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 |
|---|---|---|---|---|
| Prolactin CPT 84146 | $81.00 | $900.00 | $19.38 – $1,170.00 | 11 |
| Promethazine hcl injection HCPCS J2550 | $8.91 | $99.00 | $99.00 – $128.70 | 5 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $0.18 | $2.00 | $2.00 – $2.60 | 5 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $41.49 | $461.00 | $461.00 – $599.30 | 5 |
| Prosthetic sock multi ply bk HCPCS L8420 | $25.83 | $287.00 | $31.74 – $373.10 | 11 |
| Prost sock sgl ply blw knee ea HCPCS L8470 | $8.91 | $99.00 | $10.89 – $128.70 | 11 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $5.76 | $64.00 | $64.00 – $83.20 | 5 |
| Protect body sock ea pre ots HCPCS L0984 | $73.08 | $812.00 | $78.58 – $1,055.60 | 11 |
| Protein c activity CPT 85303 | $0.90 | $10.00 | $10.00 – $24.91 | 11 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $0.21 | $2.38 | $2.38 – $19.33 | 11 |
| Protein s total CPT 85305 | $1.62 | $18.00 | $11.61 – $23.40 | 11 |
| Protein total 24 hour urine CPT 84156 | $44.10 | $490.00 | $2.75 – $6.61 | 11 |
| Protein total body fluid CPT 84157 | $58.14 | $646.00 | $4.00 – $7.20 | 11 |
| Protein total serum plasma whole blood CPT 84155 | $44.10 | $490.00 | $3.67 – $558.60 | 11 |
| Prothrombin complex kcentra HCPCS J7168 | $1.44 | $16.00 | $2.14 – $20.80 | 11 |
| PSA (Prostate) Test CPT 84153 | $97.38 | $1,082.00 | $3.99 – $33.10 | 11 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $46.80 | $520.00 | $15.52 – $676.00 | 18 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $46.80 | $520.00 | $15.30 – $676.00 | 18 |
| Pt evaluation high complexity patient/family CPT 97163 | $71.55 | $795.00 | $104.99 – $963.30 | 18 |
| Pt evaluation low complexity patient/family CPT 97161 | $68.67 | $763.00 | $104.99 – $991.90 | 18 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $79.47 | $883.00 | $104.99 – $1,147.90 | 18 |
| Pt re-evaluation patient/family CPT 97164 | $51.03 | $567.00 | $72.73 – $678.60 | 18 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $39.42 | $438.00 | $31.06 – $569.40 | 18 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $39.06 | $434.00 | $32.23 – $564.20 | 18 |
| Pt wheelchair management each 15 minutes CPT 97542 | $29.61 | $329.00 | $33.22 – $468.00 | 18 |
| Pulmonary vent imaging CPT 78579 | $210.60 | $2,340.00 | $513.27 – $3,042.00 | 11 |
| Pulse ox single CPT 94760 | $36.18 | $402.00 | $4.36 – $1,616.00 | 14 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $17.73 | $197.00 | $170.82 – $307.48 | 11 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $0.99 | $11.00 | $11.00 – $14.30 | 5 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $313.74 | $3,486.00 | $697.12 – $4,531.80 | 11 |
| Quant diff pulm perf w/imaging CPT 78597 | $210.60 | $2,340.00 | $513.27 – $3,042.00 | 11 |
| Quest t3 uptake CPT 84479 | $103.05 | $1,145.00 | $6.47 – $1,488.50 | 11 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $116.10 | $1,290.00 | $279.85 – $1,677.00 | 11 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $238.05 | $2,645.00 | $697.12 – $3,438.50 | 11 |
| Radphm lcl tumor plr sgl day CPT 78800 | $205.20 | $2,280.00 | $513.27 – $2,964.00 | 11 |
| Rapid Strep Test CPT 87880 | $16.02 | $178.00 | $16.53 – $231.40 | 11 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $111.96 | $1,244.00 | $377.52 – $1,617.20 | 11 |
| Rbc count only automated CPT 85041 | $0.41 | $4.50 | $2.25 – $5.44 | 11 |
| Rbc irradiated each unit HCPCS P9038 | $70.02 | $778.00 | $145.22 – $1,011.40 | 11 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $61.65 | $685.00 | $249.40 – $890.50 | 11 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $51.03 | $567.00 | $184.91 – $737.10 | 11 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $57.24 | $636.00 | $265.41 – $826.80 | 11 |
| Red blood cells washed each unit HCPCS P9022 | $159.48 | $1,772.00 | $368.58 – $2,303.60 | 11 |
| Red cell mass single CPT 78120 | $188.64 | $2,096.00 | $513.27 – $2,724.80 | 11 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $28.26 | $314.00 | $314.00 – $408.20 | 5 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $3.55 | $39.47 | $6.73 – $51.31 | 11 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $54.36 | $604.00 | $257.59 – $741.00 | 18 |
| Remove cva lumen obstruct CPT 75902 | $87.66 | $974.00 | $95.60 – $1,266.20 | 11 |
| Renal function panel CPT 80069 | $105.03 | $1,167.00 | $8.68 – $1,517.10 | 11 |
| Renal venogram bil s&i CPT 75833 | $1,038.24 | $11,536.00 | $4,053.89 – $14,996.80 | 11 |
| Resp virus 6-11 targets CPT 87632 | $219.33 | $2,437.00 | $218.06 – $3,168.10 | 11 |
| Resuscitation cardiopulmonary CPT 92950 | $235.62 | $2,618.00 | $277.22 – $7,057.00 | 14 |
| Resuscitation delivery/birthing room CPT 99465 | $183.24 | $2,036.00 | $273.00 – $2,646.80 | 17 |
| Reticulocyte automated CPT 85045 | $91.17 | $1,013.00 | $3.99 – $1,316.90 | 11 |
| Rheumatoid factor quantitative CPT 86431 | $7.67 | $85.24 | $5.00 – $10.21 | 11 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $4.77 | $53.00 | $53.00 – $68.90 | 5 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $15.66 | $174.00 | $25.46 – $226.20 | 11 |
| Rho d immune globulin inj HCPCS J2790 | $176.22 | $1,958.00 | $1,958.00 – $2,545.40 | 5 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $338.67 | $3,763.00 | $716.57 – $3,408.60 | 11 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $35.91 | $399.00 | $75.22 – $518.70 | 11 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $32.49 | $361.00 | $29.38 – $469.30 | 11 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $2.97 | $33.04 | $11.01 – $42.95 | 11 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $135.54 | $1,506.00 | $513.27 – $1,957.80 | 11 |
| Rsv assay w/optic CPT 87807 | $18.45 | $205.00 | $13.10 – $266.50 | 11 |
| Rubella antibody igg CPT 86762 | $20.97 | $233.00 | $2.75 – $25.90 | 11 |
| Rubeola antibody igg CPT 86765 | $0.25 | $2.75 | $2.75 – $23.18 | 11 |
| Russell viper venom diluted CPT 85613 | $2.18 | $24.25 | $9.58 – $29.25 | 11 |
| Sarscov coronavirus ag ia CPT 87426 | $25.65 | $285.00 | $35.33 – $370.50 | 11 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $298.89 | $3,321.00 | $306.34 – $4,317.30 | 14 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $127.08 | $1,412.00 | $134.23 – $1,895.00 | 14 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $290.61 | $3,229.00 | $134.23 – $3,122.60 | 14 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $285.57 | $3,173.00 | $306.34 – $3,164.20 | 14 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $218.79 | $2,431.00 | $134.23 – $3,107.00 | 14 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $218.79 | $2,431.00 | $134.23 – $3,107.00 | 14 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $1,172.97 | $13,033.00 | $13,033.00 – $16,942.90 | 5 |
| Screening prostate cancer PSA HCPCS G0103 | $39.42 | $438.00 | $19.31 – $569.40 | 11 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $5,959.44 | $66,216.00 | $120.00 – $156.00 | 5 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $38.61 | $429.00 | $5.08 – $557.70 | 11 |
| Semen analysis w/count CPT 89310 | $15.75 | $175.00 | $8.61 – $227.50 | 11 |
| Sheath above knee HCPCS L8410 | $27.18 | $302.00 | $33.14 – $392.60 | 11 |
| Shoe lift elev heel/sole neo HCPCS L3310 | $73.17 | $813.00 | $97.63 – $1,056.90 | 11 |
| Shoulder MRI (with and without contrast) CPT 73223 | $1,010.61 | $11,229.00 | $447.92 – $14,597.70 | 11 |
| Shoulder MRI (with contrast) CPT 73222 | $752.49 | $8,361.00 | $1,006.48 – $10,869.30 | 11 |
| Shoulder MRI (without contrast) CPT 73221 | $573.30 | $6,370.00 | $306.34 – $8,281.00 | 11 |
| Shoulder X-ray CPT 73030 | $177.84 | $1,976.00 | $111.73 – $2,568.80 | 11 |
| Shrinker prosth above knee HCPCS L8460 | $71.37 | $793.00 | $108.79 – $1,030.90 | 11 |
| Shrinker prosth below knee HCPCS L8440 | $53.73 | $597.00 | $68.26 – $776.10 | 11 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $280.26 | $3,114.00 | $134.23 – $4,048.20 | 11 |
| Sickling rbc CPT 85660 | $8.10 | $90.00 | $4.81 – $117.00 | 11 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $46.44 | $516.00 | $516.00 – $670.80 | 5 |
| Sinus CT scan (with and without contrast) CPT 70488 | $715.77 | $7,953.00 | $225.20 – $10,338.90 | 11 |
| Sinus CT scan (with contrast) CPT 70487 | $898.38 | $9,982.00 | $225.20 – $12,976.60 | 11 |
| Sinus CT scan (without contrast) CPT 70486 | $811.44 | $9,016.00 | $134.23 – $9,063.60 | 11 |
| Sirolimus, oral HCPCS J7520 | $4.32 | $48.00 | $48.00 – $62.40 | 5 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $1.17 | $13.00 | $13.00 – $16.90 | 5 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $51.84 | $576.00 | $10.98 – $748.80 | 11 |
| Sling suprapubic suburetheral HCPCS C1771 | $785.07 | $8,723.00 | $7,261.00 – $9,439.30 | 5 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $3.87 | $43.00 | $5.39 – $9.75 | 11 |
| Smear gram stain CPT 87205 | $39.87 | $443.00 | $4.27 – $228.80 | 11 |
| Smear nasal eosinophil CPT 89190 | $18.18 | $202.00 | $5.79 – $262.60 | 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.