San Rafael Medical Center — price list

← Hospital overviewVerified from San Rafael Medical Center’s published price file

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

Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.

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.

48 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
"FACILITY USE-O.R., URGENT - SUBSEQUENT ADD'L 30 MIN" Inpatient & outpatient	6593 CDM	$2,130	$1,193	—	—
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC" Inpatient	493 MS-DRG	—	—	$15,528 – $62,332	—
ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES Inpatient & outpatient	20693 CPT	$24,090	$13,490	$8,633 – $27,033	—
ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED Inpatient & outpatient	20930 CPT	$13,400	$7,504	—	—
ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL Inpatient & outpatient	20931 CPT	$494	$277	—	—
AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC Inpatient & outpatient	20938 CPT	$820	$459	—	—
AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION Inpatient & outpatient	20936 CPT	$970	$543	—	—
AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION Inpatient & outpatient	20937 CPT	$1,140	$638	—	—
BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY Inpatient & outpatient	20939 CPT	$3,140	$1,758	—	—
BREAST AUGMENTATION WITH IMPLANT Inpatient & outpatient	19325 CPT	$15,370	$8,607	$11,563 – $36,210	—
BREAST REDUCTION Inpatient & outpatient	19318 CPT	$20,810	$11,654	$7,880 – $24,678	—
CHEMICAL PEEL NONFACIAL DERMAL Inpatient & outpatient	15793 CPT	$2,000	$1,120	$483 – $1,512	—
CORRECTION INVERTED NIPPLES Inpatient & outpatient	19355 CPT	$17,390	$9,738	$4,627 – $14,491	—
EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR Inpatient & outpatient	15936 CPT	$9,830	$5,505	$2,210 – $6,922	—
EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC Inpatient & outpatient	15937 CPT	$10,010	$5,606	$2,210 – $6,922	—
EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY Inpatient & outpatient	15935 CPT	$20,180	$11,301	$4,424 – $13,854	—
EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY Inpatient & outpatient	15933 CPT	$12,790	$7,162	$3,458 – $10,830	—
EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM Inpatient & outpatient	21932 CPT	$13,720	$7,683	$3,458 – $10,830	—
EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/> Inpatient & outpatient	21933 CPT	$15,350	$8,596	$3,458 – $10,830	—
EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE Inpatient & outpatient	15931 CPT	$11,050	$6,188	$3,458 – $10,830	—
EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR Inpatient & outpatient	15934 CPT	$20,180	$11,301	$4,424 – $13,854	—
EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/> Inpatient & outpatient	21931 CPT	$11,690	$6,546	$1,958 – $6,131	—
EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM Inpatient & outpatient	21930 CPT	$11,280	$6,317	$1,958 – $6,131	—
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT Inpatient	933 MS-DRG	—	—	$12,563 – $50,429	—
FULL TERM NEONATE WITH MAJOR PROBLEMS Inpatient	793 MS-DRG	—	—	$4,528 – $18,177	—
FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Inpatient	934 MS-DRG	—	—	$6,537 – $26,241	—
HEART FAILURE AND SHOCK WITHOUT CC/MCC Inpatient	293 MS-DRG	—	—	$4,013 – $16,107	—
HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL Inpatient & outpatient	20933 CPT	$3,060	$1,714	—	—
I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA Inpatient & outpatient	23930 CPT	$12,530	$7,017	$3,458 – $10,830	—
INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW Inpatient & outpatient	23935 CPT	$13,010	$7,286	$3,921 – $12,278	—