Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
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 |
|---|---|---|---|---|
| X-ray joint survey 1 view CPT 77077 | not published | not published | $140.05 – $259.73 | 4 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $988.89 | $1,939.00 | $115.93 – $127.70 | 4 |
| X-ray knee 3 views (both sides) CPT 73562 | $1,159.74 | $2,274.00 | $117.28 – $133.16 | 4 |
| X-ray knee ap standing bilateral CPT 73565 | $525.30 | $1,030.00 | $115.24 – $127.70 | 4 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $609.45 | $1,195.00 | $115.19 – $127.70 | 4 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $1,695.75 | $3,325.00 | $140.89 – $208.45 | 4 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $2,346.51 | $4,601.00 | $140.89 – $213.78 | 4 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $2,803.98 | $5,498.00 | $140.89 – $276.38 | 4 |
| X-ray male genital tract CPT 74440 | not published | not published | $263.74 – $372.86 | 4 |
| X-ray mandible complete > 4 views CPT 70110 | $1,298.46 | $2,546.00 | $140.89 – $179.33 | 4 |
| X-ray mandible ltd <4 views CPT 70100 | $688.50 | $1,350.00 | $117.28 – $127.70 | 4 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $245.71 – $245.71 | 1 |
| X-ray nasal bones complete > 3 views CPT 70160 | $499.29 | $979.00 | $117.28 – $127.70 | 4 |
| X-ray neck soft tissue CPT 70360 | $547.23 | $1,073.00 | $99.25 – $127.70 | 4 |
| X-ray nose to rectum for foreign body child CPT 76010 | $285.60 | $560.00 | $101.09 – $128.98 | 4 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $321.54 – $855.46 | 4 |
| X-ray optic foramina CPT 70190 | not published | not published | $117.28 – $145.20 | 4 |
| X-ray pelvis 1-2 views CPT 72170 | $660.96 | $1,296.00 | $97.40 – $179.33 | 4 |
| X-ray pelvis complete > 3 views CPT 72190 | $893.01 | $1,751.00 | $140.89 – $179.33 | 4 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $910.42 – $1,619.14 | 2 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $1,039.57 – $1,849.36 | 2 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,554.99 | $3,049.00 | $470.15 – $610.96 | 4 |
| X-ray ribs 2 views left CPT 71100 | $881.28 | $1,728.00 | $117.28 – $133.88 | 4 |
| X-ray ribs 3 views bilateral CPT 71110 | $1,353.03 | $2,653.00 | $140.89 – $184.49 | 4 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $1,068.45 | $2,095.00 | $140.89 – $179.33 | 4 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $2,036.94 | $3,994.00 | $140.89 – $209.11 | 4 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $1,413.72 | $2,772.00 | $138.20 – $179.33 | 4 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $1,285.71 | $2,521.00 | $114.08 – $133.22 | 4 |
| X-ray scapula complete (both sides) CPT 73010 | $1,217.88 | $2,388.00 | $115.93 – $179.33 | 4 |
| X-ray sella turcica CPT 70240 | not published | not published | $99.25 – $127.70 | 4 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $721.65 | $1,415.00 | $88.11 – $127.70 | 4 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $1,665.66 | $3,266.00 | $117.28 – $183.83 | 4 |
| X-ray sinus tract/fistula/abscess CPT 76080 | not published | not published | $193.84 – $770.53 | 4 |
| X-ray skull < 4 views CPT 70250 | $816.00 | $1,600.00 | $136.30 – $179.33 | 4 |
| X-ray skull > 4 views complete CPT 70260 | $1,542.24 | $3,024.00 | $140.89 – $209.77 | 4 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $140.89 – $293.69 | 4 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $1,351.50 | $2,650.00 | $236.37 – $304.35 | 4 |
| X-ray small intestine follow-through study CPT 74248 | $412.08 | $808.00 | $263.42 – $282.70 | 2 |
| X-ray spine single view CPT 72020 | $604.35 | $1,185.00 | $88.11 – $127.70 | 4 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $740.01 | $1,451.00 | $117.28 – $163.17 | 4 |
| X-ray sternum > 2 views CPT 71120 | $886.89 | $1,739.00 | $117.28 – $151.85 | 4 |
| X-ray surgical specimen CPT 76098 | $2,513.79 | $4,929.00 | $60.29 – $770.53 | 4 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $303.45 | $595.00 | $236.37 – $305.01 | 4 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $1,974.72 | $3,872.00 | $117.28 – $195.15 | 4 |
| X-ray thoracic spine 2 views CPT 72070 | $1,401.48 | $2,748.00 | $125.22 – $179.33 | 4 |
| X-ray thoracic spine 3 views CPT 72072 | $1,401.48 | $2,748.00 | $140.89 – $179.33 | 4 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $981.24 | $1,924.00 | $117.28 – $156.52 | 4 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $638.01 | $1,251.00 | $117.28 – $227.80 | 4 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $1,053.66 | $2,066.00 | $140.89 – $416.24 | 4 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $1,031.73 | $2,023.00 | $104.79 – $127.70 | 4 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $771.12 | $1,512.00 | $98.54 – $127.70 | 4 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $253.47 | $497.00 | $236.37 – $386.24 | 4 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $1,572.33 | $3,083.00 | $236.37 – $342.33 | 4 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $348.98 – $348.98 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $519.45 – $519.45 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $796.62 | $1,562.00 | $115.19 – $127.70 | 4 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $236.37 – $291.55 | 4 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $446.56 – $446.56 | 1 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $621.33 – $1,308.75 | 2 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $167.70 – $6,297.39 | 4 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.65 – $96.67 | 4 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.46 – $3.20 | 4 |
| Yersinia antibody CPT 86793 | not published | not published | $12.93 – $107.66 | 4 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $55,688.06 – $122,172.78 | 4 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $153.73 – $1,264.22 | 4 |
| Ziconotide injection HCPCS J2278 | not published | not published | $8.63 – $20.86 | 4 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.29 – $3.25 | 4 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.45 – $1.45 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $255.00 | $500.00 | $50.28 – $370.08 | 4 |
| Zika virus igm antibody CPT 86794 | $140.25 | $275.00 | $16.51 – $121.51 | 4 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | $23.51 | $46.10 | not published | 0 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $275.36 | $539.93 | $10.37 – $24.32 | 3 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.44 – $21.30 | 4 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $401.83 | $787.90 | $19.05 – $227.62 | 3 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $223.92 – $285.82 | 2 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $189.38 – $535.28 | 4 |
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.