Supplies, drugs & other prices at Adventist Health Howard Memorial
Willits, CA · every code in this section with a posted price and a Medicare benchmark.
169 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $28.80 | $96 | 0.1× |
| Adm of soc dtr assess 5-15 m (G0136) | $14.70 | $49 | 0.3× |
| Admin hepatitis b vaccine (G0010) range across 2 matching MRF lines |
$14.10–$18.60 | $47–$62 | varies |
| Alveoloplasty not w/extracts (D7321) | $107.40 | $358 | 0.1× |
| Alveoplasty w/ extraction (D7310) | $147 | $490 | 0.1× |
| Alveoplasty w/o extraction (D7320) | $275.10 | $917 | 0.1× |
| Amalgam 4 or > surfaces perm (D2161) | $162 | $540 | 0.2× |
| Amalgam one surface permanen (D2140) | $67.50 | $225 | 0.1× |
| Amalgam three surfaces perma (D2160) | $109.20 | $364 | 0.1× |
| Amalgam two surfaces permane (D2150) | $81 | $270 | 0.1× |
| Annual alcohol screen 15 min (G0442) range across 2 matching MRF lines |
$6.60–$13.50 | $22–$45 | varies |
| Ant resin-based cmpst crown (D2390) | $145.20 | $484 | 0.2× |
| Apicoectomy - anterior (D3410) | $402 | $1,340 | 0.5× |
| Ascvd rsk mng clin stf pr mo (G0538) | $12 | $40 | 0.1× |
| Behavior counsel obesity 15m (G0447) | $24.30 | $81 | 0.2× |
| Bitewings four images (D0274) | $39 | $130 | 0.1× |
| Brief alcohol misuse counsel (G0443) range across 2 matching MRF lines |
$22.20–$24.30 | $74–$81 | varies |
| Brief chkin by md/qhp, 11-20 (G2252) range across 3 matching MRF lines |
$18.60–$27.60 | $62–$92 | varies |
| Brief chkin, 5-10, non-e/m (G2251) range across 2 matching MRF lines |
$9.30–$10.80 | $31–$36 | varies |
| Ca screen;flexi sigmoidscope (G0104) | $42 | $140 | 0.0× |
| Ca screen;pelvic/breast exam (G0101) range across 3 matching MRF lines |
$19.80–$41.70 | $66–$139 | varies |
| Catheterize for urine spec (P9612) | $9 | $30 | 1.0× |
| Colon ca scrn not hi rsk ind (G0121) | $133.50 | $445 | 0.1× |
| Colorectal scrn; hi risk ind (G0105) | $133.50 | $445 | 0.1× |
| Complete occlusal adjustment (D9952) | $322.50 | $1,075 | 0.4× |
| Comprehensve oral evaluation (D0150) | $42.30 | $141 | 0.2× |
| Core build-up incl any pins (D2950) | $149.70 | $499 | 0.2× |
| Crown 3/4 cast base metal (D2781) | $306 | $1,020 | 0.4× |
| Crown 3/4 porcelain/ceramic (D2783) | $306 | $1,020 | 0.4× |
| Crown 3/4 resin-based compos (D2712) | $135 | $450 | 0.2× |
| Crown full cast base metal (D2791) | $492.90 | $1,643 | 0.6× |
| Crown full cast noble metal (D2792) | $500.10 | $1,667 | 0.6× |
| Crown lengthen hard tissue (D4249) | $430.50 | $1,435 | 0.5× |
| Crown porcelain fused base m (D2751) | $492.90 | $1,643 | 0.6× |
| Crown porcelain w/ h noble m (D2750) | $595.80 | $1,986 | 0.7× |
| Crown porcelain w/ noble met (D2752) | $515.10 | $1,717 | 0.6× |
| Crown porcelain/ceramic (D2740) | $546 | $1,820 | 0.7× |
| Crown resin w/ base metal (D2721) | $219.90 | $733 | 0.3× |
| Crown resin-based indirect (D2710) | $135 | $450 | 0.2× |
| Dental bitewing single image (D0270) | $27 | $90 | 0.2× |
| Dental bitewings two images (D0272) | $27 | $90 | 0.2× |
| Dental prophylaxis adult (D1110) | $52.80 | $176 | 0.3× |
| Dental tomographic survey (D0322) | $134.70 | $449 | 1.0× |
| Dental unspec restorative pr (D2999) | $180.30 | $601 | 0.2× |
| Depression screen annual (G0444) range across 2 matching MRF lines |
$6.60–$13.50 | $22–$45 | varies |
| Diab manage trn per indiv (G0108) range across 2 matching MRF lines |
$41.10–$59.10 | $137–$197 | varies |
| Diab manage trn ind/group (G0109) | $12 | $40 | 0.7× |
| Direct refer hospital observ (G0379) | $539.40 | $1,798 | 0.7× |
| Each addtnl prefab post (D2957) | $76.50 | $255 | 0.1× |
| Elec stim other than wound (G0283) | $23.40 | $78 | 1.8× |
| End thxpy, anterior tooth (D3310) | $352.80 | $1,176 | 0.4× |
| End thxpy, molar tooth (D3330) | $559.50 | $1,865 | 0.7× |
| End thxpy, premolar tooth (D3320) | $432 | $1,440 | 0.5× |
| Endodontic procedure (D3999) | $180.30 | $601 | 0.2× |
| Excision benign lesion>1.25c (D7411) | $254.70 | $849 | 0.1× |
| Exposure of unerupted tooth (D7280) | $171.60 | $572 | 0.2× |
| Extensv oral eval prob focus (D0160) | $62.40 | $208 | 0.4× |
| Extraction coronal remnants (D7111) | $43.20 | $144 | 0.1× |
| Extraction erupted tooth/exr (D7140) | $64.50 | $215 | 0.1× |
| Fecal blood scrn immunoassay (G0328) | $61.80 | $206 | 3.4× |
| Followup eval of foot pt lop (G0246) range across 2 matching MRF lines |
$14.40–$29.70 | $48–$99 | varies |
| Full mouth debridement (D4355) | $87.60 | $292 | 0.1× |
| Gingival flap proc w/ planin (D4240) | $378 | $1,260 | 0.1× |
| Gingivectomy/plasty 1 to 3 (D4211) | $183.30 | $611 | 0.0× |
| Gingivectomy/plasty 4 or mor (D4210) | $234.30 | $781 | 0.1× |
| Gngvl flap w rootplan 1-3 th (D4241) | $218.40 | $728 | 0.1× |
| Gross pulpal debridement (D3221) | $91.80 | $306 | 0.1× |
| Group mnt 2 or more 30 mins (G0271) | $8.70 | $29 | 0.5× |
| Hep c screen high risk/other (G0472) | $34.80 | $116 | 0.8× |
| High inten beh couns std 30m (G0445) range across 2 matching MRF lines |
$21.90–$24 | $73–$80 | varies |
| I&d absc intraoral soft tiss (D7510) | $117.90 | $393 | 0.1× |
| I&d abscess extraoral (D7520) | $532.80 | $1,776 | 0.6× |
| Impact tooth rem bony w/comp (D7241) | $247.20 | $824 | 0.3× |
| Impact tooth remov comp bony (D7240) | $240.90 | $803 | 0.3× |
| Impact tooth remov part bony (D7230) | $205.80 | $686 | 0.2× |
| Impact tooth remov soft tiss (D7220) | $152.10 | $507 | 0.2× |
| Initial foot exam pt lops (G0245) range across 2 matching MRF lines |
$28.80–$48.60 | $96–$162 | varies |
| Initial preventive exam (G0402) range across 3 matching MRF lines |
$87–$124.80 | $290–$416 | varies |
| Intens behave ther cardio dx (G0446) range across 2 matching MRF lines |
$22.20–$24.30 | $74–$81 | varies |
| Intentional replantation (D3470) | $192 | $640 | 0.2× |
| Intraor comprehensive series (D0210) | $63.30 | $211 | 0.2× |
| Intraoral occlusal film (D0240) | $26.40 | $88 | 0.2× |
| Intraoral periapical first (D0220) | $16.50 | $55 | 0.1× |
| Labial veneer resin direct (D2960) | $371.70 | $1,239 | 0.4× |
| Limit oral eval problm focus (D0140) | $41.40 | $138 | 0.2× |
| Limited occlusal adjustment (D9951) | $61.50 | $205 | 0.1× |
| Mesial/distal wedge proc (D4274) | $281.70 | $939 | 0.3× |
| Mnt subs tx for change dx (G0270) | $12 | $40 | 0.4× |
| Mra w/cont, lwr ext (C8912) | $1,171.50 | $3,905 | 2.6× |
| Mra w/cont, pelvis (C8918) | $1,233.90 | $4,113 | 2.7× |
| Mra w/o cont, lwr ext (C8913) | $990.90 | $3,303 | 3.2× |
| Mra w/o cont, pelvis (C8919) | $853.50 | $2,845 | 2.8× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,174.80 | $3,916 | 2.6× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,399.80 | $4,666 | 3.1× |
| Neuro csf prion prtn qual (0035U) | $141.56 | $471.87 | 0.3× |
| Njx bone sub matrl into subchondral bone defect (0707T) | $405 | $1,350 | 0.1× |
| Njx platelet plasma (0232T) range across 3 matching MRF lines |
$179.70–$1,016.40 | $599–$3,388 | varies |
| Obtaining screen pap smear (Q0091) range across 3 matching MRF lines |
$13.50–$34.50 | $45–$115 | varies |
| Occ guard, hard, full arch (D9944) | $112.50 | $375 | 0.1× |
| Occ guard, soft, full arch (D9945) | $112.50 | $375 | 0.1× |
| Occlusion analysis (D9950) | $108 | $360 | 0.1× |
| Onc Merkel Cll Carc Srm Quan (0058U) | $102.41 | $341.38 | 0.3× |
| Oral antral fistula closure (D7260) | $321.60 | $1,072 | 0.4× |
| Osseous surg 1 to 3 teeth (D4261) | $334.20 | $1,114 | 0.1× |
| Osseous surgery 4 or more (D4260) likely a partial charge, not the full procedure |
$622.20 | $2,074 | 0.1× |
| Panoramic image (D0330) | $62.70 | $209 | 0.2× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$438 | $1,460 | 0.0× |
| Perc d-e cor revasc t cabg s (C9604) likely a partial charge, not the full procedure |
$225 | $750 | 0.0× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$356.70 | $1,189 | 0.0× |
| Perc drug-el cor stent sing (C9600) likely a partial charge, not the full procedure |
$372 | $1,240 | 0.0× |
| Periodic oral evaluation (D0120) | $28.50 | $95 | 0.2× |
| Periodontal maint procedures (D4910) | $65.70 | $219 | 0.1× |
| Periodontal scaling & root (D4341) | $135.90 | $453 | 0.2× |
| Periodontal scaling 1-3teeth (D4342) | $96.30 | $321 | 0.1× |
| Place device/marker, non pro (C9728) | $1,120.20 | $3,734 | 0.6× |
| Place direct restoration (D2940) | $66 | $220 | 0.1× |
| Post 1 srfc resinbased cmpst (D2391) | $112.50 | $375 | 0.1× |
| Post 2 srfc resinbased cmpst (D2392) | $103.20 | $344 | 0.1× |
| Post 3 srfc resinbased cmpst (D2393) | $128.40 | $428 | 0.2× |
| Post >=4srfc resinbase cmpst (D2394) | $127.50 | $425 | 0.2× |
| Post and core cast + crown (D2952) | $500.70 | $1,669 | 0.6× |
| Ppps, initial visit (G0438) range across 2 matching MRF lines |
$81.90–$124.50 | $273–$415 | varies |
| Ppps, subseq visit (G0439) range across 2 matching MRF lines |
$64.20–$98.40 | $214–$328 | varies |
| Prefab post/core + crown (D2954) | $151.50 | $505 | 0.2× |
| Prefab stnlss steel crown pe (D2931) | $180.60 | $602 | 0.2× |
| Prefab stnlss steel crwn pri (D2930) | $126.90 | $423 | 0.2× |
| Psa screening (G0103) range across 5 matching MRF lines |
$22.20–$105.60 | $74–$352 | varies |
| Pulp cap direct (D3110) | $66 | $220 | 0.1× |
| Pulp cap indirect (D3120) | $62.70 | $209 | 0.1× |
| Pulp vitality test (D0460) | $15.90 | $53 | 0.0× |
| Pulpal therapy anterior prim (D3230) | $90.30 | $301 | 0.1× |
| Pulpal therapy posterior pri (D3240) | $99 | $330 | 0.1× |
| Rad exc lesion up to 1.25 cm (D7410) | $161.10 | $537 | 0.1× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $72 | $240 | 0.1× |
| Re-cement or re-bond crown (D2920) | $62.70 | $209 | 0.1× |
| Re-eval,est pt,problem focus (D0170) | $41.10 | $137 | 0.2× |
| Recement inlay onlay or part (D2910) | $30 | $100 | 0.0× |
| Rem exostosis any site (D7471) | $386.40 | $1,288 | 0.1× |
| Rem imp tooth w mucoper flp (D7210) | $111.60 | $372 | 0.1× |
| Rem nonodonto cyst > 1.25 cm (D7461) | $216.90 | $723 | 0.3× |
| Rem nonodonto cyst to 1.25cm (D7460) | $161.10 | $537 | 0.2× |
| Removal of sloughed off bone (D7550) | $113.40 | $378 | 0.1× |
| Remove torus mandibularis (D7473) | $433.50 | $1,445 | 0.5× |
| Resin 4/> surf or w incis an (D2335) | $120.30 | $401 | 0.1× |
| Resin one surface-anterior (D2330) | $112.50 | $375 | 0.1× |
| Resin three surfaces-anterio (D2332) | $153 | $510 | 0.2× |
| Resin two surfaces-anterior (D2331) | $141 | $470 | 0.2× |
| Retreat root canal anterior (D3346) | $470.40 | $1,568 | 0.6× |
| Retreat root canal molar (D3348) | $684.90 | $2,283 | 0.8× |
| Retreat root canal premolar (D3347) | $553.50 | $1,845 | 0.7× |
| Retrograde filling (D3430) | $123 | $410 | 0.1× |
| Risk ascvd tst once pr 12 mo (G0537) | $14.70 | $49 | 0.3× |
| Root surgery molar (D3425) | $420.90 | $1,403 | 0.5× |
| Routine footcare pt w lops (G0247) | $64.80 | $216 | 0.3× |
| Space maintainer fxd unilat (D1510) | $161.40 | $538 | 0.2× |
| Surg reduct osseoustuberosit (D7485) likely a partial charge, not the full procedure |
$199.20 | $664 | 0.0× |
| Surgical splint (D5988) | $156 | $520 | 0.2× |
| Therapeutic pulpotomy (D3220) | $83.70 | $279 | 0.1× |
| Tomosynthesis, mammo (G0279) range across 2 matching MRF lines |
$21–$95.10 | $70–$317 | varies |
| Tooth pin retention (D2951) | $27.30 | $91 | 0.0× |
| Tooth reimplantation (D7270) | $100.80 | $336 | 0.1× |
| Tooth root removal (D7250) | $130.20 | $434 | 0.2× |
| Trauma respons w/hosp criti (G0390) range across 3 matching MRF lines |
$688.20–$4,499.40 | $2,294–$14,998 | varies |
| Treatment of complications (D9930) | $25.20 | $84 | 0.0× |
| Trim nail(s) (G0127) range across 2 matching MRF lines |
$15.60–$229.20 | $52–$764 | varies |
| Tte w or wo fol wcon,doppler (C8929) | $80.40 | $268 | 0.1× |
| Vestibuloplasty ridge extens (D7340) likely a partial charge, not the full procedure |
$368.70 | $1,229 | 0.0× |
| Visit to determ ldct elig (G0296) range across 2 matching MRF lines |
$18.60–$33.30 | $62–$111 | varies |
| Wet mounts/ w preparations (Q0111) | $13.50 | $45 | 0.7× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.