Supplies, drugs & other prices at Sutter Lakeside Hospital

Lakeport, CA · every code in this section with a posted price and a Medicare benchmark.

31 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Adm tocilizu covid-19 1st (M0249) $924 $924 1.6×
Adm tocilizu covid-19 2nd (M0250) $1,005 $1,005 1.8×
Admin hepatitis b vaccine (G0010) $117 $117 1.9×
Admin influenza virus vac (G0008) $154 $154 2.6×
Admin pneumococcal vaccine (G0009) $144 $144 2.4×
Ca screen;pelvic/breast exam (G0101) $119 $119 0.9×
Catheterize for urine spec (P9612)
range across 2 matching MRF lines
$90–$110 $90–$110 varies
Chemo extend iv infus w/pump (G0498) $1,105 $1,105 2.6×
Direct refer hospital observ (G0379) $875 $875 1.1×
Elec stim other than wound (G0283) $129 $129 10.2×
Fecal blood scrn immunoassay (G0328) $97 $97 5.4×
Fern test (Q0114) $171 $171 17.6×
Hep c screen high risk/other (G0472) $134 $134 2.9×
Hepb screen high risk indiv (G0499) $143 $143 5.1×
Hospital outpt clinic visit (G0463)
range across 10 matching MRF lines
$110–$844 $110–$844 varies
Initial preventive exam (G0402) $274 $274 1.6×
Inj for sacroiliac jt anesth (G0260)
range across 2 matching MRF lines
$4,083–$6,124 $4,083–$6,124 varies
Mra w/cont, abd (C8900) $3,515 $3,515 7.8×
Mra w/cont, lwr ext (C8912)
range across 3 matching MRF lines
$4,189–$6,284 $4,189–$6,284 varies
Mra w/o cont, lwr ext (C8913)
range across 3 matching MRF lines
$3,346–$5,019 $3,346–$5,019 varies
Mra w/o fol w/cont, abd (C8902) $5,536 $5,536 12.3×
Mra w/o fol w/cont, chest (C8911) $6,112 $6,112 13.6×
Mra w/o fol w/cont, pelvis (C8920) $7,066 $7,066 15.7×
Mri w/o fol w/cont, breast, (C8908) $6,731 $6,731 15.0×
Mri w/o fol w/cont, brst, un (C8905) $5,169 $5,169 11.5×
Obtaining screen pap smear (Q0091) $82 $82 2.2×
Ppps, initial visit (G0438) $299 $299 1.7×
Ppps, subseq visit (G0439) $245 $245 1.8×
Psa screening (G0103) $202 $202 10.5×
Tomosynthesis, mammo (G0279)
range across 2 matching MRF lines
$150–$225 $150–$225 varies
Trauma respons w/hosp criti (G0390)
range across 3 matching MRF lines
$4,427–$6,536 $4,427–$6,536 varies

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.