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 |
|---|---|---|---|---|
| Genetic tstg severe inh cond CPT 81443 | $274.05 | $3,045.00 | $2,448.56 – $4,407.41 | 11 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $11.88 | $132.00 | $23.00 – $29.90 | 5 |
| Gentamicin peak therapeutic drug level CPT 80170 | $71.37 | $793.00 | $16.38 – $58.50 | 11 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $20.25 | $225.00 | $102.26 – $292.50 | 11 |
| Ghs flow volume loop CPT 94375 | $109.44 | $1,216.00 | $277.22 – $1,616.00 | 14 |
| Ghs histoplasma antigen CPT 87385 | $10.80 | $120.00 | $13.25 – $97.50 | 11 |
| Ghs HIV antibody CPT 86703 | $76.50 | $850.00 | $13.71 – $54.00 | 11 |
| Ghs low level laser therapy CPT 97039 | $40.14 | $446.00 | $273.00 – $579.80 | 12 |
| Ghs mbp CPT 83873 | $2.34 | $26.00 | $17.20 – $33.80 | 11 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $38.61 | $429.00 | $21.33 – $557.70 | 11 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $40.86 | $454.00 | $80.25 – $590.20 | 11 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $40.86 | $454.00 | $70.48 – $590.20 | 11 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $30.15 | $335.00 | $13.67 – $435.50 | 11 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $32.04 | $356.00 | $53.72 – $462.80 | 11 |
| Ghs musc test done w/n test comp CPT 95886 | $234.63 | $2,607.00 | $109.72 – $3,389.10 | 14 |
| Ghs ot prosthetic training/15 min CPT 97761 | $46.80 | $520.00 | $43.79 – $609.70 | 18 |
| Ghs pacing - transcutaneous CPT 92953 | $122.58 | $1,362.00 | $848.59 – $1,770.60 | 11 |
| Ghs plt ct-manual CPT 85032 | $64.35 | $715.00 | $4.31 – $67.60 | 11 |
| Ghs ppd (tb intradermal) CPT 86580 | $55.80 | $620.00 | $37.13 – $806.00 | 11 |
| Ghs quinidine CPT 80194 | $4.05 | $45.00 | $14.60 – $58.50 | 11 |
| Ghs reticulocyte count CPT 85044 | $104.31 | $1,159.00 | $4.31 – $1,506.70 | 11 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $62.64 | $696.00 | $13.91 – $904.80 | 11 |
| Ghs sedimentation rate CPT 85651 | $37.62 | $418.00 | $4.27 – $543.40 | 11 |
| Ghs semen analysis fert CPT 89320 | $38.88 | $432.00 | $12.31 – $561.60 | 11 |
| Ghs sensitivity (per antimicro) CPT 87184 | $25.74 | $286.00 | $7.48 – $371.80 | 11 |
| Ghs somatosensory testing lower extremit CPT 95926 | $305.55 | $3,395.00 | $277.22 – $4,413.50 | 14 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $156.33 | $1,737.00 | $1,048.00 – $2,258.10 | 14 |
| Ghs urine, porphyrins quant CPT 84120 | $1.26 | $14.00 | $14.00 – $26.48 | 11 |
| Gi inhouse confirmation CPT 87045 | $154.08 | $1,712.00 | $9.44 – $2,225.60 | 11 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $20.88 | $232.00 | $182.45 – $328.40 | 11 |
| Glucose 1 hr post dose CPT 82950 | $72.27 | $803.00 | $4.75 – $1,043.90 | 11 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $14.31 | $159.00 | $3.28 – $206.70 | 11 |
| Glucose blood quantitative CPT 82947 | $59.40 | $660.00 | $3.93 – $793.32 | 11 |
| Glucose body fluid CPT 82945 | $116.46 | $1,294.00 | $3.93 – $98.56 | 11 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $47.34 | $526.00 | $12.87 – $526.00 | 11 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $8.28 | $92.00 | $3.92 – $119.60 | 11 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $3.06 | $34.00 | $34.00 – $44.20 | 5 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $102.96 | $1,144.00 | $18.58 – $1,487.20 | 11 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $101.34 | $1,126.00 | $18.52 – $1,463.80 | 11 |
| Graft axiofill 1000mg HCPCS J3590 | $3,501.90 | $38,910.00 | $23.00 – $29.90 | 5 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $26.64 | $296.00 | $144.95 – $384.80 | 11 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $4,593.60 | $51,040.00 | $7,916.00 – $10,290.80 | 5 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $6,460.20 | $71,780.00 | $1,494.00 – $1,942.20 | 5 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $48.42 | $538.00 | $144.95 – $699.40 | 11 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $1,874.79 | $20,831.00 | $573.00 – $744.90 | 5 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $260.10 | $2,890.00 | $473.00 – $614.90 | 5 |
| Granisetron hcl injection HCPCS J1626 | $4.41 | $49.00 | $49.00 – $63.70 | 5 |
| Gu dilat ureter/urethra s&i CPT 74485 | $260.64 | $2,896.00 | $2,683.84 – $4,830.91 | 11 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $472.50 | $5,250.00 | $83.00 – $107.90 | 5 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $191.70 | $2,130.00 | $2,130.00 – $2,769.00 | 5 |
| Gw stiffened micro access kit HCPCS C1894 | $445.14 | $4,946.00 | $96.00 – $124.80 | 5 |
| Halo cervical into jckt vest HCPCS L0810 | $4,141.62 | $46,018.00 | $3,952.09 – $59,823.40 | 11 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $19.08 | $212.00 | $212.00 – $275.60 | 5 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $68.67 | $763.00 | $763.00 – $991.90 | 5 |
| Hand X-ray CPT 73130 | $166.59 | $1,851.00 | $111.73 – $2,406.30 | 11 |
| Haptoglobin quantitative CPT 83010 | $30.06 | $334.00 | $12.58 – $434.20 | 11 |
| Hcg qualitative CPT 84703 | $80.46 | $894.00 | $7.52 – $295.69 | 11 |
| Hcg quantitative CPT 84702 | $88.56 | $984.00 | $7.80 – $1,121.76 | 11 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $62.55 | $695.00 | $695.00 – $903.50 | 5 |
| Head CT scan (with and without contrast) CPT 70470 | $931.05 | $10,345.00 | $225.20 – $13,448.50 | 11 |
| Head CT scan (with contrast) CPT 70460 | $623.43 | $6,927.00 | $225.20 – $9,005.10 | 11 |
| Head CT scan (without contrast) CPT 70450 | $743.49 | $8,261.00 | $134.23 – $10,739.30 | 11 |
| Heart infarct image CPT 78466 | $282.87 | $3,143.00 | $513.27 – $4,085.90 | 11 |
| Helicobacter pylori antibody igm CPT 86677 | $40.95 | $455.00 | $7.75 – $30.33 | 11 |
| Hematocrit CPT 85014 | $7.74 | $86.00 | $2.00 – $23.00 | 11 |
| Hemodialysis one evaluation CPT 90935 | $568.89 | $6,321.00 | $881.16 – $8,217.30 | 11 |
| Hemoglobin CPT 85018 | $11.43 | $127.00 | $2.37 – $165.10 | 11 |
| Heparin assay CPT 85520 | $65.16 | $724.00 | $13.09 – $941.20 | 11 |
| Heparin bolus from bag HCPCS J1644 | $7.38 | $82.00 | $10.00 – $13.00 | 5 |
| Hepatitis a antibody igm CPT 86709 | $29.34 | $326.00 | $6.00 – $20.27 | 11 |
| Hepatitis b core antibody igm CPT 86705 | $29.79 | $331.00 | $7.80 – $280.80 | 11 |
| Hepatitis b core antibody total CPT 86704 | $0.36 | $4.00 | $4.00 – $21.69 | 11 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $116.64 | $1,296.00 | $134.19 – $1,076.40 | 11 |
| Hepatitis b surface ag quan CPT 87467 | $87.03 | $967.00 | $25.32 – $254.82 | 11 |
| Hepatitis b surface antibody CPT 86706 | $35.55 | $395.00 | $3.00 – $19.33 | 11 |
| Hepatitis c antibody CPT 86803 | $22.95 | $255.00 | $4.13 – $281.27 | 11 |
| Hepatobiliary system imaging CPT 78226 | $276.39 | $3,071.00 | $513.27 – $3,992.30 | 11 |
| Herpes simplex 1 ag if CPT 87274 | $41.67 | $463.00 | $11.98 – $601.90 | 11 |
| Herpes simplex 2 ag if CPT 87273 | $50.22 | $558.00 | $11.98 – $725.40 | 11 |
| Herpes simplex type 1 antibody igg CPT 86695 | $0.90 | $10.00 | $10.00 – $23.74 | 11 |
| Herpes simplex type 2 antibody igg CPT 86696 | $0.90 | $10.00 | $10.00 – $34.83 | 11 |
| Herpes simplex virus isolation CPT 87255 | $1.53 | $17.00 | $17.00 – $60.95 | 11 |
| Heterophile antibodies screening CPT 86308 | $108.99 | $1,211.00 | $5.18 – $1,574.30 | 11 |
| Heterophile antibody absrbj CPT 86310 | $1.35 | $15.00 | $7.37 – $19.50 | 11 |
| Hip joint adjustable flexion HCPCS L2622 | $576.72 | $6,408.00 | $469.85 – $8,330.40 | 11 |
| Hip X-ray CPT 73502 | $142.20 | $1,580.00 | $111.73 – $2,024.10 | 11 |
| Histamine CPT 83088 | $14.55 | $161.62 | $29.53 – $210.11 | 11 |
| Hla i low res one antigen equiv ea CPT 81374 | $2.52 | $28.00 | $28.00 – $133.79 | 11 |
| Hla i typing low res one locus ea CPT 81373 | $18.90 | $210.00 | $127.43 – $273.00 | 11 |
| Hocm 200-249mg/ml iodine,1ml HCPCS Q9960 | $6.66 | $74.00 | $74.00 – $96.20 | 5 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $0.36 | $4.00 | $4.00 – $5.20 | 5 |
| Ho flex pavlik harns pre cst HCPCS L1620 | $120.24 | $1,336.00 | $190.90 – $1,736.80 | 11 |
| Homocysteine CPT 83090 | $0.72 | $8.00 | $8.00 – $32.26 | 11 |
| Homogenization tissue CPT 87176 | $9.99 | $111.00 | $5.88 – $144.30 | 11 |
| Ho post-op hip abduction HCPCS L1686 | $1,747.35 | $19,415.00 | $1,397.63 – $25,239.50 | 11 |
| Human epididymis protein 4 (he4) CPT 86305 | $13.05 | $145.00 | $20.81 – $188.50 | 11 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $0.10 | $1.12 | $1.12 – $1.46 | 5 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | $0.18 | $2.00 | $2.00 – $2.60 | 5 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $69.93 | $777.00 | $53.00 – $68.90 | 5 |
| Hydration IV infusion each additional hour CPT 96361 | $87.93 | $977.00 | $60.12 – $941.17 | 14 |
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.