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 |
|---|---|---|---|---|
| Rheumatoid factor qualitative CPT 86430 | $44.59 | $70.00 | $1.23 – $67.90 | 12 |
| Rheumatoid factor quantitative CPT 86431 | $11.47 | $18.00 | $1.13 – $8.28 | 12 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $434.93 | $663.00 | $21.27 – $643.11 | 12 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $547.10 | $834.00 | $21.27 – $808.98 | 12 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | not published | not published | $182.44 – $182.44 | 1 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $587.12 | $875.00 | $80.37 – $848.75 | 12 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $1,482.91 | $2,210.00 | $261.10 – $2,143.70 | 12 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $1,482.91 | $2,210.00 | $291.72 – $2,143.70 | 12 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $882.18 | $1,690.00 | $104.43 – $1,639.30 | 12 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | not published | not published | $1,363.74 – $1,363.74 | 1 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $993.93 – $993.93 | 1 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $152.96 – $152.96 | 1 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | not published | not published | $91.53 – $91.53 | 1 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $635.18 – $635.18 | 1 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $853.88 – $853.88 | 1 |
| Rsv assay w/optic CPT 87807 | $22.32 | $40.00 | $2.62 – $38.80 | 12 |
| Rubella antibody igg CPT 86762 | $3.82 | $6.00 | $1.23 – $21.10 | 12 |
| Rubeola antibody igg CPT 86765 | $7.01 | $11.00 | $1.64 – $18.89 | 12 |
| Russell viper venom diluted CPT 85613 | $4.17 | $7.00 | $1.92 – $13.94 | 12 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $404.75 | $617.00 | $21.27 – $598.49 | 12 |
| Salmonella antibody CPT 86768 | $14.65 | $23.00 | $2.64 – $22.31 | 12 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $632.66 | $1,044.00 | $48.34 – $1,012.68 | 12 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $313.30 | $517.00 | $21.27 – $501.49 | 12 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $467.83 | $772.00 | $21.27 – $748.84 | 12 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $714.47 | $1,179.00 | $21.27 – $1,143.63 | 12 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $666.60 | $1,100.00 | $140.07 – $1,067.00 | 12 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $699.93 | $1,155.00 | $136.72 – $1,120.35 | 12 |
| Screening Mammogram CPT 77067 | $264.42 | $374.00 | $102.09 – $241.53 | 12 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $79,762.23 | $131,404.00 | $28.70 – $67.90 | 11 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $762.24 | $971.00 | $21.27 – $941.87 | 12 |
| Sedimentation rate erythrocyte automated CPT 85652 | $5.36 | $9.00 | $0.54 – $8.73 | 12 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $69.41 | $96.00 | $8.76 – $93.12 | 12 |
| Semen analysis w/count CPT 89310 | $17.99 | $26.00 | $1.72 – $25.22 | 11 |
| Sept9 promoter methylation analysis CPT 81327 | $224.96 | $401.00 | $38.40 – $388.97 | 11 |
| Serpina1 gene CPT 81332 | $166.06 | $296.00 | $8.73 – $287.12 | 11 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $6,475.07 | $13,895.00 | $128.33 – $303.61 | 11 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $279.51 – $279.51 | 1 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $672.04 – $672.04 | 1 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $632.12 – $632.12 | 1 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $487.13 – $487.13 | 1 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $732.85 – $732.85 | 1 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $83.08 | $129.00 | $14.23 – $125.13 | 12 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $211.89 | $323.00 | $17.61 – $313.31 | 12 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $815.17 – $815.17 | 1 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $218.45 | $333.00 | $35.29 – $323.01 | 12 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,153.11 | $3,098.00 | $637.11 – $3,005.06 | 12 |
| Shoulder MRI (with contrast) CPT 73222 | $1,794.49 | $2,582.00 | $515.39 – $2,504.54 | 12 |
| Shoulder MRI (without contrast) CPT 73221 | $1,435.17 | $2,065.00 | $325.48 – $2,003.05 | 12 |
| Shoulder X-ray CPT 73030 | $388.35 | $592.00 | $42.67 – $574.24 | 12 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $156.13 | $238.00 | $28.55 – $230.86 | 12 |
| Sialography s&i CPT 70390 | $528.74 | $806.00 | $68.19 – $781.82 | 12 |
| Sickling rbc CPT 85660 | $24.44 | $41.00 | $1.10 – $7.46 | 12 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $253.09 – $253.09 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $236.51 – $236.51 | 1 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,220.10 | $2,171.00 | $35.60 – $2,105.87 | 12 |
| Sinus CT scan (with contrast) CPT 70487 | $1,016.66 | $1,809.00 | $35.60 – $1,754.73 | 12 |
| Sinus CT scan (without contrast) CPT 70486 | $813.21 | $1,447.00 | $21.27 – $1,403.59 | 12 |
| Sinus X-ray (complete) CPT 70220 | $331.28 | $505.00 | $17.61 – $489.85 | 12 |
| Sinus X-ray (limited) CPT 70210 | $290.61 | $443.00 | $17.61 – $429.71 | 12 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $11.27 | $18.00 | $7.38 – $17.46 | 11 |
| Skull X-ray (1 to 3 views) CPT 70250 | $198.77 | $303.00 | $21.27 – $293.91 | 12 |
| Skull X-ray (complete) CPT 70260 | $297.17 | $453.00 | $21.27 – $439.41 | 12 |
| Sleep Study (Polysomnography) CPT 95810 | $2,834.20 | $4,895.00 | $153.34 – $574.32 | 12 |
| Sleep study unattended CPT 95806 | $601.92 | $581.00 | $31.29 – $563.57 | 12 |
| Sling suprapubic suburetheral HCPCS C1771 | $10,902.93 | $17,962.00 | $1,102.90 – $2,609.30 | 11 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $314.22 | $479.00 | $35.60 – $464.63 | 12 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $31.81 | $57.00 | $1.08 – $7.90 | 12 |
| Smear gram stain CPT 87205 | $7.25 | $13.00 | $0.85 – $5.71 | 12 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $7.81 | $14.00 | $1.20 – $13.58 | 12 |
| Smear wet mount CPT 87210 | $12.28 | $22.00 | $1.16 – $17.46 | 12 |
| Sodium 24 hour urine CPT 84300 | $17.53 | $28.00 | $1.01 – $7.13 | 12 |
| Sodium serum/plasma/whole blood CPT 84295 | $19.41 | $31.00 | $0.96 – $30.07 | 12 |
| Specific gravity body fluid CPT 84315 | $6.26 | $10.00 | $0.66 – $9.70 | 12 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $601.34 | $1,152.00 | $138.50 – $1,117.44 | 12 |
| Spine X-ray (single view, one level) CPT 72020 | $265.68 | $405.00 | $17.61 – $392.85 | 12 |
| Sputum specimen collection CPT 89220 | $252.58 | $365.00 | $17.04 – $354.05 | 12 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $21,271.71 | $35,044.00 | $243.54 – $576.18 | 11 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $5,623.85 | $9,265.00 | $68.06 – $161.02 | 11 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $21,271.71 | $35,044.00 | $243.54 – $576.18 | 11 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $5,623.85 | $9,265.00 | $579.33 – $1,370.61 | 11 |
| Stimulants synthetic CPT 80371 | $68.86 | $110.00 | $45.10 – $106.70 | 11 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,769.43 | $2,637.00 | $80.37 – $2,557.89 | 12 |
| Strep a ag ia CPT 87430 | $28.46 | $51.00 | $3.36 – $49.47 | 12 |
| Sugars single quant CPT 84378 | $6.89 | $11.00 | $2.31 – $16.90 | 12 |
| Sulfonylurea screen qn-sendout CPT 80377 | $80.13 | $128.00 | $52.48 – $124.16 | 11 |
| Surgical pathology level 1 gross examination only CPT 88300 | $3.80 | $9.00 | $3.69 – $13.81 | 12 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $5.91 | $14.00 | $5.74 – $34.55 | 12 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $12.66 | $30.00 | $10.69 – $50.29 | 12 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $12.66 | $30.00 | $10.69 – $67.63 | 12 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $19.41 | $46.00 | $18.86 – $144.61 | 12 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $19.41 | $46.00 | $18.86 – $306.03 | 12 |
| Susceptibility agar dilution per agent CPT 87181 | $8.93 | $16.00 | $0.95 – $15.52 | 12 |
| Susceptibility mic per plate CPT 87186 | $103.80 | $150.00 | $1.73 – $25.22 | 12 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $35.67 | $56.00 | $0.88 – $26.19 | 12 |
| System pacing micra av HCPCS C1786 | $24,429.87 | $35,044.00 | $7,183.20 – $16,994.40 | 11 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $76,337.43 | $109,504.00 | $7,183.20 – $16,994.40 | 11 |
| T3 (triiodothyronine) free CPT 84481 | $13.15 | $21.00 | $2.46 – $19.68 | 12 |
| T3 (triiodothyronine) total CPT 84480 | $26.92 | $43.00 | $2.84 – $20.77 | 12 |
| T4 (thyroxine) free CPT 84439 | $17.53 | $28.00 | $1.80 – $15.52 | 12 |
| T4 (thyroxine) total CPT 84436 | $3.76 | $6.00 | $1.37 – $8.55 | 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.