PeaceHealth Southwest Medical Center — price list

← Hospital overviewVerified from PeaceHealth Southwest Medical Center’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

125 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
3d radiographic procedure Outpatient	76376 CPT	$1,313	$853	$3.79 – $76.76	—
Administration of developmental test; each additional 30 minutes Outpatient	96113 CPT	$320	$208	$18.26 – $170	—
Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle Outpatient	96401 CPT	$430	$280	$31.94 – $259	—
Adrenocorticotropic hormone (acth) level Outpatient	82024 CPT	$893	$580	$15.45 – $125	—
Analgesics levels; 1 or 2 Outpatient	80329 CPT	$97.00	$63.05	—	—
Analysis for antibody to epstein-barr virus (mononucleosis virus); early antigen Outpatient	86663 CPT	$90.00	$58.50	$5.25 – $42.57	—
Analysis for antibody to epstein-barr virus (mononucleosis virus); nuclear antigen Outpatient	86664 CPT	$144	$93.60	$6.12 – $49.61	—
Analysis for antibody to HIV-2 virus Outpatient	86702 CPT	$69.00	$44.85	$5.41 – $43.87	—
Bacterial urine culture Outpatient	87088 CPT	$97.00	$63.05	$3.24 – $26.25	—
Blood smear interpretation by physician with written report Outpatient	85060 CPT	$97.00	$63.05	$7.70 – $70.51	—
Body fluid ph level Outpatient	83986 CPT	$71.00	$46.15	$1.43 – $11.62	—
Cath, translumin, drug-coat Outpatient	C2623 HCPCS	$4,338	$2,820	—	—
Clotting factor x assessment test; diluted Outpatient	85613 CPT	$197	$128	$3.83 – $31.08	—
Collection of blood sample from central venous tube Outpatient	36592 CPT	$922	$599	$59.01 – $479	—
Collection of blood sample from implanted device Outpatient	36591 CPT	$922	$599	$59.01 – $479	—
Complete ultrasound scan behind abdominal cavity Outpatient	76770 CPT	$905	$588	$46.37 – $376	—
Complete ultrasound scan of abdomen Outpatient	76700 CPT	$813	$528	$46.37 – $376	—
Complete ultrasound scan of pelvis Outpatient	76856 CPT	$845	$549	$46.37 – $376	—
Complete ultrasound study of arm and leg arteries Outpatient	93923 CPT	$1,230	$800	$95.77 – $777	—
Complex control of nose bleed Outpatient	30903 CPT	$919	$597	$59.01 – $4,569	—
CT scan of abdomen with contrast Outpatient	74160 CPT	$3,460	$2,249	$77.80 – $631	—
CT scan of arm without contrast Outpatient	73200 CPT	$1,929	$1,254	$46.37 – $376	—
CT scan of blood vessels of head with contrast Outpatient	70496 CPT	$7,996	$5,197	$77.80 – $631	—
CT scan of blood vessels of neck with contrast Outpatient	70498 CPT	$3,979	$2,586	$77.80 – $631	—
Cyanocobalamin (vitamin b-12) level Outpatient	82607 CPT	$358	$233	$6.03 – $48.93	—
Declotting of central venous tube Outpatient	36593 CPT	$2,870	$1,866	$147 – $4,569	—
Delivery of simple high precision radiation treatment Outpatient	77385 CPT	$3,726	$2,422	$578 – $578	—
Destruction of lower or sacral spinal facet joint nerves using imaging guidance; single facet joint Outpatient	64635 CPT	$12,108	$7,870	$866 – $7,025	—
Detection test by immunoassay technique for cryptosporidium (parasite) Outpatient	87328 CPT	$165	$107	$5.53 – $44.84	—
Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance Outpatient	32557 CPT	$5,937	$3,859	$698 – $5,663	—