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 |
|---|---|---|---|---|
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $402.13 | $613.00 | $71.41 – $594.61 | 12 |
| Cholesterol CPT 82465 | $34.43 | $55.00 | $0.87 – $6.39 | 12 |
| Cholesterol body fluid CPT 84999 | $34.43 | $55.00 | $0.41 – $0.97 | 11 |
| Cholesterol (Lipid) Test CPT 80061 | $63.85 | $102.00 | $2.68 – $37.83 | 12 |
| Cholinesterase CPT 82480 | $6.89 | $11.00 | $1.57 – $11.55 | 12 |
| Chrom analysis CPT 88273 | $265.62 | $285.00 | $6.96 – $276.45 | 12 |
| Chromatography CPT 83021 | $13.77 | $22.00 | $3.61 – $25.41 | 12 |
| Chromogenic substrate assay CPT 85130 | $56.62 | $95.00 | $2.38 – $60.14 | 12 |
| Chromo high res and frag x - sendout CPT 81243 | $50.49 | $90.00 | $11.41 – $87.30 | 12 |
| Chromosome analysis 15-20 cell count CPT 88262 | $125.82 | $135.00 | $25.10 – $177.89 | 12 |
| Chronic urticaria - sendout CPT 86343 | $54.15 | $85.00 | $2.49 – $82.45 | 12 |
| Chylomicron screen, bf - sendout CPT 82664 | $23.16 | $37.00 | $12.30 – $39.62 | 12 |
| Circumcision (newborn) CPT 54150 | $195.89 | $281.00 | $115.21 – $409.70 | 11 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $6,475.07 | $13,895.00 | $663.79 – $1,570.43 | 11 |
| Clip ligating vesolock lg HCPCS C1760 | $13,295.73 | $21,904.00 | $128.33 – $303.61 | 11 |
| Clot factor viii reltd antgn CPT 85244 | $71.52 | $120.00 | $4.08 – $116.40 | 12 |
| Clot factor xii hageman CPT 85280 | $78.67 | $132.00 | $3.87 – $128.04 | 12 |
| Clot factor xiii fibrin scrn CPT 85291 | $49.47 | $83.00 | $1.82 – $80.51 | 12 |
| Clot factor xiii fibrin stab CPT 85290 | $98.34 | $165.00 | $3.27 – $160.05 | 12 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | not published | not published | $364.27 – $364.27 | 1 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | not published | not published | $447.83 – $447.83 | 1 |
| #cmvcul-virus inoculation shell CPT 87254 | $31.25 | $56.00 | $3.91 – $54.32 | 12 |
| Cmv pcr-sendout CPT 87496 | $18.41 | $33.00 | $7.02 – $51.46 | 12 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $2.97 | $6.70 | $0.53 – $6.50 | 11 |
| Coil axium 3d 14mmx40cm qc HCPCS C1770 | $276.80 | $594.00 | $128.33 – $303.61 | 11 |
| Cold agglutinin screen (arc) CPT 86156 | $59.24 | $93.00 | $1.61 – $20.37 | 12 |
| Cold agglutinin titer CPT 86157 | $13.38 | $21.00 | $1.61 – $20.37 | 12 |
| Collagen imp urinary 2.5 ml HCPCS L8603 | $12,232.26 | $20,152.00 | $464.19 – $19,547.44 | 12 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $303.73 | $463.00 | $34.29 – $449.11 | 12 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $213.59 | $306.00 | $25.78 – $296.82 | 11 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $217.78 | $312.00 | $25.78 – $302.64 | 11 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $487.13 – $487.13 | 1 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | not published | not published | $618.60 – $618.60 | 1 |
| Colonoscopy submucous njx CPT 45381 | not published | not published | $681.25 – $681.25 | 1 |
| Colonoscopy w/control bleed CPT 45382 | not published | not published | $685.56 – $685.56 | 1 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $544.88 – $544.88 | 1 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $660.36 – $660.36 | 1 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $252.58 | $365.00 | $34.27 – $354.05 | 11 |
| Compatibility test each unit electronic CPT 86923 | $252.58 | $365.00 | $34.27 – $354.05 | 11 |
| Compatibility test each unit immediate spin technique CPT 86920 | $252.58 | $365.00 | $34.27 – $354.05 | 11 |
| Complement antigen each component c3 CPT 86160 | $154.15 | $242.00 | $2.40 – $17.34 | 12 |
| Concentration infection agents any type CPT 87015 | $43.52 | $78.00 | $1.34 – $20.37 | 12 |
| Conization of cervix CPT 57520 | not published | not published | $425.55 – $425.55 | 1 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $76.38 | $181.00 | $10.69 – $175.57 | 12 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $5.91 | $14.00 | $5.74 – $100.62 | 12 |
| Consult comp w/report rfrd material CPT 88325 | $76.38 | $181.00 | $34.27 – $175.57 | 12 |
| Contrast x-ray of ankle CPT 73615 | $832.37 | $786.00 | $124.23 – $762.42 | 12 |
| Contrast x-ray of elbow CPT 73085 | $844.02 | $797.00 | $118.50 – $773.09 | 12 |
| Contrast x-ray of hip CPT 73525 | $944.63 | $892.00 | $124.23 – $865.24 | 12 |
| Contrast x-ray of knee joint CPT 73580 | $747.65 | $706.00 | $114.21 – $684.82 | 12 |
| Contrast x-ray of wrist CPT 73115 | $434.19 | $410.00 | $67.88 – $397.70 | 12 |
| Controller infinity pt dbs HCPCS C1787 | $8,434.26 | $13,895.00 | $2,002.85 – $4,738.45 | 11 |
| Coombs direct CPT 86880 | $80.90 | $127.00 | $1.08 – $7.90 | 12 |
| Coombs indirect titer reference CPT 86886 | $95.55 | $150.00 | $1.04 – $145.50 | 12 |
| Core ndl bx lng/med perq CPT 32408 | $1,806.12 | $3,460.00 | $324.05 – $3,356.20 | 12 |
| Cortisol total am CPT 82533 | $170.90 | $273.00 | $3.26 – $23.91 | 12 |
| #covid19rsv-rsv CPT 87634 | $117.74 | $211.00 | $14.04 – $204.67 | 12 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $19.11 | $30.00 | $1.23 – $19.11 | 12 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $488.88 | $1,008.00 | $40.68 – $977.76 | 12 |
| C-peptide CPT 84681 | $6.26 | $10.00 | $4.10 – $29.42 | 12 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $331.94 | $683.00 | $62.28 – $662.51 | 12 |
| Crbrospnl fld flw imag cistern CPT 78630 | $580.42 | $865.00 | $107.65 – $839.05 | 12 |
| C-reactive protein CPT 86140 | $10.19 | $16.00 | $1.04 – $9.70 | 12 |
| C-reactive protein high sensitivity CPT 86141 | $36.31 | $57.00 | $2.59 – $50.44 | 12 |
| C-reactive protein, quantitative CPT 86406 | $19.11 | $30.00 | $2.13 – $29.10 | 12 |
| Creatine kinase CPT 82550 | $12.52 | $20.00 | $1.30 – $9.55 | 12 |
| Creatine kinase isoenzymes CPT 82552 | $5.63 | $9.00 | $2.68 – $19.64 | 12 |
| Creatine kinase mb CPT 82553 | $21.91 | $35.00 | $2.31 – $33.95 | 12 |
| Creatine - sendout CPT 82540 | $6.26 | $10.00 | $0.93 – $9.70 | 12 |
| Creatinine CPT 82565 | $28.17 | $45.00 | $1.02 – $43.65 | 12 |
| Creatinine 24 hour urine CPT 82570 | $47.58 | $76.00 | $0.82 – $7.59 | 12 |
| Creatinine clearance urine CPT 82575 | $10.64 | $17.00 | $1.89 – $16.49 | 12 |
| #creutz-prot.,western blot CPT 84182 | $65.73 | $105.00 | $5.84 – $32.32 | 12 |
| Critical care each additional 30 minutes CPT 99292 | $832.03 | $1,712.00 | $97.19 – $1,660.64 | 12 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $1,663.58 | $3,423.00 | $168.52 – $3,320.31 | 12 |
| Cryoprecipitate each unit HCPCS P9012 | $44.06 | $89.00 | $12.71 – $86.33 | 12 |
| Cryptococcus abs qn - sendout CPT 86641 | $59.88 | $94.00 | $2.88 – $91.18 | 12 |
| Cryptosporidium antigen CPT 87272 | $34.04 | $61.00 | $2.40 – $59.17 | 12 |
| Crystal identification light microscopy CPT 89060 | $52.59 | $76.00 | $1.47 – $73.72 | 12 |
| CT 3d report other modality w/workstation CPT 76377 | $461.47 | $912.00 | $373.92 – $884.64 | 11 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $1,281.96 | $2,253.00 | $521.45 – $2,185.41 | 12 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,754.83 | $6,599.00 | $71.43 – $6,401.03 | 12 |
| CT Angiogram of the Abdomen CPT 74175 | $2,380.70 | $4,184.00 | $35.60 – $4,058.48 | 12 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $2,111.03 | $4,172.00 | $35.60 – $4,046.84 | 12 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,446.13 | $4,299.00 | $35.60 – $4,170.03 | 12 |
| CT Angiogram of the Head CPT 70496 | $1,122.31 | $1,997.00 | $35.60 – $1,937.09 | 12 |
| CT Angiogram of the Neck CPT 70498 | $1,161.09 | $2,066.00 | $35.60 – $2,004.02 | 12 |
| CT angio pelvis CPT 72191 | $2,430.77 | $4,272.00 | $35.60 – $4,143.84 | 12 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,169.86 | $2,056.00 | $480.23 – $1,994.32 | 12 |
| CT guidance for needle placement CPT 77012 | $751.92 | $1,486.00 | $183.23 – $1,441.42 | 12 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $593.03 | $1,172.00 | $172.46 – $1,136.84 | 12 |
| CT limited or localized follow-up study CPT 76380 | $537.88 | $1,063.00 | $17.61 – $1,031.11 | 12 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,220.50 | $2,145.00 | $312.63 – $2,080.65 | 12 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,575.60 | $6,284.00 | $71.43 – $6,095.48 | 12 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,979.85 | $5,237.00 | $71.43 – $5,079.89 | 12 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,383.54 | $4,189.00 | $48.34 – $4,063.33 | 12 |
| CT t-spine w /wo contrast CPT 72130 | $1,795.19 | $3,155.00 | $35.60 – $3,060.35 | 12 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,114.10 | $1,958.00 | $408.13 – $1,899.26 | 12 |
| Culture aerobic additional method definitive id each CPT 87077 | $43.52 | $78.00 | $1.62 – $24.25 | 12 |
| Culture afb any source CPT 87116 | $35.15 | $63.00 | $2.16 – $15.05 | 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.