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 |
|---|---|---|---|---|
| Endoluminl ivus oct c ea CPT 92979 | $636.30 | $7,070.00 | $4,909.00 – $9,191.00 | 8 |
| Endoscopy swallow (fees) vid CPT 92612 | $185.49 | $2,061.00 | $55.57 – $1,786.20 | 18 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $24.39 | $271.00 | $271.00 – $352.30 | 5 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $1.35 | $15.00 | $15.00 – $19.50 | 5 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $6.57 | $73.00 | $7.85 – $94.90 | 11 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $69.93 | $777.00 | $8.54 – $1,010.10 | 11 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $10.44 | $116.00 | $116.00 – $150.80 | 5 |
| Epstein barr early antigen antibody CPT 86663 | $1.71 | $19.00 | $13.12 – $24.70 | 11 |
| Epstein barr nuclear antigen antibody CPT 86664 | $0.82 | $9.06 | $9.06 – $27.52 | 11 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $0.82 | $9.06 | $7.70 – $32.65 | 11 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $77.67 | $863.00 | $2.99 – $1,121.90 | 11 |
| Ercp biliary & pancreas CPT 74330 | $261.27 | $2,903.00 | $2,903.00 – $3,773.90 | 5 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $20.97 | $233.00 | $233.00 – $302.90 | 5 |
| ER Visit (level 1, minor) CPT 99281 | $49.77 | $553.00 | $108.26 – $316.88 | 11 |
| ER Visit (level 2) CPT 99282 | $224.91 | $2,499.00 | $197.14 – $3,003.80 | 11 |
| ER Visit (level 3) CPT 99283 | $368.73 | $4,097.00 | $350.48 – $5,326.10 | 11 |
| ER Visit (level 4) CPT 99284 | $598.68 | $6,652.00 | $535.72 – $8,647.60 | 11 |
| ER Visit (level 5, high severity) CPT 99285 | $1,192.95 | $13,255.00 | $764.60 – $17,231.50 | 11 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $25.92 | $288.00 | $288.00 – $374.40 | 5 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $0.36 | $4.00 | $2.00 – $2.60 | 5 |
| Esophagus motility study CPT 91010 | $249.75 | $2,775.00 | $479.10 – $3,607.50 | 11 |
| Established Patient Office Visit (level 1) CPT 99211 | $53.19 | $591.00 | $7.82 – $116.00 | 14 |
| Established Patient Office Visit (level 2) CPT 99212 | $21.15 | $235.00 | $31.32 – $133.38 | 14 |
| Established Patient Office Visit (level 3) CPT 99213 | $82.35 | $915.00 | $58.32 – $237.90 | 14 |
| Established Patient Office Visit (level 4) CPT 99214 | $54.27 | $603.00 | $85.61 – $269.10 | 14 |
| Established Patient Office Visit (level 5) CPT 99215 | $56.88 | $632.00 | $116.00 – $321.10 | 14 |
| Estradiol total CPT 82670 | $106.56 | $1,184.00 | $27.94 – $1,539.20 | 11 |
| Estrogens total-sendout CPT 82672 | $0.72 | $8.00 | $8.00 – $39.06 | 11 |
| Ethylene glycol -sendout CPT 82693 | $1.62 | $18.00 | $14.90 – $26.82 | 11 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $20.52 | $228.00 | $228.00 – $296.40 | 5 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $62.91 | $699.00 | $98.11 – $895.70 | 11 |
| Evoked oa emissions ltd CPT 92587 | $58.05 | $645.00 | $277.22 – $1,616.00 | 14 |
| Evoked potentials upper limbs CPT 95925 | $320.67 | $3,563.00 | $277.22 – $4,631.90 | 14 |
| Evoked potential visual not glaucoma CPT 95930 | $247.50 | $2,750.00 | $277.22 – $3,575.00 | 14 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $1,030.68 | $11,452.00 | $8,163.00 – $10,611.90 | 5 |
| Extension per extension per HCPCS L2760 | $228.51 | $2,539.00 | $93.09 – $3,300.70 | 11 |
| External chromosome analysis 20-25 cells CPT 88264 | $16.38 | $182.00 | $144.61 – $260.30 | 11 |
| External newborn metabolic screening panel HCPCS S3620 | $15.86 | $176.25 | $176.25 – $229.13 | 5 |
| External profiling gene expression oncology (breast) mrna 21 genes CPT 81519 | $415.80 | $4,620.00 | $3,873.00 – $6,971.40 | 11 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $16.38 | $182.00 | $95.00 – $258.75 | 11 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $6.30 | $70.00 | $4.50 – $32.27 | 11 |
| Facial bones <3 CPT 70140 | $136.35 | $1,515.00 | $111.73 – $1,969.50 | 11 |
| Factor ix complex HCPCS J7194 | $0.90 | $10.00 | $1.70 – $13.00 | 11 |
| Factor viii CPT 85240 | $4.05 | $45.00 | $17.90 – $58.50 | 11 |
| Factor viii HCPCS J7190 | $0.90 | $10.00 | $1.09 – $13.00 | 11 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $12.24 | $136.00 | $29.98 – $176.80 | 11 |
| Fat/lipids feces qualitative CPT 82705 | $1.35 | $15.00 | $5.10 – $19.50 | 11 |
| Fatty acids nonesterified CPT 82725 | $1.35 | $15.00 | $15.00 – $33.79 | 11 |
| #fecal-sodium CPT 84302 | $60.84 | $676.00 | $4.86 – $878.80 | 11 |
| Femoral lgth sock fx or equa HCPCS L2850 | $75.69 | $841.00 | $86.02 – $1,093.30 | 11 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $15.03 | $167.00 | $11.00 – $14.30 | 5 |
| Ferritin CPT 82728 | $96.12 | $1,068.00 | $13.63 – $1,217.52 | 11 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $105.66 | $1,174.00 | $134.23 – $1,526.20 | 11 |
| Fetal fibronectin CPT 82731 | $203.13 | $2,257.00 | $64.41 – $2,934.10 | 11 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $53.82 | $598.00 | $7.73 – $777.40 | 11 |
| Fetal hemoglobin rosette CPT 85461 | $56.88 | $632.00 | $9.36 – $821.60 | 11 |
| Fetal non stress test CPT 59025 | $160.20 | $1,780.00 | $259.57 – $2,314.00 | 14 |
| #_fet/norfentcnfrmur CPT 80354 | $2.34 | $26.00 | $10.00 – $13.00 | 5 |
| Fibrin degradation d dimer quantitative CPT 85379 | $21.78 | $242.00 | $10.18 – $42.90 | 11 |
| Fibrinogen activity CPT 85384 | $50.76 | $564.00 | $9.72 – $677.93 | 11 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $2,708.01 | $30,089.00 | $4,487.00 – $5,833.10 | 5 |
| Filter vena cava fem denali HCPCS C1880 | $1,039.68 | $11,552.00 | $11,552.00 – $15,017.60 | 5 |
| Flex thermoplastic collar mo HCPCS L0130 | $174.06 | $1,934.00 | $203.07 – $2,514.20 | 11 |
| Flow cytometry interp 16 or more CPT 88189 | $7.50 | $83.31 | $81.99 – $147.58 | 11 |
| Flow cytometry marker each additional CPT 88185 | $2.33 | $25.84 | $14.00 – $47.25 | 11 |
| Flow cytometry one marker technical component CPT 88184 | $7.95 | $88.34 | $27.00 – $828.38 | 11 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $75.87 | $843.00 | $843.00 – $1,095.90 | 5 |
| Fluorescent antibody titer dna CPT 86256 | $0.18 | $2.00 | $2.00 – $21.69 | 11 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $353.88 | $3,932.00 | $115.67 – $5,111.60 | 11 |
| Fluoroguide needle placement CPT 77002 | $230.76 | $2,564.00 | $135.13 – $3,333.20 | 11 |
| Fluoroscopy up to 1 hour CPT 76000 | $160.65 | $1,785.00 | $306.34 – $2,320.50 | 11 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $32.76 | $364.00 | $364.00 – $473.20 | 5 |
| Folic acid CPT 82746 | $94.41 | $1,049.00 | $14.70 – $1,260.90 | 11 |
| Follow-up angiography CPT 75898 | $163.80 | $1,820.00 | $1,820.00 – $7,297.00 | 11 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $6.21 | $69.00 | $6.28 – $89.70 | 11 |
| Fondaparinux sodium HCPCS J1652 | $2.60 | $28.85 | $28.85 – $37.51 | 5 |
| Foot arch support remov prem HCPCS L3030 | $102.42 | $1,138.00 | $91.55 – $1,479.40 | 11 |
| Foot X-ray CPT 73630 | $160.56 | $1,784.00 | $111.73 – $2,319.20 | 11 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1.44 | $16.00 | $16.00 – $20.80 | 5 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $10.80 | $120.00 | $1.47 – $156.00 | 11 |
| _fragile x methylation-sendout CPT 81244 | $27.26 | $302.93 | $44.89 – $344.50 | 11 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $31.32 | $348.00 | $85.98 – $226.20 | 11 |
| Fresh frozen plasma thawing ea un CPT 86927 | $7.56 | $84.00 | $84.00 – $393.73 | 11 |
| Fructosamine glycated protein CPT 82985 | $0.45 | $5.00 | $5.00 – $30.17 | 11 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $319.32 | $3,548.00 | $3,548.00 – $4,612.40 | 5 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $0.45 | $5.00 | $5.00 – $6.50 | 5 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $63.81 | $709.00 | $709.00 – $921.70 | 5 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $0.18 | $2.00 | $2.00 – $2.60 | 5 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $5.04 | $56.00 | $56.00 – $72.80 | 5 |
| Galactose transferase test CPT 82776 | $1.64 | $18.25 | $11.74 – $23.73 | 11 |
| Galectin-3 CPT 82777 | $4.05 | $45.00 | $44.25 – $79.65 | 11 |
| Gammaglobulin iga CPT 82784 | $9.13 | $101.39 | $3.00 – $16.74 | 11 |
| Gammaglobulin ige CPT 82785 | $0.54 | $6.00 | $6.00 – $29.63 | 11 |
| Gamma glutamyltransferase CPT 82977 | $50.94 | $566.00 | $3.91 – $645.24 | 11 |
| Gamunex-c/gammaked HCPCS J1561 | $25.56 | $284.00 | $48.96 – $369.20 | 11 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $102.96 | $1,144.00 | $1,144.00 – $1,487.20 | 5 |
| Gated heart multiple CPT 78473 | $767.88 | $8,532.00 | $513.27 – $11,091.60 | 11 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $73.80 | $820.00 | $820.00 – $1,066.00 | 5 |
| General health panel CPT 80050 | $68.22 | $758.00 | $758.00 – $985.40 | 5 |
| Generator barostim neo2 2014 HCPCS C1767 | $17,887.50 | $198,750.00 | $71,359.00 – $92,766.70 | 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.