ADVENTIST HEALTH CLEARLAKE HOSPITAL
15630 18th Ave, Clearlake, CA · Adventisthealth · · NPI 1124018031
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $9.37 | $26.02 | $7.62 – $342.11 | 7 |
| 17-hydroxypregnenolone CPT 84143 | $7.30 | $20.28 | $4.63 – $266.79 | 7 |
| 17-ketosteroids CPT 83586 | $10.70 | $29.73 | $3.81 – $149.69 | 7 |
| 2vhpv vaccine 3 dose im CPT 90650 | $218.88 | $608.00 | $11.00 – $365.54 | 6 |
| 3d ech img cgen car anomal CPT 93319 | $847.44 | $2,354.00 | $55.05 – $3,884.10 | 4 |
| 3d recon without postprocess indpndt CPT 76376 | $332.28 | $923.00 | $845.72 – $1,522.95 | 8 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $47.94 | $133.16 | $3.34 – $219.71 | 6 |
| 5' nucleotidase - sendout CPT 83915 | $3.57 | $9.91 | $1.11 – $130.33 | 7 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $36.00 | $100.00 | $95.00 – $156.75 | 3 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $37.08 | $103.00 | $103.00 – $169.95 | 3 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $38.16 | $106.00 | $106.00 – $174.90 | 3 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $25.20 | $70.00 | $45.00 – $74.25 | 3 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $48.24 | $134.00 | $77.00 – $127.05 | 3 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $51.84 | $144.00 | $83.00 – $136.95 | 3 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $35.64 | $99.00 | $71.00 – $117.15 | 3 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $63.36 | $176.00 | $176.00 – $290.40 | 3 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $3.84 | $10.67 | $1.28 – $144.81 | 7 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,742.04 | $4,839.00 | $340.87 – $7,984.35 | 8 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,891.44 | $5,254.00 | $299.45 – $7,174.20 | 8 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,603.08 | $4,453.00 | $208.42 – $6,020.85 | 8 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,947.60 | $5,410.00 | $661.42 – $9,537.51 | 8 |
| Abdominal MRI (without contrast) CPT 74181 | $1,545.48 | $4,293.00 | $434.02 – $6,172.65 | 8 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,224.36 | $3,401.00 | $89.85 – $5,611.65 | 3 |
| Abdominal Ultrasound (complete) CPT 76700 | $509.74 | $1,415.93 | $119.34 – $886.05 | 6 |
| Abdominal Ultrasound (limited) CPT 76705 | $441.36 | $1,226.00 | $87.13 – $801.90 | 6 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,067.76 | $2,966.00 | $58.57 – $4,893.90 | 3 |
| Abl1 gene CPT 81170 | $266.81 | $741.13 | $344.26 – $6,245.32 | 7 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $1,784.16 | $4,956.00 | $8,177.40 – $8,177.40 | 1 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $27.46 | $76.28 | $0.17 – $76.28 | 8 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $88.20 | $245.00 | $245.00 – $404.25 | 3 |
| Acetaminophen level CPT 80143 | $61.20 | $170.00 | $13.61 – $123.17 | 7 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $86.20 | $239.43 | $64.89 – $239.43 | 8 |
| Acetone qualitative CPT 82009 | $30.60 | $85.00 | $3.84 – $52.89 | 7 |
| Acetylcholine receptor modulating antibody CPT 86043 | $3.10 | $8.60 | $1.04 – $47.46 | 5 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $176.08 | $489.12 | $1.01 – $489.12 | 8 |
| Acute hepatitis panel CPT 80074 | $218.16 | $606.00 | $19.90 – $472.75 | 7 |
| Acyclovir 400 mg tablet HCPCS J8499 | $84.60 | $235.00 | $1.14 – $1.14 | 3 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $36.44 | $101.21 | $0.28 – $101.21 | 8 |
| #acylcarnitineprfl CPT 82017 | $35.64 | $99.00 | $16.70 – $196.28 | 7 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $21.88 | $60.78 | $1.44 – $60.78 | 8 |
| Adenovirus antibody,serum - quest CPT 86603 | $28.44 | $79.00 | $10.17 – $150.47 | 7 |
| Adh-sendout CPT 84588 | $16.20 | $45.00 | $15.27 – $398.30 | 7 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $17.64 | $49.00 | $0.28 – $8.73 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $81.36 | $226.00 | $15.29 – $699.00 | 6 |
| Administration immunization 1 vaccine CPT 90471 | $31.68 | $88.00 | $6.40 – $16.86 | 3 |
| Administration immunization each additional vaccine CPT 90472 | $25.56 | $71.00 | $17.00 – $36.30 | 3 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $28.80 | $80.00 | $80.00 – $132.00 | 3 |
| _afb id by dna probe rflx ast CPT 87149 | $5.85 | $16.24 | $3.26 – $234.21 | 7 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $36.91 | $102.54 | $102.54 – $1,900.61 | 7 |
| After cataract laser surgery CPT 66821 | $205.20 | $570.00 | $267.01 – $940.50 | 3 |
| Air conduction bilat CPT 92552 | $115.92 | $322.00 | $21.95 – $97.35 | 3 |
| Albumin body fluid quantitative each specimen CPT 82042 | $33.48 | $93.00 | $0.61 – $60.44 | 7 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $282.34 | $784.29 | $75.23 – $230.19 | 8 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $101.90 | $283.06 | $75.23 – $236.82 | 8 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $40.68 | $113.00 | $0.29 – $67.68 | 7 |
| Albumin serum plasma or whole blood CPT 82040 | $29.52 | $82.00 | $0.20 – $57.92 | 7 |
| Albuterol ipratrop non-comp HCPCS J7620 | $2.06 | $5.73 | $0.54 – $10.31 | 8 |
| Albuterol non-comp con HCPCS J7611 | $7.92 | $22.00 | $0.28 – $22.00 | 8 |
| Albuterol non-comp unit HCPCS J7613 | $3.11 | $8.64 | $0.20 – $4.59 | 8 |
| Alkaline phosphatase CPT 84075 | $36.72 | $102.00 | $0.21 – $60.44 | 7 |
| Allergen alpha lactalbumin ige CPT 86008 | $14.49 | $40.25 | $0.90 – $308.58 | 7 |
| Allergen egg white ige CPT 86003 | $180.00 | $500.00 | $0.26 – $184.79 | 7 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $2.87 | $7.97 | $0.64 – $189.35 | 7 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $20.61 | $57.26 | $36.88 – $736.55 | 7 |
| Alpha-fetoprotein amniotic CPT 82106 | $4.33 | $12.03 | $2.05 – $196.12 | 7 |
| Alpha-fetoprotein tumor marker CPT 82105 | $76.68 | $213.00 | $2.02 – $196.12 | 7 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $284.40 | $790.00 | $66.83 – $255.45 | 8 |
| Alt/sgpt CPT 84460 | $47.88 | $133.00 | $0.24 – $61.15 | 7 |
| Aluminum - quest CPT 82108 | $7.10 | $19.72 | $5.02 – $297.88 | 7 |
| Amantadine (symmetrel)-sendout CPT 80375 | $92.16 | $256.00 | $73.00 – $322.43 | 7 |
| Amino acids quant 2-5 CPT 82136 | $5.65 | $15.69 | $3.08 – $196.28 | 7 |
| Aminolevulinic acid delta CPT 82135 | $5.27 | $14.63 | $2.41 – $192.42 | 7 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $48.37 | $134.36 | $4.29 – $134.36 | 8 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $102.65 | $285.15 | $6.88 – $233.12 | 6 |
| Amitriptyline (elavil) -sendout CPT 80335 | $12.52 | $34.77 | $9.78 – $320.31 | 7 |
| Ammonia CPT 82140 | $101.52 | $282.00 | $1.89 – $170.39 | 7 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $867.24 | $2,409.00 | $57.26 – $3,974.85 | 3 |
| Amphetamine confirm urine -sendout CPT 80324 | $82.44 | $229.00 | $8.59 – $278.13 | 7 |
| Amphetamines 5 or more CPT 80326 | $205.92 | $572.00 | $4.26 – $333.77 | 7 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $33.78 | $93.82 | $1.60 – $22.91 | 8 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $32.91 | $91.41 | $3.61 – $70.80 | 8 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $473.40 | $1,315.00 | $262.99 – $3,458.32 | 5 |
| Amylase CPT 82150 | $86.76 | $241.00 | $0.37 – $75.87 | 7 |
| Anabolic steroid 1 or 2 CPT 80327 | $119.16 | $331.00 | $331.00 – $461.97 | 7 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $22.32 | $62.00 | $6.00 – $362.18 | 7 |
| Analysis gene f2 20210g>a variant CPT 81240 | $13.64 | $37.90 | $24.90 – $590.25 | 7 |
| Analysis gene f5 leiden variant CPT 81241 | $13.68 | $37.99 | $27.87 – $751.66 | 7 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $10.85 | $30.15 | $10.58 – $310.00 | 5 |
| Anca screen with reflex to titer -quest CPT 86021 | $4.82 | $13.38 | $2.01 – $175.97 | 7 |
| Androstanediol CPT 82154 | $103.59 | $287.75 | $33.08 – $336.60 | 7 |
| An fluoro guide for cvp CPT 77001 | $154.44 | $429.00 | $91.17 – $945.46 | 8 |
| Angiotensin ii CPT 82163 | $42.84 | $119.00 | $23.54 – $232.17 | 7 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $228.60 | $635.00 | $1.81 – $1.81 | 3 |
| Ankle X-ray CPT 73610 | $494.64 | $1,374.00 | $36.06 – $1,376.10 | 8 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $41.40 | $115.00 | $115.00 – $189.75 | 3 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $55.08 | $153.00 | $153.00 – $252.45 | 3 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $92.52 | $257.00 | $257.00 – $424.05 | 3 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $100.08 | $278.00 | $278.00 – $458.70 | 3 |
| Anodyne therapy charges pt CPT 97026 | $65.16 | $181.00 | $14.11 – $543.00 | 8 |
| Anora (draw only) CPT 99001 | $39.24 | $109.00 | $4.30 – $112.38 | 8 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.