PeaceHealth St. John Medical Center — price list

← Hospital overviewVerified from PeaceHealth St. John 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.

116 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
2d ultrasound scan of eye tissue and structures Outpatient	76512 CPT	$1,009	$656	$49.72 – $885	—
3d radiographic procedure Outpatient	76376 CPT	$1,275	$829	$3.79 – $67.46	—
Ambulatory blood pressure monitoring; 1 day or longer; with scanning analysis and report Outpatient	93788 CPT	$584	$380	$63.28 – $1,126	—
Analysis for antibody (igm) to toxoplasma (parasite) Outpatient	86778 CPT	$130	$84.50	$5.76 – $103	—
Analysis for antibody to epstein-barr virus (mononucleosis virus); nuclear antigen Outpatient	86664 CPT	$144	$93.60	$6.12 – $109	—
Analysis of substance using immunoassay technique; multiple step method Outpatient	83516 CPT	$118	$76.70	$4.61 – $82.05	—
Application of short leg splint from calf to foot Outpatient	29515 CPT	$2,076	$1,349	$77.29 – $1,375	—
Aspiration of bladder with insertion of bladder tube to skin Outpatient	51102 CPT	$6,054	$3,935	$994 – $17,687	—
Cerv flex n/adj foam pre ots Outpatient	L0120 HCPCS	$74.00	$48.10	$16.26 – $48.79	—
Collection of blood sample from implanted device Outpatient	36591 CPT	$729	$474	$63.28 – $1,126	—
Complete ultrasound scan of joint Outpatient	76881 CPT	$958	$623	$49.72 – $885	—
Complex control of nose bleed Outpatient	30903 CPT	$1,594	$1,036	$63.28 – $1,126	—
Complicated or multiple drainage of skin abscess Outpatient	10061 CPT	$4,325	$2,811	$193 – $3,440	—
Complicated repair of wound of forehead; cheeks; chin; mouth; neck; underarms; genitals; hands; or feet; 2.6-7.5 cm Outpatient	13132 CPT	$2,410	$1,567	$193 – $3,440	—
CT scan of arm with contrast Outpatient	73201 CPT	$7,552	$4,909	$166 – $2,952	—
CT scan of blood vessels and grafts of heart with contrast Outpatient	75574 CPT	$4,156	$2,701	$166 – $2,952	—
CT scan of chest before and after contrast Outpatient	71270 CPT	$4,035	$2,623	$83.42 – $1,484	—
CT scan of upper spine with contrast Outpatient	72126 CPT	$2,464	$1,602	$166 – $2,952	—
Detection of infectious agent antibody; quantitative Outpatient	86317 CPT	$114	$74.10	$6.00 – $107	—
Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies Outpatient	87389 CPT	$140	$91.00	$9.63 – $171	—
Detection test by nucleic acid for trichomonas vaginalis (genital parasite); amplified probe technique Outpatient	87661 CPT	$271	$176	$14.04 – $250	—
Detection test for gardnerella vaginalis (bacteria); direct probe technique Outpatient	87510 CPT	$87.00	$56.55	$8.02 – $143	—
Dihydroxyvitamin d; 1; 25 level Outpatientapprox. match	82652 CPT	$310	$202	$15.40 – $274	—
Drainage of abscess near tonsil Outpatient	42700 CPT	$3,912	$2,543	$113 – $2,004	—
Drainage of abscess of scrotum Outpatient	55100 CPT	$3,395	$2,207	$786 – $13,975	—
Drainage of abscess; cyst; or blood accumulation of dental bone Outpatient	41800 CPT	$2,098	$1,364	$63.28 – $1,126	—
Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance Outpatient	32557 CPT	$4,153	$2,699	$749 – $13,319	—
Dressing change or removal of burn tissue; less than 5% of total body surface Outpatient	16020 CPT	$2,719	$1,767	$95.43 – $1,698	—
Emergency department visit for problem of mild severity Outpatient	99281 CPT	$493	$320	$40.11 – $721	—
Emergency department visit for problem of mild to moderate severity Outpatient	99282 CPT	$878	$571	$73.03 – $1,299	—