San Rafael Medical Center
99 MONTECILLO RD, SAN RAFAEL, CA · Kaiserpermanente · · NPI 1194895227
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 |
|---|---|---|---|---|
| Growth hormone antibody CPT 86277 | $192.64 | $344.00 | $14.00 – $14.00 | 1 |
| Growth hormone panel CPT 80428 | $644.00 | $1,150.00 | $62.00 – $62.00 | 1 |
| Growth hormone panel CPT 80430 | $756.00 | $1,350.00 | $120.00 – $120.00 | 1 |
| Growth stimulation gene 2 CPT 83006 | $205.52 | $367.00 | $70.00 – $70.00 | 1 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | $89.04 | $159.00 | not published | 0 |
| Grp adapt bhv tx by tech CPT 97154 | $89.04 | $159.00 | not published | 0 |
| Gstr rstcv px v-banded gstp CPT 43842 | $2,917.60 | $5,210.00 | not published | 0 |
| Gstrst open wo constj tube CPT 43830 | $4,418.40 | $7,890.00 | not published | 0 |
| G-tube reposition CPT 43761 | $3,186.40 | $5,690.00 | not published | 0 |
| Gu dilat ureter/urethra s&i CPT 74485 | $5,510.40 | $9,840.00 | $2,734.00 – $2,734.00 | 1 |
| Guided cath fluid drainage 10030 CPT 10030 | $3,315.20 | $5,920.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $10,945.20 | $19,545.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $48,300.00 | $86,250.00 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $48,300.00 | $86,250.00 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $840.00 | $1,500.00 | not published | 0 |
| Gum graft CPT 41870 | $8,181.60 | $14,610.00 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $48,300.00 | $86,250.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | $3,735.20 | $6,670.00 | not published | 0 |
| Hair removal by electrolysis 17380 CPT 17380 | $1,657.60 | $2,960.00 | not published | 0 |
| Hair trnspl 1-15 punch grfts CPT 15775 | $1,108.80 | $1,980.00 | not published | 0 |
| Hair trnspl >15 punch grafts CPT 15776 | $1,108.80 | $1,980.00 | not published | 0 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | $50.40 | $90.00 | not published | 0 |
| Halo cervical into body jack HCPCS L0820 | $2,861.60 | $5,110.00 | not published | 0 |
| Halo cervical into jckt vest HCPCS L0810 | $3,631.60 | $6,485.00 | not published | 0 |
| Halo cerv into milwaukee typ HCPCS L0830 | $4,412.80 | $7,880.00 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $61.61 | $110.02 | $4.68 – $4.68 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $11.94 | $21.32 | $0.83 – $0.83 | 1 |
| Halo repl liner/interface HCPCS L0861 | $238.00 | $425.00 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $46.48 | $83.00 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $4,550.00 | $8,125.00 | not published | 0 |
| Hand restoration multiple fi HCPCS L6905 | $2,200.80 | $3,930.00 | not published | 0 |
| Hand restoration no fingers HCPCS L6910 | $2,144.80 | $3,830.00 | not published | 0 |
| Hand restoration replacmnt g HCPCS L6915 | $910.00 | $1,625.00 | not published | 0 |
| Hand restorat thumb/1 finger HCPCS L6900 | $2,256.80 | $4,030.00 | not published | 0 |
| Hand tendon/muscle transfer CPT 26494 | $9,564.80 | $17,080.00 | not published | 0 |
| Hand tendon reconstruction CPT 26500 | $5,023.20 | $8,970.00 | not published | 0 |
| Hand tendon reconstruction CPT 26502 | $9,564.80 | $17,080.00 | not published | 0 |
| Hand X-ray CPT 73130 | $565.60 | $1,010.00 | $118.00 – $118.00 | 1 |
| Haptoglobin quantitative CPT 83010 | $106.96 | $191.00 | $11.00 – $11.00 | 1 |
| Harness chest/shlder saddle HCPCS L6672 | $254.80 | $455.00 | not published | 0 |
| Harness figure of 8 dual con HCPCS L6676 | $182.00 | $325.00 | not published | 0 |
| Harness figure of 8 sing con HCPCS L6675 | $173.60 | $310.00 | not published | 0 |
| Harvest allogeneic stem cell CPT 38205 | $2,839.20 | $5,070.00 | not published | 0 |
| Harvest auto stem cells CPT 38206 | $6,473.60 | $11,560.00 | not published | 0 |
| Harvest cultured skin graft 15040 CPT 15040 | $4,844.00 | $8,650.00 | not published | 0 |
| Harvest eye tissue alograft CPT 68371 | $6,871.20 | $12,270.00 | not published | 0 |
| Harvest femoropopliteal vein 35572 CPT 35572 | $862.40 | $1,540.00 | not published | 0 |
| Harvest stem cell concentrte CPT 38215 | $2,475.20 | $4,420.00 | not published | 0 |
| Harvest vein for bypass 35500 CPT 35500 | $5,062.40 | $9,040.00 | not published | 0 |
| Hast w/i&r phys/qhp CPT 94452 | $1,120.00 | $2,000.00 | not published | 0 |
| Hast w/oxygen titrate CPT 94453 | $347.20 | $620.00 | not published | 0 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,372.00 | $2,450.00 | $262.00 – $262.00 | 1 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $459.20 | $820.00 | $88.00 – $88.00 | 1 |
| Hba1/hba2 gene fam vrnt CPT 81258 | $856.80 | $1,530.00 | $164.00 – $164.00 | 1 |
| Hbb full gene sequence CPT 81364 | $744.80 | $1,330.00 | $142.00 – $142.00 | 1 |
| Hbb gene com variants CPT 81361 | $1,209.60 | $2,160.00 | $77.00 – $77.00 | 1 |
| Hbb gene dup/del variants CPT 81363 | $459.20 | $820.00 | $88.00 – $88.00 | 1 |
| Hbb gene known fam variant CPT 81362 | $856.80 | $1,530.00 | $164.00 – $164.00 | 1 |
| Hb glycosylated a1c home dev CPT 83037 | $119.84 | $214.00 | $10.00 – $10.00 | 1 |
| Hbot, full body chamber, 30m HCPCS G0277 | $453.60 | $810.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $2,464.00 | $4,400.00 | $263.00 – $263.00 | 1 |
| Hcg free betachain test CPT 84704 | $183.68 | $328.00 | $14.00 – $14.00 | 1 |
| Hcg qualitative CPT 84703 | $174.16 | $311.00 | $6.00 – $6.00 | 1 |
| Hcg quantitative CPT 84702 | $291.20 | $520.00 | $14.00 – $14.00 | 1 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $174.16 | $311.00 | $123.00 – $123.00 | 1 |
| Hc metata joint dislocation anes CPT 28635 | $4,748.80 | $8,480.00 | not published | 0 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | $1,657.60 | $2,960.00 | not published | 0 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | $1,047.20 | $1,870.00 | not published | 0 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | $1,657.60 | $2,960.00 | not published | 0 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | $1,265.60 | $2,260.00 | not published | 0 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | $845.60 | $1,510.00 | not published | 0 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $3,808.00 | $6,800.00 | $719.00 – $719.00 | 1 |
| Hc nm fusion spect CT unlisted CPT 78999 | $369.60 | $660.00 | not published | 0 |
| Hc nm kidney imaging with flow CPT 78701 | $2,620.80 | $4,680.00 | $537.00 – $537.00 | 1 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $4,160.80 | $7,430.00 | $719.00 – $719.00 | 1 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $3,959.20 | $7,070.00 | $1,742.00 – $1,742.00 | 1 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $285.60 | $510.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $3,998.40 | $7,140.00 | $926.00 – $926.00 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $5,975.20 | $10,670.00 | $926.00 – $926.00 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $15,792.00 | $28,200.00 | $926.00 – $926.00 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | $4,071.20 | $7,270.00 | $351.00 – $351.00 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | $1,825.60 | $3,260.00 | $417.00 – $417.00 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | $3,550.40 | $6,340.00 | $249.00 – $249.00 | 1 |
| Head CT scan (with contrast) CPT 70460 | $2,945.60 | $5,260.00 | $238.00 – $238.00 | 1 |
| Head CT scan (without contrast) CPT 70450 | $2,682.40 | $4,790.00 | $145.00 – $145.00 | 1 |
| Hearing loss dup/del analys CPT 81431 | $1,551.20 | $2,770.00 | $297.00 – $297.00 | 1 |
| Hearing loss sequence analys CPT 81430 | $3,712.80 | $6,630.00 | $711.00 – $711.00 | 1 |
| Heart first pass add-on CPT 78496 | $1,232.00 | $2,200.00 | not published | 0 |
| Heart first pass multiple CPT 78483 | $4,015.20 | $7,170.00 | $719.00 – $719.00 | 1 |
| Heart image spect CPT 78494 | $2,150.40 | $3,840.00 | $537.00 – $537.00 | 1 |
| Heart infarct image CPT 78466 | $2,150.40 | $3,840.00 | $537.00 – $537.00 | 1 |
| Heart infarct image (ef) CPT 78468 | $4,009.60 | $7,160.00 | $719.00 – $719.00 | 1 |
| Heavy duty control cable HCPCS L6660 | $140.00 | $250.00 | not published | 0 |
| Heavy metal qual any number CPT 83015 | $68.88 | $123.00 | $19.00 – $19.00 | 1 |
| Heel leather reinforced HCPCS L3440 | $86.80 | $155.00 | not published | 0 |
| Heinz bodies direct CPT 85441 | $52.08 | $93.00 | $3.00 – $3.00 | 1 |
| Heinz bodies induced CPT 85445 | $69.44 | $124.00 | $6.00 – $6.00 | 1 |
| Helicobacter pylori antibody igm CPT 86677 | $128.80 | $230.00 | $16.00 – $16.00 | 1 |
| Hemagglutination inhibition CPT 86280 | $82.88 | $148.00 | $8.00 – $8.00 | 1 |
| Hematocrit CPT 85014 | $74.48 | $133.00 | $2.00 – $2.00 | 1 |
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.