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 |
|---|---|---|---|---|
| Electrolyte panel CPT 80051 | $48.83 | $78.00 | $1.40 – $75.66 | 12 |
| Electron microscopy diagnostic CPT 88348 | $295.40 | $700.00 | $163.38 – $679.00 | 12 |
| Encephalitis, california igg/igm CPT 86651 | $8.92 | $14.00 | $2.64 – $19.34 | 12 |
| Encephalitis, st louis igg/igm CPT 86653 | $8.92 | $14.00 | $2.64 – $19.34 | 12 |
| Encephalitis, western equine igg/igm CPT 86654 | $8.92 | $14.00 | $2.64 – $19.34 | 12 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | $12.83 | $23.00 | $2.40 – $22.31 | 12 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $18.54 | $26.60 | $0.34 – $8.53 | 12 |
| Epstein barr early antigen antibody CPT 86663 | $2.55 | $4.00 | $1.64 – $19.24 | 12 |
| Epstein barr nuclear antigen antibody CPT 86664 | $63.06 | $99.00 | $1.64 – $22.44 | 12 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $81.54 | $128.00 | $1.23 – $26.10 | 12 |
| ER Visit (level 1, minor) CPT 99281 | $311.68 | $342.00 | $17.06 – $331.74 | 12 |
| ER Visit (level 2) CPT 99282 | $502.82 | $625.00 | $31.67 – $606.25 | 12 |
| ER Visit (level 3) CPT 99283 | $1,059.08 | $1,098.00 | $55.38 – $1,065.06 | 12 |
| ER Visit (level 4) CPT 99284 | $2,826.36 | $1,796.00 | $85.16 – $1,742.12 | 12 |
| ER Visit (level 5, high severity) CPT 99285 | $3,441.94 | $2,604.00 | $122.62 – $2,525.88 | 12 |
| Esophageal motility CPT 78258 | $650.87 | $970.00 | $80.37 – $940.90 | 12 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $299.16 – $299.16 | 1 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $73.72 – $73.72 | 1 |
| Established Patient Office Visit (level 1) CPT 99211 | $290.87 | $290.00 | $19.80 – $150.35 | 12 |
| Established Patient Office Visit (level 2) CPT 99212 | $737.20 | $735.00 | $29.86 – $276.45 | 12 |
| Established Patient Office Visit (level 3) CPT 99213 | $1,479.42 | $1,475.00 | $39.60 – $354.05 | 12 |
| Established Patient Office Visit (level 4) CPT 99214 | $2,281.82 | $2,275.00 | $61.88 – $475.30 | 12 |
| Established Patient Office Visit (level 5) CPT 99215 | $3,214.61 | $3,205.00 | $94.38 – $552.90 | 12 |
| Estradiol total CPT 82670 | $8.76 | $14.00 | $5.59 – $40.77 | 12 |
| Estrogens total-sendout CPT 82672 | $41.32 | $66.00 | $4.34 – $31.81 | 12 |
| Ethylene glycol -sendout CPT 82693 | $27.54 | $44.00 | $2.98 – $42.68 | 12 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $184.67 | $295.00 | $19.62 – $286.15 | 11 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $207.04 | $297.00 | $42.37 – $288.09 | 12 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $597.71 – $597.71 | 1 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $552.25 – $552.25 | 1 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $122.25 – $122.25 | 1 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $1,004.98 – $1,004.98 | 1 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $428.37 – $428.37 | 1 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $166.47 – $166.47 | 1 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | not published | not published | $197.75 – $197.75 | 1 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | $296.06 – $296.06 | 1 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $396.21 – $396.21 | 1 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | not published | not published | $133.91 – $133.91 | 1 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $111.19 – $111.19 | 1 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $380.87 – $380.87 | 1 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $579.28 – $579.28 | 1 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | not published | not published | $117.94 – $117.94 | 1 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | not published | not published | $122.25 – $122.25 | 1 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | not published | not published | $263.64 – $263.64 | 1 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | not published | not published | $318.81 – $318.81 | 1 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $637.03 – $637.03 | 1 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | not published | not published | $160.33 – $160.33 | 1 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | $68.81 – $68.81 | 1 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | $122.25 – $122.25 | 1 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | not published | not published | $109.35 – $109.35 | 1 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | $541.81 – $541.81 | 1 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | not published | not published | $568.23 – $568.23 | 1 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | $113.65 – $113.65 | 1 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | $270.90 – $270.90 | 1 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | $374.71 – $374.71 | 1 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $5,623.85 | $9,265.00 | $1,104.95 – $2,614.15 | 11 |
| Explore/treat finger joint CPT 26080 | not published | not published | $416.49 – $416.49 | 1 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | not published | not published | $463.80 – $463.80 | 1 |
| External newborn metabolic screening panel HCPCS S3620 | $122.48 | $177.00 | $72.57 – $348.15 | 12 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $76.44 | $120.00 | $4.90 – $116.40 | 12 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $239.52 | $257.00 | $28.75 – $249.29 | 12 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $70.71 | $111.00 | $2.87 – $24.07 | 12 |
| Eye Socket (Orbit) X-ray CPT 70200 | $275.52 | $420.00 | $21.27 – $407.40 | 12 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $1,248.76 | $2,222.00 | $35.60 – $2,155.34 | 12 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,040.82 | $1,852.00 | $35.60 – $1,796.44 | 12 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $832.32 | $1,481.00 | $21.27 – $1,436.57 | 12 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $3,357.04 | $5,798.00 | $71.43 – $5,624.06 | 12 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $2,237.84 | $3,865.00 | $48.34 – $3,749.05 | 12 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $174.50 | $266.00 | $17.61 – $258.02 | 12 |
| Facial Bones X-ray (complete) CPT 70150 | $320.78 | $489.00 | $21.27 – $474.33 | 12 |
| Factor ix CPT 85250 | $17.28 | $29.00 | $3.81 – $27.93 | 12 |
| Factor viii CPT 85240 | $23.24 | $39.00 | $3.58 – $37.83 | 12 |
| Fallopian tube recnl CPT 58345 | $638.41 | $1,223.00 | $334.15 – $790.55 | 11 |
| Fat/lipids feces qualitative CPT 82705 | $10.64 | $17.00 | $1.02 – $16.49 | 12 |
| Fatty acids nonesterified CPT 82725 | $11.89 | $19.00 | $3.75 – $23.93 | 12 |
| #fecal-sodium CPT 84302 | $5.01 | $8.00 | $0.97 – $7.76 | 12 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $15.02 | $24.00 | $3.73 – $24.60 | 12 |
| Fern test HCPCS Q0114 | $41.32 | $66.00 | $1.95 – $64.02 | 11 |
| Ferritin CPT 82728 | $25.67 | $41.00 | $2.73 – $39.77 | 12 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $489.84 | $624.00 | $21.27 – $605.28 | 11 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $756.28 | $730.00 | $40.23 – $708.10 | 12 |
| Fetal fibronectin CPT 82731 | $121.44 | $194.00 | $12.88 – $188.18 | 12 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $23.84 | $40.00 | $1.55 – $38.80 | 12 |
| Fetal non stress test CPT 59025 | $738.67 | $713.00 | $40.23 – $691.61 | 12 |
| #_fet/norfentcnfrmur CPT 80354 | $10.64 | $17.00 | $2.46 – $5.82 | 11 |
| Fibrin degradation d dimer quantitative CPT 85379 | $18.48 | $31.00 | $2.04 – $30.07 | 12 |
| Fibrin degradation products CPT 85362 | $17.88 | $30.00 | $1.38 – $29.10 | 12 |
| Fibrinogen activity CPT 85384 | $17.88 | $30.00 | $1.94 – $12.59 | 12 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $11.92 | $20.00 | $3.10 – $19.40 | 12 |
| Fibrinolytic antiplasmin CPT 85410 | $40.53 | $68.00 | $1.54 – $65.96 | 12 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $7,029.06 | $11,580.00 | $2,849.50 – $6,741.50 | 11 |
| Filter vena cava fem denali HCPCS C1880 | $5,623.85 | $9,265.00 | $1,102.90 – $2,609.30 | 11 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $622.22 | $1,192.00 | $85.39 – $1,156.24 | 12 |
| Finger X-ray (both hands) CPT 73140 | $262.40 | $400.00 | $25.72 – $388.00 | 12 |
| Fixation of knee joint CPT 27570 | not published | not published | $128.39 – $128.39 | 1 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $171.39 – $171.39 | 1 |
| Flecainide (tambocor)-sendout CPT 80181 | $11.27 | $18.00 | $3.73 – $24.60 | 12 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $90.30 – $90.30 | 1 |
| Flow cytometry marker each additional CPT 88185 | $69.90 | $75.00 | $30.75 – $72.75 | 12 |
| Flow cytometry one marker technical component CPT 88184 | $69.90 | $75.00 | $30.75 – $72.75 | 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.