Visits & medical services prices at Pomona Valley Hospital Medical Center

Pomona, CA · every code in this section with a posted price and a Medicare benchmark.

57 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Ablate Heart Dysrhythm Focus (93650) $18,373 — 1.8×
Cardiac Stress Tst,Tracing Only (93017) $299.20 — 1.1×
Cardioversion (92960) $703 — 0.8×
Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) $3,010 — 0.7×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $3,010 — 0.7×
Chemotherapy Into Cns (96450) $450 — 1.1×
Color/duplex Doppler, complete (93975) $175 — 0.6×
Color/duplex Doppler, limited (93976) $175 — 1.3×
Coronary Artery Angio S&I (93454) $3,010 — 0.7×
Dup-scan aorta ivc iliac vascl/bpgs complete (93978) $175 — 0.6×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $175 — 1.3×
Dup-scan lxtr art/artl bpgs compl bi study (93925) $175 — 0.6×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $175 — 1.3×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $175 — 0.6×
Dup-scan xtr veins unilateral/limited study (93971) $175 — 1.3×
Duplex up extrem art bilat (93930) $175 — 0.6×
Duplex up extrem art unilat/ltd (93931) $175 — 1.3×
Echo Congenital Complete (93303) $948.65 — 1.3×
Echo Heart Xthoracic,Limited (93308) $208.54 — 0.7×
Echo transesophageal (93312) $700 — 1.0×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $565.94 — 0.8×
Eeg 41-60 Minutes (95812) $299.20 — 1.1×
EEG awake and asleep (95819) $299.20 — 1.1×
EEG awake drowsy (95816) $299.20 — 1.1×
EEG extended monitoring 61-119 minutes (95813) $299.20 — 1.1×
EKG signal averaged (93278) $75.96 — 1.0×
Ep & ablate supravent arrhyt (93653) $18,373 — 0.5×
Ep & ablate ventric tachy (93654) $18,373 — 0.5×
External Ecg Scanning Analysis Report (93226) $123.81 — 1.6×
Extracranial Bilat Study (93880) $175 — 0.6×
Extracranial Uni/Ltd Study (93882) $175 — 1.3×
F-up/limited tthrc echo congenital car anomaly (93304) $565.94 — 0.8×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,582 — 1.4×
Gi tract capsule endoscopy (91110) $1,582 — 1.4×
Heart catheterization, both sides, with coronary and bypass graft angiography (93461) $3,010 — 0.7×
Holter monitor recording (93225) $123.81 — 0.7×
L Hrt Art/Grft Angio (93459) $3,010 — 0.7×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $5,422 — 0.7×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $11,267 — 0.8×
Pm device eval in person (93288) $45.65 — 1.0×
Pm device progr eval dual (93280) $45.65 — 1.0×
Pm Device Progr Eval Sngl (93279) $45.65 — 1.0×
Pm/Icd Remote Tech Serv (93296) $45.65 — 1.0×
Prq Card Stent W/Angio 1 Vsl (92928) $11,267 — 0.8×
Prq Card Stent/Ath/Angio (92933)
unusually low: confirm this is the full procedure
$11,267 — 0.5×
Prq Revasc Byp Graft 1 Vsl (92937) $11,267 — 0.8×
R Hrt Art/Grft Angio (93457) $3,010 — 0.7×
R hrt coronary artery angio (93456) $3,010 — 0.7×
R&L Hrt Cath W/Ventriclgrphy (93453) $3,010 — 0.7×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $34 — 0.7×
Right Heart Cath (93451) $3,010 — 0.7×
Speech sound lang comprehen (92523) $125 — 0.6×
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $175 — 1.3×
Transtelephonic Rhythm Strip Pacemaker Eval (93293) $45.65 — 1.0×
Tte w/doppler, complete (93306) $565.94 — 0.8×
Tx atrial fib pulm vein isol (93656) $18,373 — 0.5×
Visual Evoked Potential Test (95930) $299.20 — 1.1×