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 |
|---|---|---|---|---|
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $4.32 | $12.00 | $1.70 – $165.66 | 7 |
| Warde zinc CPT 84630 | $23.04 | $64.00 | $1.15 – $133.16 | 7 |
| Wbc automated CPT 85048 | $13.32 | $37.00 | $0.06 – $29.91 | 7 |
| Whole mitochondrial genome CPT 81460 | $65.52 | $182.00 | $182.00 – $40,166.43 | 7 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $315.72 | $877.00 | $326.00 – $1,447.05 | 8 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $420.84 | $1,169.00 | $326.00 – $1,928.85 | 8 |
| Wrist X-ray CPT 73110 | $493.20 | $1,370.00 | $36.06 – $202.48 | 8 |
| Xe133 xenon 10mci HCPCS A9558 | $227.52 | $632.00 | $56.49 – $1,042.80 | 8 |
| X-ray abdomen 1 view CPT 74018 | $246.96 | $686.00 | $35.33 – $1,085.70 | 8 |
| X-ray abdomen 2 views CPT 74019 | $302.04 | $839.00 | $43.18 – $1,207.80 | 8 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $604.08 | $1,678.00 | $56.54 – $2,098.80 | 8 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $255.96 | $711.00 | $43.45 – $1,173.15 | 8 |
| X-ray ankle 2 views (both sides) CPT 73600 | $380.88 | $1,058.00 | $27.28 – $760.65 | 8 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $943.56 | $2,621.00 | $3.93 – $524.56 | 22 |
| X-ray bone age studies CPT 77072 | $152.28 | $423.00 | $28.21 – $697.95 | 8 |
| X-ray bone length studies CPT 77073 | $202.68 | $563.00 | $45.97 – $928.95 | 8 |
| X-ray bone survey complete CPT 77075 | $494.28 | $1,373.00 | $112.60 – $2,265.45 | 8 |
| X-ray bone survey infant CPT 77076 | $249.84 | $694.00 | $91.23 – $1,145.10 | 8 |
| X-ray cervical spine 2-3 views CPT 72040 | $333.00 | $925.00 | $37.27 – $1,419.00 | 8 |
| X-ray cervical spine 4-5 views CPT 72050 | $468.00 | $1,300.00 | $57.38 – $2,145.00 | 8 |
| X-ray cervical spine >= 6 views CPT 72052 | $545.40 | $1,515.00 | $72.16 – $2,499.75 | 8 |
| X-ray clavicle complete (both sides) CPT 73000 | $342.36 | $951.00 | $29.81 – $516.45 | 8 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $493.56 | $1,371.00 | $74.46 – $2,262.15 | 8 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $508.32 | $1,412.00 | $90.14 – $2,329.80 | 8 |
| X-ray elbow 2 views (both sides) CPT 73070 | $339.84 | $944.00 | $29.81 – $778.80 | 8 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $555.84 | $1,544.00 | $37.27 – $1,480.05 | 8 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $272.52 | $757.00 | $54.64 – $1,249.05 | 8 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $295.20 | $820.00 | $87.67 – $1,353.00 | 8 |
| X-ray exam entire spi 6/> vw CPT 72084 | $368.64 | $1,024.00 | $104.87 – $1,689.60 | 8 |
| X-ray exam of arm infant CPT 73092 | $173.88 | $483.00 | $29.81 – $796.95 | 8 |
| X-ray exam of eye sockets CPT 70200 | $131.76 | $366.00 | $54.35 – $603.90 | 8 |
| X-ray exam of femur 1 CPT 73551 | $164.16 | $456.00 | $35.77 – $501.60 | 8 |
| X-ray exam of mastoids CPT 70120 | $152.28 | $423.00 | $37.27 – $697.95 | 8 |
| X-ray exam of sinuses CPT 70210 | $210.96 | $586.00 | $31.01 – $966.90 | 8 |
| X-ray exam si joints CPT 72200 | $131.76 | $366.00 | $31.01 – $603.90 | 8 |
| X-ray exam thorac spine4/>vw CPT 72074 | $121.68 | $338.00 | $50.36 – $557.70 | 8 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $270.00 | $750.00 | $35.40 – $973.50 | 8 |
| X-ray facial bones complete > 3 views CPT 70150 | $474.48 | $1,318.00 | $53.47 – $1,684.65 | 8 |
| X-ray femur >=2 views (both sides) CPT 73552 | $354.96 | $986.00 | $41.81 – $1,084.05 | 8 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $295.56 | $821.00 | $22.36 – $902.55 | 8 |
| X-ray foot 2 views (both sides) CPT 73620 | $337.68 | $938.00 | $24.82 – $935.55 | 8 |
| X-ray forearm 2 views (both sides) CPT 73090 | $402.48 | $1,118.00 | $29.81 – $1,229.25 | 8 |
| X-ray hand 2 views (both sides) CPT 73120 | $422.28 | $1,173.00 | $24.82 – $1,125.30 | 8 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $336.96 | $936.00 | $27.28 – $1,029.60 | 8 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $326.16 | $906.00 | $66.80 – $1,494.90 | 8 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $402.12 | $1,117.00 | $2.67 – $272.52 | 22 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $376.20 | $1,045.00 | $62.90 – $1,724.25 | 8 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $413.28 | $1,148.00 | $73.21 – $1,894.20 | 8 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $268.56 | $746.00 | $38.03 – $1,070.85 | 8 |
| X-ray humerus >= 2 views left CPT 73060 | $359.64 | $999.00 | $29.81 – $1,098.90 | 8 |
| X-ray joint survey 1 view CPT 77077 | $290.88 | $808.00 | $47.67 – $1,333.20 | 8 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $344.16 | $956.00 | $27.28 – $749.10 | 8 |
| X-ray knee 3 views (both sides) CPT 73562 | $489.24 | $1,359.00 | $33.54 – $1,435.50 | 8 |
| X-ray knee ap standing bilateral CPT 73565 | $244.08 | $678.00 | $27.28 – $1,118.70 | 8 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $187.92 | $522.00 | $29.81 – $861.30 | 8 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $272.16 | $756.00 | $49.64 – $663.30 | 8 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $555.12 | $1,542.00 | $62.90 – $2,272.05 | 8 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $399.24 | $1,109.00 | $80.77 – $1,829.85 | 8 |
| X-ray mandible complete > 4 views CPT 70110 | $381.60 | $1,060.00 | $48.83 – $1,749.00 | 8 |
| X-ray mandible ltd <4 views CPT 70100 | $345.60 | $960.00 | $36.00 – $1,584.00 | 8 |
| X-ray nasal bones complete > 3 views CPT 70160 | $335.16 | $931.00 | $35.56 – $1,107.15 | 8 |
| X-ray neck soft tissue CPT 70360 | $240.12 | $667.00 | $24.82 – $1,054.35 | 8 |
| X-ray nose to rectum for foreign body child CPT 76010 | $179.64 | $499.00 | $33.48 – $823.35 | 8 |
| X-ray optic foramina CPT 70190 | $148.68 | $413.00 | $37.27 – $453.75 | 8 |
| X-ray pelvis 1-2 views CPT 72170 | $335.52 | $932.00 | $31.01 – $1,343.10 | 8 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $628.92 | $1,747.00 | $80.93 – $2,882.55 | 8 |
| X-ray ribs 2 views left CPT 71100 | $282.60 | $785.00 | $38.96 – $1,250.70 | 8 |
| X-ray ribs 3 views bilateral CPT 71110 | $373.32 | $1,037.00 | $47.78 – $1,711.05 | 8 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $451.80 | $1,255.00 | $46.36 – $1,791.90 | 8 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $480.60 | $1,335.00 | $60.82 – $2,202.75 | 8 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $294.48 | $818.00 | $42.42 – $1,349.70 | 8 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $335.52 | $932.00 | $35.89 – $1,349.70 | 8 |
| X-ray scapula complete (both sides) CPT 73010 | $455.40 | $1,265.00 | $35.56 – $1,390.95 | 8 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $277.56 | $771.00 | $24.82 – $848.10 | 8 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $338.04 | $939.00 | $47.84 – $1,549.35 | 8 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $654.12 | $1,817.00 | $59.94 – $2,998.05 | 8 |
| X-ray skull < 4 views CPT 70250 | $324.00 | $900.00 | $37.27 – $1,435.50 | 8 |
| X-ray skull > 4 views complete CPT 70260 | $324.00 | $900.00 | $57.86 – $1,485.00 | 8 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $596.16 | $1,656.00 | $81.92 – $2,732.40 | 8 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $776.88 | $2,158.00 | $135.72 – $2,796.75 | 8 |
| X-ray small intestine follow-through study CPT 74248 | $179.64 | $499.00 | $107.29 – $823.35 | 8 |
| X-ray spine single view CPT 72020 | $198.36 | $551.00 | $24.82 – $909.15 | 8 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $171.72 | $477.00 | $37.27 – $787.05 | 8 |
| X-ray sternum > 2 views CPT 71120 | $249.84 | $694.00 | $37.27 – $1,145.10 | 8 |
| X-ray surgical specimen CPT 76098 | $612.00 | $1,700.00 | $20.77 – $2,805.00 | 8 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $226.80 | $630.00 | $54.64 – $1,039.50 | 8 |
| X-ray thoracic spine 2 views CPT 72070 | $375.12 | $1,042.00 | $40.22 – $1,498.20 | 8 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $304.56 | $846.00 | $39.29 – $1,395.90 | 8 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $207.72 | $577.00 | $49.80 – $952.05 | 8 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $273.24 | $759.00 | $80.77 – $1,252.35 | 8 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $381.24 | $1,059.00 | $1.28 – $130.92 | 22 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $261.36 | $726.00 | $22.36 – $798.60 | 8 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $574.20 | $1,595.00 | $165.31 – $2,631.75 | 8 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $559.08 | $1,553.00 | $5.00 – $367.67 | 22 |
| X-ray wrist 2 views (both sides) CPT 73100 | $305.28 | $848.00 | $24.82 – $932.25 | 8 |
| Yersinia antibody CPT 86793 | $4.22 | $11.72 | $1.55 – $154.17 | 7 |
| Zika virus dna/rna amp probe CPT 87662 | $16.42 | $45.61 | $23.40 – $883.25 | 7 |
| Zika virus igm antibody CPT 86794 | $5.39 | $14.97 | $2.52 – $290.09 | 7 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $109.94 | $305.39 | $24.92 – $305.39 | 8 |
| Zoster vaccine-live inj CPT 90736 | $243.00 | $675.00 | $359.17 – $1,113.75 | 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.