MID-COLUMBIA MEDICAL CENTER
1700 E 19th St, The Dalles, OR · Adventisthealth · · NPI 1851369409
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $57.54 | $119.88 | $35.10 – $119.88 | 9 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $117.60 | $245.00 | $79.59 – $294.79 | 24 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | $1,131.36 | $2,357.00 | $766.77 – $2,357.00 | 24 |
| 1st/sbsq psyc collab care CPT 99494 | $76.32 | $159.00 | $35.45 – $159.00 | 24 |
| 3-d radiotherapy plan CPT 77295 | $3,742.56 | $7,797.00 | $222.69 – $711.00 | 24 |
| 3d recon without postprocess indpndt CPT 76376 | $54.44 | $113.42 | $9.24 – $30.00 | 24 |
| 5' nucleotidase - sendout CPT 83915 | $41.72 | $86.92 | $9.69 – $86.92 | 9 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $82.43 | $171.72 | $34.93 – $115.00 | 21 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $140.16 | $292.00 | $105.12 – $292.00 | 9 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $146.40 | $305.00 | $112.32 – $305.00 | 9 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $151.68 | $316.00 | $119.04 – $316.00 | 9 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $125.76 | $262.00 | $96.48 – $214.12 | 9 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $133.92 | $279.00 | $105.12 – $279.00 | 9 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $133.44 | $278.00 | $105.12 – $278.00 | 9 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $145.92 | $304.00 | $119.04 – $304.00 | 9 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $170.88 | $356.00 | $140.64 – $356.00 | 9 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $3,390.19 | $7,062.89 | $44.72 – $22,518.61 | 14 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $23.60 | $49.17 | $5.91 – $156.77 | 14 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $1,842.24 | $3,838.00 | $1,072.35 – $3,838.00 | 24 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,689.60 | $3,520.00 | $63.37 – $208.00 | 24 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,670.88 | $3,481.00 | $57.70 – $190.00 | 24 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,268.64 | $2,643.00 | $54.03 – $178.00 | 24 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,704.96 | $3,552.00 | $100.15 – $327.00 | 24 |
| Abdominal MRI (with contrast) CPT 74182 | $944.64 | $1,968.00 | $78.19 – $257.00 | 24 |
| Abdominal MRI (without contrast) CPT 74181 | $1,268.16 | $2,642.00 | $65.71 – $218.00 | 24 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,519.68 | $3,166.00 | $90.69 – $924.00 | 24 |
| Abdominal Ultrasound (complete) CPT 76700 | $420.00 | $875.00 | $36.97 – $120.00 | 24 |
| Abdominal Ultrasound (limited) CPT 76705 | $277.44 | $578.00 | $27.06 – $277.00 | 24 |
| Abdominoplasty 15830 CPT 15830 | $1,790.88 | $3,731.00 | $1,032.33 – $3,731.00 | 24 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,519.68 | $3,166.00 | $69.06 – $674.00 | 24 |
| Abl1 gene CPT 81170 | $589.92 | $1,229.00 | $48.49 – $3,687.00 | 9 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $426.72 | $889.00 | $180.07 – $889.00 | 24 |
| Ablation cryo retro lymph node CPT 38999 | $554.88 | $1,156.00 | $58.00 – $1,156.00 | 5 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,019.04 | $2,123.00 | $162.41 – $2,123.00 | 24 |
| Abscess imaging ltd area CPT 78805 | $511.20 | $1,065.00 | $46.00 – $1,065.00 | 8 |
| Abscess imaging whole body CPT 78806 | $652.80 | $1,360.00 | $46.00 – $1,360.00 | 8 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $74.50 | $155.20 | $164.51 – $494.82 | 4 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $145.07 | $302.22 | $320.35 – $963.57 | 4 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $505.06 | $1,052.20 | $1,115.33 – $3,354.73 | 4 |
| Acetylcysteine non-comp unit HCPCS J7608 | $40.85 | $85.10 | $90.21 – $271.32 | 4 |
| Acne surgery 10040 CPT 10040 | $178.08 | $371.00 | $41.59 – $371.00 | 24 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $212.64 | $443.00 | $58.00 – $443.00 | 22 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $167.04 | $348.00 | $58.00 – $348.00 | 22 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $80.64 | $168.00 | $43.03 – $224.95 | 24 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $327.36 | $682.00 | $158.49 – $2,174.42 | 13 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $24.48 | $51.00 | $7.91 – $82.96 | 22 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $25.44 | $53.00 | $12.24 – $58.00 | 24 |
| Acromp/acromionectomy prtl CPT 23130 | $961.44 | $2,003.00 | $573.95 – $2,003.00 | 24 |
| Actinotherapy uv light CPT 96900 | $38.40 | $80.00 | $23.52 – $82.70 | 24 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $41.21 | $85.86 | $32.88 – $85.86 | 24 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | $22.90 | $47.70 | $20.73 – $58.00 | 24 |
| Acup 1/> without estim ea add 15 CPT 97811 | $30.02 | $62.54 | $20.39 – $62.54 | 24 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $76.32 | $159.00 | $26.97 – $159.00 | 24 |
| Acute hepatitis panel CPT 80074 | $170.96 | $356.16 | $47.63 – $1,135.54 | 14 |
| Acyclovir 400 mg tablet HCPCS J8499 | $480.05 | $1,000.10 | $1,060.11 – $3,188.62 | 3 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $89.51 | $186.48 | $197.67 – $594.55 | 4 |
| #acylcarnitineprfl CPT 82017 | $134.32 | $279.84 | $47.21 – $279.84 | 9 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $96.36 | $200.74 | $212.78 – $640.02 | 4 |
| Adenovirus ag ia CPT 87301 | $23.55 | $49.06 | $5.88 – $58.00 | 9 |
| Adenovirus antibody,serum - quest CPT 86603 | $65.13 | $135.68 | $17.46 – $135.68 | 9 |
| Adhesiolysis tube ovary 58740 CPT 58740 | $1,384.32 | $2,884.00 | $795.07 – $2,884.00 | 24 |
| Adh-sendout CPT 84588 | $41.72 | $86.92 | $29.50 – $86.92 | 9 |
| Adjmt/revj ext fixj sys anes CPT 20693 | $691.20 | $1,440.00 | $418.66 – $1,440.00 | 24 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $3,985.92 | $8,304.00 | $638.93 – $2,949.00 | 24 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $272.21 | $567.10 | $105.05 – $315.96 | 4 |
| Admin ecg contrast agent CPT 93352 | $148.06 | $308.46 | $35.43 – $93.00 | 24 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $194.36 | $404.92 | $85.71 – $437.31 | 12 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $57.49 | $119.78 | $85.71 – $154.28 | 12 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $313.92 | $654.00 | $393.21 – $707.78 | 12 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $177.06 | $368.88 | $393.21 – $707.78 | 12 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $74.28 | $154.76 | $38.42 – $159.42 | 24 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $109.44 | $228.00 | $58.00 – $228.00 | 24 |
| Administration immunization 1 vaccine CPT 90471 | $39.18 | $81.62 | $19.20 – $159.42 | 24 |
| Administration immunization each additional component CPT 90461 | $13.44 | $28.00 | $8.58 – $58.00 | 24 |
| Administration immunization each additional vaccine CPT 90472 | $33.07 | $68.90 | $15.89 – $58.00 | 24 |
| Administration immunization first component each vaccine CPT 90460 | $35.52 | $74.00 | $19.20 – $76.22 | 24 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $39.18 | $81.62 | $17.22 – $159.42 | 24 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $18.72 | $39.00 | $12.23 – $58.00 | 24 |
| Administration vaccine hepatitis b HCPCS G0010 | $47.04 | $98.00 | $50.96 – $103.68 | 5 |
| Administration vaccine influenza virus HCPCS G0008 | $47.04 | $98.00 | $50.96 – $103.68 | 5 |
| Administration vaccine pneumococcal HCPCS G0009 | $47.04 | $98.00 | $50.96 – $103.68 | 5 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $12,304.13 | $25,633.60 | $42.20 – $51,199.38 | 14 |
| Adrenalin epinephrine inject HCPCS J0171 | $601.24 | $1,252.58 | $74.73 – $224.78 | 4 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $91.20 | $190.00 | $62.51 – $190.00 | 24 |
| Afamelanotide implant, 1 mg HCPCS J7352 | $145,182.24 | $302,463.00 | $2,943.42 – $964,342.78 | 14 |
| _afb id by dna probe rflx ast CPT 87149 | $38.26 | $79.70 | $15.98 – $79.70 | 9 |
| Air conduction bilat CPT 92552 | $58.08 | $121.00 | $40.16 – $294.61 | 24 |
| Albumin body fluid quantitative each specimen CPT 82042 | $30.53 | $63.60 | $4.95 – $63.60 | 9 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $287.28 | $598.50 | $53.08 – $1,908.20 | 14 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $30.53 | $63.60 | $3.68 – $202.78 | 14 |
| Albumin serum plasma or whole blood CPT 82040 | $27.98 | $58.30 | $2.89 – $185.88 | 14 |
| Albuterol ipratrop non-comp HCPCS J7620 | $5.40 | $11.26 | $11.94 – $35.90 | 3 |
| Albuterol non-comp con HCPCS J7611 | $5.04 | $10.50 | $11.13 – $33.48 | 3 |
| Albuterol non-comp unit HCPCS J7613 | $7.03 | $14.65 | $10.07 – $30.29 | 3 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | $44.16 | $92.00 | $28.44 – $92.00 | 22 |
| Alcohol/subs interv >30 min HCPCS G0397 | $85.44 | $178.00 | $54.38 – $393.02 | 22 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $65,073.03 | $135,568.81 | $2,440.42 – $432,234.04 | 14 |
| Alkaline phosphatase CPT 84075 | $15.26 | $31.80 | $1.65 – $101.39 | 14 |
| Allergen alpha lactalbumin ige CPT 86008 | $40.70 | $84.80 | $15.20 – $270.37 | 14 |
| Allergen egg white ige CPT 86003 | $13.23 | $27.56 | $0.89 – $58.00 | 21 |
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.