ST HELENA HOSPITAL
10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082
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 |
|---|---|---|---|---|
| 17-ketosteroids CPT 83586 | $4.46 | $29.73 | $3.81 – $147.92 | 13 |
| 2nd order venous cath CPT 36012 | $535.50 | $3,570.00 | $113.55 – $281.88 | 8 |
| 3-d radiotherapy plan CPT 77295 | $2,604.30 | $17,362.00 | $255.80 – $6,047.46 | 23 |
| 3d recon without postprocess indpndt CPT 76376 | $507.15 | $3,381.00 | $31.21 – $2,415.00 | 13 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $14.43 | $96.19 | $3.47 – $96.19 | 5 |
| 5' nucleotidase - sendout CPT 83915 | $1.49 | $9.91 | $1.11 – $128.79 | 13 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $49.50 | $330.00 | $330.00 – $330.00 | 1 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $920.70 | $6,138.00 | $41.63 – $121.89 | 17 |
| Abd aorta w/runoff s&i CPT 75630 | $4,463.40 | $29,756.00 | $13.52 – $4,194.60 | 24 |
| Abd/low ext cath 1st CPT 36245 | $2,116.65 | $14,111.00 | $65.00 – $2,477.67 | 22 |
| Abd/low ext cath 2nd CPT 36246 | $3,391.20 | $22,608.00 | $45.00 – $2,621.49 | 22 |
| Abd/low ext cath 3rd CPT 36247 | $2,475.45 | $16,503.00 | $264.22 – $4,148.43 | 22 |
| Abd/low ext cath addl CPT 36248 | $326.25 | $2,175.00 | $42.99 – $77.38 | 8 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,460.70 | $9,738.00 | $10.16 – $1,294.50 | 24 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,316.70 | $8,778.00 | $9.26 – $1,060.00 | 24 |
| Abdominal CT scan (without contrast) CPT 74150 | $964.50 | $6,430.00 | $8.61 – $1,060.00 | 24 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,304.30 | $15,362.00 | $16.39 – $3,547.00 | 24 |
| Abdominal MRI (with contrast) CPT 74182 | $1,984.95 | $13,233.00 | $12.57 – $1,917.02 | 24 |
| Abdominal MRI (without contrast) CPT 74181 | $1,547.40 | $10,316.00 | $10.54 – $1,725.00 | 24 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,189.80 | $7,932.00 | $89.72 – $1,204.90 | 22 |
| Abdominal Ultrasound (complete) CPT 76700 | $479.25 | $3,195.00 | $5.90 – $489.83 | 23 |
| Abdominal Ultrasound (limited) CPT 76705 | $363.45 | $2,423.00 | $4.32 – $352.70 | 23 |
| Abdominoplasty 15830 CPT 15830 | $457.80 | $3,052.00 | $1,173.81 – $3,052.00 | 19 |
| Abl1 gene CPT 81170 | $111.17 | $741.13 | $300.00 – $3,702.89 | 13 |
| Ablate arrhythmia add on CPT 93655 | $5,009.10 | $33,394.00 | $263.80 – $474.84 | 8 |
| Ablate heart dysrhythm focus CPT 93650 | $6,150.00 | $41,000.00 | $1,026.61 – $18,650.88 | 8 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $240.45 | $1,603.00 | $41.00 – $307.69 | 12 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $3,991.80 | $26,612.00 | $416.98 – $25,418.34 | 8 |
| Ablation cryo retro lymph node CPT 38999 | $263.85 | $1,759.00 | $586.08 – $1,054.95 | 7 |
| Ablation cryo thigh/knee CPT 27599 | $373.17 | $2,487.82 | $41.00 – $589.84 | 10 |
| Abscess drain retroperitoneal surg code CPT 49406 | $2,136.60 | $14,244.00 | $60.00 – $2,583.71 | 22 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $194.85 | $1,299.00 | $70.00 – $329.55 | 22 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $73.33 | $488.85 | $0.08 – $117.88 | 10 |
| Acetaminophen level CPT 80143 | $25.20 | $168.00 | $13.61 – $77.61 | 13 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $65.58 | $437.22 | $46.40 – $437.22 | 10 |
| Acetone qualitative CPT 82009 | $33.15 | $221.00 | $4.52 – $52.26 | 13 |
| Acetylcholine receptor modulating antibody CPT 86043 | $1.29 | $8.60 | $1.04 – $50.16 | 11 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $9.15 | $61.00 | $61.00 – $242.92 | 8 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $16.50 | $110.00 | $31.54 – $110.00 | 22 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $29.55 | $197.00 | $63.98 – $235.80 | 22 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $13.95 | $93.00 | $13.89 – $25.00 | 8 |
| Acute hepatitis panel CPT 80074 | $85.80 | $572.00 | $19.90 – $467.16 | 13 |
| Acyclovir 400 mg tablet HCPCS J8499 | $142.93 | $952.84 | $141.46 – $141.46 | 1 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $23.76 | $158.41 | $0.10 – $158.41 | 10 |
| #acylcarnitineprfl CPT 82017 | $7.53 | $50.18 | $8.47 – $193.96 | 13 |
| Adapter b 8 channel 10cm HCPCS C1883 | $1,480.76 | $9,871.75 | $1,251.75 – $1,251.75 | 1 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $190.20 | $1,268.03 | $0.99 – $5.93 | 10 |
| Adenovirus antibody,serum - quest CPT 86603 | $11.85 | $79.00 | $10.17 – $148.69 | 13 |
| Adh-sendout CPT 84588 | $6.75 | $45.00 | $15.27 – $393.59 | 13 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $448.50 | $2,990.00 | $84.51 – $1,510.08 | 19 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $6.92 | $46.11 | $0.29 – $12.34 | 10 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $174.30 | $1,162.00 | $30.83 – $928.00 | 15 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $142.80 | $952.00 | $41.01 – $928.00 | 15 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $297.00 | $1,980.00 | $41.01 – $1,361.36 | 15 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $227.85 | $1,519.00 | $25.76 – $1,064.11 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $100.35 | $669.00 | $15.29 – $928.00 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $151.65 | $1,011.00 | $15.29 – $928.00 | 15 |
| Administration immunization 1 vaccine CPT 90471 | $27.75 | $185.00 | $6.40 – $172.17 | 8 |
| Administration immunization each additional vaccine CPT 90472 | $18.00 | $120.00 | $17.00 – $35.24 | 8 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $27.75 | $185.00 | $95.65 – $185.00 | 8 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $18.00 | $120.00 | $14.74 – $120.00 | 8 |
| Adrenal cortex & medulla img CPT 78075 | $1,325.25 | $8,835.00 | $37.69 – $1,719.89 | 24 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $23.25 | $155.00 | $62.64 – $229.36 | 22 |
| _afb id by dna probe rflx ast CPT 87149 | $2.44 | $16.24 | $3.26 – $231.44 | 13 |
| #afb mycobacteria suscep. #1 CPT 87190 | $9.00 | $60.00 | $4.39 – $62.37 | 13 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $15.38 | $102.54 | $102.54 – $1,126.87 | 13 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $168.00 | $1,120.00 | $53.96 – $307.69 | 11 |
| Albumin body fluid quantitative each specimen CPT 82042 | $20.70 | $138.00 | $0.61 – $59.73 | 13 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $205.50 | $1,369.97 | $53.32 – $239.27 | 17 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $55.56 | $370.42 | $53.08 – $246.16 | 17 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $34.05 | $227.00 | $5.78 – $66.88 | 13 |
| Albumin serum plasma or whole blood CPT 82040 | $15.90 | $106.00 | $0.20 – $57.24 | 13 |
| Alkaline phosphatase CPT 84075 | $17.70 | $118.00 | $0.21 – $59.73 | 13 |
| Allergen alpha lactalbumin ige CPT 86008 | $6.04 | $40.25 | $0.90 – $182.99 | 13 |
| Allergen egg white ige CPT 86003 | $7.50 | $50.00 | $0.13 – $182.60 | 13 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $1.25 | $8.35 | $0.67 – $187.11 | 13 |
| Allergy injections; 2 or more 95117 CPT 95117 | $40.05 | $267.00 | $13.56 – $159.27 | 10 |
| Allergy injection; single 95115 CPT 95115 | $30.90 | $206.00 | $7.03 – $121.85 | 10 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $3,330.00 | $22,200.00 | $22,200.00 – $22,200.00 | 1 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $8.59 | $57.26 | $36.88 – $727.84 | 13 |
| Alpha-fetoprotein amniotic CPT 82106 | $1.80 | $12.03 | $2.05 – $193.80 | 13 |
| Alpha-fetoprotein tumor marker CPT 82105 | $60.15 | $401.00 | $2.02 – $193.80 | 13 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $3,564.15 | $23,760.99 | $69.33 – $255.45 | 17 |
| Alt/sgpt CPT 84460 | $29.25 | $195.00 | $0.24 – $60.43 | 13 |
| Aluminum - quest CPT 82108 | $2.79 | $18.60 | $3.44 – $294.36 | 13 |
| Amantadine (symmetrel)-sendout CPT 80375 | $38.40 | $256.00 | $0.05 – $612.98 | 6 |
| Amino acids quant 2-5 CPT 82136 | $2.35 | $15.69 | $3.08 – $193.96 | 13 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $30.95 | $206.34 | $4.45 – $28.35 | 10 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $53.96 | $359.74 | $5.57 – $358.00 | 7 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $17.70 | $118.00 | $0.90 – $81.16 | 10 |
| Amitriptyline (elavil) -sendout CPT 80335 | $4.32 | $28.81 | $0.05 – $189.91 | 6 |
| Ammonia CPT 82140 | $79.80 | $532.00 | $1.89 – $168.37 | 13 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $593.70 | $3,958.00 | $57.26 – $2,202.44 | 8 |
| Amphetamine confirm urine -sendout CPT 80324 | $1.29 | $8.59 | $0.05 – $164.87 | 6 |
| Amphetamines 5 or more CPT 80326 | $92.70 | $618.00 | $0.05 – $197.84 | 6 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $206.35 | $1,375.65 | $19.85 – $92.84 | 17 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $20.71 | $138.09 | $1.30 – $101.89 | 10 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $22.10 | $147.34 | $2.92 – $109.20 | 10 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $98.25 | $655.00 | $172.58 – $970.27 | 19 |
| Amylase CPT 82150 | $75.90 | $506.00 | $0.37 – $74.97 | 13 |
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.