UKIAH ADVENTIST HOSPITAL
275 Hospital Dr, Ukiah, CA · Adventisthealth · · NPI 1235120676
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 |
|---|---|---|---|---|
| Ghs mbp CPT 83873 | $3.06 | $15.29 | $15.29 – $224.52 | 11 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $165.60 | $828.00 | $21.18 – $99.88 | 7 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $157.80 | $789.00 | $79.82 – $143.68 | 7 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $165.60 | $828.00 | $63.61 – $117.08 | 17 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $75.00 | $375.00 | $10.09 – $66.41 | 17 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $165.60 | $828.00 | $48.19 – $88.86 | 17 |
| Ghs musc test done w/n test comp CPT 95886 | $48.20 | $241.00 | $45.16 – $381.95 | 16 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $31.20 | $156.00 | $19.05 – $362.25 | 16 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $42.00 | $210.00 | $30.18 – $388.30 | 17 |
| Ghs myocardial strain img spckl track CPT 93356 | $128.60 | $643.00 | $10.00 – $513.50 | 18 |
| Ghs nailbed repair/nail removal CPT 11760 | $173.20 | $866.00 | $60.00 – $1,018.06 | 17 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $26.20 | $131.00 | $21.57 – $338.23 | 16 |
| Ghs nerve blk intercostal, single level CPT 64420 | $69.60 | $348.00 | $12.00 – $235.82 | 16 |
| Ghs nerve block axillary nerve CPT 64417 | $114.60 | $573.00 | $7.00 – $192.39 | 16 |
| Ghs nerve block brachial plexus CPT 64415 | $94.40 | $472.00 | $7.00 – $210.72 | 16 |
| Ghs nerve block celiac plexus CPT 64530 | $65.60 | $328.00 | $12.00 – $335.87 | 16 |
| Ghs nerve block interscaline CPT 64510 | $53.00 | $265.00 | $12.00 – $234.45 | 16 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $163.40 | $817.00 | $12.00 – $326.55 | 16 |
| Ghs nerve block sciatic nerve CPT 64445 | $111.40 | $557.00 | $12.00 – $200.93 | 16 |
| Ghs nerve block suprascapular CPT 64418 | $60.40 | $302.00 | $47.83 – $203.15 | 16 |
| Ghs ng placement w fluoro guidance CPT 43752 | $350.00 | $1,750.00 | $33.94 – $615.36 | 17 |
| Ghs o2 saturation CPT 82810 | $40.80 | $204.00 | $9.77 – $117.66 | 11 |
| Ghs o2 uptake rest & exercise CPT 94680 | $6.00 | $30.00 | $12.70 – $258.02 | 16 |
| Ghs opcc repair cvp without subq port CPT 36575 | $22.40 | $112.00 | $29.56 – $287.52 | 16 |
| Ghs opcc repair cvp w subq port CPT 36576 | $122.60 | $613.00 | $35.00 – $643.38 | 16 |
| Ghs optokenetic CPT 92544 | $15.60 | $78.00 | $13.93 – $66.41 | 16 |
| Ghs oscillating trac CPT 92545 | $15.60 | $78.00 | $13.46 – $66.41 | 16 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $15.80 | $79.00 | $19.85 – $66.41 | 16 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $22.80 | $114.00 | $30.01 – $66.41 | 16 |
| Ghs ot prosthetic training/15 min CPT 97761 | $37.40 | $187.00 | $42.79 – $634.00 | 13 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $40.00 | $200.00 | $34.67 – $634.00 | 14 |
| Ghs pacing - transcutaneous CPT 92953 | $445.40 | $2,227.00 | $0.88 – $910.44 | 17 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $172.60 | $863.00 | $12.00 – $124.61 | 17 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $35.20 | $176.00 | $12.00 – $112.35 | 16 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $4.74 | $23.70 | $15.10 – $249.76 | 11 |
| Ghs peritonsillar abscess i andd CPT 42700 | $136.80 | $684.00 | $35.00 – $272.62 | 16 |
| Ghs picc line insert < 5 CPT 36568 | $61.00 | $305.00 | $66.41 – $525.51 | 16 |
| Ghs plngl fx pm cl CPT 26725 | $253.20 | $1,266.00 | $17.00 – $527.43 | 16 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $509.00 | $2,545.00 | $124.69 – $10,474.05 | 17 |
| Ghs pos nystagmus CPT 92542 | $15.60 | $78.00 | $13.93 – $66.41 | 16 |
| Ghs ppd (tb intradermal) CPT 86580 | $33.80 | $169.00 | $3.36 – $95.96 | 18 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $1.72 | $8.59 | $8.59 – $130.46 | 11 |
| Ghs protoporphyrins fract CPT 84202 | $2.55 | $12.75 | $12.75 – $193.56 | 11 |
| Ghs pr without cont pulse ox CPT 94625 | $8.60 | $43.00 | $16.05 – $104.45 | 13 |
| Ghs refill of implantable pump CPT 95990 | $45.80 | $229.00 | $49.52 – $155.45 | 16 |
| Ghs removal intranasal foreign body CPT 30300 | $149.60 | $748.00 | $56.22 – $360.32 | 17 |
| Ghs removal pharyngeal foreign body CPT 42809 | $145.60 | $728.00 | $66.41 – $265.31 | 16 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $430.40 | $2,152.00 | $22.00 – $951.45 | 16 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $354.20 | $1,771.00 | $66.41 – $903.76 | 16 |
| Ghs reticulocyte count CPT 85044 | $23.60 | $118.00 | $3.79 – $58.01 | 11 |
| Ghs sedimentation rate CPT 85651 | $30.20 | $151.00 | $3.40 – $47.85 | 11 |
| Ghs semen analysis fert CPT 89320 | $67.80 | $339.00 | $12.31 – $222.00 | 11 |
| Ghs semen analysis, post-vas CPT 89300 | $7.80 | $39.00 | $3.84 – $116.03 | 16 |
| Ghs sensitivity (per antimicro) CPT 87184 | $24.00 | $120.00 | $6.07 – $92.88 | 11 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $123.20 | $616.00 | $66.41 – $335.42 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $152.60 | $763.00 | $66.41 – $441.27 | 16 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $142.40 | $712.00 | $20.00 – $350.74 | 16 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $100.00 | $500.00 | $41.00 – $281.34 | 16 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $99.00 | $495.00 | $38.00 – $296.46 | 16 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $1,220.60 | $6,103.00 | $12.00 – $276.37 | 17 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $120.00 | $600.00 | $43.00 – $372.72 | 16 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $158.00 | $790.00 | $66.41 – $407.75 | 16 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $113.20 | $566.00 | $41.00 – $334.68 | 16 |
| Ghs sleep study unattended CPT 95800 | $19.00 | $95.00 | $39.53 – $1,694.94 | 16 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $39.80 | $199.00 | $26.97 – $634.00 | 13 |
| Ghs sphenopalatine ganglion block CPT 64505 | $152.20 | $761.00 | $17.00 – $422.82 | 17 |
| Ghs spont nystagmus CPT 92541 | $15.60 | $78.00 | $14.57 – $66.41 | 16 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $164.80 | $824.00 | $74.52 – $634.00 | 13 |
| Ghs st - eval for alt comm CPT 92567 | $15.60 | $78.00 | $8.80 – $66.41 | 17 |
| Ghs strapping shoulder - 29240 CPT 29240 | $21.00 | $105.00 | $10.00 – $98.08 | 16 |
| Ghs st - re-eval for alt comm CPT 92597 | $55.60 | $278.00 | $74.35 – $634.00 | 13 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $714.00 | $3,570.00 | $55.00 – $1,018.06 | 17 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $124.20 | $621.00 | $66.41 – $559.97 | 17 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $212.00 | $1,060.00 | $65.00 – $423.65 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $239.00 | $1,195.00 | $37.00 – $487.20 | 16 |
| Ghs vaginal delivery only CPT 59409 | $521.40 | $2,607.00 | $35.00 – $1,867.56 | 16 |
| Ghs windowing of cast CPT 29730 | $46.00 | $230.00 | $28.29 – $102.48 | 16 |
| Gi inhouse confirmation CPT 87045 | $41.00 | $205.00 | $9.44 – $127.20 | 11 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $365.80 | $1,829.00 | $121.98 – $9,690.45 | 16 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $90.20 | $451.00 | $164.86 – $451.00 | 9 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $340.64 | $1,703.20 | $135.00 – $827.03 | 10 |
| Glucagon plasma - sendout CPT 82943 | $2.54 | $12.70 | $12.70 – $163.60 | 11 |
| Glucose 1 hr post dose CPT 82950 | $24.40 | $122.00 | $4.75 – $64.01 | 11 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $19.00 | $95.00 | $0.43 – $4.78 | 15 |
| Glucose blood quantitative CPT 82947 | $20.20 | $101.00 | $0.63 – $53.02 | 18 |
| Glucose body fluid CPT 82945 | $22.80 | $114.00 | $3.93 – $52.84 | 11 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $34.60 | $173.00 | $173.00 – $598.03 | 9 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $91.20 | $456.00 | $12.87 – $173.59 | 11 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $14.60 | $73.00 | $3.92 – $52.93 | 11 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $40.40 | $202.02 | $0.76 – $202.02 | 5 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $1,439.42 | $7,197.08 | $11.29 – $152.61 | 13 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $47.00 | $235.00 | $16.41 – $250.58 | 11 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $68.40 | $342.00 | $16.38 – $249.76 | 11 |
| Gonioscopy CPT 92020 | $38.60 | $193.00 | $16.80 – $183.27 | 17 |
| Goniotomy CPT 65820 | $577.20 | $2,886.00 | $45.00 – $1,103.34 | 16 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $360.80 | $1,804.00 | $645.55 – $2,886.77 | 10 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $33.80 | $169.00 | $30.23 – $227.85 | 18 |
| Graft axiofill 1000mg HCPCS J3590 | $60.90 | $304.50 | $304.50 – $304.50 | 2 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $448.80 | $2,244.00 | $75.46 – $1,018.61 | 12 |
| Graft hand or finger tendon CPT 26416 | $648.40 | $3,242.00 | $66.41 – $1,531.25 | 16 |
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.