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 |
|---|---|---|---|---|
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $158.85 | $1,765.00 | $273.09 – $2,013.70 | 14 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $28.62 | $318.00 | $318.00 – $413.40 | 5 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $0.27 | $3.00 | $3.00 – $3.90 | 5 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $392.40 | $4,360.00 | $4.00 – $5.20 | 5 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $2.25 | $25.00 | $25.00 – $32.50 | 5 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $1.26 | $14.00 | $14.00 – $32.22 | 11 |
| #hypersens-actinomyces ab CPT 86602 | $1.40 | $15.56 | $10.18 – $20.23 | 11 |
| Hysterosalpingography s&i CPT 74740 | $195.93 | $2,177.00 | $306.34 – $2,830.10 | 11 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $98.82 | $1,098.00 | $1,098.00 – $1,427.40 | 5 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $1,977.48 | $21,972.00 | $953.01 – $28,563.60 | 11 |
| I131 iodide cap, rx HCPCS A9517 | $29.97 | $333.00 | $24.07 – $432.90 | 11 |
| Iaadi respiratory synctial virus CPT 87280 | $50.94 | $566.00 | $13.42 – $735.80 | 11 |
| Ibuprofen injection HCPCS J1741 | $238.59 | $2,651.00 | $2,651.00 – $3,446.30 | 5 |
| Idarubicin hcl injection HCPCS J9211 | $32.31 | $359.00 | $359.00 – $466.70 | 5 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $269.73 | $2,997.00 | $2,997.00 – $3,896.10 | 5 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $7.08 | $78.67 | $40.00 – $188.71 | 11 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $13.84 | $153.73 | $153.73 – $828.38 | 11 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $8.06 | $89.50 | $50.00 – $393.73 | 11 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,452.42 | $16,138.00 | $11.13 – $20,979.40 | 11 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $95.13 | $1,057.00 | $1,057.00 – $1,374.10 | 5 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $103.77 | $1,153.00 | $169.54 – $1,498.90 | 11 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $26.64 | $296.00 | $45.31 – $384.80 | 11 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $79.11 | $879.00 | $20.81 – $1,142.70 | 11 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $0.59 | $6.55 | $6.55 – $37.46 | 11 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $3.24 | $36.00 | $11.98 – $21.56 | 11 |
| Immunodiffusion nes CPT 86329 | $2.43 | $27.00 | $14.05 – $35.10 | 11 |
| Immunofixation electrophoresis serum CPT 86334 | $9.13 | $101.39 | $3.00 – $40.21 | 11 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $22.32 | $248.00 | $118.97 – $322.40 | 11 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $22.32 | $248.00 | $218.74 – $393.73 | 11 |
| Immunology procedure CPT 86849 | $17.53 | $194.78 | $194.78 – $253.21 | 5 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $5,332.86 | $59,254.00 | $329.00 – $427.70 | 5 |
| Implant ureth bulk agent HCPCS L8606 | $192.87 | $2,143.00 | $278.74 – $2,785.90 | 11 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $167.58 | $1,862.00 | $745.62 – $2,420.60 | 11 |
| In-111 pentetreotide HCPCS A9572 | $906.75 | $10,075.00 | $2,000.94 – $13,097.50 | 11 |
| Infect ag drug suscept pheno predict CPT 87900 | $7.70 | $85.50 | $85.50 – $234.63 | 11 |
| Infect ag eia chlamydia trachomatis CPT 87320 | $1.71 | $19.00 | $15.00 – $27.00 | 11 |
| Infect ag eia influenza a or b ea CPT 87400 | $13.86 | $154.00 | $14.13 – $200.20 | 11 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $7.70 | $85.50 | $85.50 – $231.71 | 11 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $7.70 | $85.50 | $85.50 – $463.41 | 11 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $85.32 | $948.00 | $32.77 – $275.60 | 11 |
| Infect ag ia optc obs influenza CPT 87804 | $12.15 | $135.00 | $16.55 – $135.20 | 11 |
| Infect ag if pneumocystis carinii CPT 87281 | $35.46 | $394.00 | $11.98 – $512.20 | 11 |
| Infect ag if varicella zoster CPT 87290 | $44.64 | $496.00 | $13.42 – $496.00 | 11 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $19.62 | $218.00 | $95.80 – $283.40 | 11 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $434.43 | $4,827.00 | $232.00 – $5,802.05 | 11 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $7.70 | $85.50 | $85.50 – $879.59 | 11 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $7.70 | $85.50 | $26.07 – $111.15 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $20.61 | $229.00 | $11.98 – $297.70 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $41.40 | $460.00 | $13.82 – $598.00 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $41.40 | $460.00 | $11.98 – $598.00 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $31.14 | $346.00 | $14.38 – $430.30 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $0.34 | $3.73 | $3.73 – $18.59 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $28.44 | $316.00 | $24.08 – $410.80 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $23.49 | $261.00 | $11.98 – $21.56 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $42.21 | $469.00 | $11.98 – $21.56 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $35.64 | $396.00 | $11.98 – $514.80 | 11 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $33.30 | $370.00 | $35.09 – $130.00 | 11 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $17.28 | $192.00 | $8.00 – $63.16 | 11 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $65.43 | $727.00 | $37.27 – $699.40 | 11 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $434.43 | $4,827.00 | $416.78 – $6,275.10 | 11 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $21.38 | $237.50 | $22.50 – $63.16 | 11 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $48.95 | $543.90 | $41.68 – $707.07 | 11 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $0.72 | $8.00 | $8.00 – $63.16 | 11 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $32.94 | $366.00 | $51.31 – $475.80 | 11 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $44.19 | $491.00 | $142.63 – $638.30 | 11 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $52.56 | $584.00 | $142.63 – $759.20 | 11 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $2.39 | $26.50 | $26.50 – $63.16 | 11 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $23.31 | $259.00 | $259.00 – $750.20 | 11 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $99.27 | $1,103.00 | $262.99 – $1,433.90 | 11 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $39.60 | $440.00 | $42.84 – $84.50 | 11 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $6.53 | $72.50 | $42.84 – $94.25 | 11 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $7.74 | $86.00 | $42.84 – $111.80 | 11 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $7.65 | $85.00 | $75.00 – $153.18 | 11 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $139.59 | $1,551.00 | $142.63 – $2,016.30 | 11 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $128.52 | $1,428.00 | $31.09 – $1,856.40 | 11 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $36.09 | $401.00 | $19.99 – $521.30 | 11 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $31.32 | $348.00 | $273.00 – $1,647.00 | 17 |
| Initiation & management bipap/cpap initial day CPT 94660 | $96.66 | $1,074.00 | $273.00 – $1,647.00 | 17 |
| Inj, bupivacaine liposome HCPCS J0666 | $0.99 | $11.00 | $1.85 – $14.30 | 11 |
| Inj, clevidipine butyrate HCPCS C9248 | $5.49 | $61.00 | $61.00 – $79.30 | 5 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $431.19 | $4,791.00 | $1,045.15 – $6,228.30 | 11 |
| Injection, doxercalciferol HCPCS J1270 | $1.80 | $20.00 | $20.00 – $26.00 | 5 |
| Injection during cath supravalvular aortography CPT 93567 | $37.17 | $413.00 | $30.91 – $536.90 | 11 |
| Injection,onabotulinumtoxina HCPCS J0585 | $5.76 | $64.00 | $6.50 – $83.20 | 11 |
| Injection, renflexis HCPCS Q5104 | $20.34 | $226.00 | $27.00 – $293.80 | 11 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $49.95 | $555.00 | $60.12 – $931.00 | 14 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $28.89 | $321.00 | $283.00 – $931.00 | 8 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $67.32 | $748.00 | $273.09 – $931.00 | 14 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $17.01 | $189.00 | $17.80 – $931.00 | 14 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | $4.41 | $49.00 | $49.00 – $63.70 | 5 |
| Inj ivig privigen 500 mg HCPCS J1459 | $23.22 | $258.00 | $50.74 – $335.40 | 11 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $7.74 | $86.00 | $86.00 – $111.80 | 5 |
| Inj multihance HCPCS A9577 | $22.32 | $248.00 | $248.00 – $322.40 | 5 |
| Inj prohance multipack HCPCS A9576 | $3.42 | $38.00 | $38.00 – $49.40 | 5 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $0.45 | $5.00 | $5.00 – $6.50 | 5 |
| Inj secretin synthetic human HCPCS J2850 | $15.84 | $176.00 | $40.52 – $228.80 | 11 |
| Insert swan-ganz cath CPT 93503 | $375.93 | $4,177.00 | $2,021.06 – $5,430.10 | 12 |
| Insitu hybridization auto CPT 88367 | $7.87 | $87.40 | $87.40 – $828.38 | 11 |
| Insitu hybridization manual CPT 88368 | $11.05 | $122.75 | $122.75 – $828.38 | 11 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $13.58 | $150.87 | $120.00 – $393.73 | 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.