ADVENTIST HEALTH MENDOCINO COAST
700 River Dr, Fort Bragg, CA · Adventisthealth · · NPI 1538113725
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 |
|---|---|---|---|---|
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | $229.68 | $348.00 | $20.67 – $181.25 | 3 |
| Unlisted laps px bladder CPT 51999 | $3,717.78 | $5,633.00 | $20.67 – $188.50 | 3 |
| Unlisted laps px ovidct ovry CPT 58679 | $601.92 | $912.00 | $20.67 – $181.25 | 3 |
| Unlisted laps px renal CPT 50549 | $1,709.40 | $2,590.00 | $20.67 – $181.25 | 3 |
| Unlisted laps px spleen CPT 38129 | $2,983.86 | $4,521.00 | $20.67 – $181.25 | 3 |
| Unlisted laps px uterus CPT 58578 | $1,321.32 | $2,002.00 | $20.67 – $20.67 | 1 |
| Unlisted oph svc/procedure CPT 92499 | $40.26 | $61.00 | $20.67 – $70.28 | 3 |
| Unlisted procedure rectum CPT 45999 | $793.32 | $1,202.00 | $20.67 – $20.67 | 1 |
| Unlisted procedure urinary 58750 CPT 58750 | $2,038.08 | $3,088.00 | $788.76 – $4,477.60 | 12 |
| Unlisted px abdomen muscskel CPT 22999 | $1,399.86 | $2,121.00 | $20.67 – $43.50 | 3 |
| Unlisted px accessory sinus CPT 31299 | $289.74 | $439.00 | $20.67 – $20.67 | 1 |
| Unlisted px ant segment eye CPT 66999 | $415.80 | $630.00 | $20.67 – $20.67 | 1 |
| Unlisted px arthroscopy CPT 29999 | $1,622.28 | $2,458.00 | $20.67 – $20.67 | 1 |
| Unlisted px conjunctiva CPT 68399 | $170.94 | $259.00 | $20.67 – $101.50 | 3 |
| Unlisted px external ear CPT 69399 | $170.94 | $259.00 | $20.67 – $43.50 | 3 |
| Unlisted px foot/toes CPT 28899 | $3,607.56 | $5,466.00 | $20.67 – $278.92 | 4 |
| Unlisted px leg/ankle CPT 27899 | $1,941.06 | $2,941.00 | $20.67 – $65.25 | 3 |
| Unlisted px male genital sys CPT 55899 | $636.90 | $965.00 | $15.00 – $21.75 | 3 |
| Unlisted px middle ear CPT 69799 | $208.56 | $316.00 | $20.67 – $20.67 | 1 |
| Unlisted px neck/thorax CPT 21899 | $291.06 | $441.00 | $20.67 – $278.92 | 2 |
| Unlisted px pelvis/hip joint CPT 27299 | $170.94 | $259.00 | $20.67 – $20.67 | 1 |
| Unlisted px small intestine CPT 44799 | $3,622.08 | $5,488.00 | $20.67 – $58.00 | 3 |
| Unlisted px tongue flr mouth CPT 41599 | $180.84 | $274.00 | $20.67 – $20.67 | 1 |
| Unlisted special svc px/rprt CPT 99199 | $147.18 | $223.00 | $20.67 – $323.35 | 4 |
| Unlisted ultrasound procedure CPT 76999 | $642.18 | $973.00 | $20.67 – $20.67 | 1 |
| Upgrade pm system CPT 33214 | $1,045.44 | $1,584.00 | $85.00 – $832.91 | 12 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,090.68 | $6,198.00 | $107.36 – $5,105.28 | 13 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $218.46 | $331.00 | $83.78 – $331.00 | 12 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,119.16 | $4,726.00 | $69.38 – $2,877.90 | 13 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $275.22 | $417.00 | $35.00 – $511.89 | 12 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $308.88 | $468.00 | $15.00 – $656.03 | 12 |
| Uppr gi scope w/submuc inj CPT 43236 | $308.88 | $468.00 | $124.25 – $639.63 | 12 |
| Urachal cyst/sinus excision 51500 CPT 51500 | $1,452.00 | $2,200.00 | $60.00 – $981.14 | 12 |
| Urea nitrogen CPT 84520 | $69.96 | $106.00 | $4.19 – $35.89 | 5 |
| Urea nitrogen 24 hour urine CPT 84540 | $94.38 | $143.00 | $4.75 – $43.18 | 5 |
| Ureteral reflux study CPT 78740 | $498.96 | $756.00 | $27.80 – $497.10 | 13 |
| Ureter endoscopy & treatment CPT 50961 | $699.60 | $1,060.00 | $32.00 – $613.35 | 12 |
| Ureteroneocystostomy 50780 CPT 50780 | $2,492.82 | $3,777.00 | $75.00 – $1,668.69 | 12 |
| Ureteroureterostomy 50760 CPT 50760 | $2,521.86 | $3,821.00 | $178.70 – $1,680.28 | 12 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $345.84 | $524.00 | $15.62 – $340.42 | 13 |
| Urethrlys transvag with scope CPT 53500 | $1,685.64 | $2,554.00 | $30.00 – $1,178.33 | 12 |
| Urethrocystography void s&i CPT 74455 | $382.80 | $580.00 | $15.99 – $369.70 | 13 |
| Uric acid blood CPT 84550 | $33.00 | $50.00 | $0.33 – $41.16 | 5 |
| Uric acid urine CPT 84560 | $23.76 | $36.00 | $0.21 – $43.18 | 5 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $5.94 | $9.00 | $1.41 – $19.66 | 11 |
| Urinalysis (with microscopy) CPT 81001 | $93.72 | $142.00 | $3.63 – $27.81 | 5 |
| Urinalysis (without microscopy) CPT 81003 | $54.12 | $82.00 | $1.46 – $20.46 | 12 |
| Urine Culture Test CPT 87086 | $73.92 | $112.00 | $9.04 – $72.40 | 5 |
| Urine flow measurement 51736 CPT 51736 | $31.68 | $48.00 | $8.70 – $28.00 | 12 |
| Urine pregnancy test CPT 81025 | $76.56 | $116.00 | $2.80 – $46.43 | 12 |
| Urography, antegrade CPT 74425 | $299.64 | $454.00 | $18.48 – $303.60 | 13 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $266.64 | $404.00 | $170.16 – $585.80 | 4 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $242.88 | $368.00 | $154.80 – $533.60 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | $99.00 | $150.00 | $23.21 – $55.10 | 5 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $183.48 | $278.00 | $38.00 – $124.34 | 5 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $141.24 | $214.00 | $38.00 – $77.92 | 5 |
| Vaccine dtap-ipv/hib im CPT 90698 | $186.12 | $282.00 | $38.00 – $156.64 | 5 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $44.88 | $68.00 | $37.76 – $60.18 | 5 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $66.66 | $101.00 | $16.69 – $55.10 | 5 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $118.14 | $179.00 | $73.63 – $259.55 | 5 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $494.34 | $749.00 | $110.37 – $1,086.05 | 5 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $64.68 | $98.00 | $26.00 – $47.47 | 5 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $124.08 | $188.00 | $75.33 – $272.60 | 7 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $116.16 | $176.00 | $63.56 – $255.20 | 5 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $277.86 | $421.00 | $153.53 – $610.45 | 5 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $50.82 | $77.00 | $34.06 – $111.65 | 5 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $336.60 | $510.00 | $38.00 – $394.91 | 6 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $268.62 | $407.00 | $38.00 – $197.98 | 5 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $137.94 | $209.00 | $32.80 – $303.05 | 5 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $137.94 | $209.00 | $57.04 – $303.05 | 7 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $36.30 | $55.00 | $9.83 – $79.75 | 5 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $50.81 | $76.98 | $15.50 – $37.74 | 7 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $38.28 | $58.00 | $16.14 – $42.90 | 7 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $127.38 | $193.00 | $8.48 – $92.83 | 7 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $38.28 | $58.00 | $25.88 – $37.74 | 5 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $55.44 | $84.00 | $19.19 – $42.90 | 7 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | $34.32 | $52.00 | $10.20 – $37.74 | 5 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $38.94 | $59.00 | $26.20 – $85.55 | 5 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $121.44 | $184.00 | $42.72 – $266.80 | 5 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $60.72 | $92.00 | $39.25 – $133.40 | 5 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $17.82 | $27.00 | $4.96 – $39.15 | 5 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $261.36 | $396.00 | $232.57 – $574.20 | 5 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $202.62 | $307.00 | $270.19 – $982.38 | 5 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $689.70 | $1,045.00 | $171.50 – $1,515.25 | 5 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $237.60 | $360.00 | $26.00 – $200.10 | 5 |
| Vaccine mmr live subcutaneous CPT 90707 | $221.76 | $336.00 | $26.03 – $115.92 | 5 |
| Vaccine mmrv live subcutaneous CPT 90710 | $533.28 | $808.00 | $38.00 – $347.00 | 5 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $220.44 | $334.00 | $20.69 – $140.50 | 5 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $425.70 | $645.00 | $26.00 – $309.59 | 5 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $418.44 | $634.00 | $262.12 – $919.30 | 5 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $491.70 | $745.00 | $22.00 – $819.50 | 7 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $71.28 | $108.00 | $26.03 – $57.37 | 5 |
| Vaccine rabies im CPT 90675 | $808.90 | $1,225.60 | $156.18 – $470.10 | 6 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $958.98 | $1,453.00 | $382.88 – $2,106.85 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $1,509.42 | $2,287.00 | $714.07 – $3,316.15 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $1,509.42 | $2,287.00 | $667.36 – $3,316.15 | 4 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | $412.50 | $625.00 | $367.62 – $906.25 | 4 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $192.06 | $291.00 | $38.00 – $176.42 | 5 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $186.12 | $282.00 | $38.00 – $123.29 | 5 |
| Vaccine tdap >=7 years im CPT 90715 | $125.47 | $190.11 | $26.00 – $60.36 | 6 |
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.