Mark Twain Medical Center
768 Mountain Ranch Rd, San Andreas, CA · CommonSpirit Health · · NPI 1508968819
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 |
|---|---|---|---|---|
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | not published | not published | $96.98 – $96.98 | 5 |
| Ghs nerve blk intercostal, single level CPT 64420 | $230.44 | $346.00 | $68.36 – $339.08 | 14 |
| Ghs nerve block axillary nerve CPT 64417 | $630.71 | $947.00 | $74.76 – $928.06 | 14 |
| Ghs nerve block brachial plexus CPT 64415 | $128.54 | $193.00 | $49.93 – $189.14 | 14 |
| Ghs nerve block celiac plexus CPT 64530 | $1,160.18 | $1,742.00 | $161.07 – $1,707.16 | 14 |
| Ghs nerve block interscaline CPT 64510 | $3,631.70 | $5,453.00 | $40.88 – $154.84 | 14 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,850.15 | $2,778.00 | $58.47 – $221.48 | 14 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,212.12 | $1,820.00 | $48.38 – $183.26 | 14 |
| Ghs nerve block suprascapular CPT 64418 | $1,190.15 | $1,787.00 | $44.50 – $168.56 | 14 |
| Ghs ng placement w fluoro guidance CPT 43752 | $1,300.04 | $1,952.00 | $28.20 – $149.10 | 14 |
| Ghs opcc repair cvp without subq port CPT 36575 | not published | not published | $52.37 – $52.37 | 5 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $131.83 – $131.83 | 5 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $41.30 | $62.00 | $16.04 – $60.76 | 14 |
| Ghs ot work hardening-additional hours CPT 97546 | $232.44 | $349.00 | $90.29 – $342.02 | 12 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $199.80 | $300.00 | $77.61 – $294.00 | 14 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,999.34 | $3,002.00 | $40.88 – $154.84 | 14 |
| Ghs peritonsillar abscess i andd CPT 42700 | $364.97 | $548.00 | $83.73 – $537.04 | 14 |
| Ghs picc line insert < 5 CPT 36568 | not published | not published | $78.67 – $78.67 | 5 |
| Ghs plngl fx pm cl CPT 26725 | $557.45 | $837.00 | $155.51 – $705.60 | 14 |
| Ghs ppd (tb intradermal) CPT 86580 | $33.97 | $51.00 | $4.82 – $49.98 | 14 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $7.83 | $11.75 | $6.37 – $11.75 | 14 |
| Ghs protoporphyrins fract CPT 84202 | $35.24 | $52.91 | $14.35 – $35.17 | 14 |
| Ghs pr without cont pulse ox CPT 94625 | $266.40 | $400.00 | $103.48 – $392.00 | 12 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $462.21 | $694.00 | $179.54 – $680.12 | 12 |
| Ghs quinidine CPT 80194 | $24.31 | $36.50 | $14.60 – $35.77 | 14 |
| Ghs removal intranasal foreign body CPT 30300 | $50.62 | $76.00 | $19.67 – $74.48 | 14 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $170.46 – $170.46 | 5 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $969.70 | $1,456.00 | $342.63 – $1,426.88 | 14 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $373.39 – $373.39 | 5 |
| Ghs reticulocyte count CPT 85044 | $51.29 | $77.00 | $3.79 – $75.46 | 14 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $386.95 | $581.00 | $4.19 – $34.09 | 14 |
| Ghs sedimentation rate CPT 85651 | $126.54 | $190.00 | $3.40 – $186.20 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $241.76 | $363.00 | $93.91 – $355.74 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $245.76 | $369.00 | $95.47 – $361.62 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $336.33 | $505.00 | $130.65 – $494.90 | 14 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $282.39 | $424.00 | $109.69 – $415.52 | 14 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $186.48 | $280.00 | $72.44 – $274.40 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $177.16 | $266.00 | $68.82 – $260.68 | 14 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $220.45 | $331.00 | $85.63 – $324.38 | 14 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $322.98 – $322.98 | 5 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $436.20 – $436.20 | 5 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $69.63 – $69.63 | 5 |
| Ghs st - eval for alt comm CPT 92567 | $39.30 | $59.00 | $15.27 – $57.82 | 12 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $41.01 – $41.01 | 5 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $341.00 | $512.00 | $103.48 – $392.00 | 14 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $144.40 – $144.40 | 5 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $122.19 – $122.19 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $146.96 – $146.96 | 5 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $171.86 – $171.86 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | $15.99 | $24.00 | $13.00 – $23.52 | 14 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $780.72 – $780.72 | 5 |
| Ghs windowing of cast CPT 29730 | not published | not published | $32.46 – $32.46 | 5 |
| Gi inhouse confirmation CPT 87045 | $55.95 | $84.00 | $9.44 – $23.13 | 14 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $197.37 – $197.37 | 5 |
| Glaucoma surgery CPT 66150 | not published | not published | $580.60 – $580.60 | 5 |
| Glaucoma surgery CPT 66155 | not published | not published | $580.60 – $580.60 | 5 |
| Glaucoma surgery CPT 66160 | not published | not published | $580.60 – $580.60 | 5 |
| Glaucoma surgery CPT 66170 | not published | not published | $774.13 – $774.13 | 5 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $916.37 | $1,375.92 | $355.96 – $1,348.41 | 12 |
| Glucagon plasma - sendout CPT 82943 | $13.31 | $19.98 | $10.82 – $19.59 | 14 |
| Glucose 1 hr post dose CPT 82950 | $61.94 | $93.00 | $4.75 – $11.65 | 14 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $51.95 | $78.00 | $6.05 – $14.83 | 14 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $104.57 | $157.00 | $2.87 – $68.60 | 14 |
| Glucose blood quantitative CPT 82947 | $49.95 | $75.00 | $3.93 – $9.64 | 14 |
| Glucose body fluid CPT 82945 | $78.59 | $118.00 | $3.29 – $13.56 | 14 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $42.63 | $64.00 | $12.87 – $31.54 | 14 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $47.29 | $71.00 | $3.92 – $9.61 | 14 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $119.88 | $180.00 | $5.42 – $10.00 | 14 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $111.23 | $167.00 | $4.47 – $8.24 | 14 |
| Goniotomy CPT 65820 | not published | not published | $484.05 – $484.05 | 5 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $8,265.12 | $12,410.09 | $705.14 – $4,379.09 | 14 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $645.54 – $645.54 | 5 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $4,303.03 | $6,461.00 | $25.78 – $6,331.78 | 14 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $5,597.07 | $8,404.00 | $2,174.12 – $8,235.92 | 12 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $10,543.45 | $15,831.00 | $103.77 – $15,514.38 | 14 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $965.52 – $965.52 | 5 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $37,470.50 | $56,262.00 | $90.81 – $343.98 | 12 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,827.35 – $2,827.35 | 5 |
| Great toe with reduction 28495 CPT 28495 | $272.40 | $409.00 | $75.62 – $400.82 | 14 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $518.61 – $518.61 | 5 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $513.77 – $513.77 | 5 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $159.72 – $159.72 | 5 |
| Grfg autol soft tiss dir exc CPT 15769 | $851.15 | $1,278.00 | $330.62 – $1,252.44 | 14 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,094.11 – $1,094.11 | 5 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $907.42 – $907.42 | 5 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,197.51 – $1,197.51 | 5 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,167.60 – $1,167.60 | 5 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,162.58 – $1,162.58 | 5 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $555.39 – $555.39 | 5 |
| G-tube reposition CPT 43761 | not published | not published | $91.00 – $91.00 | 5 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $152.94 – $152.94 | 5 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $305.70 | $459.00 | $9.32 – $35.28 | 12 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $457.56 – $457.56 | 5 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $580.60 – $580.60 | 5 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $354.60 – $354.60 | 5 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $387.06 – $387.06 | 5 |
| Haptoglobin quantitative CPT 83010 | $20.95 | $31.45 | $12.58 – $30.83 | 14 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $77.76 – $77.76 | 5 |
| Harvest auto stem cells CPT 38206 | not published | not published | $79.04 – $79.04 | 5 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $247.36 – $247.36 | 5 |
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.