childrens-hospital-at-stanford-standardcharges.json · JSON

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	8	—	$107,253	$29.32	$9,871	$17,000
Psychiatric diagnostic evaluation	CPT	90791	5	$654	—	$221.55	$486.6	$654
Psychiatric eval with medical services	CPT	90792	5	$728	—	$342.4	$538.9	$714.35
Psychotherapy 30 minutes	CPT	90832	5	$318	—	$100.71	$207.08	$311.46
Psychotherapy 45 minutes	CPT	90834	5	$436	—	$161.13	$265.61	$427.82
Psychotherapy 60 minutes	CPT	90837	5	$632	—	$171.2	$470.57	$632
Crisis psychotherapy 60 minutes	CPT	90839	5	$1,024	—	$186.01	$491.47	$647.96
emergency
Critical care, first hour	CPT	99291	5	$1,093	—	$546.5	$765.1	$1,093
imaging
CT head without contrast	CPT	70450	8	$8,648	$4,324	$3,649.46	$6,101.03	$28,538
CT head with contrast	CPT	70460	8	$9,512	$4,756	$4,014.06	$6,310.94	$28,538
CT head with and without contrast	CPT	70470	8	$9,946	$4,973	$4,197.21	$6,416.38	$28,538
CT neck with contrast	CPT	70491	8	$12,682	$6,341	$5,351.8	$7,081.09	$28,538
MRI brain without contrast	CPT	70551	8	$12,294	$6,147	$1,354.2	$5,188.07	$28,538
MRI brain with contrast	CPT	70552	8	$14,139	$7,069.5	$5,966.66	$7,435.07	$28,538
MRI brain with and without contrast	CPT	70553	8	$15,635	$7,817.5	$1,691.8	$7,480.57	$28,538
Chest X-ray single view	CPT	71045	8	$2,073	$1,036.5	$874.81	$4,503.64	$28,538
Chest X-ray 2 views	CPT	71046	8	$2,373	$1,186.5	$874.81	$1,117.68	$28,538
Chest X-ray 3 views	CPT	71047	8	$2,546	$1,273	$1,074.41	$4,618.55	$28,538
CT chest without contrast	CPT	71250	8	$11,530	$5,765	$4,865.66	$6,801.22	$28,538
CT chest with contrast	CPT	71260	8	$12,682	$6,341	$5,351.8	$7,081.09	$28,538
CT chest with and without contrast	CPT	71270	8	$13,259	$6,629.5	$5,595.3	$7,221.28	$28,538
MRI chest without contrast	CPT	71550	8	$12,294	$6,147	$1,354.2	$5,790.47	$28,538
MRI chest with contrast	CPT	71551	8	$14,139	$7,069.5	$5,966.66	$7,435.07	$28,538
MRI chest with and without contrast	CPT	71552	8	$15,366	$7,683	$1,691.8	$7,237.39	$28,538
Lumbosacral spine X-ray	CPT	72100	8	$1,706	$853	$719.93	$4,414.48	$28,538
CT cervical spine without contrast	CPT	72125	8	$8,646	$4,323	$3,648.61	$6,100.55	$28,538
CT thoracic spine without contrast	CPT	72128	8	$8,646	$4,323	$3,648.61	$6,100.55	$28,538
CT lumbar spine without contrast	CPT	72131	8	$8,646	$4,323	$3,648.61	$6,100.55	$28,538
MRI cervical spine without contrast	CPT	72141	8	$12,294	$6,147	$3,476.44	$5,790.47	$28,538
MRI thoracic spine without contrast	CPT	72146	8	$12,294	$6,147	$3,476.44	$5,790.47	$28,538
MRI lumbar spine without contrast	CPT	72148	8	$12,294	$6,147	$3,476.44	$5,790.47	$28,538
MRI lumbar spine with and without contrast	CPT	72149	8	$14,139	$7,069.5	$5,966.66	$7,435.07	$28,538
MRI cervical spine with and without contrast	CPT	72156	8	$15,366	$7,683	$6,484.45	$7,733.17	$28,538
MRI lumbar spine with contrast	CPT	72158	8	$15,366	$7,683	$6,484.45	$7,733.17	$28,538
CT pelvis without contrast	CPT	72192	8	$11,530	$5,765	$4,865.66	$6,801.22	$28,538
CT pelvis with contrast	CPT	72193	8	$12,682	$6,341	$5,351.8	$7,081.09	$28,538
Shoulder X-ray	CPT	73030	8	$2,047	$1,023.5	$863.83	$4,497.32	$28,538
Humerus X-ray	CPT	73060	8	$1,563	$781.5	$659.59	$4,379.73	$28,538
Hand X-ray 3 views	CPT	73130	8	$1,635	$817.5	$689.97	$4,397.23	$28,538
MRI upper extremity joint without contrast	CPT	73221	8	$12,294	$6,147	$1,729.78	$5,790.47	$28,538
MRI upper extremity joint with and without contrast	CPT	73223	8	$15,366	$7,683	$6,484.45	$7,733.17	$28,538
Knee X-ray 1-2 views	CPT	73560	8	$1,781	$890.5	$751.58	$4,432.7	$28,538
Ankle X-ray 3 views	CPT	73610	8	$1,635	$817.5	$689.97	$4,397.23	$28,538
MRI lower extremity joint without contrast	CPT	73721	8	$12,294	$6,147	$1,729.78	$3,671.92	$28,538
MRI lower extremity joint with and without contrast	CPT	73723	7	$15,366	$7,683	$6,484.45	$7,466.34	$28,538
CT abdomen without contrast	CPT	74150	8	$11,530	$5,765	$4,865.66	$6,801.22	$28,538
CT abdomen with contrast	CPT	74160	8	$12,682	$6,341	$5,351.8	$7,081.09	$28,538
CT abdomen with and without contrast	CPT	74170	8	$12,392	$6,196	$5,229.42	$7,010.64	$28,538
CT abdomen and pelvis without contrast	CPT	74176	8	$15,374	$7,687	$6,487.83	$7,735.12	$28,538
CT abdomen and pelvis with contrast	CPT	74177	8	$16,912	$8,456	$7,136.86	$8,108.77	$28,538
CT abdomen and pelvis with and without contrast	CPT	74178	8	$17,683	$8,841.5	$7,462.23	$8,460.43	$28,538
MRI abdomen without contrast	CPT	74181	8	$13,725	$6,862.5	$1,354.2	$5,973.65	$28,538
MRI abdomen with and without contrast	CPT	74183	8	$15,366	$7,683	$1,691.8	$7,237.39	$28,538
Abdominal ultrasound complete	CPT	76700	8	$4,273	$2,136.5	$1,685.05	$2,012.58	$28,538
Abdominal ultrasound limited	CPT	76705	8	$3,192	$1,596	$895.48	$1,427.22	$28,538
Retroperitoneal ultrasound complete	CPT	76770	8	$3,186	$1,593	$1,344.49	$4,774.04	$28,538
Obstetric ultrasound first trimester	CPT	76801	8	$2,567	$1,283.5	$1,083.27	$4,623.66	$28,538
Obstetric ultrasound after first trimester	CPT	76805	8	$2,665	$1,332.5	$1,124.63	$4,647.46	$28,538
Obstetric ultrasound with fetal anatomy	CPT	76811	7	$3,254	$1,627	$1,373.19	$1,581.12	$28,538
Transvaginal ultrasound	CPT	76830	8	$2,736	$1,368	$1,154.59	$4,664.71	$28,538
Pelvic ultrasound complete	CPT	76856	8	$3,192	$1,596	$1,347.02	$4,775.5	$28,538
Scrotal ultrasound	CPT	76870	8	$3,192	$1,596	$1,347.02	$4,775.5	$28,538
EKG tracing only	CPT	93005	8	$2,067	$1,033.5	$871.01	$1,074.06	$28,538
Transthoracic echocardiogram complete	CPT	93306	8	$9,251	$4,625.5	$4,495.06	$6,587.04	$28,538
Transthoracic echocardiogram	CPT	93307	8	$4,642	$2,321	$1,871.69	$2,204.99	$28,538
Stress echocardiogram	CPT	93350	8	$8,339	$4,169.5	$4,051.92	$6,332	$28,538
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	8	—	$115,908	$36.02	$19,312	$24,970
Intracranial hemorrhage/CVA w CC	MS-DRG	065	8	—	$156,137	$36.02	$19,312	$24,970
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	8	—	$289,775	$36.02	$24,970	$43,000
Respiratory infections & inflammations w MCC	MS-DRG	177	8	—	$267,176	$36.02	$24,970	$38,730
COPD w MCC	MS-DRG	190	8	—	$292,290	$36.02	$24,970	$38,730
COPD w CC	MS-DRG	191	8	—	$17,388	$29.32	$9,871	$12,858
COPD w/o CC/MCC	MS-DRG	192	8	—	$176,902	$36.02	$9,871	$17,000
Simple pneumonia & pleurisy w CC	MS-DRG	194	8	—	$30,036	$29.32	$9,871	$12,858
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	8	—	$15,328	$29.32	$9,871	$12,858
Heart failure & shock w MCC	MS-DRG	291	8	—	—	$43.14	$38,730	$45,673
Heart failure & shock w CC	MS-DRG	292	8	—	$74,426	$29.32	$9,871	$17,000
Cardiac arrhythmia w MCC	MS-DRG	308	8	—	$92,635	$29.32	$9,871	$17,000
Cardiac arrhythmia w CC	MS-DRG	309	8	—	$32,035	$29.32	$9,871	$12,858
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	8	—	$25,222	$29.32	$9,871	$12,858
GI hemorrhage w CC	MS-DRG	378	8	—	$43,223	$29.32	$9,871	$12,858
GI hemorrhage w/o CC/MCC	MS-DRG	379	8	—	$17,673	$29.32	$9,871	$12,858
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	8	—	$50,357	$29.32	$9,871	$12,858
Fractures of femur w/o MCC	MS-DRG	533	8	—	$58,778	$29.32	$9,871	$12,858
Kidney/UTI w MCC	MS-DRG	689	8	—	$46,253	$29.32	$9,871	$12,858
Kidney/UTI w/o MCC	MS-DRG	690	8	—	$47,437	$29.32	$9,871	$12,858
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	8	—	$332,988	$36.02	$38,730	$45,673
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	8	—	$58,792	$29.32	$9,871	$12,858
Initial hospital care, low complexity	CPT	99221	5	$390	—	$195	$342.94	$390
Initial hospital care, moderate complexity	CPT	99222	5	$534	—	$267	$466.49	$534
Initial hospital care, high complexity	CPT	99223	5	$786	—	$393	$688.31	$786
Hospital discharge, <30 min	CPT	99238	5	$280	—	$140	$252.81	$280
Hospital discharge, >30 min	CPT	99239	5	$418	—	$209	$382.4	$418
lab
Basic metabolic panel (BMP)	CPT	80048	4	$1,035	$517.5	$219.25	$364	$8,000
Electrolyte panel	CPT	80051	4	$1,428	$714	$372.1	$551.21	$8,000
Comprehensive metabolic panel	CPT	80053	4	$1,243	$621.5	$304.55	$429.54	$8,000
Lipid panel	CPT	80061	4	$662	$331	$255.53	$288.6	$8,000
Renal function panel	CPT	80069	4	$1,006	$503	$388.32	$438.57	$8,000
Hepatic function panel	CPT	80076	4	$861	$430.5	$158.26	$332.35	$8,000
Urinalysis non-automated	CPT	81002	4	$186	$93	$28.56	$38.63	$8,000
Urinalysis automated	CPT	81003	4	$366	$183	$141.28	$159.56	$8,000
Glucose quantitative	CPT	82947	4	$389	$194.5	$92.64	$150.15	$8,000
Hemoglobin A1c	CPT	83036	4	$315	$157.5	$23.16	$121.59	$8,000
Thyroid stimulating hormone (TSH)	CPT	84443	4	$661	$330.5	$7.79	$35.42	$8,000
Complete blood count with automated differential	CPT	85025	4	$821	$410.5	$4.89	$171.77	$8,000
Complete blood count without differential	CPT	85027	4	$717	$358.5	$135.87	$171.38	$8,000
Urine culture bacterial	CPT	87086	4	$1,016	$508	$231.21	$379.25	$8,000
Urine culture identification	CPT	87088	4	$555	$277.5	$214.23	$241.95	$8,000
Tissue exam by pathologist level IV	CPT	88305	4	$1,938	$969	$748.07	$844.87	$8,000
maternity
Fetal non-stress test	CPT	59025	7	$1,352	$676	$570.54	$703.04	$28,538
Routine obstetric care including vaginal delivery	CPT	59400	5	$8,136	—	$4,068	$7,171.43	$8,136
Routine obstetric care with C-section	CPT	59510	5	$9,101	—	$4,429.11	$7,879.75	$9,101
office
Office visit, new patient, 15-29 min	CPT	99202	9	$886	$443	$51.06	$287.65	$28,538
Office visit, new patient, 30-44 minutes	CPT	99203	9	$424	$77.5	$65.41	$350.95	$28,538
Office visit, new patient, 45-59 min	CPT	99204	9	$644	$95	$80.18	$438.33	$28,538
Office visit, new patient, 60-74 min	CPT	99205	9	$799	$107.5	$90.73	$685.16	$28,538
Office visit, established patient, 5 min	CPT	99211	9	$623	$311.5	$27.43	$106	$28,538
Office visit, established patient, 10-19 min	CPT	99212	9	$179	$44	$37.14	$167.1	$28,538
Office visit, established patient, 20-29 minutes	CPT	99213	9	$623	$311.5	$51.06	$270.37	$28,538
Office visit, established patient, 30-39 minutes	CPT	99214	9	$423	$74	$62.46	$389.21	$28,538
Office visit, established patient, 40-54 min	CPT	99215	9	$566	$89	$75.12	$459.04	$28,538
surgery
Major small/large bowel procedures w MCC	MS-DRG	329	8	—	$289,009	$36.02	$12,858	$38,730
Major small/large bowel procedures w CC	MS-DRG	330	8	—	$159,276	$36.02	$9,871	$17,000
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	8	—	$107,061	$29.32	$9,871	$17,000
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	8	—	$221,844	$36.02	$9,871	$17,000
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	8	—	$87,672	$29.32	$9,871	$17,000
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	8	—	$381,831	$43.14	$38,730	$45,673
Major joint replacement w MCC	MS-DRG	469	8	—	$392,770	$43.14	$12,858	$38,730
Major joint replacement w/o MCC	MS-DRG	470	8	—	$371,367	$43.14	$12,858	$38,730
Hip & femur procedures except major joint w MCC	MS-DRG	480	8	—	$191,925	$36.02	$9,871	$17,000
Hip & femur procedures except major joint w CC	MS-DRG	481	8	—	$138,732	$36.02	$9,871	$17,000
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	8	—	$85,299	$29.32	$9,871	$17,000
OR procedure for obesity w MCC	MS-DRG	619	8	—	$103,815	$29.32	$12,858	$72,407
OR procedure for obesity w CC	MS-DRG	620	8	—	$89,148	$29.32	$12,858	$72,407
OR procedure for obesity w/o CC/MCC	MS-DRG	621	8	—	$92,471	$29.32	$12,858	$72,407
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	8	—	$55,895	$29.32	$9,871	$12,858
PCI single major coronary artery	CPT	92920	3	$36,642	$18,321	$6,362.86	$8,000	$20,494
PCI with drug-eluting stent	CPT	92928	3	$36,642	$18,321	$4,762.31	$8,000	$20,494
Left heart catheterization	CPT	93452	5	$36,642	$18,321	$8,000	$20,494	$63,035
Coronary angiography with cath	CPT	93455	5	$155,376	$77,688	$8,000	$63,035	$86,902
Coronary angiography with bypass cath	CPT	93458	5	$24,871	$12,436	$8,000	$13,910	$63,035

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 9)

Payer	Codes covered	Median rate
Blue Cross Blue Shield	141	$435.33
Aetna	139	$1,880.7
Health Net	127	$8,000
Meritain Health	125	$4,072.27
Cigna	125	$895.48
UnitedHealthcare	120	$28,538
umr	106	$28,538
sutter	103	$28,538
optum	23	$275

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