San Dimas Community Hospital

1350 W Covina Blvd, San Dimas, CA 91773 · (909) 599-6811

Acute Care HospitalsProprietaryCMS rating 2/5Los Angeles, CA metro Website ↗

Price file

Prices published

File dated 2026-09-01

3,159 price rows for 48 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · metro median $48

cash

$8 to $54

56 negotiated rates

$810

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $2,703

$446

cash

$203 to $1,316

56 negotiated rates

$9,567

list

CT scan of the head, no contrast

CPT 70450 · metro median $1,428

$133

cash

$94 to $855

56 negotiated rates

$6,964

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $1,774

$224

cash

$213 to $1,236

56 negotiated rates

$4,824

list

Cesarean section hospital stay, no complications

MS-DRG 788 · metro median $9,537

$9,223

cash

$7,540 to $13,960

40 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · metro median $35

$35

cash

$29 to $217

56 negotiated rates

$356

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 4 lines · metro median $1,190

$1,190

cash

$423 to $1,785

208 negotiated rates

$5,443

list

Colonoscopy with biopsy

CPT 45380 · lowest of 2 lines · metro median $2,080

$1,531

cash

$474 to $2,297

104 negotiated rates

$7,723

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 2 lines · metro median $1,551

$1,531

cash

$574 to $2,297

104 negotiated rates

$8,415

list

Complete blood count (CBC) with differential

CPT 85025 · metro median $32

cash

$7 to $50

56 negotiated rates

$301

list

Comprehensive metabolic panel (blood test)

CPT 80053 · metro median $58

$10

cash

$10 to $68

56 negotiated rates

$1,151

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $422

$130

cash

$108 to $645

55 negotiated rates

$1,060

list

Gallbladder removal (laparoscopic)

CPT 47562 · metro median $13,208

$7,737

cash

$669 to $11,606

52 negotiated rates

$19,706

list

Gonorrhea test (DNA)

CPT 87591 · metro median $35

$35

cash

$29 to $217

56 negotiated rates

$267

list

Hip or knee replacement, no major complications

MS-DRG 470 · metro median $18,536

$18,311

cash

$18,043 to $33,181

40 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392 · metro median $7,861

$7,545

cash

$7,437 to $13,672

40 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743 · metro median $12,124

$11,864

cash

$11,692 to $21,499

40 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · metro median $4,582

$4,582

cash

$493 to $6,874

52 negotiated rates

$22,205

list

Knee arthroscopy with meniscus repair

CPT 29881 · metro median $4,187

$4,187

cash

$790 to $6,282

52 negotiated rates

$15,225

list

Left heart catheterization

CPT 93452 · metro median $5,658

$4,149

cash

$549 to $6,224

52 negotiated rates

$14,792

list

Lipid panel (cholesterol test)

CPT 80061 · metro median $18

$13

cash

$13 to $85

56 negotiated rates

$828

list

Liver function panel

CPT 80076 · metro median $45

cash

$7 to $52

56 negotiated rates

$549

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $2,967

$446

cash

$317 to $3,980

56 negotiated rates

$8,454

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · metro median $1,790

$305

cash

$206 to $2,013

56 negotiated rates

$6,379

list

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

CPT 72148 · metro median $2,214

$305

cash

$181 to $2,240

56 negotiated rates

$6,379

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $2,093

$305

cash

$181 to $2,022

56 negotiated rates

$6,198

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473 · metro median $23,400

$23,111

cash

$8,072 to $41,879

48 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · metro median $1,199

$1,132

cash

$206 to $1,698

52 negotiated rates

$9,334

list

PSA test (prostate)

CPT 84153 · metro median $18

$18

cash

$17 to $117

56 negotiated rates

$252

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · metro median $15

cash

$6 to $38

56 negotiated rates

$249

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 4 lines · metro median $90

$32

cash

$9 to $263

216 negotiated rates

$203

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · metro median $706

$133

cash

$91 to $374

56 negotiated rates

$1,479

list

Prothrombin time (blood clotting test)

CPT 85610 · metro median $9

cash

$4 to $25

56 negotiated rates

$182

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · metro median $4,196

$5,011

cash

$302 to $7,517

52 negotiated rates

$10,167

list

Screening mammogram (both breasts)

CPT 77067 · metro median $281

$107

cash

$88 to $532

55 negotiated rates

$590

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$605 to $3,457

18 negotiated rates

$11,146

list

Spinal fusion (not neck), no complications

MS-DRG 460

—

cash

$44,657 to $59,723

2 negotiated rates

—

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · metro median $1,829

$903

cash

$220 to $1,355

52 negotiated rates

$9,112

list

TSH test (thyroid)

CPT 84443 · metro median $18

$16

cash

$16 to $107

56 negotiated rates

$435

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · metro median $4,321

$7,576

cash

$242 to $11,365

52 negotiated rates

$13,896

list

Transvaginal ultrasound

CPT 76830 · metro median $515

$133

cash

$71 to $280

56 negotiated rates

$1,535

list

Ultrasound of the abdomen (complete)

CPT 76700 · metro median $1,147

$133

cash

$82 to $361

56 negotiated rates

$2,556

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 2 lines · metro median $1,160

$1,160

cash

$321 to $1,741

104 negotiated rates

$5,354

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 2 lines · metro median $1,160

$1,160

cash

$336 to $1,741

104 negotiated rates

$6,026

list

Urinalysis with microscope

CPT 81001 · metro median $35

cash

$3 to $20

56 negotiated rates

$221

list

Vaginal delivery hospital stay, no complications

MS-DRG 807 · metro median $6,855

$6,557

cash

$4,944 to $13,628

40 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400

—

cash

$1,994 to $2,921

10 negotiated rates

$2,921

list

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

CPT 72110 · metro median $652

$133

cash

$43 to $201

56 negotiated rates

$1,399

list

Source files

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

https://sandimashospital.com/wp-content/uploads/2026/09/930000139_SanDimasCommunityHospital_standardcharges.json
San Dimas Community Hospital · parsed · json v3.0 · file dated 2026-09-01 · 39.7 MB · 3159 price rows read · read Nov 2026