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 |
|---|---|---|---|---|
| St evaluate speech sound production CPT 92522 | $142.40 | $712.00 | $91.96 – $634.00 | 14 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $155.40 | $777.00 | $187.30 – $881.18 | 14 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $248.20 | $1,241.00 | $57.30 – $634.00 | 13 |
| St evaluation swallow function CPT 92610 | $124.60 | $623.00 | $59.71 – $634.00 | 13 |
| Stimulants synthetic CPT 80371 | $1.40 | $7.00 | $0.08 – $320.85 | 6 |
| Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 | $310.20 | $1,551.00 | $36.97 – $816.34 | 16 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $225.20 | $1,126.00 | $11.00 – $223.84 | 17 |
| Strapping of chest CPT 29200 | $22.40 | $112.00 | $15.00 – $87.11 | 16 |
| Strapping of elbow or wrist 29260 CPT 29260 | $20.40 | $102.00 | $15.83 – $82.71 | 16 |
| Strapping of hand or finger CPT 29280 | $20.80 | $104.00 | $10.00 – $83.17 | 16 |
| Strapping of hip CPT 29520 | $24.60 | $123.00 | $6.00 – $83.76 | 16 |
| Strapping of knee CPT 29530 | $261.20 | $1,306.00 | $6.00 – $183.27 | 17 |
| Strapping of toes 29550 CPT 29550 | $14.00 | $70.00 | $6.00 – $66.41 | 16 |
| Strep b dna amp probe CPT 87653 | $117.40 | $587.00 | $35.09 – $463.02 | 11 |
| Stress test pulmonary CPT 94618 | $122.40 | $612.00 | $12.08 – $183.27 | 18 |
| Stress tte complete CPT 93351 | $722.00 | $3,610.00 | $83.32 – $2,741.01 | 18 |
| St treatment speech individual CPT 92507 | $104.40 | $522.00 | $79.85 – $634.00 | 14 |
| St treatment swallow dysfunction/oral CPT 92526 | $204.00 | $1,020.00 | $48.51 – $634.00 | 13 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | $186.80 | $934.00 | $66.41 – $592.87 | 16 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | $58.40 | $292.00 | $66.41 – $182.96 | 16 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | $56.20 | $281.00 | $66.41 – $181.30 | 16 |
| Subtalar arthro w/fb rmvl CPT 29904 | $450.60 | $2,253.00 | $65.00 – $880.74 | 16 |
| Subtalar arthro w/fusion CPT 29907 | $612.40 | $3,062.00 | $66.41 – $1,194.80 | 16 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $2.41 | $12.04 | $2.04 – $20.21 | 8 |
| Sugars single quant CPT 84378 | $23.38 | $116.88 | $10.24 – $154.61 | 11 |
| Sulfonylurea screen qn-sendout CPT 80377 | $25.60 | $128.00 | $0.08 – $446.41 | 6 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $97.00 | $485.00 | $36.85 – $458.00 | 10 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | $8.60 | $43.00 | $13.20 – $504.83 | 6 |
| Support clav 29.6-40.5in med HCPCS L3650 | $43.60 | $218.00 | $32.62 – $129.03 | 15 |
| Suprv interfacilty transport CPT 99485 | $28.60 | $143.00 | $66.41 – $143.00 | 10 |
| Suprv interfac trnsport addl CPT 99486 | $25.00 | $125.00 | $66.41 – $125.00 | 10 |
| Surg dx exam anorectal CPT 45990 | $72.00 | $360.00 | $42.00 – $158.14 | 16 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | $541.80 | $2,709.00 | $66.41 – $1,214.72 | 16 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | $541.60 | $2,708.00 | $66.41 – $1,234.81 | 16 |
| Surgical opening of stomach 43500 CPT 43500 | $529.60 | $2,648.00 | $66.41 – $1,064.11 | 16 |
| Surgical pathology level 1 gross examination only CPT 88300 | $28.00 | $140.00 | $12.01 – $150.00 | 11 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $66.20 | $331.00 | $30.04 – $314.92 | 11 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $80.40 | $402.00 | $32.00 – $347.02 | 11 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $122.20 | $611.00 | $17.00 – $468.39 | 11 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $270.80 | $1,354.00 | $125.71 – $988.31 | 11 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $521.60 | $2,608.00 | $266.04 – $1,997.66 | 11 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | $897.40 | $4,487.00 | $66.41 – $1,865.49 | 16 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | $1,013.60 | $5,068.00 | $45.00 – $2,146.80 | 16 |
| Surgical revision intestine CPT 44680 | $717.20 | $3,586.00 | $66.41 – $1,432.17 | 16 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $299.80 | $1,499.00 | $30.00 – $634.36 | 16 |
| Susceptibility agar dilution per agent CPT 87181 | $13.60 | $68.00 | $1.66 – $30.41 | 11 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $14.00 | $70.00 | $1.74 – $38.86 | 11 |
| Susceptibility mic per plate CPT 87186 | $40.00 | $200.00 | $6.92 – $116.57 | 11 |
| Suspension of testis CPT 54620 | $205.60 | $1,028.00 | $33.88 – $445.82 | 16 |
| Suspension of uterus 58400 CPT 58400 | $43.40 | $217.00 | $66.41 – $670.00 | 16 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $701.00 | $3,505.00 | $66.41 – $1,477.99 | 16 |
| Suture bile duct injury 47900 CPT 47900 | $920.20 | $4,601.00 | $25.00 – $1,892.21 | 16 |
| Svc venogram s&i CPT 75827 | $40.60 | $203.00 | $52.29 – $4,834.97 | 16 |
| Sympathectomy digital artery CPT 64820 | $535.80 | $2,679.00 | $40.00 – $1,149.46 | 16 |
| Sympathectomy supfc palmar CPT 64823 | $553.20 | $2,766.00 | $66.41 – $1,216.54 | 16 |
| Synvisc or synvisc-one HCPCS J7325 | $406.80 | $2,034.00 | $6.96 – $97.16 | 15 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $1.96 | $9.80 | $4.40 – $59.38 | 11 |
| System pacing micra av HCPCS C1786 | $2,613.60 | $13,068.00 | $13,068.00 – $13,068.00 | 2 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $6,472.80 | $32,364.00 | $15,955.00 – $15,955.00 | 2 |
| T3 (triiodothyronine) free CPT 84481 | $42.80 | $214.00 | $16.94 – $228.52 | 11 |
| T3 (triiodothyronine) total CPT 84480 | $36.40 | $182.00 | $14.18 – $191.11 | 11 |
| T4 (thyroxine) free CPT 84439 | $45.80 | $229.00 | $7.91 – $121.57 | 11 |
| T4 (thyroxine) total CPT 84436 | $25.60 | $128.00 | $6.87 – $92.70 | 11 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $4.36 | $21.79 | $0.40 – $25.36 | 8 |
| Tacrolimus therapeutic drug level CPT 80197 | $2.44 | $12.21 | $12.21 – $200.10 | 11 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $1,720.95 | $8,604.73 | $14.17 – $79.59 | 13 |
| Tah w/mmk 58152 CPT 58152 | $837.20 | $4,186.00 | $66.41 – $1,988.54 | 16 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $5,029.77 | $25,148.84 | $73.94 – $291.90 | 13 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | $4.00 | $20.00 | $0.46 – $20.00 | 6 |
| Tap block uni by cont infusion 64487 CPT 64487 | $40.00 | $200.00 | $55.85 – $243.11 | 14 |
| Target gsa panel hmtlmph neop CPT 81450 | $490.00 | $2,450.00 | $759.53 – $46,336.35 | 11 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $493.00 | $2,465.00 | $1,964.13 – $46,336.35 | 11 |
| Target gsa panel organ neop CPT 81445 | $620.00 | $3,100.00 | $597.91 – $46,336.35 | 11 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $297.11 | $1,485.53 | $0.25 – $7.06 | 13 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | $33.20 | $166.00 | $36.96 – $65.71 | 13 |
| Tbs techl calculation only CPT 77091 | $64.60 | $323.00 | $26.40 – $215.78 | 9 |
| Tbs techl prep&transmis data CPT 77090 | $64.60 | $323.00 | $2.10 – $215.78 | 9 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $187.40 | $937.00 | $100.00 – $1,057.60 | 11 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $102.20 | $511.00 | $40.00 – $817.55 | 11 |
| Tc-99m depreotide HCPCS A9536 | $654.80 | $3,274.00 | $2,110.89 – $8,754.51 | 8 |
| Tc-99m diag per dose HCPCS A4641 | $617.80 | $3,089.00 | $3,089.00 – $3,089.00 | 2 |
| Tc-99m disofenin HCPCS A9510 | $636.20 | $3,181.00 | $162.92 – $3,181.00 | 8 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $763.40 | $3,817.00 | $934.13 – $12,861.37 | 11 |
| Tc-99m exametazime diag HCPCS A9521 | $636.20 | $3,181.00 | $2,184.37 – $12,861.37 | 8 |
| Tc-99m gluceptate HCPCS A9550 | $636.20 | $3,181.00 | $144.73 – $3,181.00 | 3 |
| Tc-99m labeled rbc HCPCS A9560 | $645.60 | $3,228.00 | $287.08 – $3,228.00 | 8 |
| Tc-99m maa HCPCS A9540 | $877.40 | $4,387.00 | $80.16 – $4,387.00 | 8 |
| Tc-99m mebrofenin HCPCS A9537 | $93.80 | $469.00 | $274.25 – $469.00 | 8 |
| Tc-99m medronate HCPCS A9503 | $636.20 | $3,181.00 | $97.57 – $3,181.00 | 8 |
| Tc-99m mertiatide HCPCS A9562 | $842.00 | $4,210.00 | $2,052.06 – $5,813.84 | 8 |
| Tc-99m oxidronate HCPCS A9561 | $93.80 | $469.00 | $137.38 – $469.00 | 8 |
| Tc-99m pentetate dtpa HCPCS A9539 | $842.00 | $4,210.00 | $68.69 – $4,210.00 | 8 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $804.00 | $4,020.00 | $25.62 – $4,020.00 | 5 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $71.00 | $355.00 | $7.97 – $355.00 | 8 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $701.60 | $3,508.00 | $104.79 – $3,508.00 | 8 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $112.40 | $562.00 | $504.00 – $1,226.71 | 8 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $636.20 | $3,181.00 | $145.30 – $4,497.95 | 13 |
| Tc-99m sulfur colloid HCPCS A9541 | $783.00 | $3,915.00 | $245.04 – $3,915.00 | 8 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $154.20 | $771.00 | $212.00 – $696.43 | 8 |
| Tca peel dermal 15789 CPT 15789 | $382.60 | $1,913.00 | $182.80 – $504.83 | 6 |
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.