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 |
|---|---|---|---|---|
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $2,103.20 | $4,914.00 | $175.45 – $4,815.72 | 13 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | $2,103.20 | $4,914.00 | $47.39 – $1,292.62 | 12 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | $7,817.85 | $18,266.00 | $59.54 – $6,262.20 | 13 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $970.50 – $9,076.82 | 9 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $23.54 | $55.00 | $1.38 – $53.90 | 11 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $15,788.50 | $36,889.00 | $33.20 – $36,151.22 | 15 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $154.08 | $360.00 | $0.64 – $171.50 | 10 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $168.73 – $255.27 | 3 |
| Mesh tiss ovitex lpr 15x15x25cm 6mm oval HCPCS C9364 | $13,212.36 | $30,870.00 | $14.14 – $8,140.86 | 13 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $261.94 | $612.00 | $2.05 – $599.76 | 12 |
| Metabolic Blood Panel (Basic) CPT 80048 | $279.92 | $654.00 | $8.46 – $23.52 | 17 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $384.35 | $898.00 | $5.59 – $27.19 | 17 |
| Metabolic panel ionized ca CPT 80047 | $65.49 | $153.00 | $8.17 – $49.00 | 17 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $26.97 | $63.00 | $0.30 – $61.74 | 10 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $186.61 | $436.00 | $3.42 – $61.74 | 12 |
| Methotrexate therapeutic drug level CPT 80204 | $13.60 | $31.77 | $15.89 – $99.38 | 15 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $3,230.98 | $7,549.00 | $0.61 – $52.92 | 14 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $139.53 | $326.00 | $8.10 – $319.48 | 11 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $790.52 | $1,847.00 | $0.92 – $1,810.06 | 10 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $9.42 | $22.00 | $0.38 – $21.56 | 10 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $58.64 | $137.00 | $11.25 – $24.50 | 8 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $484.07 | $1,131.00 | $24.30 – $52.92 | 8 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $32.10 | $75.00 | $1.70 – $19.60 | 11 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $23.12 | $54.00 | $24.30 – $52.92 | 8 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $65.92 | $154.00 | $69.30 – $150.92 | 8 |
| Mgmt promoter methylation analysis CPT 81287 | $276.32 | $645.60 | $124.64 – $313.60 | 14 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $960.44 | $2,244.00 | $0.42 – $1,099.56 | 11 |
| Microbe susceptible mlc CPT 87187 | $20.30 | $47.41 | $16.18 – $103.50 | 17 |
| Microdissection manual CPT 88381 | $69.45 | $162.26 | $81.13 – $489.51 | 12 |
| Microsatellite instability CPT 81301 | $203.30 | $475.00 | $124.85 – $898.08 | 16 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $210.62 – $332.01 | 3 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $329.56 | $770.00 | $0.18 – $52.92 | 11 |
| Middle cerebral artery echo CPT 76821 | $163.07 | $381.00 | $82.17 – $511.83 | 15 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $403.18 | $942.00 | $2.16 – $108.78 | 10 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $4,859.94 | $11,355.00 | $35.92 – $1,764.00 | 15 |
| Mitomycin instillation HCPCS J9281 | $16,468.16 | $38,477.00 | $282.12 – $37,707.46 | 16 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $1,649.52 | $3,854.00 | $33.65 – $3,776.92 | 15 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $2,221.55 – $3,501.94 | 3 |
| Mlh1 gene CPT 81288 | $156.22 | $365.00 | $182.50 – $495.54 | 15 |
| Mlh1 gene dup/delete variant CPT 81294 | $114.14 | $266.66 | $115.91 – $521.50 | 16 |
| Mlh1 gene full seq CPT 81292 | $114.16 | $266.72 | $72.77 – $1,740.24 | 16 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $677.58 – $16,348.58 | 9 |
| Mnl appl strs jt radiography CPT 77071 | $267.93 | $626.00 | $24.56 – $613.48 | 15 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | not published | not published | $72.60 – $109.84 | 3 |
| Mnl prep&insj i-artic rx dev CPT 20704 | not published | not published | $125.47 – $189.83 | 3 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $120.63 – $182.50 | 3 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $110.66 – $2,033.48 | 9 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $301.94 – $2,033.48 | 9 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $276.25 – $1,882.11 | 9 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $115.35 – $181.84 | 3 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,165.67 – $1,763.54 | 3 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $460.91 – $697.31 | 3 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $237.54 | $555.00 | $57.20 – $112.11 | 7 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $10,163.72 | $23,747.00 | $4,201.18 – $17,900.68 | 12 |
| Mopath procedure level 1 CPT 81400 | $140.82 | $329.00 | $20.31 – $164.78 | 15 |
| Mopath procedure level 3 CPT 81402 | $108.72 | $254.00 | $123.88 – $387.32 | 15 |
| Mopath procedure level 5 CPT 81404 | $516.17 | $1,206.00 | $72.77 – $708.13 | 15 |
| Mopath procedure level 6 CPT 81405 | $742.76 | $1,735.40 | $72.77 – $776.47 | 15 |
| Mopath procedure level 7 CPT 81406 | $516.17 | $1,206.00 | $72.77 – $728.86 | 15 |
| Mopath procedure level 8 CPT 81407 | $556.40 | $1,300.00 | $72.77 – $2,180.52 | 15 |
| Mopath procedure level 9 CPT 81408 | $650.56 | $1,520.00 | $72.77 – $5,153.20 | 15 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $235.40 | $550.00 | $1.53 – $52.92 | 11 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $57.78 | $135.00 | $9.00 – $20.00 | 11 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $194.56 | $454.56 | $22.50 – $743.65 | 15 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $47.08 | $110.00 | $41.00 – $202.40 | 15 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $194.56 | $454.56 | $27.50 – $208.66 | 15 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $272.15 – $4,120.64 | 9 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $2,354.00 | $5,500.00 | $22.50 – $897.01 | 15 |
| M/phmtrc alys skeletal musc CPT 88355 | $30.89 | $72.15 | $36.08 – $156.93 | 15 |
| Mpl gene analysis common variants CPT 81338 | $210.26 | $491.25 | $100.00 – $387.32 | 14 |
| MRA abdomen post contrast CPT 74185 | $2,294.08 | $5,360.00 | $476.26 – $3,331.02 | 12 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $1,885.77 | $4,406.00 | $329.74 – $2,096.00 | 12 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $2,099.34 | $4,905.00 | $330.05 – $3,320.24 | 12 |
| MRA pelvis CPT 72198 | $2,099.34 | $4,905.00 | $331.39 – $2,955.68 | 12 |
| MRI breast without cont bi CPT 77047 | $1,581.89 | $3,696.00 | $214.07 – $3,294.76 | 15 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $2,199.07 | $5,138.00 | $361.03 – $4,605.02 | 15 |
| MRI chest without contrast CPT 71550 | $1,879.35 | $4,391.00 | $307.13 – $3,585.82 | 15 |
| MRI chest without & w/contrast CPT 71552 | $3,062.77 | $7,156.00 | $453.77 – $5,836.88 | 15 |
| MRI chest w IV cont CPT 71551 | $2,293.66 | $5,359.00 | $374.13 – $4,805.92 | 15 |
| MRI guid ndl plc s&i CPT 77021 | $1,959.82 | $4,579.00 | $366.76 – $4,487.42 | 12 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,892.19 | $4,421.00 | $307.13 – $3,292.80 | 15 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $3,784.38 | $8,842.00 | $333.68 – $6,585.60 | 15 |
| MRI orbit fac&nck w IV cont CPT 70542 | $2,389.10 | $5,582.00 | $264.84 – $5,005.84 | 15 |
| MRI tmj CPT 70336 | $2,140.86 | $5,002.00 | $307.13 – $4,447.24 | 12 |
| MRI without fol w/cont, breast HCPCS C8908 | $3,318.29 | $7,753.00 | $453.77 – $6,890.38 | 12 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $39.81 | $93.00 | $46.50 – $91.14 | 6 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $39.81 | $93.00 | $46.50 – $91.14 | 6 |
| Msh2 gene dup/delete variant CPT 81297 | $114.14 | $266.66 | $115.91 – $549.61 | 16 |
| Msh2 gene full seq CPT 81295 | $114.14 | $266.66 | $72.77 – $983.51 | 16 |
| Msh6 gene dup/delete variant CPT 81300 | $114.14 | $266.66 | $115.91 – $613.23 | 16 |
| Msh6 gene full seq CPT 81298 | $114.14 | $266.66 | $72.77 – $1,653.78 | 16 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $2,242.48 – $3,534.95 | 3 |
| Mthfr gene analy common variants CPT 81291 | $25.68 | $60.00 | $30.00 – $168.35 | 13 |
| M.tuberculo dna dir probe CPT 87555 | $42.80 | $100.00 | $26.88 – $83.30 | 17 |
| Mucopolysaccharides CPT 83864 | $172.96 | $404.10 | $22.86 – $97.13 | 17 |
| Mumps antibody igg CPT 86735 | $6.54 | $15.26 | $2.50 – $33.61 | 17 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $995.43 – $2,324.22 | 9 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $1,079.59 – $4,651.63 | 9 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $1,078.31 – $4,651.63 | 9 |
| Muscle transfers CPT 23397 | not published | not published | $1,099.24 – $9,076.82 | 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.