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 |
|---|---|---|---|---|
| X-ray clavicle complete (both sides) CPT 73000 | $181.35 | $1,209.00 | $1.17 – $129.37 | 24 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $520.50 | $3,470.00 | $5.00 – $418.36 | 24 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $492.75 | $3,285.00 | $7.12 – $506.11 | 24 |
| X-ray consultation CPT 76140 | $26.10 | $174.00 | $141.38 – $219.37 | 5 |
| X-ray elbow 2 views (both sides) CPT 73070 | $180.60 | $1,204.00 | $1.13 – $129.37 | 24 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $302.85 | $2,019.00 | $1.28 – $141.38 | 24 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $273.15 | $1,821.00 | $3.36 – $275.65 | 24 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $179.55 | $1,197.00 | $4.01 – $497.30 | 24 |
| X-ray exam entire spi 6/> vw CPT 72084 | $192.90 | $1,286.00 | $4.66 – $596.92 | 24 |
| X-ray exam of arm infant CPT 73092 | $109.35 | $729.00 | $1.17 – $138.89 | 24 |
| X-ray exam of eye sockets CPT 70200 | $240.30 | $1,602.00 | $2.02 – $195.80 | 24 |
| X-ray exam of femur 1 CPT 73551 | $21.90 | $146.00 | $27.00 – $253.68 | 13 |
| X-ray exam of mastoids CPT 70120 | $120.30 | $802.00 | $1.34 – $154.10 | 24 |
| X-ray exam of sinuses CPT 70210 | $156.15 | $1,041.00 | $1.28 – $153.40 | 24 |
| X-ray exam si joints CPT 72200 | $144.00 | $960.00 | $1.28 – $138.89 | 24 |
| X-ray exam thorac spine4/>vw CPT 72074 | $213.75 | $1,425.00 | $1.60 – $226.19 | 24 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $128.85 | $859.00 | $9.64 – $115.61 | 24 |
| X-ray facial bones complete > 3 views CPT 70150 | $240.15 | $1,601.00 | $1.87 – $195.10 | 24 |
| X-ray femur >=2 views (both sides) CPT 73552 | $293.85 | $1,959.00 | $2.18 – $226.19 | 24 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $207.90 | $1,386.00 | $0.96 – $115.61 | 24 |
| X-ray foot 2 views (both sides) CPT 73620 | $244.35 | $1,629.00 | $1.17 – $122.25 | 24 |
| X-ray forearm 2 views (both sides) CPT 73090 | $178.20 | $1,188.00 | $1.17 – $129.37 | 24 |
| X-ray hand 2 views (both sides) CPT 73120 | $257.85 | $1,719.00 | $1.17 – $138.89 | 24 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $184.35 | $1,229.00 | $1.17 – $117.35 | 24 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $223.35 | $1,489.00 | $3.29 – $368.28 | 24 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $266.70 | $1,778.00 | $2.67 – $279.27 | 24 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $285.45 | $1,903.00 | $3.44 – $333.16 | 24 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $239.70 | $1,598.00 | $3.71 – $400.94 | 24 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $185.40 | $1,236.00 | $2.18 – $200.88 | 24 |
| X-ray humerus >= 2 views left CPT 73060 | $277.95 | $1,853.00 | $1.28 – $141.38 | 24 |
| X-ray joint survey 1 view CPT 77077 | $145.65 | $971.00 | $18.30 – $275.65 | 24 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $262.80 | $1,752.00 | $1.28 – $129.37 | 24 |
| X-ray knee 3 views (both sides) CPT 73562 | $308.55 | $2,057.00 | $1.34 – $141.33 | 24 |
| X-ray knee ap standing bilateral CPT 73565 | $183.75 | $1,225.00 | $1.28 – $122.31 | 24 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $94.65 | $631.00 | $1.17 – $122.25 | 24 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $342.60 | $2,284.00 | $1.60 – $221.23 | 24 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $310.65 | $2,071.00 | $2.23 – $226.89 | 24 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $359.70 | $2,398.00 | $2.65 – $293.33 | 24 |
| X-ray mandible complete > 4 views CPT 70110 | $246.30 | $1,642.00 | $1.81 – $154.10 | 24 |
| X-ray mandible ltd <4 views CPT 70100 | $168.60 | $1,124.00 | $1.34 – $129.31 | 24 |
| X-ray nasal bones complete > 3 views CPT 70160 | $204.00 | $1,360.00 | $1.28 – $129.37 | 24 |
| X-ray neck soft tissue CPT 70360 | $159.30 | $1,062.00 | $1.28 – $115.61 | 24 |
| X-ray nose to rectum for foreign body child CPT 76010 | $102.45 | $683.00 | $1.34 – $136.89 | 24 |
| X-ray optic foramina CPT 70190 | $267.30 | $1,782.00 | $1.55 – $154.10 | 24 |
| X-ray pelvis 1-2 views CPT 72170 | $205.80 | $1,372.00 | $1.28 – $138.89 | 24 |
| X-ray pelvis complete > 3 views CPT 72190 | $243.45 | $1,623.00 | $1.55 – $166.12 | 24 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $586.65 | $3,911.00 | $2.65 – $570.38 | 24 |
| X-ray ribs 2 views left CPT 71100 | $208.80 | $1,392.00 | $1.60 – $142.08 | 24 |
| X-ray ribs 3 views bilateral CPT 71110 | $294.60 | $1,964.00 | $1.97 – $195.80 | 24 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $226.65 | $1,511.00 | $1.97 – $166.87 | 24 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $293.55 | $1,957.00 | $2.29 – $221.93 | 24 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $188.85 | $1,259.00 | $1.38 – $153.46 | 24 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $199.35 | $1,329.00 | $1.28 – $141.38 | 24 |
| X-ray scapula complete (both sides) CPT 73010 | $285.30 | $1,902.00 | $1.28 – $138.89 | 24 |
| X-ray sella turcica CPT 70240 | $77.85 | $519.00 | $1.38 – $115.61 | 24 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $185.40 | $1,236.00 | $1.13 – $117.35 | 24 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $200.70 | $1,338.00 | $1.81 – $195.10 | 24 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $665.40 | $4,436.00 | $3.93 – $725.89 | 24 |
| X-ray skull < 4 views CPT 70250 | $221.55 | $1,477.00 | $1.76 – $154.10 | 24 |
| X-ray skull > 4 views complete CPT 70260 | $272.55 | $1,817.00 | $2.50 – $222.63 | 24 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $220.35 | $1,469.00 | $4.26 – $311.70 | 24 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $365.70 | $2,438.00 | $3.40 – $327.04 | 24 |
| X-ray small intestine follow-through study CPT 74248 | $160.20 | $1,068.00 | $5.48 – $311.12 | 24 |
| X-ray spine single view CPT 72020 | $159.30 | $1,062.00 | $1.13 – $115.61 | 24 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $177.45 | $1,183.00 | $1.60 – $173.17 | 24 |
| X-ray sternum > 2 views CPT 71120 | $257.10 | $1,714.00 | $1.49 – $161.16 | 24 |
| X-ray surgical specimen CPT 76098 | $470.25 | $3,135.00 | $1.17 – $725.89 | 24 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $343.95 | $2,293.00 | $3.84 – $323.71 | 24 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $240.75 | $1,605.00 | $1.76 – $207.12 | 24 |
| X-ray thoracic spine 2 views CPT 72070 | $189.00 | $1,260.00 | $1.60 – $161.16 | 24 |
| X-ray thoracic spine 3 views CPT 72072 | $202.35 | $1,349.00 | $1.60 – $183.15 | 24 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $203.70 | $1,358.00 | $1.60 – $166.12 | 24 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $135.60 | $904.00 | $3.04 – $250.69 | 24 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $171.90 | $1,146.00 | $3.71 – $458.10 | 24 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $259.65 | $1,731.00 | $1.28 – $129.37 | 24 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $139.20 | $928.00 | $0.96 – $115.61 | 24 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $490.95 | $3,273.00 | $5.00 – $409.92 | 24 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $403.65 | $2,691.00 | $5.00 – $363.32 | 24 |
| X-ray wrist 2 views (both sides) CPT 73100 | $233.40 | $1,556.00 | $1.17 – $122.25 | 24 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $49.95 | $333.00 | $88.84 – $366.40 | 19 |
| Yersinia antibody CPT 86793 | $1.76 | $11.72 | $1.55 – $152.35 | 13 |
| Zika virus dna/rna amp probe CPT 87662 | $6.84 | $45.61 | $23.40 – $523.70 | 13 |
| Zika virus igm antibody CPT 86794 | $2.25 | $14.97 | $2.52 – $171.95 | 13 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $72.76 | $485.04 | $16.10 – $485.04 | 10 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $2,232.49 | $14,883.27 | $33.71 – $91.67 | 13 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $400.05 | $2,667.00 | $11.18 – $505.14 | 10 |
| Zoster vaccine-live inj CPT 90736 | $31.95 | $213.00 | $213.00 – $496.91 | 9 |
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.