SIERRA VISTA HOSPITAL, INC.
1010 Murray Ave, San Luis Obispo, CA · Adventisthealth · · NPI 1639101116
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 |
|---|---|---|---|---|
| 5% dextrose and 0.45% saline HCPCS S5010 | $82.44 | $916.00 | $916.00 – $1,190.80 | 5 |
| 5% dextrose with potassium HCPCS S5012 | $61.38 | $682.00 | $682.00 – $886.60 | 5 |
| 5' nucleotidase - sendout CPT 83915 | $1.99 | $22.07 | $11.15 – $28.69 | 11 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $1.13 | $12.50 | $12.01 – $21.62 | 11 |
| Abd aorta w/runoff s&i CPT 75630 | $1,495.80 | $16,620.00 | $4,053.89 – $21,606.00 | 11 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $831.42 | $9,238.00 | $225.20 – $12,009.40 | 11 |
| Abdominal CT scan (with contrast) CPT 74160 | $761.04 | $8,456.00 | $225.20 – $10,992.80 | 11 |
| Abdominal CT scan (without contrast) CPT 74150 | $779.04 | $8,656.00 | $134.23 – $11,252.80 | 11 |
| Abdominal MRI (with and without contrast) CPT 74183 | $991.80 | $11,020.00 | $447.92 – $14,326.00 | 11 |
| Abdominal MRI (with contrast) CPT 74182 | $667.08 | $7,412.00 | $447.92 – $9,635.60 | 11 |
| Abdominal MRI (without contrast) CPT 74181 | $845.46 | $9,394.00 | $306.34 – $12,212.20 | 11 |
| Abdominal pad HCPCS L1270 | $42.03 | $467.00 | $118.71 – $607.10 | 11 |
| Abdominal Ultrasound (complete) CPT 76700 | $413.55 | $4,595.00 | $134.23 – $5,393.70 | 11 |
| Abdominal Ultrasound (limited) CPT 76705 | $327.60 | $3,640.00 | $134.23 – $4,732.00 | 11 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $0.18 | $2.00 | $2.00 – $2.60 | 5 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $68.67 | $763.00 | $763.00 – $991.90 | 5 |
| Acetone qualitative CPT 82009 | $19.80 | $220.00 | $4.52 – $286.00 | 11 |
| Acetylcholine receptor modulating antibody CPT 86043 | $4.26 | $47.34 | $12.05 – $61.54 | 11 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $1.80 | $20.00 | $20.00 – $26.00 | 5 |
| Acute hepatitis panel CPT 80074 | $76.77 | $853.00 | $16.25 – $1,108.90 | 11 |
| Acyclovir 400 mg tablet HCPCS J8499 | $126.63 | $1,407.00 | $1.84 – $2.39 | 5 |
| #acylcarnitineprfl CPT 82017 | $4.50 | $50.00 | $16.87 – $65.00 | 11 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $0.90 | $10.00 | $10.00 – $13.00 | 5 |
| Adh-sendout CPT 84588 | $21.26 | $236.25 | $26.00 – $61.09 | 11 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $23.67 | $263.00 | $2.00 – $2.60 | 5 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $149.31 | $1,659.00 | $92.44 – $8,185.00 | 15 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $138.15 | $1,535.00 | $424.08 – $8,185.00 | 15 |
| Administration immunization 1 vaccine CPT 90471 | $12.51 | $139.00 | $92.44 – $166.39 | 11 |
| Administration immunization each additional vaccine CPT 90472 | $27.27 | $303.00 | $17.45 – $334.10 | 11 |
| Administration vaccine hepatitis b HCPCS G0010 | $16.92 | $188.00 | $60.12 – $136.50 | 11 |
| Administration vaccine influenza virus HCPCS G0008 | $8.28 | $92.00 | $60.12 – $119.60 | 11 |
| Administration vaccine pneumococcal HCPCS G0009 | $7.74 | $86.00 | $60.12 – $108.22 | 11 |
| _afb id by dna probe rflx ast CPT 87149 | $20.61 | $229.00 | $20.05 – $124.80 | 11 |
| #afb mycobacteria suscep. #1 CPT 87190 | $5.85 | $65.00 | $7.31 – $84.50 | 11 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $654.66 | $7,274.00 | $1,070.39 – $9,456.20 | 11 |
| Albumin body fluid quantitative each specimen CPT 82042 | $44.10 | $490.00 | $7.54 – $14.00 | 11 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $82.17 | $913.00 | $53.08 – $1,186.90 | 11 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $75.87 | $843.00 | $53.08 – $1,095.90 | 11 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $13.32 | $148.00 | $10.62 – $192.40 | 11 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $56.07 | $623.00 | $5.78 – $42.90 | 11 |
| Albumin serum plasma or whole blood CPT 82040 | $44.10 | $490.00 | $3.91 – $558.60 | 11 |
| Alkaline phosphatase CPT 84075 | $40.77 | $453.00 | $5.18 – $588.90 | 11 |
| Allergen alpha lactalbumin ige CPT 86008 | $0.44 | $4.84 | $4.84 – $32.27 | 11 |
| Allergen egg white ige CPT 86003 | $0.54 | $6.00 | $4.00 – $9.40 | 11 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $196.11 | $2,179.00 | $144.95 – $2,832.70 | 11 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $3,146.04 | $34,956.00 | $5,296.00 – $6,884.80 | 5 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $56.07 | $623.00 | $144.95 – $809.90 | 11 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $19.08 | $212.00 | $144.95 – $275.60 | 11 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $4,028.28 | $44,758.62 | $44,758.62 – $58,186.21 | 5 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $64.53 | $717.00 | $144.95 – $798.20 | 11 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $4.32 | $48.00 | $48.00 – $115.94 | 11 |
| Alpha-fetoprotein tumor marker CPT 82105 | $65.34 | $726.00 | $16.77 – $872.65 | 11 |
| Alprostadil for injection HCPCS J0270 | $1.53 | $17.00 | $17.00 – $22.10 | 5 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $33.84 | $376.00 | $94.45 – $488.80 | 11 |
| Alt/sgpt CPT 84460 | $51.75 | $575.00 | $5.30 – $747.50 | 11 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $1.17 | $13.00 | $13.00 – $16.90 | 5 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $84.15 | $935.00 | $935.00 – $1,215.50 | 5 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $3.06 | $34.00 | $34.00 – $44.20 | 5 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $1.62 | $17.99 | $4.00 – $5.20 | 5 |
| Ammonia CPT 82140 | $53.82 | $598.00 | $14.57 – $396.50 | 11 |
| Amphetamine confirm urine -sendout CPT 80324 | $2.34 | $26.00 | $26.00 – $33.80 | 5 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $16.20 | $180.00 | $180.00 – $234.00 | 5 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $35.46 | $394.00 | $21.48 – $512.20 | 11 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $20.88 | $232.00 | $17.00 – $22.10 | 5 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $4.86 | $54.00 | $54.00 – $70.20 | 5 |
| Amylase CPT 82150 | $13.32 | $148.00 | $6.48 – $16.83 | 11 |
| Analysis gene f2 20210g>a variant CPT 81240 | $8.55 | $95.00 | $65.69 – $123.50 | 11 |
| Analysis gene f5 leiden variant CPT 81241 | $2.61 | $29.00 | $29.00 – $132.07 | 11 |
| An fluoro guide for cvp CPT 77001 | $181.80 | $2,020.00 | $109.71 – $2,626.00 | 11 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $894.88 | $9,943.07 | $2.00 – $2.60 | 5 |
| Ankle X-ray CPT 73610 | $168.39 | $1,871.00 | $111.73 – $2,432.30 | 11 |
| Anora (draw only) CPT 99001 | $2.88 | $32.00 | $28.00 – $36.40 | 5 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $1.40 | $15.56 | $12.88 – $23.18 | 11 |
| Antibody elution rbc reference CPT 86860 | $8.19 | $91.00 | $91.00 – $393.73 | 11 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $14.22 | $158.00 | $18.37 – $46.80 | 11 |
| Antibody id rbc panel CPT 86870 | $103.86 | $1,154.00 | $158.66 – $828.38 | 11 |
| Antibody screen rbc CPT 86850 | $81.00 | $900.00 | $9.77 – $117.00 | 11 |
| Anti mog serum - sendout CPT 86362 | $49.50 | $550.00 | $12.05 – $93.60 | 11 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $8.97 | $99.68 | $12.05 – $129.58 | 11 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $1.50 | $16.68 | $2.00 – $21.69 | 11 |
| Antinuclear antibodies CPT 86038 | $4.50 | $50.00 | $4.00 – $53.63 | 11 |
| Antinuclear antibodies titer CPT 86039 | $2.43 | $27.00 | $11.16 – $35.10 | 11 |
| Antistreptolysin o titer CPT 86060 | $1.26 | $14.00 | $7.30 – $18.20 | 11 |
| Antithrombin iii activity CPT 85300 | $1.08 | $12.00 | $11.85 – $21.33 | 11 |
| Aquaporin-4 antibody cba each CPT 86052 | $65.25 | $725.00 | $12.05 – $682.50 | 11 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $3.06 | $34.00 | $0.80 – $26.00 | 11 |
| Artery xray each vessel 7577426 CPT 75774 | $654.12 | $7,268.00 | $102.82 – $9,448.40 | 11 |
| Artery xray of abdomen 75726-26 CPT 75726 | $811.35 | $9,015.00 | $7,144.24 – $12,859.63 | 11 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $1,091.34 | $12,126.00 | $4,053.89 – $13,772.20 | 11 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $1,370.25 | $15,225.00 | $4,053.89 – $19,792.50 | 11 |
| Artery x-rays lung CPT 75741 | $802.80 | $8,920.00 | $4,053.89 – $11,596.00 | 11 |
| Artery x-rays lung CPT 75746 | $790.29 | $8,781.00 | $4,053.89 – $11,415.30 | 11 |
| Artery x-rays lungs CPT 75743 | $1,034.73 | $11,497.00 | $4,053.89 – $14,946.10 | 11 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $788.58 | $8,762.00 | $7,144.24 – $12,859.63 | 11 |
| Ascenda two piece catheter HCPCS C1772 | $6,239.79 | $69,331.00 | $69,331.00 – $90,130.30 | 5 |
| Assay myeloperoxidase CPT 83876 | $2.25 | $25.00 | $25.00 – $91.55 | 11 |
| Assay of prostaglandin CPT 84150 | $21.04 | $233.75 | $41.77 – $303.88 | 11 |
| Assay of semen fructose CPT 82757 | $5.76 | $64.00 | $17.34 – $83.20 | 11 |
| Assay toxin or antitoxin CPT 87230 | $6.21 | $69.00 | $19.74 – $89.70 | 11 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $35.28 | $392.00 | $4.27 – $509.60 | 11 |
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.