Montclair Hospital Medical Center

5000 San Bernardino Road, Montclair, CA 91763 · Acute care hospital · Emergency room

These are Montclair Hospital Medical Center's own posted figures from its standard-charges file dated September 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

163 of the services we track have a posted price here; 160 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	$1,057.00	$7,580.38	$174.42 – $7,580.38
Emergency room visit, level 1 (minor) CPT 99281	$107.00	$754.88	$21.77 – $754.88
Emergency room visit, level 2 CPT 99282	$196.00	$1,290.44	$34.97 – $1,290.44
Emergency room visit, level 3 (moderate) CPT 99283	$349.00	$2,284.44	$63.97 – $2,284.44
Emergency room visit, level 4 CPT 99284	$534.00	$3,409.93	$98.04 – $3,409.93
Emergency room visit, level 5 (most severe) CPT 99285	$762.00	$5,058.67	$155.03 – $5,058.67
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$256.00	$1,471.18	$100.39 – $1,471.18

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
Abdominal X-ray, 1 view CPT 74018	$111.00	$771.31	$16.73 – $771.31
Ankle X-ray, 3 or more views CPT 73610	$111.00	$948.44	$26.32 – $948.44
Breast ultrasound, one breast, complete CPT 76641	$133.00	$2,117.50	$65.44 – $2,117.50
Breast ultrasound, one breast, limited CPT 76642	$111.00	$856.00	$49.43 – $856.00
Chest X-ray, 1 view CPT 71045	$111.00	$745.25	$9.71 – $745.25
Chest X-ray, 2 views CPT 71046	$111.00	$1,036.75	$18.13 – $1,036.75
CT angiogram of the chest (checks for lung clots) CPT 71275	$224.00	$6,227.38	$192.35 – $6,227.38
CT angiogram of the head CPT 70496	$224.00	$7,088.13	$191.53 – $7,088.13
CT scan of the abdomen and pelvis, with contrast CPT 74177	$446.00	$9,567.25	$202.90 – $9,567.25
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$446.00	$10,297.50	$233.05 – $10,297.50
CT scan of the abdomen and pelvis, without contrast CPT 74176	$305.00	$7,926.11	$101.10 – $7,926.11
CT scan of the abdomen, without contrast CPT 74150	$133.00	$6,743.00	$116.66 – $6,743.00
CT scan of the chest, with contrast CPT 71260	$224.00	$5,910.70	$170.83 – $5,910.70
CT scan of the chest, without contrast CPT 71250	$133.00	$6,179.25	$127.11 – $6,179.25
CT scan of the head, without contrast CPT 70450	$133.00	$6,964.38	$94.42 – $6,964.38
CT scan of the neck (cervical spine), without contrast CPT 72125	$133.00	$5,885.00	$127.11 – $5,885.00
CT scan of the pelvis, with contrast CPT 72193	$224.00	$4,823.75	$213.26 – $4,823.75
CT scan of the sinuses or face, without contrast CPT 70486	$133.00	$6,183.38	$125.62 – $6,183.38
Diagnostic mammogram, both breasts CPT 77066	$121.00	$1,060.00	$108.06 – $1,060.00
Diagnostic mammogram, one breast CPT 77065	$94.00	$844.90	$84.30 – $844.90
Foot X-ray, 3 or more views CPT 73630	$111.00	$1,914.38	$25.01 – $1,914.38
Hand X-ray, 3 or more views CPT 73130	$111.00	$1,092.15	$26.32 – $1,092.15
Knee X-ray, 3 views CPT 73562	$111.00	$1,113.75	$25.15 – $1,113.75
Leg or arm vein ultrasound, both sides CPT 93970	$305.00	$3,356.38	$173.75 – $3,356.38
Leg or arm vein ultrasound, one side CPT 93971	$133.00	$2,302.48	$101.89 – $2,302.48
Lower back X-ray, 2 or 3 views CPT 72100	$133.00	$1,105.02	$29.98 – $1,105.02
MRI of the abdomen, without and with contrast CPT 74183	$446.00	$6,358.26	$263.48 – $6,358.26
MRI of the brain, without and with contrast CPT 70553	$446.00	$8,453.75	$316.79 – $8,453.75
MRI of the brain, without contrast CPT 70551	$305.00	$5,922.50	$188.21 – $5,922.50
MRI of the knee or other leg joint, without contrast CPT 73721	$305.00	$6,378.75	$206.20 – $6,378.75
MRI of the lower back (lumbar spine), without contrast CPT 72148	$305.00	$6,378.75	$181.42 – $6,378.75
MRI of the mid back (thoracic spine), without contrast CPT 72146	$305.00	$6,197.50	$183.45 – $6,197.50
MRI of the neck (cervical spine), without contrast CPT 72141	$305.00	$6,197.50	$181.08 – $6,197.50
MRI of the pelvis, without and with contrast CPT 72197	$446.00	$8,270.40	$263.00 – $8,270.40
MRI of the shoulder or other arm joint, without contrast CPT 73221	$305.00	$6,378.75	$206.55 – $6,378.75
Neck X-ray, 2 or 3 views CPT 72040	$111.00	$983.90	$24.97 – $983.90
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$133.00	$2,142.15	$67.93 – $2,142.15
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$133.00	$1,479.00	$90.65 – $1,479.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$133.00	$1,235.00	$47.84 – $1,235.00
Screening mammogram, both breasts CPT 77067	$99.00	$589.51	$88.39 – $589.51
Shoulder X-ray, 2 or more views CPT 73030	$111.00	$1,068.38	$25.59 – $1,068.38
Transvaginal pregnancy ultrasound CPT 76817	$133.00	$1,173.21	$51.77 – $1,173.21
Transvaginal ultrasound CPT 76830	$133.00	$1,535.00	$70.84 – $1,535.00
Ultrasound of the abdomen, complete CPT 76700	$133.00	$2,556.13	$82.35 – $2,556.13
Ultrasound of the neck or thyroid CPT 76536	$133.00	$1,690.39	$65.98 – $1,690.39
Wrist X-ray, 3 or more views CPT 73110	$111.00	$1,123.53	$27.41 – $1,123.53
X-ray of the lower back, 4 or more views CPT 72110	$133.00	$1,398.75	$43.40 – $1,398.75

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$8.00	$809.88	$8.04 – $809.88
Blood culture CPT 87040	$10.00	$557.91	$9.80 – $557.91
Blood draw (venipuncture) CPT 36415	$9.00	$67.62	$8.87 – $67.62
BNP test (heart failure) CPT 83880	$39.00	$590.84	$24.12 – $590.84
C-reactive protein (CRP) test CPT 86140	$5.00	$216.50	$4.92 – $216.50
Chlamydia test (DNA/NAAT) CPT 87491	$35.00	$356.06	$29.37 – $356.06
Complete blood count (CBC) with differential CPT 85025	$7.00	$301.13	$7.38 – $301.13
Complete blood count (CBC), automated CPT 85027	$6.00	$158.35	$6.15 – $158.35
Comprehensive metabolic panel (blood test) CPT 80053	$10.00	$1,150.88	$10.03 – $1,150.88
COVID-19 PCR test CPT 87635	$51.00	$256.55	$48.74 – $256.55
D-dimer test (blood clots) CPT 85379	$10.00	$397.19	$9.67 – $397.19
Drug screen, instrument chemistry CPT 80307	$62.00	$439.06	$43.50 – $439.06
Ferritin (iron stores) test CPT 82728	$13.00	$365.75	$12.95 – $365.75
Free T4 (thyroid) test CPT 84439	$9.00	$341.48	$8.57 – $341.48
Glucose (blood sugar) test CPT 82947	$3.00	$158.21	$3.73 – $158.21
Gonorrhea test (DNA/NAAT) CPT 87591	$35.00	$267.46	$29.10 – $267.46
Hemoglobin A1c test CPT 83036	$9.00	$215.88	$9.22 – $215.88
Hepatitis C antibody test CPT 86803	$14.00	$328.63	$13.56 – $328.63
HIV-1/HIV-2 antigen and antibody test CPT 87389	$24.00	$120.40	$16.21 – $120.40
Iron test CPT 83540	$6.00	$228.17	$6.15 – $228.17
Kidney function panel CPT 80069	$8.00	$534.88	$8.25 – $534.88
Lipase test (pancreas) CPT 83690	$6.00	$338.73	$6.55 – $338.73
Lipid panel, cholesterol and triglycerides CPT 80061	$13.00	$827.75	$12.72 – $827.75
Liver function panel CPT 80076	$8.00	$548.63	$7.32 – $548.63
Magnesium test CPT 83735	$6.00	$248.35	$6.37 – $248.35
Partial thromboplastin time (PTT), clotting test CPT 85730	$6.00	$249.12	$5.71 – $249.12
Pregnancy blood test (hCG), quantitative CPT 84702	$15.00	$486.58	$14.30 – $486.58
Prothrombin time (PT/INR), clotting test CPT 85610	$4.00	$181.98	$4.00 – $181.98
PSA (prostate specific antigen), free CPT 84154	$18.00	$190.16	$14.77 – $190.16
PSA (prostate specific antigen), total CPT 84153	$18.00	$251.59	$17.47 – $251.59
Rapid strep test CPT 87880	$16.00	$82.65	$8.02 – $82.65
Sed rate (ESR) test CPT 85652	$2.00	$134.50	$2.56 – $134.50
TB skin test CPT 86580	$37.00	$147.18	$12.17 – $147.18
Thyroid stimulating hormone (TSH) CPT 84443	$16.00	$434.50	$15.96 – $434.50
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$66.00	$757.23	$11.76 – $757.23
Troponin test (heart damage) CPT 84484	$12.00	$474.31	$9.72 – $474.31
Urinalysis, automated, with microscope CPT 81001	$3.00	$221.38	$3.01 – $221.38
Urinalysis, automated, without microscope CPT 81003	$2.00	$126.73	$2.14 – $126.73
Urinalysis, manual, with microscope CPT 81000	$4.00	$69.26	$2.96 – $69.26
Urinalysis, manual, without microscope CPT 81002	$3.00	$81.03	$2.47 – $81.03
Urine culture, colony count CPT 87086	$8.00	$522.50	$6.48 – $522.50
Urine pregnancy test CPT 81025	$8.00	$258.75	$4.02 – $258.75
Vitamin B12 test CPT 82607	$15.00	$380.88	$14.33 – $380.88
Vitamin D test CPT 82306	$29.00	$212.30	$23.78 – $212.30

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$305.00	$2,928.75	$168.51 – $2,928.75
ECG tracing only (no interpretation) CPT 93005	$75.00	$699.88	$23.52 – $699.88
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$699.00	$4,329.67	$177.42 – $4,329.67
Left heart catheterization CPT 93452	$4,149.00	$14,792.30	$549.26 – $14,792.30
Left heart catheterization with coronary angiogram CPT 93458	$4,149.00	$18,228.50	$693.51 – $18,228.50
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,656.00	$10,855.60	$295.90 – $10,855.60

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
Appendix removal, laparoscopic CPT 44970	$7,737.00	$19,307.70	$391.98 – $19,307.70
Breast biopsy with ultrasound guidance CPT 19083	$2,113.00	$7,497.75	$613.92 – $7,497.75
Colonoscopy with biopsy CPT 45380	$1,531.00	$9,591.67	$473.68 – $9,591.67
Colonoscopy with polyp removal (snare) CPT 45385	$1,531.00	$10,781.30	$574.08 – $10,781.30
Colonoscopy, diagnostic CPT 45378	$1,190.00	$9,928.60	$423.48 – $9,928.60
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,190.00	$5,910.28	$78.50 – $5,910.28
Gallbladder removal, laparoscopic CPT 47562	$7,737.00	$17,655.50	$668.60 – $17,655.50
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$13,604.00	$32,503.40	$748.40 – $32,503.40
Hysteroscopy with biopsy or polyp removal CPT 58558	$4,143.00	$17,945.20	$251.48 – $17,945.20
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$4,582.00	$33,746.40	$493.45 – $33,746.40
Removal of a breast lump, open surgery CPT 19120	$5,011.00	$14,376.50	$302.26 – $14,376.50
Screening colonoscopy, average risk HCPCS G0121	$1,190.00	$6,501.30	$1,130.71 – $6,501.30
Screening colonoscopy, high risk HCPCS G0105	$1,190.00	$5,442.56	$1,130.71 – $5,442.56
Upper endoscopy (EGD) with biopsy CPT 43239	$1,160.00	$10,818.70	$335.91 – $10,818.70
Upper endoscopy (EGD), diagnostic CPT 43235	$1,160.00	$10,178.70	$321.48 – $10,178.70

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	not posted	$1,025.00	$19.62 – $1,025.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$2,921.00	$876.30 – $2,921.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$9,132.00	$6,996.00 – $18,265.04
C-section, without complications MS-DRG 788	$9,864.00	$7,540.00 – $19,729.58
Chest pain MS-DRG 313	$7,563.00	$7,519.28 – $15,127.84
COPD flare-up, with major complications MS-DRG 190	$11,299.00	$11,064.70 – $22,598.94
COPD flare-up, without complications MS-DRG 192	$6,812.00	$6,135.19 – $13,624.74
Fainting (syncope) MS-DRG 312	$9,024.00	$8,802.72 – $18,049.22
Gastrointestinal bleeding, with complications MS-DRG 378	$10,075.00	$10,015.00 – $20,151.60
Heart failure, with major complications MS-DRG 291	$12,996.00	$11,015.77 – $25,992.44
Heart failure, without complications MS-DRG 293	$6,080.00	$6,045.01 – $20,265.65
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$94,885.00	$48,150.00 – $189,770.88
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$19,211.00	$7,650.00 – $38,423.72
Irregular heartbeat, without complications MS-DRG 310	$6,081.00	$5,526.21 – $12,162.12
Kidney failure, with complications MS-DRG 683	$9,065.00	$7,788.89 – $18,130.14
Kidney or urinary tract infection, without major complications MS-DRG 690	$8,426.00	$7,704.82 – $17,444.89
Neck (cervical) spinal fusion, without complications MS-DRG 473	$24,148.00	$7,200.00 – $48,297.84
Normal newborn care MS-DRG 795	$2,551.00	$1,581.89 – $5,103.40
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$8,124.00	$7,676.64 – $18,451.75
Pneumonia, with complications MS-DRG 194	$8,391.00	$8,341.61 – $16,783.16
Pneumonia, with major complications MS-DRG 193	$13,291.00	$12,063.30 – $26,582.10
Pneumonia, without complications MS-DRG 195	$6,682.00	$6,643.33 – $13,364.60
Psychoses (inpatient psychiatric stay) MS-DRG 885	$14,084.00	$6,518.71 – $29,250.00
Sepsis, with major complications MS-DRG 871	$19,342.00	$13,277.32 – $38,685.80
Sepsis, without major complications MS-DRG 872	$10,486.00	$9,219.33 – $50,147.08
Skin infection (cellulitis), without major complications MS-DRG 603	$9,017.00	$6,999.04 – $19,100.50
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$53,517.04 – $53,517.04
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$8,138.00	$7,902.11 – $16,276.34
Stroke, with complications or clot-busting drug MS-DRG 65	$10,361.00	$10,298.40 – $20,722.00
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$12,580.00	$6,750.00 – $26,587.07
Vaginal delivery, without complications MS-DRG 807	$7,122.00	$4,990.00 – $14,245.24
Weight loss surgery, without complications MS-DRG 621	$15,160.00	$5,400.00 – $46,180.62

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$392.00	$1,945.83	$65.68 – $1,945.83

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$276.00	$1,039.79	$21.17 – $1,039.79

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$29.00	$201.00	$27.72 – $201.00
Physical therapy evaluation, low complexity CPT 97161	$103.00	$624.18	$98.01 – $624.18
Physical therapy evaluation, moderate complexity CPT 97162	$103.00	$858.25	$98.02 – $858.25
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$30.00	$380.81	$9.14 – $380.81
Therapeutic activities, 15 minutes CPT 97530	$37.00	$480.15	$15.98 – $480.15

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$92.00	$507.91	$18.75 – $507.91
IV hydration, each additional hour CPT 96361	$59.00	$830.50	$14.60 – $830.50
IV hydration, first hour CPT 96360	$272.00	$1,675.92	$51.30 – $1,675.92
IV push injection of a drug, first CPT 96374	$272.00	$1,675.92	$49.82 – $1,675.92
IV push injection, each additional drug CPT 96375	$59.00	$545.96	$21.29 – $545.96

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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