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 |
|---|---|---|---|---|
| Sigmoidoscopy w/tumr remove CPT 45338 | $984.00 | $2,050.00 | $106.27 – $951.00 | 24 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $833.28 | $1,736.00 | $84.21 – $1,736.00 | 24 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $331.75 | $691.15 | $732.62 – $2,203.59 | 4 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,704.00 | $3,550.00 | $57.70 – $189.00 | 24 |
| Sinus CT scan (with contrast) CPT 70487 | $1,348.32 | $2,809.00 | $51.36 – $168.00 | 24 |
| Sinus CT scan (without contrast) CPT 70486 | $891.84 | $1,858.00 | $39.21 – $128.00 | 24 |
| Sirolimus, oral HCPCS J7520 | $1,083.84 | $2,258.00 | $2,393.48 – $7,199.18 | 4 |
| Skin Biopsy CPT 11102 | $154.08 | $321.00 | $29.44 – $321.00 | 24 |
| Skin full graft 20sq cm less 15200 CPT 15200 | $3,189.12 | $6,644.00 | $589.32 – $6,644.00 | 24 |
| Skin full graft add-on 15241 CPT 15241 | $1,594.08 | $3,321.00 | $86.56 – $3,321.00 | 24 |
| Skin pedicle flap arms/legs CPT 15572 | $5,850.72 | $12,189.00 | $651.44 – $12,189.00 | 24 |
| Skin pedicle flap trunk CPT 15570 | $3,189.12 | $6,644.00 | $651.86 – $6,644.00 | 24 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $1,594.08 | $3,321.00 | $96.64 – $590.00 | 24 |
| Sleep Study (Polysomnography) CPT 95810 | $2,188.80 | $4,560.00 | $58.00 – $1,901.44 | 24 |
| Sleep study unattended CPT 95806 | $272.64 | $568.00 | $44.31 – $478.09 | 24 |
| Slitting of prepuce CPT 54001 | $305.28 | $636.00 | $126.73 – $636.00 | 24 |
| Slp eval non-spch gen comm dev CPT 92605 | $240.00 | $500.00 | $58.00 – $500.00 | 9 |
| Slp pure tone screening CPT 92551 | $19.68 | $41.00 | $15.84 – $58.00 | 9 |
| Slp ther svc non-spch gen CPT 92606 | $187.75 | $391.14 | $58.00 – $391.14 | 9 |
| Sm-153 lexidron ther HCPCS A9604 | $8,175.36 | $17,032.00 | $58.00 – $17,032.00 | 5 |
| Small bowel endoscopy CPT 44360 | $216.48 | $451.00 | $124.86 – $451.00 | 24 |
| Small bowel endoscopy CPT 44376 | $425.28 | $886.00 | $242.89 – $886.00 | 24 |
| Small bowel endoscopy CPT 44382 | $1,544.64 | $3,218.00 | $66.41 – $947.00 | 24 |
| Small bowel endoscopy br/wa CPT 44380 | $1,556.64 | $3,243.00 | $52.13 – $627.00 | 24 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $37.65 | $78.44 | $4.23 – $250.09 | 14 |
| Smear gram stain CPT 87205 | $32.05 | $66.78 | $2.85 – $212.91 | 14 |
| Smear nasal eosinophil CPT 89190 | $26.97 | $56.18 | $3.25 – $58.00 | 9 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $101.25 | $210.94 | $12.64 – $210.94 | 12 |
| Smear wet mount CPT 87210 | $29.51 | $61.48 | $1.16 – $196.02 | 21 |
| Snrpn/ube3a gene CPT 81331 | $104.30 | $217.30 | $48.49 – $217.30 | 9 |
| Sodium 24 hour urine CPT 84300 | $22.39 | $46.64 | $2.36 – $148.70 | 14 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $20.11 | $41.90 | $44.41 – $133.59 | 4 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $118.21 | $246.28 | $261.06 – $785.21 | 4 |
| Sodium serum/plasma/whole blood CPT 84295 | $18.83 | $39.22 | $1.89 – $125.05 | 14 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $312.96 | $652.00 | $0.88 – $2,078.77 | 14 |
| Special physics consult CPT 77370 | $568.32 | $1,184.00 | $160.01 – $3,774.95 | 13 |
| Special radiation dosimetry CPT 77331 | $224.38 | $467.46 | $45.30 – $146.00 | 24 |
| Special radiation treatment CPT 77470 | $1,425.12 | $2,969.00 | $105.27 – $338.00 | 24 |
| Special teletx port plan CPT 77321 | $791.52 | $1,649.00 | $49.30 – $158.00 | 24 |
| Speech audiometry complete CPT 92556 | $69.12 | $144.00 | $46.14 – $144.00 | 24 |
| Speech recep thresh CPT 92555 | $44.64 | $93.00 | $29.51 – $130.63 | 24 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | $4,760.16 | $9,917.00 | $665.73 – $9,917.00 | 24 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | $208.80 | $435.00 | $58.00 – $478.09 | 24 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $398.88 | $831.00 | $10.24 – $826.25 | 24 |
| Splenectomy total open 38100 CPT 38100 | $1,752.96 | $3,652.00 | $1,025.12 – $3,652.00 | 24 |
| Splicing of ureters CPT 50770 | $1,744.32 | $3,634.00 | $1,003.13 – $3,634.00 | 24 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $3.36 | $7.00 | $3.64 – $58.00 | 12 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $5,850.72 | $12,189.00 | $597.82 – $2,699.00 | 24 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $2,925.12 | $6,094.00 | $114.91 – $6,094.00 | 24 |
| Sputum specimen collection CPT 89220 | $197.92 | $412.34 | $20.86 – $412.34 | 21 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $12,319.20 | $25,665.00 | $58.00 – $25,665.00 | 5 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $150.10 | $312.70 | $109.08 – $996.98 | 13 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $287.04 | $598.00 | $102.30 – $1,906.60 | 13 |
| St evaluate speech sound production CPT 92522 | $147.04 | $306.34 | $111.31 – $976.70 | 13 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $232.52 | $484.42 | $225.97 – $1,544.48 | 13 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $299.52 | $624.00 | $90.84 – $1,989.50 | 13 |
| St evaluation swallow function CPT 92610 | $232.52 | $484.42 | $57.63 – $1,544.48 | 13 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $242.40 | $505.00 | $15.06 – $90.00 | 24 |
| Strapping of elbow or wrist 29260 CPT 29260 | $242.40 | $505.00 | $15.49 – $93.00 | 24 |
| Strapping of hand or finger CPT 29280 | $242.40 | $505.00 | $16.63 – $96.00 | 24 |
| Strapping of knee CPT 29530 | $242.40 | $505.00 | $15.26 – $94.00 | 24 |
| Strapping of toes 29550 CPT 29550 | $242.40 | $505.00 | $9.48 – $62.00 | 24 |
| Strep a ag ia CPT 87430 | $62.58 | $130.38 | $21.92 – $130.38 | 9 |
| Stress test pulmonary CPT 94618 | $163.32 | $340.26 | $22.49 – $294.61 | 24 |
| Stress tte complete CPT 93351 | $1,414.08 | $2,946.00 | $58.00 – $1,209.89 | 24 |
| St treatment speech individual CPT 92507 | $256.32 | $534.00 | $58.00 – $202.46 | 24 |
| St treatment swallow dysfunction/oral CPT 92526 | $210.64 | $438.84 | $83.91 – $1,399.15 | 13 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | $489.60 | $1,020.00 | $331.70 – $1,020.00 | 24 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | $153.60 | $320.00 | $103.66 – $320.00 | 24 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | $147.84 | $308.00 | $99.65 – $308.00 | 24 |
| Subtalar arthro w/deb CPT 29906 | $1,007.04 | $2,098.00 | $609.13 – $2,098.00 | 24 |
| Subtalar arthro w/exc CPT 29905 | $790.08 | $1,646.00 | $469.28 – $1,646.00 | 24 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $94.49 | $196.85 | $111.14 – $334.29 | 4 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $17,431.46 | $36,315.55 | $1,476.12 – $18,415.27 | 3 |
| Sulfonylurea screen qn-sendout CPT 80377 | $71.74 | $149.46 | $48.49 – $149.46 | 5 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $1,161.86 | $2,420.55 | $1,079.28 – $3,246.30 | 3 |
| Surg dx exam anorectal CPT 45990 | $4,771.68 | $9,941.00 | $95.95 – $335.00 | 24 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | $1,260.00 | $2,625.00 | $694.87 – $2,625.00 | 24 |
| Surgical exposure prostate 55860 CPT 55860 | $1,326.72 | $2,764.00 | $765.47 – $2,764.00 | 24 |
| Surgical opening of stomach 43500 CPT 43500 | $1,205.28 | $2,511.00 | $718.71 – $2,511.00 | 24 |
| Surgical pathology level 1 gross examination only CPT 88300 | $47.32 | $98.58 | $4.24 – $64.04 | 21 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $101.76 | $212.00 | $6.57 – $82.70 | 21 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $74.28 | $154.76 | $10.24 – $115.39 | 21 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $1,214.40 | $2,530.00 | $34.93 – $115.39 | 21 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $359.52 | $749.00 | $48.49 – $793.68 | 21 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $406.08 | $846.00 | $48.49 – $1,783.96 | 21 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $864.96 | $1,802.00 | $416.17 – $1,802.00 | 24 |
| Susceptibility agar dilution per agent CPT 87181 | $11.19 | $23.32 | $1.11 – $58.00 | 9 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $20.86 | $43.46 | $2.06 – $138.56 | 14 |
| Susceptibility mic per plate CPT 87186 | $100.74 | $209.88 | $8.65 – $669.16 | 14 |
| Suscept studies macrobroth dilution ea CPT 87188 | $13.05 | $27.19 | $1.81 – $58.00 | 9 |
| Suspend bowel w/prosthesis CPT 44700 | $1,522.56 | $3,172.00 | $884.79 – $3,172.00 | 24 |
| Suspension of testis CPT 54620 | $454.56 | $947.00 | $265.78 – $947.00 | 24 |
| Suspension of uterus 58400 CPT 58400 | $714.24 | $1,488.00 | $404.05 – $1,488.00 | 24 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $1,604.64 | $3,343.00 | $931.32 – $3,343.00 | 24 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $16.79 | $34.98 | $1.03 – $74.35 | 21 |
| T3 (triiodothyronine) free CPT 84481 | $77.85 | $162.18 | $16.94 – $517.08 | 14 |
| T3 (triiodothyronine) total CPT 84480 | $67.16 | $139.92 | $14.18 – $446.11 | 14 |
| T4 (thyroxine) free CPT 84439 | $46.30 | $96.46 | $8.70 – $307.54 | 14 |
| T4 (thyroxine) total CPT 84436 | $30.53 | $63.60 | $4.37 – $202.78 | 14 |
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.