Arroyo Grande Hospital
1400 E Church St, Santa Maria, CA · CommonSpirit Health · · NPI 1760510937
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 |
|---|---|---|---|---|
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $48,075.10 | $112,325.00 | $7,100.10 – $30,252.60 | 12 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $52,882.40 | $123,557.00 | $9,231.28 – $39,333.28 | 12 |
| Icd crtp serena MRI HCPCS C2621 | $22,428.49 | $52,403.00 | $4,201.18 – $17,900.68 | 10 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $7,817.85 | $18,266.00 | $1,910.61 – $8,140.86 | 12 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $755.33 – $929.06 | 3 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $199.08 – $4,120.64 | 9 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $141.41 – $2,058.68 | 9 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $522.92 – $4,122.60 | 9 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $141.83 – $3,484.48 | 9 |
| I&d lacrimal gland CPT 68400 | not published | not published | $209.34 – $1,230.63 | 9 |
| I&d lacrimal sac CPT 68420 | not published | not published | $229.42 – $2,964.26 | 9 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $186.27 – $3,636.52 | 9 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $3,636.52 – $3,636.52 | 6 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $3,636.52 – $3,636.52 | 6 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $719.04 | $1,680.00 | $29.00 – $683.06 | 12 |
| Igh gene rearrange amp meth CPT 81261 | $75.33 | $176.00 | $57.50 – $510.13 | 13 |
| Igh@ var region somatic mutation analy CPT 81263 | $175.48 | $410.00 | $198.00 – $758.87 | 13 |
| Igk rearrangeabn clonal pop CPT 81264 | $75.33 | $176.00 | $67.50 – $445.04 | 13 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $138.87 | $324.44 | $22.50 – $158.72 | 12 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $55.40 | $129.42 | $64.71 – $347.76 | 15 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $175.66 | $410.40 | $20.00 – $174.77 | 15 |
| Ikbkap gene CPT 81260 | $17.39 | $40.61 | $20.31 – $101.28 | 16 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $701.50 – $1,105.81 | 3 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $2,286.49 – $3,604.30 | 3 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,768.93 | $4,133.00 | $135.09 – $4,050.34 | 7 |
| Iliac revasc add-on 37222 CPT 37222 | $7,017.06 | $16,395.00 | $160.31 – $16,067.10 | 9 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $991.16 – $1,562.41 | 3 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $256.38 | $599.00 | $27.00 – $54.00 | 13 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $150.23 | $351.00 | $11.50 – $23.00 | 13 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $598.11 – $8,286.17 | 9 |
| Immune complex assay CPT 86332 | $55.37 | $129.36 | $8.09 – $62.79 | 17 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $106.15 | $248.00 | $5.50 – $53.63 | 17 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $5.50 | $12.83 | $3.50 – $53.63 | 17 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $19.26 | $45.00 | $2.79 – $30.88 | 17 |
| Immunofixation electrophoresis serum CPT 86334 | $94.16 | $220.00 | $4.17 – $57.56 | 17 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $76.70 | $179.20 | $15.90 – $234.51 | 12 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $120.19 | $280.80 | $15.83 – $308.52 | 15 |
| Immunoglobulin assay CPT 86023 | $10.85 | $25.33 | $12.46 – $32.11 | 17 |
| Immunology procedure CPT 86849 | $39.01 | $91.14 | $45.57 – $91.13 | 9 |
| Implant biventricular device 33976 CPT 33976 | not published | not published | $1,611.91 – $2,540.92 | 3 |
| Implant brain electrodes CPT 61531 | not published | not published | $1,078.31 – $1,699.79 | 3 |
| Implant brain electrodes CPT 61533 | not published | not published | $1,332.50 – $2,100.49 | 3 |
| Implant brain electrodes CPT 61760 | not published | not published | $1,137.69 – $1,793.40 | 3 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $83,180.09 | $194,346.00 | $869.40 – $3,704.40 | 12 |
| Implant cochlear device CPT 69930 | not published | not published | $1,293.62 – $40,415.02 | 9 |
| Implant cochlear osia osi300 HCPCS L8690 | $7,817.85 | $18,266.00 | $1,469.70 – $6,262.20 | 12 |
| Implant eye drug system CPT 67027 | not published | not published | $675.01 – $19,522.55 | 9 |
| Implant hormone pellet(s) 11980 CPT 11980 | not published | not published | $88.44 – $507.02 | 9 |
| Implant nerve end CPT 64787 | not published | not published | $264.45 – $416.87 | 3 |
| Implant neuroelectrde addl CPT 61868 | not published | not published | $303.76 – $373.62 | 3 |
| Implant neuroelectrode CPT 61867 | not published | not published | $916.39 – $1,127.16 | 3 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $891.19 – $27,247.24 | 9 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $163.20 – $15,844.78 | 9 |
| Implant neuroelectrodes CPT 64555 | not published | not published | $8,338.82 – $8,338.82 | 6 |
| Implant neuroelectrodes CPT 64561 | not published | not published | $675.35 – $8,338.82 | 8 |
| Implant neurostim arrays CPT 61886 | not published | not published | $434.49 – $38,719.74 | 9 |
| Implant open hernia repair w/mesh 49568 CPT 49568 | not published | not published | $316.67 – $316.67 | 1 |
| Implant single ventricular device 33975 CPT 33975 | not published | not published | $1,192.80 – $1,880.27 | 3 |
| Implant spinal canal cath CPT 62351 | not published | not published | $442.60 – $9,076.82 | 9 |
| Implant spine infusion pump CPT 62361 | not published | not published | $229.85 – $22,456.74 | 9 |
| Implant spine infusion pump CPT 62362 | $21,830.14 | $51,005.00 | $300.76 – $49,984.90 | 14 |
| Implant tcat pulm vlv perq CPT 33477 | not published | not published | $1,116.16 – $1,688.64 | 3 |
| Implant ureter in bowel CPT 50800 | not published | not published | $939.89 – $1,481.59 | 3 |
| Implant ureth bulk agent HCPCS L8606 | $2,103.20 | $4,914.00 | $146.09 – $763.42 | 13 |
| Impl neurostim electr perc CPT 63650 | $8,027.57 | $18,756.00 | $500.71 – $18,380.88 | 14 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | not published | not published | $173.49 – $262.47 | 3 |
| Implnt spinl canal catheter 62350 CPT 62350 | $5,800.69 | $13,553.00 | $299.48 – $13,281.94 | 14 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $503.77 – $16,348.58 | 8 |
| Implt brain chemotx add-on 61517 CPT 61517 | not published | not published | $43.19 – $65.34 | 3 |
| Impltj ntrstrml crnl rng seg CPT 65785 | not published | not published | $1,946.38 – $5,111.45 | 9 |
| Impres&prep auricular prosth CPT 21086 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep def obt prosth CPT 21080 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep facial prosth CPT 21088 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep intrm obt prosth CPT 21079 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep mndbl res prosth CPT 21081 | not published | not published | $7,516.44 – $7,516.44 | 6 |
| Impres&prep nasal prosth CPT 21087 | not published | not published | $7,516.44 – $7,516.44 | 6 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $295.06 – $295.06 | 6 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $7,516.44 – $7,516.44 | 6 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $4,120.64 – $4,120.64 | 6 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $1,882.11 – $1,882.11 | 6 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $1,623.41 | $3,793.00 | $205.20 – $3,717.14 | 14 |
| In-111 pentetreotide HCPCS A9572 | $6,152.50 | $14,375.00 | $2,432.70 – $14,087.50 | 11 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $501.13 – $789.95 | 3 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $415.69 – $9,076.82 | 9 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $622.04 – $4,122.60 | 9 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $1,202.62 – $1,895.76 | 3 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $1,114.20 – $1,756.37 | 3 |
| Incis 1 vertebral seg thorac CPT 22212 | not published | not published | $1,186.40 – $1,870.17 | 3 |
| Incis addl spine segment CPT 22216 | not published | not published | $352.04 – $554.93 | 3 |
| Incise bile duct sphincter CPT 47460 | not published | not published | $860.42 – $1,356.33 | 3 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $241.81 – $2,481.19 | 9 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $145.68 – $1,230.63 | 9 |
| Incise flexor carpi radialis CPT 25001 | not published | not published | $251.30 – $4,122.60 | 9 |
| Incise hand/finger tendon CPT 26460 | not published | not published | $197.37 – $2,033.48 | 9 |
| Incise hip/thigh nerve CPT 64763 | not published | not published | $290.51 – $2,481.19 | 9 |
| Incise hip/thigh nerve CPT 64766 | not published | not published | $484.05 – $2,481.19 | 9 |
| Incise inner ear CPT 69801 | not published | not published | $198.23 – $1,882.11 | 9 |
| Incise inner ear nerve CPT 69915 | not published | not published | $1,512.36 – $4,120.64 | 9 |
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.