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 |
|---|---|---|---|---|
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $235.00 | $1,175.00 | $21.45 – $465.00 | 18 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $132.60 | $663.00 | $23.52 – $559.97 | 18 |
| Wrist arthroscopy CPT 29840 | $324.20 | $1,621.00 | $55.00 – $718.02 | 16 |
| Wrist arthroscopy/surgery CPT 29844 | $355.80 | $1,779.00 | $66.41 – $785.20 | 16 |
| Wrist arthroscopy/surgery CPT 29846 | $370.80 | $1,854.00 | $66.41 – $824.14 | 16 |
| Wrist endoscopy/surgery CPT 29848 | $549.40 | $2,747.00 | $55.00 – $810.21 | 16 |
| Wrist X-ray CPT 73110 | $319.00 | $1,595.00 | $8.88 – $204.64 | 18 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | $518.80 | $2,594.00 | $66.41 – $1,475.60 | 16 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | $477.40 | $2,387.00 | $145.00 – $1,065.09 | 13 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | $611.60 | $3,058.00 | $739.37 – $1,331.70 | 13 |
| Xe133 xenon 10mci HCPCS A9558 | $673.40 | $3,367.00 | $131.64 – $3,367.00 | 8 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $541.00 | $2,705.00 | $34.00 – $977.89 | 16 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $501.80 | $2,509.00 | $47.00 – $894.70 | 16 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | $129.00 | $645.00 | $66.41 – $604.44 | 16 |
| X-ray abdomen 1 view CPT 74018 | $131.80 | $659.00 | $8.86 – $252.48 | 18 |
| X-ray abdomen 2 views CPT 74019 | $185.40 | $927.00 | $10.95 – $302.78 | 18 |
| X-ray abdomen >=3 views CPT 74021 | $10.00 | $50.00 | $12.67 – $352.99 | 16 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $285.60 | $1,428.00 | $15.28 – $286.08 | 18 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $196.20 | $981.00 | $9.59 – $258.57 | 18 |
| X-ray ankle 2 views (both sides) CPT 73600 | $242.40 | $1,212.00 | $8.18 – $190.29 | 18 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $503.80 | $2,519.00 | $27.33 – $806.84 | 18 |
| X-ray bone age studies CPT 77072 | $93.00 | $465.00 | $9.20 – $201.37 | 18 |
| X-ray bone length studies CPT 77073 | $154.00 | $770.00 | $13.24 – $304.78 | 18 |
| X-ray bone survey complete CPT 77075 | $330.00 | $1,650.00 | $26.20 – $556.72 | 18 |
| X-ray bone survey infant CPT 77076 | $200.20 | $1,001.00 | $32.97 – $286.08 | 18 |
| X-ray cervical spine 2-3 views CPT 72040 | $214.60 | $1,073.00 | $10.61 – $232.24 | 18 |
| X-ray cervical spine 4-5 views CPT 72050 | $237.40 | $1,187.00 | $13.22 – $346.54 | 18 |
| X-ray cervical spine >= 6 views CPT 72052 | $306.60 | $1,533.00 | $14.60 – $436.79 | 18 |
| X-ray clavicle complete (both sides) CPT 73000 | $290.80 | $1,454.00 | $8.18 – $201.37 | 18 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $381.80 | $1,909.00 | $47.84 – $639.25 | 18 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $483.80 | $2,419.00 | $58.78 – $745.92 | 18 |
| X-ray elbow 2 views (both sides) CPT 73070 | $293.80 | $1,469.00 | $8.18 – $201.37 | 18 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $309.00 | $1,545.00 | $8.52 – $220.07 | 18 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $257.20 | $1,286.00 | $28.27 – $429.07 | 18 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $208.80 | $1,044.00 | $8.88 – $746.47 | 18 |
| X-ray exam entire spi 6/> vw CPT 72084 | $249.60 | $1,248.00 | $10.13 – $896.00 | 18 |
| X-ray exam of arm infant CPT 73092 | $98.60 | $493.00 | $7.81 – $190.29 | 18 |
| X-ray exam of eye sockets CPT 70200 | $186.80 | $934.00 | $13.38 – $304.78 | 18 |
| X-ray exam of femur 1 CPT 73551 | $235.60 | $1,178.00 | $4.95 – $285.62 | 18 |
| X-ray exam of jaw joint CPT 70328 | $209.80 | $1,049.00 | $8.86 – $190.29 | 18 |
| X-ray exam of mastoids CPT 70120 | $1,139.80 | $5,699.00 | $8.86 – $239.86 | 18 |
| X-ray exam of salivary gland CPT 70380 | $6.40 | $32.00 | $8.15 – $257.39 | 16 |
| X-ray exam of sinuses CPT 70210 | $142.60 | $713.00 | $8.52 – $238.78 | 18 |
| X-ray exam si joints CPT 72200 | $137.40 | $687.00 | $8.52 – $201.37 | 18 |
| X-ray exam thorac spine4/>vw CPT 72074 | $260.00 | $1,300.00 | $11.63 – $352.08 | 18 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $139.00 | $695.00 | $8.86 – $163.96 | 18 |
| X-ray facial bones complete > 3 views CPT 70150 | $204.20 | $1,021.00 | $12.70 – $303.69 | 18 |
| X-ray femur >=2 views (both sides) CPT 73552 | $286.00 | $1,430.00 | $5.58 – $339.55 | 18 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $236.40 | $1,182.00 | $6.79 – $162.78 | 18 |
| X-ray foot 2 views (both sides) CPT 73620 | $241.60 | $1,208.00 | $7.81 – $190.29 | 18 |
| X-ray forearm 2 views (both sides) CPT 73090 | $313.00 | $1,565.00 | $7.81 – $201.37 | 18 |
| X-ray hand 2 views (both sides) CPT 73120 | $248.40 | $1,242.00 | $8.18 – $190.29 | 18 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $240.00 | $1,200.00 | $7.81 – $182.67 | 18 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $253.20 | $1,266.00 | $8.25 – $552.81 | 18 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $208.80 | $1,044.00 | $7.02 – $419.17 | 18 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $227.00 | $1,135.00 | $8.52 – $500.07 | 18 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $286.60 | $1,433.00 | $9.01 – $601.84 | 18 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $190.00 | $950.00 | $5.79 – $301.51 | 18 |
| X-ray humerus >= 2 views left CPT 73060 | $296.20 | $1,481.00 | $8.18 – $220.07 | 18 |
| X-ray joint survey 1 view CPT 77077 | $147.00 | $735.00 | $16.72 – $429.07 | 18 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $235.80 | $1,179.00 | $8.18 – $201.37 | 18 |
| X-ray knee 3 views (both sides) CPT 73562 | $304.20 | $1,521.00 | $9.59 – $219.98 | 18 |
| X-ray knee ap standing bilateral CPT 73565 | $142.00 | $710.00 | $8.54 – $190.38 | 18 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $70.80 | $354.00 | $7.81 – $190.29 | 18 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $175.40 | $877.00 | $10.97 – $344.36 | 18 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $286.00 | $1,430.00 | $12.88 – $353.17 | 18 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $304.40 | $1,522.00 | $14.60 – $456.58 | 18 |
| X-ray mandible complete > 4 views CPT 70110 | $317.40 | $1,587.00 | $11.99 – $239.86 | 18 |
| X-ray mandible ltd <4 views CPT 70100 | $153.00 | $765.00 | $9.22 – $201.28 | 18 |
| X-ray nasal bones complete > 3 views CPT 70160 | $156.20 | $781.00 | $8.52 – $201.37 | 18 |
| X-ray neck soft tissue CPT 70360 | $152.60 | $763.00 | $8.86 – $163.96 | 18 |
| X-ray nose to rectum for foreign body child CPT 76010 | $73.40 | $367.00 | $8.49 – $213.08 | 18 |
| X-ray of mammary ducts CPT 77054 | $356.60 | $1,783.00 | $21.34 – $1,413.22 | 18 |
| X-ray optic foramina CPT 70190 | $108.00 | $540.00 | $10.63 – $239.86 | 18 |
| X-ray pelvis 1-2 views CPT 72170 | $185.20 | $926.00 | $8.52 – $201.37 | 18 |
| X-ray pelvis complete > 3 views CPT 72190 | $216.60 | $1,083.00 | $12.54 – $258.57 | 18 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $598.40 | $2,992.00 | $25.37 – $887.83 | 18 |
| X-ray ribs 2 views left CPT 71100 | $172.00 | $860.00 | $10.61 – $221.16 | 18 |
| X-ray ribs 3 views bilateral CPT 71110 | $258.20 | $1,291.00 | $13.72 – $304.78 | 18 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $251.80 | $1,259.00 | $12.85 – $259.75 | 18 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $351.40 | $1,757.00 | $15.28 – $345.45 | 18 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $173.20 | $866.00 | $10.58 – $238.87 | 18 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $186.40 | $932.00 | $8.52 – $220.07 | 18 |
| X-ray scapula complete (both sides) CPT 73010 | $308.40 | $1,542.00 | $9.25 – $201.37 | 18 |
| X-ray sella turcica CPT 70240 | $97.00 | $485.00 | $9.20 – $163.96 | 18 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $268.00 | $1,340.00 | $7.47 – $182.67 | 18 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $202.20 | $1,011.00 | $10.61 – $303.69 | 18 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $446.00 | $2,230.00 | $24.21 – $752.68 | 18 |
| X-ray skull < 4 views CPT 70250 | $178.80 | $894.00 | $8.86 – $239.86 | 18 |
| X-ray skull > 4 views complete CPT 70260 | $272.20 | $1,361.00 | $13.38 – $346.54 | 18 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $230.80 | $1,154.00 | $27.59 – $485.18 | 18 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $403.20 | $2,016.00 | $32.55 – $502.79 | 18 |
| X-ray small intestine follow-through study CPT 74248 | $80.60 | $403.00 | $32.60 – $467.02 | 18 |
| X-ray spine single view CPT 72020 | $156.80 | $784.00 | $7.81 – $163.96 | 18 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $128.80 | $644.00 | $10.61 – $269.55 | 18 |
| X-ray sternum > 2 views CPT 71120 | $192.60 | $963.00 | $9.54 – $250.85 | 18 |
| X-ray surgical specimen CPT 76098 | $399.80 | $1,999.00 | $10.12 – $752.68 | 18 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $268.60 | $1,343.00 | $25.16 – $503.88 | 18 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $218.20 | $1,091.00 | $11.65 – $322.39 | 18 |
| X-ray thoracic spine 2 views CPT 72070 | $209.00 | $1,045.00 | $9.90 – $250.85 | 18 |
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.