RIDEOUT MEMORIAL HOSPITAL
726 4th St, Marysville, CA · Adventisthealth · · NPI 1720088354
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 |
|---|---|---|---|---|
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $3.52 | $16.00 | $0.18 – $4.96 | 7 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $14,999.00 | $68,177.28 | $190.43 – $1,474.00 | 12 |
| Ip/obs cnsltj new/est low 45 CPT 99253 | $59.18 | $269.00 | $3.62 – $497.65 | 14 |
| Ip/obs cnsltj new/est mod 60 CPT 99254 | $75.02 | $341.00 | $341.00 – $562.65 | 6 |
| Ip/obs consltj new/est sf 35 CPT 99252 | $37.40 | $170.00 | $2.34 – $280.50 | 14 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $108.29 | $492.24 | $2.93 – $87.27 | 7 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $1,466.67 | $6,666.67 | $65.86 – $1,333.33 | 12 |
| Iron CPT 83540 | $141.46 | $643.00 | $1.62 – $11.65 | 12 |
| Iron binding capacity CPT 83550 | $36.96 | $168.00 | $1.90 – $15.73 | 12 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $124.21 | $564.57 | $0.25 – $381.37 | 7 |
| Irradiation of blood product each unit reference CPT 86945 | $27.50 | $125.00 | $7.80 – $86.76 | 12 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $82.06 | $373.00 | $11.55 – $615.45 | 8 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $2,115.44 | $9,615.63 | $84.23 – $521.47 | 12 |
| Ivc venogram s&i CPT 75825 | $1,665.40 | $7,570.00 | $132.01 – $9,951.15 | 12 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $129.14 | $587.00 | $33.53 – $968.55 | 12 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $129.14 | $587.00 | $19.40 – $968.55 | 12 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $129.14 | $587.00 | $20.81 – $968.55 | 12 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $246.84 | $1,122.00 | $67.61 – $1,851.30 | 12 |
| Ivp w/nephrotomography CPT 74415 | $952.82 | $4,331.00 | $50.77 – $7,146.15 | 12 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $227.26 | $1,033.00 | $39.72 – $1,704.45 | 12 |
| Jak2 targeted sequence analysis CPT 81279 | $64.90 | $295.00 | $13.02 – $333.36 | 12 |
| John cunningham antibody CPT 86711 | $6.60 | $30.00 | $2.92 – $30.40 | 12 |
| Ketamine and metabolite screen - quest CPT 80357 | $23.32 | $106.00 | $8.00 – $9.92 | 6 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $63.80 | $290.00 | $2.29 – $41.20 | 12 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $16.78 | $76.26 | $0.30 – $6.96 | 16 |
| Kidney imag w/bld flow multi CPT 78709 | $807.84 | $3,672.00 | $87.71 – $6,058.80 | 12 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $531.08 | $2,414.00 | $98.64 – $3,983.10 | 12 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $889.90 | $4,045.00 | $45.01 – $3,151.50 | 12 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $4,220.48 | $19,184.00 | $19,184.00 – $19,184.00 | 3 |
| Kit lead specify 5-6-5 HCPCS C1778 | $5,955.84 | $27,072.00 | $305.00 – $503.25 | 4 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,025.20 | $4,660.00 | $3,908.00 – $6,448.20 | 4 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,497.98 | $6,809.00 | $6,809.00 – $11,234.85 | 6 |
| Knee MRI (with and without contrast) CPT 73723 | $2,702.70 | $12,285.00 | $91.44 – $13,513.50 | 12 |
| Knee MRI (with contrast) CPT 73722 | $2,220.90 | $10,095.00 | $67.61 – $11,104.50 | 12 |
| Knee MRI (without contrast) CPT 73721 | $1,980.66 | $9,003.00 | $181.47 – $8,188.95 | 12 |
| Knee X-ray CPT 73564 | $580.80 | $2,640.00 | $14.16 – $2,069.10 | 12 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $14.92 | $67.81 | $47.98 – $59.50 | 6 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $124.21 | $564.60 | $0.40 – $931.60 | 7 |
| Lactate dehydrogenase (ldh) CPT 83615 | $128.70 | $585.00 | $1.07 – $10.87 | 12 |
| Lactated ringers intravenous solution HCPCS J7120 | $15.19 | $69.07 | $2.65 – $84.40 | 7 |
| Lactation class HCPCS S9443 | $11.44 | $52.00 | $52.00 – $85.80 | 6 |
| Lactic acid CPT 83605 | $129.36 | $588.00 | $3.06 – $41.60 | 12 |
| Lactoferrin fecal qualitative CPT 83630 | $47.74 | $217.00 | $3.77 – $41.40 | 12 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $5,280.00 | $24,000.00 | $37.43 – $1,474.00 | 12 |
| Laparoscopy excise lesions CPT 58662 | $470.73 | $2,139.67 | $22.69 – $1,072.36 | 22 |
| Laparoscopy lysis CPT 58660 | $443.52 | $2,016.00 | $21.62 – $1,010.84 | 22 |
| Laparoscopy remove adnexa CPT 58661 | $433.07 | $1,968.50 | $20.75 – $987.39 | 22 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $6,270.00 | $28,500.00 | $2,250.00 – $3,712.50 | 4 |
| Lead capillary CPT 83655 | $5.72 | $26.00 | $3.48 – $21.80 | 12 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $2,684.66 | $12,203.00 | $575.00 – $948.75 | 4 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,940.00 | $27,000.00 | $282.00 – $465.30 | 4 |
| Left compres band <3"/yd HCPCS A6448 | $3.30 | $15.00 | $0.44 – $27.75 | 20 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $839.74 | $3,817.00 | $72.98 – $2,879.25 | 12 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $25.96 | $118.00 | $7.05 – $325.62 | 10 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $120.34 | $547.00 | $9.60 – $194.48 | 7 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $5,310.15 | $24,137.03 | $160.34 – $1,093.41 | 12 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $2,751.09 | $12,504.95 | $1,030.08 – $3,314.27 | 12 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $37.92 | $172.36 | $0.06 – $63.23 | 7 |
| Levetiracetam therapeutic drug level CPT 80177 | $27.94 | $127.00 | $2.36 – $23.85 | 12 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $13.84 | $62.90 | $58.42 – $72.44 | 6 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $214.62 | $975.55 | $552.18 – $684.70 | 6 |
| Liberta rc ipg HCPCS C1820 | $11,935.22 | $54,251.00 | $48,966.00 – $48,966.00 | 3 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $27.74 | $126.07 | $41.30 – $51.22 | 6 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $24.86 | $113.00 | $113.00 – $140.12 | 6 |
| Lidocaine therapeutic drug level CPT 80176 | $21.78 | $99.00 | $4.10 – $26.44 | 12 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | $29.09 | $132.23 | $2.46 – $119.82 | 22 |
| Limited autopsy CPT 88037 | $110.00 | $500.00 | $500.00 – $620.00 | 6 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $36.61 | $166.43 | $2.83 – $206.37 | 7 |
| Lipase CPT 83690 | $171.60 | $780.00 | $1.92 – $12.40 | 12 |
| Lipoprotein blood quant CPT 83704 | $25.74 | $117.00 | $6.06 – $61.54 | 12 |
| Lipoprotein direct measurement hdl CPT 83718 | $122.98 | $559.00 | $2.31 – $28.40 | 12 |
| Lipoprotein direct measurement ldl CPT 83721 | $128.04 | $582.00 | $1.64 – $18.90 | 12 |
| Lithium therapeutic drug level CPT 80178 | $155.54 | $707.00 | $1.84 – $25.60 | 12 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,602.84 | $20,922.00 | $97.92 – $34,521.30 | 10 |
| Liver Function Test CPT 80076 | $163.02 | $741.00 | $2.30 – $14.71 | 12 |
| Liver imag w/vasclr flow CPT 78202 | $763.62 | $3,471.00 | $61.42 – $5,727.15 | 12 |
| Liver/spleen imag static only CPT 78215 | $418.88 | $1,904.00 | $44.23 – $3,141.60 | 12 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $302.06 | $1,373.00 | $59.29 – $2,265.45 | 12 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.88 | $4.00 | $1.61 – $4.96 | 7 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $12.75 | $57.94 | $6.23 – $71.85 | 7 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,323.32 | $15,106.00 | $117.83 – $14,520.00 | 12 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,825.02 | $12,841.00 | $117.83 – $13,035.00 | 12 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,238.28 | $10,174.00 | $108.15 – $8,081.70 | 12 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,938.32 | $13,356.00 | $195.39 – $13,648.80 | 12 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,689.50 | $12,225.00 | $200.82 – $10,423.05 | 12 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,654.96 | $12,068.00 | $267.58 – $8,957.85 | 12 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $476.74 | $2,167.00 | $16.89 – $854.70 | 12 |
| L/s ratio fetal lung CPT 83661 | $12.54 | $57.00 | $6.57 – $39.58 | 12 |
| Lung Function Test (Spirometry) CPT 94010 | $156.86 | $713.00 | $15.24 – $1,176.45 | 12 |
| Lung perfusion imaging CPT 78580 | $554.62 | $2,521.00 | $57.51 – $4,159.65 | 12 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $3,484.80 | $15,840.00 | $215.95 – $1,474.00 | 12 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $5,371.98 | $24,418.11 | $43.51 – $1,474.00 | 12 |
| Lymphatics/lymph node imaging CPT 78195 | $889.46 | $4,043.00 | $96.90 – $6,670.95 | 12 |
| Lymphocyte transformation mitogen CPT 86353 | $9.59 | $43.58 | $8.72 – $88.25 | 12 |
| Macroscopic exam arthropod CPT 87168 | $98.56 | $448.00 | $0.82 – $89.60 | 12 |
| Macroscopic exam parasite CPT 87169 | $128.04 | $582.00 | $0.82 – $16.80 | 12 |
| Magnesium CPT 83735 | $191.84 | $872.00 | $1.85 – $12.06 | 12 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $20.03 | $91.06 | $5.36 – $44.71 | 7 |
| Magnetic image bone marrow CPT 77084 | $925.54 | $4,207.00 | $307.92 – $6,941.55 | 11 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $55.00 | $250.00 | $16.78 – $412.50 | 12 |
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.