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 |
|---|---|---|---|---|
| Sodium chloride 3 % ivpb HCPCS J7131 | $16.22 | $45.05 | $0.14 – $45.05 | 8 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $83.88 | $233.00 | $198.66 – $343.25 | 8 |
| Sodium serum/plasma/whole blood CPT 84295 | $43.92 | $122.00 | $0.17 – $56.03 | 7 |
| Special supplies phys/qhp CPT 99070 | $1,325.52 | $3,682.00 | $1.01 – $1.67 | 3 |
| Specific gravity body fluid CPT 84315 | $12.24 | $34.00 | $0.09 – $29.36 | 7 |
| Sperm antibody test CPT 89325 | $17.37 | $48.25 | $5.15 – $124.74 | 7 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $619.92 | $1,722.00 | $10.61 – $285.10 | 22 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $210.24 | $584.00 | $445.32 – $445.32 | 3 |
| Splint finger 4 prong foam sm HCPCS A4570 | $90.00 | $250.00 | $170.00 – $280.50 | 3 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $276.84 | $769.00 | $89.05 – $1,268.85 | 8 |
| Staph a dna amp probe CPT 87640 | $67.32 | $187.00 | $40.26 – $401.37 | 7 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $118.80 | $330.00 | $91.47 – $544.50 | 8 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $468.00 | $1,300.00 | $518.00 – $854.70 | 3 |
| Sterile water/saline, 10 ml HCPCS A4216 | $20.70 | $57.51 | $4.81 – $7.93 | 3 |
| St evaluate speech sound production CPT 92522 | $254.52 | $707.00 | $91.96 – $1,166.55 | 8 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $276.84 | $769.00 | $187.30 – $1,268.85 | 8 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $127.80 | $355.00 | $57.30 – $585.75 | 8 |
| St evaluation swallow function CPT 92610 | $221.76 | $616.00 | $69.97 – $1,016.40 | 8 |
| Stimulants synthetic CPT 80371 | $54.00 | $150.00 | $7.00 – $278.13 | 7 |
| Strep b dna amp probe CPT 87653 | $10.99 | $30.52 | $10.71 – $401.37 | 7 |
| Stress test pulmonary CPT 94618 | $58.68 | $163.00 | $43.20 – $268.95 | 6 |
| Stress tte complete CPT 93351 | $648.72 | $1,802.00 | $354.71 – $2,973.30 | 6 |
| Str markers specimen anal CPT 81265 | $108.00 | $300.00 | $191.15 – $4,449.46 | 7 |
| St treatment speech individual CPT 92507 | $213.12 | $592.00 | $80.91 – $976.80 | 8 |
| St treatment swallow dysfunction/oral CPT 92526 | $216.72 | $602.00 | $48.51 – $828.30 | 8 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $6.45 | $17.92 | $4.22 – $17.92 | 8 |
| Sugars single quant CPT 84378 | $3.69 | $10.24 | $1.18 – $134.03 | 7 |
| Sulfonylurea screen qn-sendout CPT 80377 | $45.21 | $125.59 | $4.00 – $386.97 | 7 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $75.96 | $211.00 | $52.57 – $515.92 | 8 |
| Surgical pathology level 1 gross examination only CPT 88300 | $46.80 | $130.00 | $12.01 – $130.00 | 7 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $93.60 | $260.00 | $30.04 – $260.00 | 7 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $108.36 | $301.00 | $43.72 – $301.00 | 7 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $196.92 | $547.00 | $32.48 – $157.71 | 7 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $462.24 | $1,284.00 | $125.71 – $1,284.00 | 7 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $855.72 | $2,377.00 | $239.88 – $2,377.00 | 7 |
| Susceptibility agar dilution per agent CPT 87181 | $16.92 | $47.00 | $0.23 – $26.36 | 7 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $16.92 | $47.00 | $0.23 – $33.68 | 7 |
| Susceptibility mic per plate CPT 87186 | $162.16 | $450.44 | $0.60 – $101.05 | 7 |
| Suscept studies macrobroth dilution ea CPT 87188 | $2.12 | $5.90 | $0.39 – $77.52 | 7 |
| Synvisc or synvisc-one HCPCS J7325 | $109.44 | $304.00 | $20.58 – $41.62 | 8 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $20.88 | $58.00 | $0.43 – $51.47 | 7 |
| T3 (triiodothyronine) free CPT 84481 | $93.60 | $260.00 | $2.54 – $198.09 | 7 |
| T3 (triiodothyronine) total CPT 84480 | $64.80 | $180.00 | $1.79 – $165.66 | 7 |
| T4 (thyroxine) free CPT 84439 | $80.64 | $224.00 | $0.71 – $105.38 | 7 |
| T4 (thyroxine) total CPT 84436 | $51.12 | $142.00 | $2.55 – $80.35 | 7 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $8.35 | $23.19 | $0.54 – $23.19 | 8 |
| Tacrolimus therapeutic drug level CPT 80197 | $24.84 | $69.00 | $1.68 – $173.45 | 7 |
| Target gsa panel hmtlmph neop CPT 81450 | $882.00 | $2,450.00 | $1,680.00 – $40,166.43 | 7 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $887.40 | $2,465.00 | $1,964.13 – $57,344.74 | 7 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $339.84 | $944.00 | $100.09 – $944.00 | 7 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $150.88 | $419.10 | $24.79 – $708.69 | 7 |
| Tc-99m apcitide diag HCPCS A9504 | $82.80 | $230.00 | $230.00 – $1,431.29 | 8 |
| Tc-99m depreotide HCPCS A9536 | $82.80 | $230.00 | $230.00 – $2,179.68 | 8 |
| Tc-99m disofenin HCPCS A9510 | $132.12 | $367.00 | $106.73 – $605.55 | 8 |
| Tc-99m fanolesomab diag HCPCS A9566 | $1,140.84 | $3,169.00 | $3,169.00 – $5,228.85 | 3 |
| Tc-99m gluceptate HCPCS A9550 | $82.80 | $230.00 | $230.00 – $379.50 | 3 |
| Tc-99m labeled rbc HCPCS A9560 | $227.88 | $633.00 | $225.32 – $1,044.45 | 8 |
| Tc-99m maa HCPCS A9540 | $134.28 | $373.00 | $42.55 – $615.45 | 8 |
| Tc-99m mebrofenin HCPCS A9537 | $84.96 | $236.00 | $117.68 – $389.40 | 8 |
| Tc-99m medronate HCPCS A9503 | $106.20 | $295.00 | $175.49 – $486.75 | 8 |
| Tc-99m pentetate dtpa HCPCS A9539 | $101.16 | $281.00 | $32.12 – $463.65 | 8 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $81.00 | $225.00 | $3.42 – $371.25 | 8 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $103.68 | $288.00 | $48.82 – $475.20 | 8 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $538.20 | $1,495.00 | $227.87 – $2,466.75 | 8 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $82.80 | $230.00 | $145.30 – $1,796.65 | 8 |
| Tc-99m sulfur colloid HCPCS A9541 | $81.00 | $225.00 | $105.15 – $2,045.69 | 8 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $84.96 | $236.00 | $224.14 – $389.40 | 8 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $14.96 | $41.55 | $9.40 – $461.26 | 7 |
| T cells absolute cd 4 count CPT 86361 | $8.57 | $23.80 | $6.37 – $314.80 | 7 |
| T cells total count CPT 86359 | $12.15 | $33.75 | $6.04 – $441.74 | 7 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $9,857.15 | $27,380.96 | $106.95 – $27,380.96 | 8 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $31.24 | $86.78 | $6.73 – $86.78 | 8 |
| Test for chlorohydrocarbons CPT 82441 | $42.12 | $117.00 | $6.89 – $70.20 | 7 |
| Test stress cardiovascular tracing only CPT 93017 | $541.80 | $1,505.00 | $75.31 – $2,483.25 | 6 |
| Theophylline therapeutic drug level CPT 80198 | $107.28 | $298.00 | $16.22 – $165.43 | 7 |
| Therapeutic procd strg endur HCPCS G0237 | $99.36 | $276.00 | $17.33 – $543.00 | 8 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $24.48 | $68.00 | $1.80 – $14.00 | 8 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,375.20 | $3,820.00 | $92.33 – $6,303.00 | 3 |
| Thrombin time CPT 85670 | $3.47 | $9.63 | $0.56 – $67.60 | 7 |
| Thromboplastin inhibition CPT 85705 | $46.80 | $130.00 | $11.04 – $99.16 | 7 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $2.07 | $5.75 | $0.37 – $75.63 | 7 |
| Thyroglobulin antibody CPT 86800 | $72.72 | $202.00 | $2.24 – $185.89 | 7 |
| Thyroid imaging CPT 78013 | $480.24 | $1,334.00 | $259.10 – $2,201.10 | 6 |
| Thyroid met imaging CPT 78015 | $1,467.36 | $4,076.00 | $116.06 – $6,725.40 | 6 |
| Thyroid (TSH) Test CPT 84443 | $101.52 | $282.00 | $2.48 – $196.44 | 7 |
| Thyroid Ultrasound CPT 76536 | $460.08 | $1,278.00 | $85.69 – $1,027.95 | 6 |
| Thyroid uptake measurement CPT 78012 | $480.24 | $1,334.00 | $509.22 – $2,201.10 | 6 |
| Thyroxine binding globulin (tbg) CPT 84442 | $4.73 | $13.14 | $1.94 – $161.49 | 7 |
| Tissue culture placenta CPT 88235 | $63.18 | $175.50 | $107.62 – $1,290.68 | 7 |
| Tissue culture skin/biopsy CPT 88233 | $85.91 | $238.65 | $147.50 – $1,396.53 | 7 |
| Tissue culture tumor CPT 88239 | $63.00 | $175.00 | $169.27 – $1,668.75 | 7 |
| Tissue exam koh skin/hair/nails CPT 87220 | $20.52 | $57.00 | $2.43 – $49.90 | 7 |
| Tissue transglutaminase iga CPT 86364 | $23.40 | $65.00 | $1.33 – $45.33 | 5 |
| Tl-201 thallium diag per mci HCPCS A9505 | $581.04 | $1,614.00 | $58.27 – $2,663.10 | 8 |
| Tobramycin peak therapeutic drug level CPT 80200 | $110.16 | $306.00 | $2.31 – $188.41 | 7 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $125.28 | $348.00 | $70.99 – $574.20 | 6 |
| Tomosynthesis breast screen bilateral CPT 77063 | $125.64 | $349.00 | $70.74 – $575.85 | 6 |
| Total tau CPT 84394 | $108.00 | $300.00 | $128.92 – $386.76 | 5 |
| Toxoplasma antibody igg CPT 86777 | $75.60 | $210.00 | $12.65 – $167.71 | 7 |
| Toxoplasma antibody igm CPT 86778 | $4.61 | $12.80 | $1.84 – $174.08 | 7 |
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.