Banner Lassen Medical Center
1800 Spring Ridge Drive, Susanville, CA · Banner Health · · NPI 1538197231
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 |
|---|---|---|---|---|
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $3,705.74 | $6,105.00 | $1,104.95 – $2,614.15 | 11 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $787.53 – $787.53 | 1 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $459.49 – $459.49 | 1 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $909.15 – $909.15 | 1 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $860.01 – $860.01 | 1 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $844.04 – $844.04 | 1 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $909.15 – $909.15 | 1 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $921.44 – $921.44 | 1 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $222.37 – $222.37 | 1 |
| Knee MRI (with and without contrast) CPT 73723 | $3,518.78 | $5,063.00 | $635.04 – $4,911.11 | 12 |
| Knee MRI (with contrast) CPT 73722 | $2,932.20 | $4,219.00 | $753.39 – $4,092.43 | 12 |
| Knee MRI (without contrast) CPT 73721 | $2,345.62 | $3,375.00 | $324.92 – $3,273.75 | 12 |
| Knee X-ray CPT 73564 | $445.42 | $679.00 | $45.70 – $658.63 | 12 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $319.47 | $487.00 | $31.38 – $472.39 | 12 |
| Knee X-ray (3 views, both knees) CPT 73562 | $389.66 | $594.00 | $38.58 – $576.18 | 12 |
| Knee X-ray (standing, both knees) CPT 73565 | $303.73 | $463.00 | $17.61 – $449.11 | 12 |
| Kras gene addl variants CPT 81276 | $110.52 | $197.00 | $38.65 – $255.09 | 12 |
| Kras gene variants exon 2 CPT 81275 | $78.54 | $140.00 | $38.65 – $255.09 | 12 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $47.64 | $86.00 | $27.64 – $83.42 | 12 |
| Lactate dehydrogenase (ldh) CPT 83615 | $11.89 | $19.00 | $1.21 – $8.86 | 12 |
| Lactic acid CPT 83605 | $23.79 | $38.00 | $2.31 – $15.53 | 12 |
| Lactoferrin fecal qualitative CPT 83630 | $30.05 | $48.00 | $3.94 – $46.56 | 12 |
| Lactoferrin fecal quant CPT 83631 | $96.40 | $154.00 | $3.93 – $149.38 | 12 |
| Laparo partial colectomy 44204 CPT 44204 | not published | not published | $1,911.08 – $1,911.08 | 1 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | $1,042.93 – $1,042.93 | 1 |
| Laparoscopy remove adnexa CPT 58661 | not published | not published | $806.80 – $806.80 | 1 |
| Laparo-vag hyst incl t/o CPT 58552 | not published | not published | $1,017.47 – $1,017.47 | 1 |
| Lap colectomy/coloproctostomy 44207 CPT 44207 | not published | not published | $393.15 – $393.15 | 1 |
| Lap enterolysis CPT 44180 | not published | not published | $1,121.70 – $1,121.70 | 1 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $87.24 – $87.24 | 1 |
| Lap ing hernia repair recur CPT 49651 | not published | not published | $532.59 – $532.59 | 1 |
| Lap paraesophag hern repair CPT 43281 | not published | not published | $420.17 – $420.17 | 1 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $1,035.83 | $1,484.00 | $96.71 – $959.33 | 12 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $18,613.05 | $30,664.00 | $3,798.65 – $8,987.05 | 11 |
| Lead capillary CPT 83655 | $8.76 | $14.00 | $2.42 – $17.54 | 12 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $18,613.05 | $30,664.00 | $1,104.95 – $2,614.15 | 11 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $11,966.40 | $19,714.00 | $1,104.95 – $2,614.15 | 11 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $723.56 | $1,194.00 | $48.34 – $1,158.18 | 12 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,017.37 | $1,788.00 | $266.11 – $1,734.36 | 12 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $813.67 | $1,430.00 | $205.16 – $1,387.10 | 12 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $757.50 | $1,250.00 | $48.34 – $1,212.50 | 12 |
| Leishmania antibody CPT 86717 | $24.84 | $39.00 | $2.45 – $37.83 | 12 |
| Lens, intraocular (new tech) HCPCS C1780 | $985.03 | $1,413.00 | $579.33 – $1,370.61 | 11 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,503.69 | $2,157.00 | $243.54 – $576.18 | 11 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $1,503.69 | $2,157.00 | $243.54 – $576.18 | 11 |
| Levetiracetam therapeutic drug level CPT 80177 | $7.51 | $12.00 | $2.65 – $19.44 | 12 |
| Liberta rc ipg HCPCS C1820 | $53,175.63 | $87,604.00 | $2,002.85 – $4,738.45 | 11 |
| Lidocaine therapeutic drug level CPT 80176 | $7.51 | $12.00 | $2.94 – $21.55 | 12 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $2,620,825.43 | $3,759,504.00 | $1,541,396.64 – $3,646,718.88 | 11 |
| Lipase CPT 83690 | $32.55 | $52.00 | $1.38 – $10.03 | 12 |
| Lipoprotein blood high res frac & quant CPT 83701 | $29.42 | $47.00 | $6.77 – $45.59 | 12 |
| Lipoprotein blood quant CPT 83704 | $16.90 | $27.00 | $6.84 – $46.28 | 12 |
| Lipoprotein direct measurement hdl CPT 83718 | $6.89 | $11.00 | $1.64 – $11.14 | 12 |
| Lipoprotein direct measurement ldl CPT 83721 | $20.03 | $32.00 | $1.23 – $13.56 | 12 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $15.65 | $25.00 | $6.84 – $46.27 | 12 |
| Lithium therapeutic drug level CPT 80178 | $12.52 | $20.00 | $1.32 – $19.40 | 12 |
| Liver elastography 91200 CPT 91200 | $325.30 | $314.00 | $31.29 – $304.58 | 12 |
| Liver Function Test CPT 80076 | $67.61 | $108.00 | $1.63 – $19.40 | 12 |
| Liver imaging CPT 78201 | $514.66 | $767.00 | $107.65 – $743.99 | 12 |
| Liver imag w/vasclr flow CPT 78202 | $754.20 | $1,124.00 | $107.65 – $1,090.28 | 12 |
| Liver/spleen imag static only CPT 78215 | $702.54 | $1,047.00 | $80.37 – $1,015.59 | 12 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $609.27 | $908.00 | $80.37 – $880.76 | 12 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.56 | $2.24 | $0.92 – $2.46 | 12 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $361.31 | $635.00 | $21.27 – $615.95 | 12 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,095.63 | $3,683.00 | $35.60 – $3,572.51 | 12 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,746.26 | $3,069.00 | $71.43 – $2,976.93 | 12 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,396.89 | $2,455.00 | $21.27 – $2,381.35 | 12 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,672.12 | $6,465.00 | $71.43 – $6,271.05 | 12 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,060.38 | $5,388.00 | $71.43 – $5,226.36 | 12 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,448.08 | $4,310.00 | $48.34 – $4,180.70 | 12 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $465.76 | $710.00 | $21.27 – $688.70 | 12 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $670.43 | $1,022.00 | $21.27 – $991.34 | 12 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $746.53 | $1,138.00 | $21.27 – $1,103.86 | 12 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $173.84 | $265.00 | $34.29 – $257.05 | 12 |
| Low frequency non-thermal Ultrasound CPT 97610 | $192.32 | $266.00 | $39.74 – $258.02 | 11 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $435.74 | $801.00 | $62.28 – $776.97 | 12 |
| Lung Function Test (Spirometry) CPT 94010 | $285.60 | $525.00 | $31.29 – $509.25 | 12 |
| Lung perfusion imaging CPT 78580 | $756.89 | $1,128.00 | $80.37 – $1,094.16 | 12 |
| Lymphatics/lymph node imaging CPT 78195 | $1,454.73 | $2,168.00 | $107.65 – $2,102.96 | 12 |
| Lymphocyte transformation mitogen CPT 86353 | $98.74 | $155.00 | $9.81 – $150.35 | 12 |
| Macroscopic exam parasite CPT 87169 | $2.23 | $4.00 | $0.86 – $6.27 | 12 |
| Magnesium CPT 83735 | $32.55 | $52.00 | $1.34 – $11.64 | 12 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $1.07 | $4.10 | $1.68 – $8.17 | 12 |
| Mammosite ced HCPCS C1728 | $8,434.26 | $13,895.00 | $5,696.95 – $13,478.15 | 11 |
| Marker biop eviva buckle ss HCPCS A4648 | $687.12 | $1,132.00 | $128.33 – $303.61 | 11 |
| Mastoids complete CPT 70130 | $356.21 | $543.00 | $75.64 – $526.71 | 12 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $53.36 | $87.90 | $16.24 – $38.41 | 12 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $8.14 | $13.00 | $2.89 – $21.22 | 12 |
| Mayo aathr protein s free CPT 85306 | $5.96 | $10.00 | $3.06 – $22.47 | 12 |
| Mayo activated protein c resistance assay CPT 85307 | $60.20 | $101.00 | $3.06 – $22.47 | 12 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $156.50 | $250.00 | $7.71 – $242.50 | 12 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $67.61 | $108.00 | $6.97 – $16.49 | 11 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $78.88 | $126.00 | $4.51 – $10.67 | 11 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $4.38 | $7.00 | $2.87 – $21.68 | 12 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $26.29 | $42.00 | $17.22 – $40.74 | 11 |
| Mayo alpha 1 antitrypsin CPT 82103 | $5.63 | $9.00 | $2.69 – $19.70 | 12 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $38.81 | $62.00 | $3.02 – $57.23 | 12 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $19.41 | $31.00 | $2.46 – $5.82 | 11 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $142.49 | $254.00 | $24.33 – $246.38 | 12 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $93.13 | $166.00 | $18.33 – $161.02 | 12 |
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.