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 |
|---|---|---|---|---|
| Treat toe dislocation CPT 28666 | $7,968.80 | $14,230.00 | not published | 0 |
| Treat toe fracture CPT 28525 | $2,508.80 | $4,480.00 | not published | 0 |
| Treat trigeminal nerve CPT 61790 | $5,924.80 | $10,580.00 | not published | 0 |
| Treat trigeminal tract CPT 61791 | $7,106.40 | $12,690.00 | not published | 0 |
| Treat ulnar fracture CPT 24675 | $1,220.80 | $2,180.00 | not published | 0 |
| Treat ulnar fracture CPT 24685 | $19,857.60 | $35,460.00 | not published | 0 |
| Treat vaginal bleeding CPT 57180 | $1,299.20 | $2,320.00 | not published | 0 |
| Treat wrist bone fracture CPT 25635 | $1,142.40 | $2,040.00 | not published | 0 |
| Treat wrist dislocation CPT 25675 | $1,125.60 | $2,010.00 | not published | 0 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $66,774.33 | $119,239.88 | $141.00 – $141.00 | 1 |
| Treponema pallidum ag if CPT 87285 | $33.60 | $60.00 | $11.00 – $11.00 | 1 |
| Treponema pallidum antibody CPT 86780 | $57.68 | $103.00 | $13.00 – $13.00 | 1 |
| Treprostinil injection HCPCS J3285 | $20,538.91 | $36,676.62 | $55.00 – $55.00 | 1 |
| Treprostinil, non-comp unit HCPCS J7686 | not published | not published | $800.00 – $800.00 | 1 |
| Trg gene rearrangement anal CPT 81342 | $543.20 | $970.00 | $88.00 – $88.00 | 1 |
| Trh stimulation panel CPT 80439 | $655.20 | $1,170.00 | $62.00 – $62.00 | 1 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $8.33 | $14.87 | $0.86 – $0.86 | 1 |
| Triamcinolone a inj prs-free HCPCS J3300 | $219.45 | $391.88 | $24.00 – $24.00 | 1 |
| Triamcinolone diacetate inj HCPCS J3302 | not published | not published | $0.42 – $0.42 | 1 |
| Triamcinolone hexacetonl inj HCPCS J3303 | $21.36 | $38.15 | $2.95 – $2.95 | 1 |
| Trichinella antibody CPT 86784 | $51.52 | $92.00 | $11.00 – $11.00 | 1 |
| Trichomonas assay w/optic CPT 87808 | $54.32 | $97.00 | $14.00 – $14.00 | 1 |
| #tricyclicantidprssnt CPT 80337 | $16.24 | $29.00 | not published | 0 |
| Triglycerides CPT 84478 | $91.84 | $164.00 | $5.00 – $5.00 | 1 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | not published | not published | $5.39 – $5.39 | 1 |
| Trimethobenzamide hci 250mg HCPCS Q0173 | $14.00 | $25.00 | $0.85 – $0.85 | 1 |
| Trimethobenzamide hcl inj HCPCS J3250 | $72.06 | $128.68 | $54.00 – $54.00 | 1 |
| Trim nail(s) HCPCS G0127 | $459.20 | $820.00 | not published | 0 |
| Trim nondyst nails CPT 11719 | $280.00 | $500.00 | not published | 0 |
| Triptorelin pamoate HCPCS J3315 | $9,604.29 | $17,150.52 | $492.00 – $492.00 | 1 |
| Trluml dil aq o/f can without st CPT 66174 | $10,365.60 | $18,510.00 | not published | 0 |
| Trluml dil aq o/f can w/st CPT 66175 | $4,642.40 | $8,290.00 | not published | 0 |
| Trml dstrj ios bvn 1st 2 l/s CPT 64628 | $27,798.40 | $49,640.00 | not published | 0 |
| Trml dstrj ios bvn ea addl CPT 64629 | $492.80 | $880.00 | not published | 0 |
| Trmt of fracture (femoral shaft) 27500 CPT 27500 | $1,120.00 | $2,000.00 | not published | 0 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | $6,165.60 | $11,010.00 | not published | 0 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $1,976.80 | $3,530.00 | not published | 0 |
| Trnscath plc stnt ante carotid art CPT 37218 | $4,911.20 | $8,770.00 | not published | 0 |
| Trnscath plc vas stent w/s&i ea addl artery CPT 37237 | $12,908.00 | $23,050.00 | not published | 0 |
| Trnscath plc vas stent w/s&i ea addl vein CPT 37239 | $18,642.40 | $33,290.00 | not published | 0 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $32,760.00 | $58,500.00 | not published | 0 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $10,679.20 | $19,070.00 | not published | 0 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $4,614.40 | $8,240.00 | not published | 0 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $7,033.60 | $12,560.00 | not published | 0 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $7,033.60 | $12,560.00 | not published | 0 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $3,528.00 | $6,300.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | $11,132.80 | $19,880.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 | $4,418.40 | $7,890.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $7,571.20 | $13,520.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | $6,720.00 | $12,000.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | $6,725.60 | $12,010.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | $5,504.80 | $9,830.00 | not published | 0 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | $8,741.60 | $15,610.00 | not published | 0 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | $739.20 | $1,320.00 | $281.00 – $281.00 | 1 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | $3,232.32 | $5,772.00 | $1,418.00 – $1,418.00 | 1 |
| Troponin quantitative CPT 84484 | $285.60 | $510.00 | $11.00 – $11.00 | 1 |
| Tr retinal les preterm inf CPT 67229 | $2,951.20 | $5,270.00 | not published | 0 |
| Trurl dstrj prst8 tiss rf wv CPT 53854 | $4,228.00 | $7,550.00 | not published | 0 |
| Truskin, per sq centimeter HCPCS Q4167 | $0.56 | $1.00 | not published | 0 |
| Truss addition to std pad wa HCPCS L8320 | $81.20 | $145.00 | not published | 0 |
| Truss add to std pad scrotal HCPCS L8330 | $75.60 | $135.00 | not published | 0 |
| Truss double with standard pad HCPCS L8310 | $201.60 | $360.00 | not published | 0 |
| Truss single with standard pad HCPCS L8300 | $128.80 | $230.00 | not published | 0 |
| Tte w or without contr, cont ecg HCPCS C8930 | $3,158.40 | $5,640.00 | not published | 0 |
| Tte w or without fol w/con,stres HCPCS C8928 | $2,542.40 | $4,540.00 | not published | 0 |
| Tte w or without fol w/cont, com HCPCS C8921 | $3,046.40 | $5,440.00 | not published | 0 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $2,542.40 | $4,540.00 | not published | 0 |
| Tubal Ligation (Laparoscopic) CPT 58670 | $4,323.20 | $7,720.00 | not published | 0 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $170.24 | $304.00 | not published | 0 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | $212.80 | $380.00 | not published | 0 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $330.44 | $590.08 | not published | 0 |
| Tumor cell deplete of harvst CPT 38211 | $2,475.20 | $4,420.00 | not published | 0 |
| Tvh >250 gms 58290 CPT 58290 | $13,647.20 | $24,370.00 | not published | 0 |
| Twelve volt battery utah/equ HCPCS L7364 | $534.80 | $955.00 | not published | 0 |
| Tx atrial fib pulm vein isol CPT 93656 | $39,104.80 | $69,830.00 | not published | 0 |
| Tx closed distal humerus fx CPT 24999 | $1,125.60 | $2,010.00 | not published | 0 |
| Tx closed hip disl traumatic without anes CPT 27250 | $1,260.00 | $2,250.00 | not published | 0 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $5,359.20 | $9,570.00 | not published | 0 |
| Tx closed tib shaft fx without manip CPT 27750 | $1,125.60 | $2,010.00 | not published | 0 |
| Tx contour defects >10.0 cc CPT 11954 | $1,657.60 | $2,960.00 | not published | 0 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | $2,122.40 | $3,790.00 | not published | 0 |
| Tx l/r atrial fib addl CPT 93657 | $4,799.20 | $8,570.00 | not published | 0 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $10,690.40 | $19,090.00 | not published | 0 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $7,991.20 | $14,270.00 | not published | 0 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | $9,357.60 | $16,710.00 | not published | 0 |
| Tx open nsl fx uncomp CPT 21325 | $2,240.00 | $4,000.00 | not published | 0 |
| Tx open nsl sptl fx CPT 21336 | $9,564.80 | $17,080.00 | not published | 0 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $10,925.60 | $19,510.00 | not published | 0 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $1,047.20 | $1,870.00 | not published | 0 |
| Tympanic membrane repair CPT 69610 | $8,820.00 | $15,750.00 | not published | 0 |
| Tympanolysis transcanal 69450 CPT 69450 | $5,325.60 | $9,510.00 | not published | 0 |
| Tympanometry & reflex thresh CPT 92550 | $509.60 | $910.00 | not published | 0 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $2,088.80 | $3,730.00 | not published | 0 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | $14,319.20 | $25,570.00 | not published | 0 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | $14,319.20 | $25,570.00 | not published | 0 |
| Tyms gene com variants CPT 81346 | $1,209.60 | $2,160.00 | $77.00 – $77.00 | 1 |
| Typhoid vaccine oral CPT 90690 | $63.28 | $113.00 | not published | 0 |
| U2af1 gene common variants CPT 81357 | $324.80 | $580.00 | $85.00 – $85.00 | 1 |
| Ua w/micro/comp poc CPT 81000 | $165.76 | $296.00 | $3.00 – $3.00 | 1 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | $17,921.01 | $32,001.80 | $72.00 – $72.00 | 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.