Hospital San Francisco

371 De Diego Ave, San Juan, PR 00923 · (787) 767-5100

Acute Care HospitalsProprietaryWebsite ↗

Price file

Prices published

File dated 2026-08-26

552 price rows for 25 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048

—

cash

$8 to $16

19 negotiated rates

$33

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177

—

cash

$275 to $513

19 negotiated rates

$325

list

CT scan of the head, no contrast

CPT 70450

—

cash

$96 to $438

19 negotiated rates

$325

list

CT scan of the pelvis, with contrast

CPT 72193

—

cash

$120 to $463

19 negotiated rates

$325

list

Chlamydia test (DNA)

CPT 87491

—

cash

$18 to $150

26 negotiated rates

$31

list

Complete blood count (CBC) with differential

CPT 85025

—

cash

$7 to $12

22 negotiated rates

$27

list

Comprehensive metabolic panel (blood test)

CPT 80053

—

cash

$9 to $25

19 negotiated rates

$41

list

Diagnostic mammogram (both breasts)

CPT 77066

—

cash

$75 to $175

15 negotiated rates

$150

list

Gonorrhea test (DNA)

CPT 87591

—

cash

$18 to $50

19 negotiated rates

$30

list

Lipid panel (cholesterol test)

CPT 80061

—

cash

$12 to $40

25 negotiated rates

$187

list

Liver function panel

CPT 80076

—

cash

$7 to $17

19 negotiated rates

$49

list

MRI of the brain, with and without contrast

CPT 70553

—

cash

$271 to $1,950

20 negotiated rates

$650

list

MRI of the knee or other lower joint, no contrast

CPT 73721

—

cash

$171 to $1,300

19 negotiated rates

$650

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148

—

cash

$161 to $1,300

19 negotiated rates

$650

list

MRI of the neck (cervical spine), no contrast

CPT 72141

—

cash

$161 to $1,300

19 negotiated rates

$650

list

PSA test (prostate)

CPT 84153

—

cash

$16 to $35

28 negotiated rates

$35

list

Partial thromboplastin time (blood clotting test)

CPT 85730

—

cash

$5 to $11

19 negotiated rates

$30

list

Pregnancy ultrasound (after first trimester)

CPT 76805

—

cash

$35 to $150

19 negotiated rates

$150

list

Prothrombin time (blood clotting test)

CPT 85610

—

cash

$3 to $10

19 negotiated rates

$20

list

Screening mammogram (both breasts)

CPT 77067

—

cash

$70 to $145

14 negotiated rates

$120

list

TSH test (thyroid)

CPT 84443

—

cash

$15 to $30

19 negotiated rates

$83

list

Transvaginal ultrasound

CPT 76830

—

cash

$40 to $200

19 negotiated rates

$120

list

Ultrasound of the abdomen (complete)

CPT 76700

—

cash

$75 to $131

19 negotiated rates

$100

list

Urinalysis with microscope

CPT 81001

—

cash

$5 to $8

4 negotiated rates

$15

list

X-ray of the lower spine (4 or more views)

CPT 72110

—

cash

$29 to $65

19 negotiated rates

$55

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://hpt.inmediata.com/?handler=DF&d=F2BB6A0B-8C30-481F-B1D2-DA63B3577635
Hospital San Francisco · discovered · json v3.0.0 · file dated 2026-08-26 · 2.3 MB · 552 price rows read · read Oct 2026
https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/coverage-information/machine-readable/941105628-san-francisco-medical-center-standard-charges-ncal-en.csv
San Francisco Medical Center · discovered