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 |
|---|---|---|---|---|
| Laryngoplasty laryngeal web CPT 31580 | $11,933.60 | $21,310.00 | not published | 0 |
| Laryngoplasty medialization CPT 31591 | $18,916.80 | $33,780.00 | not published | 0 |
| Laryngoscope w/vc inj CPT 31570 | $5,476.80 | $9,780.00 | not published | 0 |
| Laryngoscopic sensory i&r CPT 92615 | $138.88 | $248.00 | not published | 0 |
| Laryngoscopic sensory vid CPT 92614 | $336.00 | $600.00 | not published | 0 |
| Laryngoscop w/arytenoidectom CPT 31560 | $8,898.40 | $15,890.00 | not published | 0 |
| Laryngoscop w/vc inj + scope CPT 31571 | $12,460.00 | $22,250.00 | not published | 0 |
| Laryngoscopy and dilation CPT 31528 | $10,925.60 | $19,510.00 | not published | 0 |
| Laryngoscopy and dilation CPT 31529 | $9,598.40 | $17,140.00 | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $6,227.20 | $11,120.00 | not published | 0 |
| Laryngoscopy for treatment CPT 31527 | $7,795.20 | $13,920.00 | not published | 0 |
| Laryngoscopy telescopic CPT 31579 | $1,584.80 | $2,830.00 | not published | 0 |
| Laryngoscopy w/biopsy CPT 31535 | $10,404.80 | $18,580.00 | not published | 0 |
| Laryngoscopy w/bx & op scope CPT 31536 | $18,121.60 | $32,360.00 | not published | 0 |
| Laryngoscopy w/exc of tumor CPT 31540 | $9,800.00 | $17,500.00 | not published | 0 |
| Laryngoscopy w/fb & op scope CPT 31531 | $7,655.20 | $13,670.00 | not published | 0 |
| Laryngoscopy w/fb removal CPT 31530 | $5,560.80 | $9,930.00 | not published | 0 |
| Laryngoscopy with biopsy CPT 31576 | $5,224.80 | $9,330.00 | not published | 0 |
| Laryngoscopy with biopsy 31510 CPT 31510 | $8,696.80 | $15,530.00 | not published | 0 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | $3,757.60 | $6,710.00 | not published | 0 |
| Larynscop remve cart + scop CPT 31561 | $8,573.60 | $15,310.00 | not published | 0 |
| Larynscop w/tumr exc + scope CPT 31541 | $17,343.20 | $30,970.00 | not published | 0 |
| Laser surgery eye strands CPT 67031 | $2,951.20 | $5,270.00 | not published | 0 |
| Laser surgery of cervix 57513 CPT 57513 | $5,969.60 | $10,660.00 | not published | 0 |
| Laser surgery of prostate CPT 52648 | $19,493.60 | $34,810.00 | not published | 0 |
| Laser surg penis lesion(s) CPT 54057 | $5,605.60 | $10,010.00 | not published | 0 |
| Laser treatment of retina CPT 67039 | $8,472.80 | $15,130.00 | not published | 0 |
| Laser treatment of retina CPT 67040 | $15,702.40 | $28,040.00 | not published | 0 |
| Lateral canthopexy CPT 21282 | $5,045.60 | $9,010.00 | not published | 0 |
| Lateral thoracic extension HCPCS L1210 | $369.60 | $660.00 | not published | 0 |
| Lateral trochanteric pad HCPCS L1290 | $112.00 | $200.00 | not published | 0 |
| Latex suspension sleeve each HCPCS L6632 | $75.60 | $135.00 | not published | 0 |
| Lat retinacular release open CPT 27425 | $9,564.80 | $17,080.00 | not published | 0 |
| Lavage cannulation maxillary sinus CPT 31000 | $1,612.80 | $2,880.00 | not published | 0 |
| Lavh >250 gms 58553 CPT 58553 | $13,283.20 | $23,720.00 | not published | 0 |
| Lb with mastopexy 15839 CPT 15839 | $6,882.40 | $12,290.00 | not published | 0 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $48,300.00 | $86,250.00 | not published | 0 |
| Lead capillary CPT 83655 | $21.84 | $39.00 | $11.00 – $11.00 | 1 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $48,300.00 | $86,250.00 | not published | 0 |
| Leads any type vad, rep only HCPCS Q0487 | $406.56 | $726.00 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $48,300.00 | $86,250.00 | not published | 0 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | not published | 0 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | not published | 0 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | not published | 0 |
| Lefort ii anterior intrusion CPT 21150 | $11,933.60 | $21,310.00 | not published | 0 |
| Left compres band >=3" <5"/yd HCPCS A6449 | $6.79 | $12.12 | not published | 0 |
| Left compres band <3"/yd HCPCS A6448 | $1.68 | $3.00 | not published | 0 |
| Left compres band >=5"/yd HCPCS A6450 | $8.80 | $15.72 | not published | 0 |
| Legg perthes orth newington HCPCS L1710 | $2,517.20 | $4,495.00 | not published | 0 |
| Legg perthes orthosis trilat HCPCS L1720 | $1,856.40 | $3,315.00 | not published | 0 |
| Legg perthes orth scottish r HCPCS L1730 | $1,593.20 | $2,845.00 | not published | 0 |
| Legg perthes patten bottom t HCPCS L1755 | $2,217.60 | $3,960.00 | not published | 0 |
| Legion pneumo dna dir prob CPT 87540 | $203.28 | $363.00 | $19.00 – $19.00 | 1 |
| Legion pneumo dna quant CPT 87542 | $420.00 | $750.00 | $38.00 – $38.00 | 1 |
| Leg perthes orth toronto typ HCPCS L1700 | $2,150.40 | $3,840.00 | not published | 0 |
| Leg vein fusion 34530 CPT 34530 | $7,789.60 | $13,910.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,803.20 | $3,220.00 | not published | 0 |
| Leishmania antibody CPT 86717 | $124.32 | $222.00 | $11.00 – $11.00 | 1 |
| Lengthening of hand tendon CPT 26478 | $2,508.80 | $4,480.00 | not published | 0 |
| Lengthening of palate CPT 42227 | $11,933.60 | $21,310.00 | not published | 0 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | $11,933.60 | $21,310.00 | not published | 0 |
| Lengthening of thigh tendon CPT 27393 | $7,968.80 | $14,230.00 | not published | 0 |
| Lengthening of thigh tendons CPT 27394 | $12,045.60 | $21,510.00 | not published | 0 |
| Lengthening of thigh tendons CPT 27395 | $7,968.80 | $14,230.00 | not published | 0 |
| Lengthen metacarpal/finger CPT 26568 | $10,035.20 | $17,920.00 | not published | 0 |
| Lengthen radius or ulna CPT 25391 | $16,990.40 | $30,340.00 | not published | 0 |
| Lengthen radius & ulna CPT 25393 | $7,968.80 | $14,230.00 | not published | 0 |
| Lens, intraocular (new tech) HCPCS C1780 | $48,300.00 | $86,250.00 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $1,131.20 | $2,020.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $3,778.14 | $6,746.67 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $2,128.00 | $3,800.00 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $209.41 | $373.94 | $3.95 – $3.95 | 1 |
| Leukacyte transfusion CPT 86950 | $403.20 | $720.00 | $184.00 – $184.00 | 1 |
| Leukocyte phagocytosis CPT 86344 | $80.64 | $144.00 | $10.00 – $10.00 | 1 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $20,794.82 | $37,133.61 | $155.00 – $155.00 | 1 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $20,965.50 | $37,438.40 | $1,737.00 – $1,737.00 | 1 |
| Leuprolide acetate injeciton HCPCS J9218 | $1,322.50 | $2,361.60 | not published | 0 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $221.00 – $221.00 | 1 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $51.00 – $51.00 | 1 |
| Lev 1 hosp type b ed visit HCPCS G0380 | $472.08 | $843.00 | not published | 0 |
| Lev 2 hosp type b ed visit HCPCS G0381 | $872.48 | $1,558.00 | not published | 0 |
| Lev 3 hosp type b ed visit HCPCS G0382 | $1,621.76 | $2,896.00 | not published | 0 |
| Lev 4 hosp type b ed visit HCPCS G0383 | $2,712.64 | $4,844.00 | not published | 0 |
| Lev 5 hosp type b ed visit HCPCS G0384 | $4,220.16 | $7,536.00 | not published | 0 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $2.53 – $2.53 | 1 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.30 – $0.30 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.09 – $0.09 | 1 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $152.49 | $272.30 | $0.05 – $0.05 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $24.64 | $44.00 | $13.00 – $13.00 | 1 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $102.54 | $183.11 | $1.96 – $1.96 | 1 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $490.00 – $490.00 | 1 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | not published | not published | $7.74 – $7.74 | 1 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $6,104.00 | $10,900.00 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $25,158.00 | $44,925.00 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $46.02 | $82.18 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $40.54 | $72.40 | $0.01 – $0.01 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | $112.00 | $200.00 | $14.00 – $14.00 | 1 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $30,744.64 | $54,901.14 | not published | 0 |
| Lift assist for elbow HCPCS L6635 | $266.00 | $475.00 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $84.00 | $150.00 | 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.