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 |
|---|---|---|---|---|
| MRI tmj CPT 70336 | $1,324.80 | $3,680.00 | $1,350.14 – $6,072.00 | 8 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,012.04 | $5,589.00 | $476.22 – $6,147.90 | 8 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $3,528.72 | $9,802.00 | $560.10 – $16,173.30 | 8 |
| MRI upper extremity w/dye CPT 73219 | $1,800.00 | $5,000.00 | $527.23 – $8,250.00 | 8 |
| Msh2 gene known variants CPT 81296 | $121.58 | $337.73 | $107.80 – $1,140.62 | 7 |
| Msh6 gene known variants CPT 81299 | $110.88 | $308.00 | $107.80 – $1,028.92 | 7 |
| Mthfr gene analy common variants CPT 81291 | $23.52 | $65.34 | $42.69 – $852.79 | 7 |
| Mucopolysaccharides CPT 83864 | $54.09 | $150.25 | $22.86 – $225.16 | 7 |
| Multiple sleep latency test CPT 95805 | $3,138.84 | $8,719.00 | $280.74 – $14,386.35 | 6 |
| Mumps antibody igg CPT 86735 | $59.76 | $166.00 | $0.78 – $154.17 | 7 |
| Mycoplasma antibody igm CPT 86738 | $31.68 | $88.00 | $1.44 – $154.17 | 7 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $108.00 | $300.00 | $140.32 – $2,033.77 | 7 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $103.05 | $286.25 | $0.99 – $273.48 | 7 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $1.57 | $4.37 | $4.37 – $44.93 | 8 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $75.13 | $208.69 | $0.20 – $1.41 | 5 |
| Natriuretic peptide CPT 83880 | $149.40 | $415.00 | $11.84 – $396.88 | 7 |
| Natural killer cells total count CPT 86357 | $12.01 | $33.37 | $5.66 – $431.35 | 7 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $1,831.68 | $5,088.00 | $352.06 – $8,395.20 | 8 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,457.36 | $6,826.00 | $297.58 – $8,045.40 | 8 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $2,359.08 | $6,553.00 | $238.84 – $7,425.00 | 8 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $3,575.16 | $9,931.00 | $592.86 – $10,234.95 | 8 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $2,088.00 | $5,800.00 | $497.21 – $9,570.00 | 8 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $1,608.84 | $4,469.00 | $391.86 – $7,083.45 | 8 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $2,428.56 | $6,746.00 | $790.73 – $11,130.90 | 8 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $1,741.32 | $4,837.00 | $542.79 – $7,981.05 | 8 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $1,752.84 | $4,869.00 | $516.93 – $7,700.55 | 8 |
| Neisseria meningitidis CPT 86741 | $4.22 | $11.72 | $1.55 – $154.17 | 7 |
| Nfct ds bv&vaginitis dna alg CPT 81514 | $644.76 | $1,791.00 | $210.39 – $4,710.15 | 7 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $180.92 | $502.56 | $0.20 – $142.70 | 6 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $54.31 | $150.87 | $3.32 – $150.87 | 6 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,730.52 | $4,807.00 | $188.05 – $7,931.55 | 6 |
| Nm imaging bone/joint whole body CPT 78306 | $1,685.16 | $4,681.00 | $202.29 – $7,723.65 | 6 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,271.16 | $3,531.00 | $240.65 – $5,826.15 | 6 |
| Nm imaging gastric emptying study CPT 78264 | $1,229.76 | $3,416.00 | $460.54 – $5,636.40 | 6 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,245.24 | $3,459.00 | $186.19 – $5,707.35 | 6 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,520.64 | $4,224.00 | $586.01 – $6,969.60 | 6 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,585.44 | $4,404.00 | $223.18 – $7,266.60 | 6 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,265.04 | $3,514.00 | $417.30 – $5,798.10 | 6 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $703.80 | $1,955.00 | $315.73 – $3,225.75 | 6 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $911.52 | $2,532.00 | $170.85 – $4,177.80 | 6 |
| Npm1 gene CPT 81310 | $77.40 | $215.00 | $197.21 – $700.98 | 7 |
| Nuclear Stress Test (Heart) CPT 78452 | $2,720.16 | $7,556.00 | $499.34 – $12,467.40 | 6 |
| Nudt15 gene common variants CPT 81306 | $83.91 | $233.09 | $233.09 – $3,378.35 | 7 |
| Observation direct referral from physician office for admission HCPCS G0379 | $753.84 | $2,094.00 | $2,094.00 – $3,455.10 | 3 |
| Observation per hour HCPCS G0378 | $341.64 | $949.00 | $298.00 – $491.70 | 3 |
| Obstetrics panel CPT 80055 | $201.24 | $559.00 | $51.39 – $267.26 | 7 |
| Obtaining screen pap smear HCPCS Q0091 | $32.76 | $91.00 | $91.00 – $350.29 | 7 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $388.08 | $1,078.00 | $156.28 – $1,778.70 | 6 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $21.87 | $60.75 | $1.80 – $14.77 | 8 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $8,212.12 | $22,811.44 | $173.64 – $542.24 | 8 |
| Off/op cnsltj new/est low 30 CPT 99243 | $46.80 | $130.00 | $130.00 – $214.50 | 3 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $62.28 | $173.00 | $173.00 – $285.45 | 3 |
| Off/op consltj new/est sf 20 CPT 99242 | $37.44 | $104.00 | $104.00 – $171.60 | 3 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $83.89 | $233.04 | $2.21 – $233.04 | 6 |
| Oncology prostate prob score CPT 81539 | $277.20 | $770.00 | $770.00 – $6,855.08 | 7 |
| Onco (ovar) five proteins CPT 81503 | $223.20 | $620.00 | $445.00 – $10,565.63 | 7 |
| Oncoprotein dcp CPT 83951 | $20.61 | $57.26 | $36.88 – $1,197.42 | 7 |
| Oncoprotein her-2/neu CPT 83950 | $122.13 | $339.25 | $218.51 – $753.08 | 7 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $19.08 | $53.00 | $0.25 – $21.00 | 8 |
| Opioids & opiate analogs 3/4 CPT 80363 | $3.60 | $10.00 | $10.00 – $382.88 | 7 |
| Organic acids total quant ea spec CPT 83918 | $51.84 | $144.00 | $23.18 – $186.20 | 7 |
| Oropharyngeal biopsy 42800 CPT 42800 | $1,333.08 | $3,703.00 | $66.27 – $6,109.95 | 3 |
| Orthovisc inj per dose HCPCS J7324 | $146.16 | $406.00 | $302.91 – $618.74 | 8 |
| Osmolality blood CPT 83930 | $74.16 | $206.00 | $0.39 – $105.22 | 7 |
| Osmolality urine CPT 83935 | $67.32 | $187.00 | $0.72 – $79.72 | 7 |
| Ot evaluation high complexity patient/family CPT 97167 | $196.92 | $547.00 | $180.36 – $902.55 | 8 |
| Ot evaluation low complexity patient/family CPT 97165 | $157.32 | $437.00 | $326.00 – $721.05 | 8 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $177.84 | $494.00 | $326.00 – $815.10 | 8 |
| Oth resp proc, group HCPCS G0239 | $120.24 | $334.00 | $326.00 – $551.10 | 8 |
| Oth resp proc, indiv HCPCS G0238 | $99.36 | $276.00 | $276.00 – $543.00 | 8 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $90.36 | $251.00 | $251.00 – $543.00 | 8 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $77.76 | $216.00 | $216.00 – $543.00 | 8 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $62.28 | $173.00 | $31.86 – $543.00 | 8 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $17.64 | $49.00 | $23.88 – $80.85 | 3 |
| Ot re-evaluation patient/family CPT 97168 | $101.88 | $283.00 | $125.25 – $543.00 | 8 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $77.76 | $216.00 | $15.98 – $543.00 | 8 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $14.40 | $40.00 | $28.46 – $543.00 | 8 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $46.08 | $128.00 | $29.81 – $543.00 | 8 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $63.36 | $176.00 | $15.72 – $543.00 | 8 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $64.08 | $178.00 | $17.53 – $543.00 | 8 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $153.36 | $426.00 | $7.62 – $702.90 | 8 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $12.32 | $34.22 | $1.94 – $34.22 | 8 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $1,216.44 | $3,379.00 | $1,189.06 – $5,575.35 | 8 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $11.95 | $33.21 | $9.68 – $33.21 | 6 |
| Parathormone (pth) intact CPT 83970 | $189.00 | $525.00 | $13.17 – $482.51 | 7 |
| Parathyroid planar imaging CPT 78070 | $1,125.00 | $3,125.00 | $137.86 – $5,156.25 | 6 |
| Path clin consltj sf 5-20 CPT 80503 | $50.04 | $139.00 | $23.04 – $160.61 | 5 |
| Pdgfra gene CPT 81314 | $189.00 | $525.00 | $378.11 – $4,793.22 | 7 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,800.00 | $5,000.00 | $339.01 – $8,250.00 | 8 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,106.36 | $5,851.00 | $293.26 – $8,047.05 | 8 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,855.44 | $5,154.00 | $204.64 – $7,410.15 | 8 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,536.64 | $9,824.00 | $660.00 – $16,209.60 | 8 |
| Pelvic MRI (with contrast) CPT 72196 | $1,656.36 | $4,601.00 | $536.92 – $7,591.65 | 8 |
| Pelvic MRI (without contrast) CPT 72195 | $1,594.80 | $4,430.00 | $491.22 – $7,309.50 | 8 |
| Pelvic Ultrasound (complete) CPT 76856 | $515.88 | $1,433.00 | $97.04 – $904.20 | 6 |
| Pelvic Ultrasound (limited) CPT 76857 | $340.20 | $945.00 | $60.49 – $565.95 | 6 |
| Peng benzathine/procaine inj HCPCS J0558 | $6.12 | $17.00 | $6.78 – $53.15 | 8 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $6.84 | $19.00 | $8.58 – $87.04 | 8 |
| Peripheral vascular rehab CPT 93668 | $75.60 | $210.00 | $210.00 – $346.50 | 3 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $76.32 | $212.00 | $191.40 – $191.40 | 1 |
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.