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 |
|---|---|---|---|---|
| Antigen therapy services CPT 95149 | $250.32 | $447.00 | not published | 0 |
| Antigen therapy services CPT 95165 | $165.20 | $295.00 | not published | 0 |
| Antigen therapy services CPT 95170 | $201.60 | $360.00 | not published | 0 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $6.57 | $11.73 | $1.49 – $1.49 | 1 |
| Antihemophilic viii/vwf comp HCPCS J7186 | $6.04 | $10.79 | $1.23 – $1.23 | 1 |
| Anti-inhibitor HCPCS J7198 | $8.97 | $16.02 | $2.45 – $2.45 | 1 |
| Anti mog serum - sendout CPT 86362 | $29.68 | $53.00 | $11.00 – $11.00 | 1 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $21.84 | $39.00 | $11.00 – $11.00 | 1 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $29.68 | $53.00 | $11.00 – $11.00 | 1 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | $7,240.80 | $12,930.00 | not published | 0 |
| Antinuclear antibodies CPT 86038 | $53.20 | $95.00 | $11.00 – $11.00 | 1 |
| Antinuclear antibodies titer CPT 86039 | $49.28 | $88.00 | $10.00 – $10.00 | 1 |
| Antiphosphatidylserine antibody CPT 86148 | $58.24 | $104.00 | $14.00 – $14.00 | 1 |
| Antipsychotics nos 1-3 CPT 80342 | $80.08 | $143.00 | $29.00 – $29.00 | 1 |
| Antipsychotics nos 4-6 CPT 80343 | $16.24 | $29.00 | not published | 0 |
| Antipsychotics nos 7/more CPT 80344 | $16.24 | $29.00 | not published | 0 |
| Antistreptolysin o screen CPT 86063 | $71.12 | $127.00 | $5.00 – $5.00 | 1 |
| Antistreptolysin o titer CPT 86060 | $33.60 | $60.00 | $6.00 – $6.00 | 1 |
| Antithrombin iii activity CPT 85300 | $157.92 | $282.00 | $11.00 – $11.00 | 1 |
| Antithrombin iii injection HCPCS J7197 | $13.29 | $23.73 | $4.08 – $4.08 | 1 |
| Antithrombin recombinant HCPCS J7196 | $9.22 | $16.46 | not published | 0 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | $8,845.92 | $15,796.28 | $5,013.00 – $5,013.00 | 1 |
| Antithymocyte globuln rabbit HCPCS J7511 | $1,958.74 | $3,497.75 | $996.00 – $996.00 | 1 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | $4,155.20 | $7,420.00 | not published | 0 |
| Ant sgm img ir flrscn angrph CPT 92287 | $436.80 | $780.00 | not published | 0 |
| Ant sgm img i&r speclr mic CPT 92286 | $504.00 | $900.00 | not published | 0 |
| Ant thrc vrt body tethrg <7 CPT 22836 | $414.40 | $740.00 | not published | 0 |
| Ant thrc vrt body tethrg 8+ CPT 22837 | $414.40 | $740.00 | not published | 0 |
| Aoi transducer/actuator repl HCPCS L8694 | $0.56 | $1.00 | not published | 0 |
| Aortic dysfunction/dilation CPT 81410 | $1,153.60 | $2,060.00 | $220.00 – $220.00 | 1 |
| Aortic dysfunction/dilation CPT 81411 | $3,085.60 | $5,510.00 | $591.00 – $591.00 | 1 |
| Aortic hemiarch graft 33866 CPT 33866 | $2,609.60 | $4,660.00 | not published | 0 |
| Apc gene dup/delet variants CPT 81203 | $980.00 | $1,750.00 | $88.00 – $88.00 | 1 |
| Apc gene full sequence CPT 81201 | $1,780.80 | $3,180.00 | $342.00 – $342.00 | 1 |
| Apc gene known fam variants CPT 81202 | $638.40 | $1,140.00 | $123.00 – $123.00 | 1 |
| Aphakia prosth service temp CPT 92358 | $256.48 | $458.00 | not published | 0 |
| Apheresis immunoads slctv CPT 36516 | $12,952.80 | $23,130.00 | not published | 0 |
| Apheresis plasma CPT 36514 | $6,473.60 | $11,560.00 | not published | 0 |
| Apheresis platelets CPT 36513 | $1,584.80 | $2,830.00 | not published | 0 |
| Apheresis rbc CPT 36512 | $8,411.20 | $15,020.00 | not published | 0 |
| Apheresis wbc CPT 36511 | $4,838.40 | $8,640.00 | not published | 0 |
| Apl(pml-rara) quant - sendout CPT 81315 | $548.80 | $980.00 | $91.00 – $91.00 | 1 |
| Apomorphine hydrochloride HCPCS J0364 | $174.99 | $312.49 | $3.80 – $3.80 | 1 |
| Appendectomy CPT 44950 | $10,886.40 | $19,440.00 | not published | 0 |
| Appendectomy add-on 44955 CPT 44955 | $6,372.80 | $11,380.00 | not published | 0 |
| Appendix Removal (Laparoscopic) CPT 44970 | $22,680.00 | $40,500.00 | not published | 0 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $4,844.00 | $8,650.00 | not published | 0 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $1,148.00 | $2,050.00 | not published | 0 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $232.96 | $416.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $9,469.60 | $16,910.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $1,148.00 | $2,050.00 | not published | 0 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $800.80 | $1,430.00 | not published | 0 |
| Appl bdy cst sho to hip 1thi CPT 29044 | $683.20 | $1,220.00 | not published | 0 |
| Appl bdy cst sho to hip b th CPT 29046 | $772.80 | $1,380.00 | not published | 0 |
| Appl bdy cst sho to hip head CPT 29040 | $834.40 | $1,490.00 | not published | 0 |
| Appl body cast sho to hips CPT 29035 | $1,321.60 | $2,360.00 | not published | 0 |
| Appl cast figure-of-eight CPT 29049 | $772.80 | $1,380.00 | not published | 0 |
| Appl cast plaster velpeau CPT 29058 | $772.80 | $1,380.00 | not published | 0 |
| Appl cast shoulder spica CPT 29055 | $772.80 | $1,380.00 | not published | 0 |
| Appl halo type body cast CPT 29000 | $772.80 | $1,380.00 | not published | 0 |
| Appl hip spica cast1&1/2 CPT 29325 | $778.40 | $1,390.00 | not published | 0 |
| Appl hip spica cast 1 leg CPT 29305 | $890.40 | $1,590.00 | not published | 0 |
| Application clubfoot cast CPT 29450 | $683.20 | $1,220.00 | not published | 0 |
| Application finger splntstatic 29130 CPT 29130 | $436.80 | $780.00 | not published | 0 |
| Application halo femoral CPT 20663 | $7,968.80 | $14,230.00 | not published | 0 |
| Application halo pelvic CPT 20662 | $5,112.80 | $9,130.00 | not published | 0 |
| Application long leg splint 29505 CPT 29505 | $526.40 | $940.00 | not published | 0 |
| Application lower leg splint 29515 CPT 29515 | $532.00 | $950.00 | not published | 0 |
| Application multi layer compression below knee (both sides) CPT 29581 | $879.20 | $1,570.00 | not published | 0 |
| Application of body cast CPT 29010 | $772.80 | $1,380.00 | not published | 0 |
| Application of body cast CPT 29015 | $772.80 | $1,380.00 | not published | 0 |
| Application of cylinder cast 29365 CPT 29365 | $890.40 | $1,590.00 | not published | 0 |
| Application of forearm cast 29075 CPT 29075 | $761.60 | $1,360.00 | not published | 0 |
| Application of long arm cast 29065 CPT 29065 | $772.80 | $1,380.00 | not published | 0 |
| Application of long leg cast CPT 29355 | $828.80 | $1,480.00 | not published | 0 |
| Application of long leg cast 29345 CPT 29345 | $800.80 | $1,430.00 | not published | 0 |
| Application of paste boot 29580 CPT 29580 | $616.00 | $1,100.00 | not published | 0 |
| Application short leg cast 29405 CPT 29405 | $778.40 | $1,390.00 | not published | 0 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $4,844.00 | $8,650.00 | not published | 0 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $4,844.00 | $8,650.00 | not published | 0 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $48,300.00 | $86,250.00 | not published | 0 |
| Appl long leg cast brace CPT 29358 | $772.80 | $1,380.00 | not published | 0 |
| Appl mltpln uni ext fixj sys CPT 20692 | $9,878.40 | $17,640.00 | not published | 0 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $69.44 | $124.00 | not published | 0 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $104.72 | $187.00 | not published | 0 |
| Appl modality 1+lllt po pain CPT 97037 | $75.60 | $135.00 | not published | 0 |
| Appl multlay comprs arm/hand CPT 29584 | $716.80 | $1,280.00 | not published | 0 |
| Appl patllr tdn bearing cast CPT 29435 | $890.40 | $1,590.00 | not published | 0 |
| Appl unipln uni ext fixj sys CPT 20690 | $15,019.20 | $26,820.00 | not published | 0 |
| Apply finger cast 29086 CPT 29086 | $823.20 | $1,470.00 | not published | 0 |
| Apply forearm splintdynamic 29126 CPT 29126 | $800.80 | $1,430.00 | not published | 0 |
| Apply hand/wrist cast 29085 CPT 29085 | $823.20 | $1,470.00 | not published | 0 |
| Apply interstit radiat compl CPT 77778 | $3,880.80 | $6,930.00 | $926.00 – $926.00 | 1 |
| Apply intrcav radiat compl CPT 77763 | $4,328.80 | $7,730.00 | $926.00 – $926.00 | 1 |
| Apply intrcav radiat interm CPT 77762 | $4,328.80 | $7,730.00 | $771.00 – $771.00 | 1 |
| Apply intrcav radiat simple CPT 77761 | $4,502.40 | $8,040.00 | $771.00 – $771.00 | 1 |
| Apply of finger splint 29131 CPT 29131 | $526.40 | $940.00 | not published | 0 |
| Apply rem fixation device CPT 20660 | $4,687.20 | $8,370.00 | not published | 0 |
| Apply rigid leg cast 29445 CPT 29445 | $1,848.00 | $3,300.00 | not published | 0 |
| Apply r&l pulm art bands CPT 33620 | $5,532.80 | $9,880.00 | not published | 0 |
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.