Adventist Health St Helena
ADVENTIST HEALTH ST HELENA in Saint Helena, CA charges 8.1x the Medicare reimbursement rate on average, with 57% of analyzed procedures showing significant price variations.
Saint Helena, CA 94574 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
No credit card required. Results in 60 seconds.
Pricing grade
F
Very high
Avg markup vs Medicare
8.1x
Charge / Medicare rate
Max markup
12.99x
Worst procedure
Procedures analyzed
37
With pricing data
Outlier procedures
56.8%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $80,444 | $40,222 | — | 13x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $232,883 | $116,442 | — | 12.5x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC | 234 | $609,276 | $304,638 | — | 12.2x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 220 | $572,925 | $286,462 | — | 11.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $569,083 | $284,542 | — | 10.3x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $266,547 | $133,274 | — | 10.3x |
| REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | 468 | $278,181 | $139,090 | — | 10x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $156,265 | $78,132 | — | 9.6x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | 233 | $802,132 | $401,066 | — | 9.4x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 219 | $844,171 | $422,085 | — | 9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $112,998 | $56,499 | — | 8.8x |
| OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC | 229 | $282,300 | $141,150 | — | 8.8x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $150,015 | $75,008 | — | 8.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $170,586 | $85,293 | — | 8.4x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $189,489 | $94,744 | — | 8.4x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $78,651 | $39,326 | — | 8.3x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | 271 | $295,553 | $147,777 | — | 8.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $144,884 | $72,442 | — | 8.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $98,288 | $49,144 | — | 8x |
| RENAL FAILURE WITH CC | 683 | $67,376 | $33,688 | — | 7.9x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | 270 | $414,515 | $207,257 | — | 7.6x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $137,843 | $68,921 | — | 7.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $95,383 | $47,691 | — | 7.5x |
| OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | 673 | $275,257 | $137,628 | — | 7.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $61,949 | $30,974 | — | 7.3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $69,701 | $34,850 | — | 7.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $117,695 | $58,847 | — | 6.8x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $194,803 | $97,401 | — | 6.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $132,819 | $66,409 | — | 6.5x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $59,366 | $29,683 | — | 6.4x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $220,312 | $110,156 | — | 6.3x |
| RENAL FAILURE WITH MCC | 682 | $88,470 | $44,235 | — | 6x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $120,302 | $60,151 | — | 5.8x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | 274 | $185,373 | $92,686 | — | 5.5x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | 266 | $336,681 | $168,340 | — | 5x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | 267 | $236,920 | $118,460 | — | 4.6x |
| PSYCHOSES | 885 | $57,192 | $28,596 | — | 4.4x |
Got a bill from ADVENTIST HEALTH ST HELENA?
Upload your bill and our AI compares every line item against these benchmark prices. Free analysis in 60 seconds. You only pay if we find savings.
Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
Related pricing data
Got a bill from Adventist Health St Helena?
Free guides to help you take action
Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use