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 |
|---|---|---|---|---|
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $986.40 | $2,055.00 | $186.07 – $1,222.00 | 24 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $635.52 | $1,324.00 | $191.74 – $1,221.00 | 24 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $633.12 | $1,319.00 | $261.11 – $1,319.00 | 24 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $769.92 | $1,604.00 | $285.06 – $1,604.00 | 24 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $767.04 | $1,598.00 | $301.65 – $1,598.00 | 24 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $886.56 | $1,847.00 | $338.61 – $1,847.00 | 24 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $839.52 | $1,749.00 | $332.34 – $1,749.00 | 24 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $927.84 | $1,933.00 | $371.02 – $1,933.00 | 24 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $174.01 | $362.52 | $20.73 – $162.00 | 24 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $169.43 | $352.98 | $58.00 – $198.00 | 24 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $119.06 | $248.04 | $12.11 – $58.00 | 24 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $75.36 | $157.00 | $52.69 – $157.00 | 24 |
| Ghs musc test done w/n test comp CPT 95886 | $146.88 | $306.00 | $45.06 – $306.00 | 24 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $94.56 | $197.00 | $18.24 – $197.00 | 24 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $126.24 | $263.00 | $36.73 – $263.00 | 24 |
| Ghs myocardial strain img spckl track CPT 93356 | $52.41 | $109.18 | $9.82 – $348.10 | 13 |
| Ghs nailbed repair/nail removal CPT 11760 | $798.72 | $1,664.00 | $101.81 – $590.00 | 24 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $50.88 | $106.00 | $21.20 – $106.00 | 24 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,237.44 | $2,578.00 | $51.49 – $312.00 | 24 |
| Ghs nerve block brachial plexus CPT 64415 | $204.96 | $427.00 | $65.22 – $427.00 | 24 |
| Ghs nerve block sciatic nerve CPT 64445 | $242.40 | $505.00 | $64.58 – $505.00 | 24 |
| Ghs ng placement w fluoro guidance CPT 43752 | $503.04 | $1,048.00 | $33.49 – $126.00 | 24 |
| Ghs opcc repair cvp without subq port CPT 36575 | $326.88 | $681.00 | $29.01 – $454.00 | 24 |
| Ghs opcc repair cvp w subq port CPT 36576 | $2,235.36 | $4,657.00 | $164.81 – $1,084.00 | 24 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $48.00 | $100.00 | $19.39 – $100.00 | 24 |
| Ghs ot prosthetic training/15 min CPT 97761 | $63.09 | $131.44 | $40.22 – $419.07 | 13 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $46.30 | $96.46 | $50.16 – $121.55 | 24 |
| Ghs ot work hardening-additional hours CPT 97546 | $136.87 | $285.14 | $58.00 – $285.14 | 4 |
| Ghs pacing - transcutaneous CPT 92953 | $918.24 | $1,913.00 | $0.90 – $1,463.49 | 24 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $72.50 | $151.05 | $23.89 – $481.59 | 13 |
| Ghs peritonsillar abscess i andd CPT 42700 | $365.28 | $761.00 | $125.42 – $617.00 | 24 |
| Ghs phenylketonurid CPT 84030 | $10.81 | $22.53 | $1.24 – $58.00 | 9 |
| Ghs picc line insert < 5 CPT 36568 | $1,267.20 | $2,640.00 | $81.23 – $2,640.00 | 24 |
| Ghs plngl fx pm cl CPT 26725 | $545.28 | $1,136.00 | $293.64 – $1,136.00 | 24 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $1,648.80 | $3,435.00 | $58.00 – $1,901.44 | 24 |
| Ghs ppd (tb intradermal) CPT 86580 | $15.84 | $33.00 | $10.88 – $64.04 | 21 |
| Ghs protoporphyrins fract CPT 84202 | $87.51 | $182.32 | $14.35 – $581.29 | 14 |
| Ghs pr without cont pulse ox CPT 94625 | $108.88 | $226.84 | $70.23 – $723.23 | 13 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $273.12 | $569.00 | $58.00 – $569.00 | 4 |
| Ghs quinidine CPT 80194 | $31.55 | $65.72 | $9.60 – $65.72 | 9 |
| Ghs removal intranasal foreign body CPT 30300 | $323.04 | $673.00 | $113.68 – $673.00 | 24 |
| Ghs removal pharyngeal foreign body CPT 42809 | $711.84 | $1,483.00 | $113.94 – $664.00 | 24 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $931.68 | $1,941.00 | $587.96 – $1,941.00 | 24 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $771.36 | $1,607.00 | $458.23 – $1,607.00 | 24 |
| Ghs sedimentation rate CPT 85651 | $33.58 | $69.96 | $2.99 – $223.05 | 14 |
| Ghs sensitivity (per antimicro) CPT 87184 | $31.04 | $64.66 | $4.84 – $206.16 | 14 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $635.52 | $1,324.00 | $85.54 – $567.00 | 24 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $335.04 | $698.00 | $116.14 – $522.00 | 24 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $498.24 | $1,038.00 | $104.10 – $653.00 | 24 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $234.24 | $488.00 | $146.48 – $488.00 | 24 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $635.04 | $1,323.00 | $68.54 – $456.00 | 24 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $368.16 | $767.00 | $68.81 – $426.00 | 24 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $345.60 | $720.00 | $85.77 – $551.00 | 24 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $355.68 | $741.00 | $127.71 – $741.00 | 24 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $264.00 | $550.00 | $165.18 – $550.00 | 24 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $120.08 | $250.16 | $47.67 – $250.16 | 24 |
| Ghs sphenopalatine ganglion block CPT 64505 | $500.64 | $1,043.00 | $93.60 – $464.00 | 24 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $187.75 | $391.14 | $102.23 – $1,247.07 | 13 |
| Ghs st - eval for alt comm CPT 92567 | $24.96 | $52.00 | $8.58 – $82.70 | 24 |
| Ghs strapping shoulder - 29240 CPT 29240 | $45.60 | $95.00 | $15.26 – $95.00 | 24 |
| Ghs st - re-eval for alt comm CPT 92597 | $187.24 | $390.08 | $58.00 – $390.08 | 24 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $976.80 | $2,035.00 | $174.12 – $958.00 | 24 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $272.64 | $568.00 | $131.08 – $568.00 | 24 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $484.32 | $1,009.00 | $267.66 – $1,009.00 | 24 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $509.76 | $1,062.00 | $291.84 – $915.00 | 24 |
| Ghs urine, porphyrins quant CPT 84120 | $63.60 | $132.50 | $14.71 – $422.45 | 14 |
| Ghs vaginal delivery only CPT 59409 | $1,222.08 | $2,546.00 | $681.48 – $2,546.00 | 24 |
| Ghs windowing of cast CPT 29730 | $100.80 | $210.00 | $37.51 – $210.00 | 24 |
| Gi inhouse confirmation CPT 87045 | $35.62 | $74.20 | $7.00 – $236.57 | 14 |
| Glassia injection HCPCS J0257 | $1,846.29 | $3,846.43 | $5.66 – $12,263.57 | 14 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $610.27 | $1,271.40 | $135.00 – $4,053.60 | 14 |
| Glucagon plasma - sendout CPT 82943 | $7.43 | $15.47 | $2.21 – $58.00 | 9 |
| Glucose 1 hr post dose CPT 82950 | $26.97 | $56.18 | $2.67 – $179.12 | 14 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $13.74 | $28.62 | $0.36 – $91.25 | 21 |
| Glucose blood quantitative CPT 82947 | $29.00 | $60.42 | $2.25 – $182.50 | 14 |
| Glucose body fluid CPT 82945 | $28.49 | $59.36 | $0.51 – $189.26 | 21 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $114.48 | $238.50 | $58.00 – $238.50 | 24 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $71.23 | $148.40 | $12.87 – $473.14 | 21 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $24.42 | $50.88 | $1.99 – $162.22 | 14 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $59.04 | $123.00 | $130.38 – $392.16 | 4 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $4,462.22 | $9,296.29 | $11.29 – $29,639.36 | 14 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $77.85 | $162.18 | $18.58 – $517.08 | 14 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $71.74 | $149.46 | $18.52 – $476.52 | 14 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $7,011.89 | $14,608.10 | $5,580.90 – $16,786.40 | 4 |
| Granisetron hcl injection HCPCS J1626 | $89.67 | $186.81 | $56.18 – $168.98 | 4 |
| Great toe with reduction 28495 CPT 28495 | $439.20 | $915.00 | $151.96 – $590.00 | 24 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $11.70 | $24.38 | $12.24 – $58.00 | 22 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | $2,931.84 | $6,108.00 | $1,692.79 – $6,108.00 | 24 |
| Guided cath fluid drainage 10030 CPT 10030 | $966.24 | $2,013.00 | $114.70 – $2,013.00 | 24 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $67.09 | $139.77 | $150.95 – $445.63 | 2 |
| Guid loc target vol rad tx CPT 77387 | $620.64 | $1,293.00 | $36.06 – $4,122.47 | 13 |
| Gw stiffened micro access kit HCPCS C1894 | $101.21 | $210.86 | $46.00 – $210.86 | 8 |
| Gynecomastia (males) 19300 CPT 19300 | $886.08 | $1,846.00 | $413.01 – $1,846.00 | 24 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $127.39 | $265.40 | $281.32 – $846.17 | 4 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $18.22 | $37.95 | $40.23 – $121.00 | 4 |
| Hand X-ray CPT 73130 | $155.18 | $323.30 | $8.57 – $93.00 | 24 |
| Haptoglobin quantitative CPT 83010 | $60.04 | $125.08 | $12.58 – $398.79 | 14 |
| Harvest auto stem cells CPT 38206 | $124.32 | $259.00 | $66.51 – $259.00 | 24 |
| Harvest cultured skin graft 15040 CPT 15040 | $3,189.12 | $6,644.00 | $109.98 – $6,644.00 | 24 |
| Hb glycosylated a1c home dev CPT 83037 | $15.36 | $32.00 | $3.11 – $58.00 | 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.