TRI VALLEY HEALTH SYSTEM
Hospital
Procedure Prices at TRI VALLEY HEALTH SYSTEM
BLOOD ALCOHOL DRAW
CPT 36415
$39.6
Mechanical Traction
CPT 97012
$90
Therapeutic Activities
CPT 97530
$112.5
Therapeutic Exercises
CPT 97110
$121.5
CBC WITH AUTO PART
CPT 85025
$130.5
OFFICE VISIT EST MODERATE
CPT 99213
$165.12
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$184.5
Knee Arthroscopy
CPT 29881
$252.9
ER Visit — Low-Moderate Complexity
CPT 99283
$270.9
Chest X-Ray (1 view)
CPT 71045
$279
Diagnostic Mammogram (unilateral)
CPT 77065
$364.5
EKG Tracing
CPT 93005
$370.8
Psychotherapy, 1 hour
CPT 90837
$428.4
ER Visit — Moderate Complexity
CPT 99284
$433.8
Diagnostic Mammogram (bilateral)
CPT 77066
$457.2
Screening Mammogram (bilateral)
CPT 77067
$473.4
Laparoscopic Cholecystectomy
CPT 47562
$517.5
Chest X-Ray (2 views)
CPT 71046
$525.6
ASST ARTHRO ROTATOR CUFF REP
CPT 29827
$574.2
Thoracic Spine X-Ray
CPT 72072
$575.1
INJ FORAMEN EPIDURAL L/S
CPT 64483
$592.41
Abdominal Ultrasound — Limited
CPT 76705
$667.8
ER Visit — High Complexity
CPT 99285
$682.2
Knee Replacement
CPT 27447
$770.4
Hip Replacement
CPT 27130
$782.1
OB Ultrasound
CPT 76805
$799.2
Abdominal Ultrasound
CPT 76700
$927
Retroperitoneal Ultrasound
CPT 76770
$936.9
Recurrent Inguinal Hernia Repair
CPT 49520
$1,187.1
Upper GI Endoscopy w/ Biopsy
CPT 43239
$1,428.3
Colonoscopy
CPT 45378
$1,516.5
CT Chest
CPT 71250
$1,789.2
Colonoscopy w/ Biopsy
CPT 45380
$1,801.8
Inguinal Hernia Repair
CPT 49505
$2,330.1
Echocardiogram w/ Doppler
CPT 93306
$2,379.6
MRI Joint of Lower Extremity
CPT 73721
$3,331.8
Cataract Surgery
CPT 66984
$3,534.3
MRI Brain w/o Contrast
CPT 70551
$4,186.8
Vaginal Delivery
CPT 59400
$4,318.2
VBAC Delivery
CPT 59610
$4,508.1
CT Abdomen & Pelvis
CPT 74177
$4,587.3
C-Section
CPT 59510
$5,413.5
MRI Brain w/ Contrast
CPT 70553
$5,831.1
Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.