Supplies, drugs & other prices at Adventist Health Sonora
Sonora, CA · every code in this section with a posted price and a Medicare benchmark.
182 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) | $16.32 | $96 | 0.0× |
| Adm of soc dtr assess 5-15 m (G0136) | $8.33 | $49 | 0.2× |
| Admin hepatitis b vaccine (G0010) | $10.54 | $62 | 0.2× |
| Alveoloplasty not w/extracts (D7321) | $60.86 | $358 | 0.0× |
| Alveoplasty w/ extraction (D7310) | $83.30 | $490 | 0.0× |
| Alveoplasty w/o extraction (D7320) | $155.89 | $917 | 0.1× |
| Amalgam 4 or > surfaces perm (D2161) | $91.80 | $540 | 0.1× |
| Amalgam one surface permanen (D2140) | $38.25 | $225 | 0.0× |
| Amalgam three surfaces perma (D2160) | $61.88 | $364 | 0.1× |
| Amalgam two surfaces permane (D2150) | $45.90 | $270 | 0.1× |
| Annual alcohol screen 15 min (G0442) range across 3 matching MRF lines |
$3.74–$22.27 | $22–$131 | varies |
| Ant resin-based cmpst crown (D2390) | $82.28 | $484 | 0.1× |
| Apicoectomy - anterior (D3410) | $227.80 | $1,340 | 0.3× |
| Ascvd rsk mng clin stf pr mo (G0538) | $6.80 | $40 | 0.1× |
| Behavior counsel obesity 15m (G0447) range across 2 matching MRF lines |
$13.77–$22.27 | $81–$131 | varies |
| Bitewings four images (D0274) | $22.10 | $130 | 0.1× |
| Brief alcohol misuse counsel (G0443) range across 3 matching MRF lines |
$7.31–$13.77 | $43–$81 | varies |
| Brief chkin by md/qhp, 11-20 (G2252) range across 3 matching MRF lines |
$10.54–$28.90 | $62–$170 | varies |
| Brief chkin, 5-10, non-e/m (G2251) range across 2 matching MRF lines |
$5.27–$6.12 | $31–$36 | varies |
| Ca screen;flexi sigmoidscope (G0104) | $23.80 | $140 | 0.0× |
| Ca screen;pelvic/breast exam (G0101) range across 3 matching MRF lines |
$11.22–$20.40 | $66–$120 | varies |
| Catheterize for urine spec (P9612) | $15.47 | $91 | 1.7× |
| Chemo extend iv infus w/pump (G0498) range across 2 matching MRF lines |
$216.75–$305.66 | $1,275–$1,798 | varies |
| Colon ca scrn not hi rsk ind (G0121) | $75.65 | $445 | 0.1× |
| Colorectal scrn; hi risk ind (G0105) | $75.65 | $445 | 0.1× |
| Complete occlusal adjustment (D9952) | $182.75 | $1,075 | 0.2× |
| Comprehensve oral evaluation (D0150) | $23.97 | $141 | 0.1× |
| Core build-up incl any pins (D2950) | $84.83 | $499 | 0.1× |
| Crown 3/4 cast base metal (D2781) | $173.40 | $1,020 | 0.2× |
| Crown 3/4 porcelain/ceramic (D2783) | $173.40 | $1,020 | 0.2× |
| Crown 3/4 resin-based compos (D2712) | $76.50 | $450 | 0.1× |
| Crown full cast base metal (D2791) | $279.31 | $1,643 | 0.3× |
| Crown full cast noble metal (D2792) | $283.39 | $1,667 | 0.3× |
| Crown lengthen hard tissue (D4249) | $243.95 | $1,435 | 0.3× |
| Crown porcelain fused base m (D2751) | $279.31 | $1,643 | 0.3× |
| Crown porcelain w/ h noble m (D2750) | $337.62 | $1,986 | 0.4× |
| Crown porcelain w/ noble met (D2752) | $291.89 | $1,717 | 0.4× |
| Crown porcelain/ceramic (D2740) | $309.40 | $1,820 | 0.4× |
| Crown resin w/ base metal (D2721) | $124.61 | $733 | 0.1× |
| Crown resin-based indirect (D2710) | $76.50 | $450 | 0.1× |
| Cysto impl 4 or more (C9740) likely a partial charge, not the full procedure |
$2,828.97 | $16,641 | 0.2× |
| Cystoscopy prostatic imp 1-3 (C9739) likely a partial charge, not the full procedure |
$720.12 | $4,236 | 0.1× |
| Demonstrate use home inr mon (G0248) | $37.40 | $220 | 0.2× |
| Dental bitewing single image (D0270) range across 2 matching MRF lines |
$2.55–$15.30 | $15–$90 | varies |
| Dental bitewings two images (D0272) | $15.30 | $90 | 0.1× |
| Dental prophylaxis adult (D1110) | $29.92 | $176 | 0.2× |
| Dental tomographic survey (D0322) | $76.33 | $449 | 0.6× |
| Dental unspec restorative pr (D2999) | $102.17 | $601 | 0.1× |
| Depression screen annual (G0444) range across 3 matching MRF lines |
$3.57–$7.65 | $21–$45 | varies |
| Diab manage trn per indiv (G0108) range across 2 matching MRF lines |
$21.59–$23.29 | $127–$137 | varies |
| Diab manage trn ind/group (G0109) range across 2 matching MRF lines |
$6.80–$11.22 | $40–$66 | varies |
| Direct refer hospital observ (G0379) | $138.55 | $815 | 0.2× |
| Each addtnl prefab post (D2957) | $43.35 | $255 | 0.1× |
| Elec stim other than wound (G0283) | $13.26 | $78 | 1.0× |
| End thxpy, anterior tooth (D3310) | $199.92 | $1,176 | 0.2× |
| End thxpy, molar tooth (D3330) | $317.05 | $1,865 | 0.4× |
| End thxpy, premolar tooth (D3320) | $244.80 | $1,440 | 0.3× |
| Endodontic procedure (D3999) | $102.17 | $601 | 0.1× |
| Excision benign lesion>1.25c (D7411) | $144.33 | $849 | 0.1× |
| Exposure of unerupted tooth (D7280) | $97.24 | $572 | 0.1× |
| Extensv oral eval prob focus (D0160) | $35.36 | $208 | 0.2× |
| Extraction coronal remnants (D7111) | $24.48 | $144 | 0.0× |
| Extraction erupted tooth/exr (D7140) | $36.55 | $215 | 0.0× |
| Fecal blood scrn immunoassay (G0328) range across 2 matching MRF lines |
$37.06–$88.40 | $218–$520 | varies |
| Followup eval of foot pt lop (G0246) range across 3 matching MRF lines |
$8.16–$38.59 | $48–$227 | varies |
| Full mouth debridement (D4355) | $49.64 | $292 | 0.1× |
| Gingival flap proc w/ planin (D4240) | $214.20 | $1,260 | 0.1× |
| Gingivectomy/plasty 1 to 3 (D4211) | $103.87 | $611 | 0.0× |
| Gingivectomy/plasty 4 or mor (D4210) | $132.77 | $781 | 0.0× |
| Gngvl flap w rootplan 1-3 th (D4241) | $123.76 | $728 | 0.1× |
| Gross pulpal debridement (D3221) | $52.02 | $306 | 0.1× |
| Group mnt 2 or more 30 mins (G0271) | $21.59 | $127 | 1.3× |
| Hep c screen high risk/other (G0472) | $19.72 | $116 | 0.4× |
| High inten beh couns std 30m (G0445) range across 3 matching MRF lines |
$7.14–$13.60 | $42–$80 | varies |
| Hospital outpt clinic visit (G0463) | $10.88 | $64 | 0.1× |
| I&d absc intraoral soft tiss (D7510) | $66.81 | $393 | 0.1× |
| I&d abscess extraoral (D7520) | $301.92 | $1,776 | 0.3× |
| Impact tooth rem bony w/comp (D7241) | $140.08 | $824 | 0.2× |
| Impact tooth remov comp bony (D7240) | $136.51 | $803 | 0.2× |
| Impact tooth remov part bony (D7230) | $116.62 | $686 | 0.1× |
| Impact tooth remov soft tiss (D7220) | $86.19 | $507 | 0.1× |
| Initial foot exam pt lops (G0245) range across 3 matching MRF lines |
$16.32–$38.59 | $96–$227 | varies |
| Initial preventive exam (G0402) range across 3 matching MRF lines |
$54.40–$70.72 | $320–$416 | varies |
| Intens behave ther cardio dx (G0446) range across 3 matching MRF lines |
$7.31–$13.77 | $43–$81 | varies |
| Intentional replantation (D3470) | $108.80 | $640 | 0.1× |
| Intraor comprehensive series (D0210) | $35.87 | $211 | 0.1× |
| Intraoral occlusal film (D0240) | $14.96 | $88 | 0.1× |
| Intraoral periapical first (D0220) | $9.35 | $55 | 0.1× |
| Labial veneer resin direct (D2960) | $210.63 | $1,239 | 0.3× |
| Limit oral eval problm focus (D0140) | $23.46 | $138 | 0.1× |
| Limited occlusal adjustment (D9951) | $34.85 | $205 | 0.0× |
| Mesial/distal wedge proc (D4274) | $159.63 | $939 | 0.2× |
| Mnt subs tx for change dx (G0270) | $15.64 | $92 | 0.5× |
| Mra w/cont, lwr ext (C8912) | $486.54 | $2,862 | 1.1× |
| Mra w/cont, pelvis (C8918) | $486.54 | $2,862 | 1.1× |
| Mra w/o cont, lwr ext (C8913) | $486.54 | $2,862 | 1.6× |
| Mra w/o cont, pelvis (C8919) | $486.54 | $2,862 | 1.6× |
| Mra w/o fol w/cont, lwr ext (C8914) | $486.54 | $2,862 | 1.1× |
| Mra w/o fol w/cont, pelvis (C8920) | $486.54 | $2,862 | 1.1× |
| Neuro csf prion prtn qual (0035U) | $80.22 | $471.87 | 0.1× |
| Njx bone sub matrl into subchondral bone defect (0707T) | $229.50 | $1,350 | 0.1× |
| Njx platelet plasma (0232T) range across 4 matching MRF lines |
$202.13–$1,126.59 | $1,189–$6,627 | varies |
| Obtaining screen pap smear (Q0091) range across 3 matching MRF lines |
$7.65–$47.09 | $45–$277 | varies |
| Occ guard, hard, full arch (D9944) | $63.75 | $375 | 0.1× |
| Occ guard, soft, full arch (D9945) | $63.75 | $375 | 0.1× |
| Occlusion analysis (D9950) | $61.20 | $360 | 0.1× |
| Onc Merkel Cll Carc Srm Quan (0058U) range across 2 matching MRF lines |
$58.03–$59.71 | $341.38–$351.25 | varies |
| Oral antral fistula closure (D7260) | $182.24 | $1,072 | 0.2× |
| Osseous surg 1 to 3 teeth (D4261) | $189.38 | $1,114 | 0.0× |
| Osseous surgery 4 or more (D4260) likely a partial charge, not the full procedure |
$352.58 | $2,074 | 0.0× |
| Oth resp proc, group (G0239) | $33.66 | $198 | 0.7× |
| Oth resp proc, indiv (G0238) | $33.66 | $198 | 0.9× |
| Panoramic image (D0330) | $35.53 | $209 | 0.1× |
| Perc d-e cor revasc chro sin (C9607) range across 2 matching MRF lines |
$12,024.27 | $1,460–$70,731 | 0.5× |
| Perc d-e cor revasc t cabg s (C9604) likely a partial charge, not the full procedure |
$127.50 | $750 | 0.0× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$202.13 | $1,189 | 0.0× |
| Perc drug-el cor stent sing (C9600) range across 2 matching MRF lines unusually low: confirm this is the full procedure |
$7,010.12 | $1,240–$41,236 | 0.5× |
| Periodic oral evaluation (D0120) | $16.15 | $95 | 0.1× |
| Periodontal maint procedures (D4910) | $37.23 | $219 | 0.0× |
| Periodontal scaling & root (D4341) | $77.01 | $453 | 0.1× |
| Periodontal scaling 1-3teeth (D4342) | $54.57 | $321 | 0.1× |
| Place device/marker, non pro (C9728) range across 2 matching MRF lines |
$634.78–$907.80 | $3,734–$5,340 | varies |
| Place direct restoration (D2940) | $37.40 | $220 | 0.0× |
| Post 1 srfc resinbased cmpst (D2391) | $53.55 | $315 | 0.1× |
| Post 2 srfc resinbased cmpst (D2392) | $70.04 | $412 | 0.1× |
| Post 3 srfc resinbased cmpst (D2393) | $87.04 | $512 | 0.1× |
| Post >=4srfc resinbase cmpst (D2394) | $106.76 | $628 | 0.1× |
| Post and core cast + crown (D2952) | $283.73 | $1,669 | 0.3× |
| Ppps, initial visit (G0438) | $70.55 | $415 | 0.4× |
| Ppps, subseq visit (G0439) | $55.76 | $328 | 0.4× |
| Prefab post/core + crown (D2954) | $85.85 | $505 | 0.1× |
| Prefab stnlss steel crown pe (D2931) | $102.34 | $602 | 0.1× |
| Prefab stnlss steel crwn pri (D2930) | $71.91 | $423 | 0.1× |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$33.64–$35.53 | $197.90–$209 | varies |
| Psa screening (G0103) range across 7 matching MRF lines |
$2.16–$117.30 | $12.70–$690 | varies |
| Pulp cap direct (D3110) | $37.40 | $220 | 0.0× |
| Pulp cap indirect (D3120) | $35.53 | $209 | 0.0× |
| Pulp vitality test (D0460) | $9.01 | $53 | 0.0× |
| Pulpal therapy anterior prim (D3230) | $51.17 | $301 | 0.1× |
| Pulpal therapy posterior pri (D3240) | $56.10 | $330 | 0.1× |
| Rad exc lesion up to 1.25 cm (D7410) | $91.29 | $537 | 0.0× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) range across 2 matching MRF lines |
$40.80–$55.25 | $240–$325 | varies |
| Re-cement or re-bond crown (D2920) | $35.53 | $209 | 0.0× |
| Re-eval,est pt,problem focus (D0170) | $23.29 | $137 | 0.1× |
| Recement inlay onlay or part (D2910) | $17 | $100 | 0.0× |
| Rem exostosis any site (D7471) | $218.96 | $1,288 | 0.1× |
| Rem imp tooth w mucoper flp (D7210) | $63.24 | $372 | 0.0× |
| Rem nonodonto cyst > 1.25 cm (D7461) | $122.91 | $723 | 0.1× |
| Rem nonodonto cyst to 1.25cm (D7460) | $91.29 | $537 | 0.1× |
| Removal of sloughed off bone (D7550) | $64.26 | $378 | 0.1× |
| Remove torus mandibularis (D7473) | $245.65 | $1,445 | 0.3× |
| Resin 4/> surf or w incis an (D2335) | $84.49 | $497 | 0.1× |
| Resin one surface-anterior (D2330) | $45.39 | $267 | 0.1× |
| Resin three surfaces-anterio (D2332) | $71.23 | $419 | 0.1× |
| Resin two surfaces-anterior (D2331) | $58.48 | $344 | 0.1× |
| Retreat root canal anterior (D3346) | $266.56 | $1,568 | 0.3× |
| Retreat root canal molar (D3348) | $388.11 | $2,283 | 0.5× |
| Retreat root canal premolar (D3347) | $313.65 | $1,845 | 0.4× |
| Retrograde filling (D3430) | $69.70 | $410 | 0.1× |
| Risk ascvd tst once pr 12 mo (G0537) | $8.33 | $49 | 0.2× |
| Root surgery molar (D3425) | $238.51 | $1,403 | 0.3× |
| Routine footcare pt w lops (G0247) range across 2 matching MRF lines |
$36.72–$50.15 | $216–$295 | varies |
| Space maintainer fxd unilat (D1510) | $91.46 | $538 | 0.1× |
| Surg reduct osseoustuberosit (D7485) likely a partial charge, not the full procedure |
$112.88 | $664 | 0.0× |
| Surgical splint (D5988) | $88.40 | $520 | 0.1× |
| Therapeutic procd strg endur (G0237) | $21.08 | $124 | 0.6× |
| Therapeutic pulpotomy (D3220) | $47.43 | $279 | 0.1× |
| Tomosynthesis, mammo (G0279) range across 2 matching MRF lines |
$11.90–$45.39 | $70–$267 | varies |
| Tooth pin retention (D2951) | $15.47 | $91 | 0.0× |
| Tooth reimplantation (D7270) | $57.12 | $336 | 0.1× |
| Tooth root removal (D7250) | $73.78 | $434 | 0.1× |
| Treatment of complications (D9930) | $14.28 | $84 | 0.0× |
| Trim nail(s) (G0127) range across 3 matching MRF lines |
$8.84–$129.88 | $52–$764 | varies |
| Trluml perip athrc abd aorta (0236T) likely a partial charge, not the full procedure |
$3,131.23 | $18,419 | 0.2× |
| Trluml Perip Athrc Brchiocph (0237T) likely a partial charge, not the full procedure |
$3,131.23 | $18,419 | 0.2× |
| Trluml Perip Athrc Iliac Art (0238T) likely a partial charge, not the full procedure |
$3,131.23 | $18,419 | 0.1× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) likely a partial charge, not the full procedure |
$3,131.23 | $18,419 | 0.2× |
| Tte w or wo fol wcon,doppler (C8929) | $45.56 | $268 | 0.0× |
| Unsched dialysis esrd pt hos (G0257) | $482.80 | $2,840 | 0.5× |
| Vestibuloplasty ridge extens (D7340) likely a partial charge, not the full procedure |
$208.93 | $1,229 | 0.0× |
| Visit to determ ldct elig (G0296) range across 3 matching MRF lines |
$10.54–$23.12 | $62–$136 | varies |
| Wet mounts/ w preparations (Q0111) | $7.65 | $45 | 0.4× |
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.