Supplies, drugs & other prices at Pomona Valley Hospital Medical Center
Pomona, CA · every code in this section with a posted price and a Medicare benchmark.
30 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Autolog prp not diab ulcer (G0460) | $38.60 | — | 0.0× |
| Covid-19 lab test non-cdc (U0002) range across 3 matching MRF lines |
$59.01–$100 | — | varies |
| Drug test def 1-7 classes (G0480) | $73.75 | — | 0.6× |
| Drug test def 22+ classes (G0483) range across 2 matching MRF lines |
$75–$1,560 | — | varies |
| Fern test (Q0114) | $11.20 | — | 1.1× |
| Inj for sacroiliac jt anesth (G0260) | $450 | — | 0.5× |
| Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) | $375 | — | 0.7× |
| Mra w/cont, abd (C8900) | $600 | — | 1.3× |
| Mra w/cont, chest (C8909) | $600 | — | 1.3× |
| Mra w/cont, lwr ext (C8912) | $600 | — | 1.3× |
| Mra w/cont, pelvis (C8918) | $600 | — | 1.3× |
| Mra w/o cont, abd (C8901) | $500 | — | 1.6× |
| Mra w/o cont, chest (C8910) | $500 | — | 1.6× |
| Mra w/o cont, lwr ext (C8913) | $500 | — | 1.6× |
| Mra w/o cont, pelvis (C8919) | $500 | — | 1.6× |
| Mra w/o fol w/cont, abd (C8902) | $600 | — | 1.3× |
| Mra w/o fol w/cont, chest (C8911) | $600 | — | 1.3× |
| Mra w/o fol w/cont, lwr ext (C8914) | $600 | — | 1.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $600 | — | 1.3× |
| Mra, w/dye, upper extremity (C8934) | $600 | — | 1.3× |
| Mra, w/o dye, upper extr (C8935) | $500 | — | 1.6× |
| Mra, w/o&w/dye, upper extr (C8936) | $600 | — | 1.3× |
| Mri w/cont, breast, bi (C8906) | $600 | — | 1.3× |
| Mri w/cont, breast, uni (C8903) | $600 | — | 2.7× |
| Mri w/o fol w/cont, breast, (C8908) | $600 | — | 1.3× |
| Mri w/o fol w/cont, brst, un (C8905) | $600 | — | 1.3× |
| Neuro csf prion prtn qual (0035U) | $531.87 | — | 1.0× |
| Pathogen test for platelets (P9100) | $87.25 | — | 1.1× |
| Prostate biopsy, any mthd (G0416) | $530.17 | — | 1.1× |
| Psa screening (G0103) | $22.20 | — | 1.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.