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 |
|---|---|---|---|---|
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $16.20 | $108.00 | $18.05 – $108.00 | 13 |
| Screening Mammogram CPT 77067 | $231.45 | $1,543.00 | $38.84 – $693.27 | 24 |
| Screening prostate cancer PSA HCPCS G0103 | $49.35 | $329.00 | $2.45 – $212.46 | 13 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $19.65 | $131.00 | $36.00 – $36.00 | 1 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $2,574.45 | $17,163.00 | $3.00 – $3.00 | 1 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $404.70 | $2,698.00 | $217.47 – $1,782.57 | 8 |
| Sedimentation rate erythrocyte automated CPT 85652 | $44.40 | $296.00 | $2.70 – $30.17 | 13 |
| Semen analysis presence/motility CPT 89321 | $36.00 | $240.00 | $1.45 – $139.13 | 13 |
| Semen analysis w/count CPT 89310 | $28.95 | $193.00 | $8.61 – $193.00 | 13 |
| Serial casting application 97139app CPT 97139 | $72.30 | $482.00 | $286.00 – $482.00 | 7 |
| Serpina1 gene CPT 81332 | $6.55 | $43.65 | $19.05 – $610.10 | 13 |
| Sertraline (zoloft) - sendout CPT 80332 | $30.00 | $200.00 | $0.05 – $189.91 | 6 |
| Set radiation therapy field CPT 77280 | $508.80 | $3,392.00 | $42.26 – $749.85 | 23 |
| Set radiation therapy field CPT 77285 | $67.05 | $447.00 | $63.75 – $599.04 | 19 |
| Set radiation therapy field CPT 77290 | $1,297.65 | $8,651.00 | $93.01 – $1,401.60 | 23 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $22.63 | $150.86 | $0.13 – $150.86 | 7 |
| Sgmdsc w/band ligation CPT 45350 | $56.55 | $377.00 | $55.00 – $1,000.31 | 19 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $1,356.90 | $9,046.00 | $181.00 – $181.00 | 1 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $530.10 | $3,534.00 | $35.00 – $2,021.29 | 19 |
| Sho arthrs srg capsulorraphy CPT 29806 | $611.85 | $4,079.00 | $169.40 – $2,425.00 | 19 |
| Sho arthrs srg compl synvct CPT 29821 | $56.25 | $375.00 | $55.00 – $1,346.62 | 19 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $321.90 | $2,146.00 | $80.00 – $1,308.69 | 19 |
| Sho arthrs srg lss&rescj ads CPT 29825 | $346.80 | $2,312.00 | $95.00 – $1,333.07 | 19 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | $346.50 | $2,310.00 | $80.00 – $1,335.78 | 19 |
| Sho arthrs srg rpr slap les CPT 29807 | $598.65 | $3,991.00 | $31.00 – $2,365.39 | 19 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $349.35 | $2,329.00 | $55.00 – $1,427.91 | 19 |
| Shoe post-op mens m HCPCS L3260 | $166.80 | $1,112.00 | $109.00 – $109.00 | 1 |
| Shorten radius or ulna CPT 25390 | $452.25 | $3,015.00 | $92.70 – $2,208.24 | 19 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $615.00 | $4,100.00 | $494.04 – $2,506.29 | 19 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,131.05 | $14,207.00 | $15.64 – $3,540.53 | 24 |
| Shoulder MRI (with contrast) CPT 73222 | $1,372.95 | $9,153.00 | $11.77 – $1,912.65 | 24 |
| Shoulder MRI (without contrast) CPT 73221 | $1,706.85 | $11,379.00 | $9.80 – $1,725.00 | 24 |
| Shoulder X-ray CPT 73030 | $305.85 | $2,039.00 | $1.34 – $141.38 | 24 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $148.95 | $993.00 | $3.40 – $204.86 | 24 |
| Sialography s&i CPT 70390 | $314.25 | $2,095.00 | $2.77 – $440.54 | 24 |
| Sigmoidoscopy and biopsy CPT 45331 | $42.15 | $281.00 | $20.00 – $301.07 | 19 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $42.15 | $281.00 | $55.00 – $516.38 | 19 |
| Sigmoidoscopy w/ablation CPT 45346 | $88.95 | $593.00 | $50.00 – $610.60 | 19 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $67.20 | $448.00 | $50.00 – $587.32 | 19 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $52.80 | $352.00 | $95.20 – $553.56 | 19 |
| Sig w/tndsc balloon dilation CPT 45340 | $44.10 | $294.00 | $80.54 – $927.15 | 19 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,360.20 | $9,068.00 | $10.28 – $1,082.59 | 24 |
| Sinus CT scan (with contrast) CPT 70487 | $1,254.30 | $8,362.00 | $9.47 – $1,060.00 | 24 |
| Sinus CT scan (without contrast) CPT 70486 | $941.10 | $6,274.00 | $8.25 – $1,060.00 | 24 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $26.70 | $178.00 | $0.05 – $357.88 | 6 |
| Skel musc relaxant 3 or more CPT 80370 | $0.90 | $6.00 | $0.05 – $205.62 | 6 |
| Sleep Study (Polysomnography) CPT 95810 | $1,343.10 | $8,954.00 | $499.27 – $4,182.80 | 12 |
| Sleep study unattended CPT 95806 | $364.50 | $2,430.00 | $50.16 – $1,318.37 | 23 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $3.04 | $20.25 | $10.98 – $20.25 | 8 |
| Sling suprapubic suburetheral HCPCS C1771 | $1,935.90 | $12,906.00 | $7,517.00 – $7,517.00 | 1 |
| Slitting of prepuce CPT 54001 | $81.60 | $544.00 | $32.00 – $372.81 | 19 |
| Slp pure tone screening CPT 92551 | $13.50 | $90.00 | $90.00 – $90.00 | 1 |
| Slp ther svc non-spch gen CPT 92606 | $42.45 | $283.00 | $283.00 – $447.00 | 7 |
| Small bowel endoscopy CPT 44360 | $79.95 | $533.00 | $140.43 – $411.97 | 19 |
| Small bowel endoscopy CPT 44366 | $132.45 | $883.00 | $35.00 – $682.93 | 19 |
| Small bowel endoscopy CPT 44369 | $135.60 | $904.00 | $35.00 – $696.75 | 19 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $21.30 | $142.00 | $0.26 – $62.06 | 13 |
| Smear gram stain CPT 87205 | $47.55 | $317.00 | $0.15 – $49.31 | 13 |
| Smear nasal eosinophil CPT 89190 | $39.00 | $260.00 | $0.27 – $54.83 | 13 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $30.60 | $204.00 | $0.32 – $69.21 | 13 |
| Smear wet mount CPT 87210 | $66.30 | $442.00 | $1.34 – $49.31 | 13 |
| Smpd1 gene common variants CPT 81330 | $7.05 | $47.00 | $22.09 – $856.00 | 13 |
| Snrpn/ube3a gene CPT 81331 | $50.25 | $335.00 | $51.07 – $445.62 | 13 |
| Sodium 24 hour urine CPT 84300 | $37.20 | $248.00 | $0.22 – $56.15 | 13 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $16.20 | $108.03 | $4.38 – $58.75 | 10 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $8.95 | $59.67 | $2.23 – $59.67 | 10 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $8.92 | $59.46 | $1.11 – $59.46 | 10 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $9.93 | $66.18 | $0.12 – $66.18 | 10 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $36.35 | $242.32 | $3.91 – $242.32 | 10 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $40.50 | $270.00 | $120.62 – $356.80 | 10 |
| Sodium serum/plasma/whole blood CPT 84295 | $26.25 | $175.00 | $0.17 – $55.37 | 13 |
| Sp bone agrft morsel add-on CPT 20937 | $88.95 | $593.00 | $129.56 – $403.72 | 19 |
| Sp bone algrft morsel add-on CPT 20930 | $636.64 | $4,244.24 | $144.98 – $4,244.24 | 11 |
| Special physics consult CPT 77370 | $380.70 | $2,538.00 | $136.54 – $1,046.07 | 12 |
| Special radiation dosimetry CPT 77331 | $30.90 | $206.00 | $30.12 – $83.81 | 19 |
| Special radiation treatment CPT 77470 | $1,039.80 | $6,932.00 | $116.24 – $2,406.05 | 23 |
| Special supplies phys/qhp CPT 99070 | $682.74 | $4,551.61 | $4.01 – $4.01 | 1 |
| Special teletx port plan CPT 77321 | $562.35 | $3,749.00 | $56.59 – $1,140.06 | 23 |
| Specific gravity body fluid CPT 84315 | $7.05 | $47.00 | $0.09 – $29.01 | 13 |
| Specimen fat stain CPT 89125 | $21.45 | $143.00 | $5.88 – $49.85 | 13 |
| Sperm antibody test CPT 89325 | $7.24 | $48.25 | $5.15 – $123.26 | 13 |
| Spinal bone allograftstructural 20931 CPT 20931 | $58.35 | $389.00 | $35.00 – $268.24 | 19 |
| Spinal bone autograftlocal 20936 CPT 20936 | $636.64 | $4,244.24 | $154.35 – $679.46 | 11 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $920.25 | $6,135.00 | $18.00 – $937.74 | 22 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $325.05 | $2,167.00 | $64.59 – $892.31 | 11 |
| Splint finger 4 prong foam sm HCPCS A4570 | $30.30 | $202.00 | $60.50 – $60.50 | 1 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $1,686.60 | $11,244.00 | $1,013.02 – $11,288.41 | 17 |
| Srs cranial lesion complex CPT 61798 | $3,145.05 | $20,967.00 | $762.05 – $11,257.00 | 9 |
| Srs cranial lesion simple CPT 61796 | $3,145.05 | $20,967.00 | $762.05 – $11,257.00 | 9 |
| Srs cran les complex addl CPT 61799 | $1,634.10 | $10,894.00 | $198.06 – $11,257.00 | 9 |
| Srs cran les simple addl CPT 61797 | $1,634.10 | $10,894.00 | $143.34 – $11,257.00 | 9 |
| Srs linear based CPT 77372 | $7,872.00 | $52,480.00 | $1,156.43 – $17,612.14 | 9 |
| Srs multisource CPT 77371 | $5,275.80 | $35,172.00 | $1,524.14 – $17,612.14 | 9 |
| Srs spinal lesion CPT 63620 | $3,145.05 | $20,967.00 | $762.05 – $11,257.00 | 9 |
| Srs spinal lesion addl CPT 63621 | $1,634.10 | $10,894.00 | $164.93 – $11,257.00 | 9 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $194.25 | $1,295.00 | $89.05 – $579.48 | 15 |
| Staph a dna amp probe CPT 87640 | $26.25 | $175.00 | $35.09 – $396.62 | 13 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $88.80 | $592.00 | $91.47 – $447.00 | 14 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $3,736.80 | $24,912.00 | $4,505.00 – $4,505.00 | 1 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $2,438.10 | $16,254.00 | $1,300.00 – $1,300.00 | 1 |
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.