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 |
|---|---|---|---|---|
| Ultrasound transabd ea addl gest CPT 76812 | $752.82 | $959.00 | $196.65 – $930.23 | 12 |
| Unlisted transfusion med px CPT 86999 | $208.29 | $301.00 | $4.90 – $291.97 | 11 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $222.38 | $339.00 | $34.29 – $328.83 | 12 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $1,495.90 | $2,629.00 | $35.60 – $2,550.13 | 12 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $1,196.61 | $2,103.00 | $21.27 – $2,039.91 | 12 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $1,917.00 | $3,375.00 | $71.43 – $3,273.75 | 12 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,597.78 | $2,813.00 | $71.43 – $2,728.61 | 12 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,278.00 | $2,250.00 | $48.34 – $2,182.50 | 12 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $385.07 | $587.00 | $21.27 – $569.39 | 12 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $487.41 | $743.00 | $21.27 – $720.71 | 12 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $369.80 – $369.80 | 1 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $386.40 – $386.40 | 1 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $787.20 | $1,200.00 | $35.60 – $1,164.00 | 12 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $737.34 | $1,124.00 | $35.60 – $1,090.28 | 12 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $401.13 – $401.13 | 1 |
| Urea nitrogen CPT 84520 | $26.92 | $43.00 | $0.79 – $41.71 | 12 |
| Urea nitrogen 24 hour urine CPT 84540 | $3.76 | $6.00 | $1.11 – $5.82 | 12 |
| Ureteral reflux study CPT 78740 | $555.59 | $828.00 | $80.37 – $803.16 | 12 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $495.28 | $755.00 | $48.34 – $732.35 | 12 |
| Urethrocystography void s&i CPT 74455 | $733.41 | $1,118.00 | $48.34 – $1,084.46 | 12 |
| Uric acid blood CPT 84550 | $8.76 | $14.00 | $0.90 – $13.58 | 12 |
| Uric acid urine CPT 84560 | $13.77 | $22.00 | $1.02 – $6.96 | 12 |
| Urinalysis microscopic only CPT 81015 | $5.89 | $10.00 | $0.61 – $9.70 | 12 |
| Urinalysis (with microscopy) CPT 81001 | $5.89 | $10.00 | $0.63 – $9.70 | 12 |
| Urinalysis (without microscopy) CPT 81003 | $4.12 | $7.00 | $0.45 – $6.79 | 12 |
| Urine Culture Test CPT 87086 | $13.95 | $25.00 | $1.61 – $13.58 | 12 |
| Urine pregnancy test CPT 81025 | $34.16 | $58.00 | $1.72 – $56.26 | 12 |
| Urography, antegrade CPT 74425 | $579.25 | $883.00 | $71.43 – $856.51 | 12 |
| Use 1st target lesion CPT 76982 | $388.58 | $495.00 | $21.27 – $480.15 | 12 |
| Vaccine Administration (one shot) CPT 90471 | $47.04 | $105.00 | $14.23 – $101.85 | 12 |
| Valproic acid total therapeutic drug level CPT 80164 | $33.18 | $53.00 | $2.71 – $19.87 | 12 |
| Vancomycin peak therapeutic drug level CPT 80202 | $25.67 | $41.00 | $2.71 – $39.77 | 12 |
| Varicella zoster antibody igg CPT 86787 | $28.03 | $44.00 | $1.23 – $18.78 | 12 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $23.82 | $43.00 | $17.63 – $41.71 | 12 |
| Venipuncture <3 yrs other vein CPT 36406 | $22.16 | $40.00 | $16.40 – $38.80 | 12 |
| Venogram ext bil s&i CPT 75822 | $635.66 | $969.00 | $154.80 – $939.93 | 12 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $514.96 | $785.00 | $100.85 – $761.45 | 12 |
| Ventilator each subsequent day CPT 94003 | $691.12 | $1,425.00 | $58.24 – $1,382.25 | 12 |
| Ventilator Management (first day) CPT 94002 | $967.09 | $1,994.00 | $73.92 – $1,934.18 | 12 |
| Version cephalic external CPT 59412 | $841.85 | $745.00 | $305.45 – $722.65 | 11 |
| Very long chain fatty acids CPT 82726 | $97.03 | $155.00 | $3.95 – $150.35 | 12 |
| Video Swallow Study (Modified Barium Swallow) CPT 74230 | $237.47 | $362.00 | $35.60 – $351.14 | 12 |
| Vital capacity test CPT 94150 | $53.86 | $99.00 | $9.19 – $96.03 | 12 |
| Vitamin b-12 CPT 82607 | $11.89 | $19.00 | $3.02 – $21.99 | 12 |
| Vitamin D Test CPT 82306 | $55.71 | $89.00 | $3.69 – $34.19 | 12 |
| Volume measurement urine timed CPT 81050 | $6.48 | $11.00 | $0.73 – $10.67 | 12 |
| Walking (Gait) Training (each 15 minutes) CPT 97116 | $60.01 | $83.00 | $18.61 – $80.51 | 12 |
| Warde 1003990 aldosterone CPT 82088 | $21.28 | $34.00 | $5.33 – $59.76 | 12 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $77.62 | $124.00 | $4.51 – $40.77 | 12 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $6.89 | $11.00 | $2.58 – $18.91 | 12 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $5.63 | $9.00 | $3.69 – $37.04 | 12 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $20.03 | $32.00 | $3.10 – $31.04 | 12 |
| Warde 1015200 kappa light chain free CPT 83521 | $11.89 | $19.00 | $3.45 – $28.50 | 12 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $5.01 | $8.00 | $1.60 – $11.76 | 12 |
| Warde 3008005 oligoclonal bands CPT 83916 | $7.51 | $12.00 | $4.92 – $36.13 | 12 |
| Warde 3016000 west nile virus antibody CPT 86788 | $14.01 | $22.00 | $3.37 – $24.72 | 12 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $14.01 | $22.00 | $2.88 – $21.34 | 12 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $3.18 | $5.00 | $2.05 – $17.97 | 12 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $4.46 | $8.00 | $1.78 – $11.85 | 12 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $6.70 | $12.00 | $3.60 – $26.37 | 12 |
| Warde 3400852 arsenic CPT 82175 | $23.16 | $37.00 | $3.79 – $27.82 | 12 |
| Warde 3708165 mercury urine CPT 83825 | $23.79 | $38.00 | $3.25 – $23.30 | 12 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $31.21 | $49.00 | $3.68 – $47.53 | 12 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $3.82 | $6.00 | $2.41 – $19.02 | 12 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $66.98 | $107.00 | $1.62 – $10.69 | 12 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $8.76 | $14.00 | $5.74 – $56.64 | 12 |
| Warde aldolase CPT 82085 | $3.13 | $5.00 | $1.94 – $14.24 | 12 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $74.49 | $119.00 | $3.37 – $77.60 | 12 |
| Warde amiodarone therapeutic drug level CPT 80151 | $25.04 | $40.00 | $3.73 – $38.80 | 12 |
| Warde analysis gene hfe common variants CPT 81256 | $8.98 | $16.00 | $6.56 – $92.66 | 12 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $49.37 | $88.00 | $22.55 – $143.06 | 12 |
| Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites CPT 80339 | $78.88 | $126.00 | $51.66 – $122.22 | 11 |
| Warde anti-mullerian hormone CPT 82166 | $21.28 | $34.00 | $7.72 – $63.72 | 12 |
| Warde apolipoprotein b CPT 82172 | $40.06 | $64.00 | $2.05 – $21.70 | 12 |
| Warde bile acids CPT 82239 | $8.14 | $13.00 | $3.42 – $24.02 | 12 |
| Warde cadmium blood CPT 82300 | $8.14 | $13.00 | $4.73 – $33.94 | 12 |
| Warde calcitonin CPT 82308 | $19.41 | $31.00 | $5.36 – $39.29 | 12 |
| Warde calculus (stone) infrared CPT 82365 | $15.02 | $24.00 | $2.58 – $23.28 | 12 |
| Warde clozapine therapeutic drug level CPT 80159 | $11.27 | $18.00 | $4.03 – $27.13 | 12 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $35.06 | $56.00 | $4.39 – $38.80 | 12 |
| Warde collagen cross links c-telopeptide CPT 82523 | $39.44 | $63.00 | $3.74 – $27.41 | 12 |
| Warde complement total hemolytic CPT 86162 | $5.10 | $8.00 | $3.28 – $29.82 | 12 |
| Warde copper CPT 82525 | $100.79 | $161.00 | $2.48 – $18.20 | 12 |
| Warde cryoglobulin CPT 82595 | $8.14 | $13.00 | $1.29 – $12.61 | 12 |
| Warde erythropoietin CPT 82668 | $5.01 | $8.00 | $3.28 – $27.57 | 12 |
| Warde estrogen fractionated CPT 82671 | $30.05 | $48.00 | $6.46 – $47.37 | 12 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $7.01 | $11.00 | $2.42 – $19.95 | 12 |
| Warde folic acid rbc CPT 82747 | $14.40 | $23.00 | $3.53 – $22.31 | 12 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $3.76 | $6.00 | $1.94 – $14.22 | 12 |
| Warde gastrin CPT 82941 | $5.01 | $8.00 | $3.28 – $25.87 | 12 |
| Warde growth hormone (hgh) CPT 83003 | $8.14 | $13.00 | $3.33 – $24.45 | 12 |
| Warde haloperidol therapeutic drug level CPT 80173 | $30.67 | $49.00 | $3.16 – $47.53 | 12 |
| Warde helminth antibody strongyloides igg CPT 86682 | $19.75 | $31.00 | $2.60 – $19.07 | 12 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $13.15 | $21.00 | $2.57 – $20.37 | 12 |
| Warde hepatitis a antibody CPT 86708 | $4.46 | $7.00 | $2.48 – $18.17 | 12 |
| Warde hepatitis be antibody CPT 86707 | $11.47 | $18.00 | $2.31 – $17.46 | 12 |
| Warde hepatitis delta agent antibody CPT 86692 | $22.30 | $35.00 | $3.43 – $33.95 | 12 |
| Warde immunofixation electrophoresis urine CPT 86335 | $56.69 | $89.00 | $5.87 – $43.05 | 12 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $10.60 | $19.00 | $2.31 – $18.43 | 12 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $61.38 | $110.00 | $45.10 – $377.59 | 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.