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 |
|---|---|---|---|---|
| Ketogenic steroids fract CPT 83582 | $145.60 | $260.00 | $14.00 – $14.00 | 1 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $142.80 | $255.00 | $8.00 – $8.00 | 1 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $10.68 | $19.08 | $0.35 – $0.35 | 1 |
| Kidney endoscopy CPT 50551 | $4,384.80 | $7,830.00 | not published | 0 |
| Kidney endoscopy CPT 50553 | $10,718.40 | $19,140.00 | not published | 0 |
| Kidney endoscopy CPT 50570 | $5,129.60 | $9,160.00 | not published | 0 |
| Kidney endoscopy CPT 50575 | $11,457.60 | $20,460.00 | not published | 0 |
| Kidney endoscopy & biopsy CPT 50555 | $6,624.80 | $11,830.00 | not published | 0 |
| Kidney endoscopy & biopsy CPT 50574 | $3,326.40 | $5,940.00 | not published | 0 |
| Kidney endoscopy & treatment CPT 50557 | $9,744.00 | $17,400.00 | not published | 0 |
| Kidney endoscopy & treatment CPT 50561 | $10,718.40 | $19,140.00 | not published | 0 |
| Kidney endoscopy & treatment CPT 50576 | $7,431.20 | $13,270.00 | not published | 0 |
| Kidney endoscopy & treatment CPT 50580 | $7,582.40 | $13,540.00 | not published | 0 |
| Kidney function study CPT 78725 | $1,248.80 | $2,230.00 | $537.00 – $537.00 | 1 |
| Kidney imaging morphology CPT 78700 | $1,825.60 | $3,260.00 | $537.00 – $537.00 | 1 |
| Kidney imag w/bld flow multi CPT 78709 | $1,646.40 | $2,940.00 | $719.00 – $719.00 | 1 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $2,144.80 | $3,830.00 | $719.00 – $719.00 | 1 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $901.60 | $1,610.00 | $142.00 – $142.00 | 1 |
| Kit case 4.2mm spinejack HCPCS C1062 | $5,247.90 | $9,371.25 | not published | 0 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $199.36 | $356.00 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $48,300.00 | $86,250.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $660.80 | $1,180.00 | $54.00 – $54.00 | 1 |
| Kit hfx iq ipg bundle HCPCS C1822 | $23,940.00 | $42,750.00 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $2,156.00 | $3,850.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $7,278.53 | $12,997.38 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $4,525.14 | $8,080.60 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $8,196.40 | $14,636.42 | not published | 0 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $4,998.00 | $8,925.00 | not published | 0 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,904.00 | $3,400.00 | not published | 0 |
| Kit trach suct cls 30.5cm HCPCS A4605 | $35.26 | $62.96 | not published | 0 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | $10,018.40 | $17,890.00 | not published | 0 |
| Knee arthroscopy/drainage CPT 29871 | $10,018.40 | $17,890.00 | not published | 0 |
| Knee arthroscopy dx CPT 29870 | $8,769.60 | $15,660.00 | not published | 0 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | $7,324.80 | $13,080.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29850 | $5,622.40 | $10,040.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29851 | $6,070.40 | $10,840.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29873 | $9,822.40 | $17,540.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29874 | $10,018.40 | $17,890.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29875 | $10,018.40 | $17,890.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29876 | $4,340.00 | $7,750.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29879 | $5,034.40 | $8,990.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29880 | $9,996.00 | $17,850.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29882 | $6,014.40 | $10,740.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29883 | $5,129.60 | $9,160.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29884 | $8,769.60 | $15,660.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29886 | $8,769.60 | $15,660.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29887 | $10,040.80 | $17,930.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29888 | $18,200.00 | $32,500.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29889 | $16,396.80 | $29,280.00 | not published | 0 |
| Knee cap medial or lateral p HCPCS L2800 | $151.20 | $270.00 | not published | 0 |
| Knee control condylar pad HCPCS L2810 | $112.00 | $200.00 | not published | 0 |
| Knee control full kneecap HCPCS L2795 | $120.40 | $215.00 | not published | 0 |
| Knee disart expand wall sock HCPCS L5653 | $733.60 | $1,310.00 | not published | 0 |
| Knee disarticulat leather so HCPCS L5640 | $873.60 | $1,560.00 | not published | 0 |
| Knee disc/dial lock/adj flex HCPCS L2425 | $159.60 | $285.00 | not published | 0 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | $159.60 | $285.00 | not published | 0 |
| Knee joint cam lock each joi HCPCS L2415 | $134.40 | $240.00 | not published | 0 |
| Knee joint drop lock ea jnt HCPCS L2405 | $98.00 | $175.00 | not published | 0 |
| Knee lift loop drop lock rin HCPCS L2492 | $126.00 | $225.00 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $6,199.20 | $11,070.00 | $616.00 – $616.00 | 1 |
| Knee MRI (with contrast) CPT 73722 | $4,160.80 | $7,430.00 | $1,054.00 – $1,054.00 | 1 |
| Knee MRI (without contrast) CPT 73721 | $3,438.40 | $6,140.00 | $323.00 – $323.00 | 1 |
| Knee orth pos locking joint HCPCS L1831 | $324.80 | $580.00 | not published | 0 |
| Knee-shin exo fluid swing ph HCPCS L5724 | $2,170.00 | $3,875.00 | not published | 0 |
| Knee-shin exo frct swg & sta HCPCS L5718 | $1,366.40 | $2,440.00 | not published | 0 |
| Knee-shin exo frict swg & st HCPCS L5712 | $646.80 | $1,155.00 | not published | 0 |
| Knee-shin exo mech stance ph HCPCS L5716 | $1,094.80 | $1,955.00 | not published | 0 |
| Knee-shin exo mnl lock ultra HCPCS L5711 | $784.00 | $1,400.00 | not published | 0 |
| Knee-shin exo variable frict HCPCS L5714 | $562.80 | $1,005.00 | not published | 0 |
| Knee-shin ext jnts fld swg e HCPCS L5726 | $2,217.60 | $3,960.00 | not published | 0 |
| Knee-shin fluid swg & stance HCPCS L5728 | $3,567.20 | $6,370.00 | not published | 0 |
| Knee-shin pneum/hydra pneum HCPCS L5780 | $1,716.40 | $3,065.00 | not published | 0 |
| Knee-shin pneum swg frct exo HCPCS L5722 | $1,220.80 | $2,180.00 | not published | 0 |
| Knee-shin sys hydraul stance HCPCS L5848 | $1,187.20 | $2,120.00 | not published | 0 |
| Knee-shin sys stance flexion HCPCS L5845 | $1,979.60 | $3,535.00 | not published | 0 |
| Knee X-ray CPT 73564 | $672.00 | $1,200.00 | $142.00 – $142.00 | 1 |
| Kne-shin exo sng axi mnl loc HCPCS L5710 | $540.40 | $965.00 | not published | 0 |
| Kne sing axis fric shin sach HCPCS L5200 | $4,513.60 | $8,060.00 | not published | 0 |
| Ko dbl upright w/air pre cst HCPCS L1847 | $635.60 | $1,135.00 | not published | 0 |
| Ko derot ant cruciate custom HCPCS L1840 | $1,296.40 | $2,315.00 | not published | 0 |
| Ko elastic w/joints pre ots HCPCS L1812 | $147.59 | $263.56 | not published | 0 |
| Ko rigid without joints pre ots HCPCS L1836 | $148.40 | $265.00 | not published | 0 |
| Ko single upright pre cst HCPCS L1843 | $988.40 | $1,765.00 | not published | 0 |
| Ko single upright prefab ots HCPCS L1851 | $800.24 | $1,429.00 | not published | 0 |
| Ko supracondylar socket mold HCPCS L1860 | $1,512.00 | $2,700.00 | not published | 0 |
| Ko swedish type pre ots HCPCS L1850 | $406.00 | $725.00 | not published | 0 |
| Ko w/0 joint rigid molded to HCPCS L1834 | $1,033.20 | $1,845.00 | not published | 0 |
| Ko w adj flex/ext rotat mold HCPCS L1846 | $1,495.20 | $2,670.00 | not published | 0 |
| Ko w/adj jt rot cntrl molded HCPCS L1844 | $2,237.20 | $3,995.00 | not published | 0 |
| Kras gene addl variants CPT 81276 | $3,875.20 | $6,920.00 | $85.00 – $85.00 | 1 |
| Kras gene variants exon 2 CPT 81275 | $442.40 | $790.00 | $85.00 – $85.00 | 1 |
| Kyleena, 19.5 mg HCPCS J7296 | $2,125.00 | $3,794.65 | not published | 0 |
| Kyphosis pad HCPCS L1020 | $123.20 | $220.00 | not published | 0 |
| Kyphosis pad floating HCPCS L1025 | $165.20 | $295.00 | not published | 0 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $168.00 | $300.00 | not published | 0 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $248.08 | $443.00 | not published | 0 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $23.55 | $42.06 | $0.39 – $0.39 | 1 |
| Labioplasty 56800 CPT 56800 | $7,145.60 | $12,760.00 | not published | 0 |
| Lacer molded to patient mode HCPCS L2330 | $554.40 | $990.00 | not published | 0 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $175.92 | $314.14 | 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.