Sierra Nevada Memorial Hospital
155 Glasson Way, Grass Valley, CA · CommonSpirit Health · · NPI 1659361392
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $15.23 | $27.94 | $18.72 – $27.94 | 14 |
| 17-hydroxypregnenolone CPT 84143 | $16.35 | $30.00 | $20.10 – $30.00 | 14 |
| 17-ketosteroids CPT 83586 | $14.26 | $26.16 | $12.80 – $26.16 | 14 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $2,119.51 | $3,889.00 | $1,038.22 – $3,811.22 | 11 |
| 2nd order venous cath CPT 36012 | not published | not published | $130.30 – $464.23 | 4 |
| 3d ech img cgen car anomal CPT 93319 | $535.74 | $983.00 | $658.61 – $963.34 | 6 |
| 3-d radiotherapy plan CPT 77295 | $10,373.53 | $19,034.00 | $410.00 – $18,653.32 | 13 |
| 5' nucleotidase - sendout CPT 83915 | $6.74 | $12.35 | $8.28 – $12.35 | 14 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $67.58 | $124.00 | $23.03 – $121.52 | 11 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $2,326.65 – $8,288.82 | 4 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $3,634.61 | $6,669.00 | $45.11 – $4,379.62 | 13 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $6.54 | $12.00 | $8.04 – $12.00 | 14 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $577.18 – $2,056.22 | 4 |
| Abd/low ext cath 1st CPT 36245 | not published | not published | $232.83 – $829.49 | 4 |
| Abd/low ext cath 2nd CPT 36246 | not published | not published | $279.40 – $995.37 | 4 |
| Abd/low ext cath 3rd CPT 36247 | not published | not published | $332.38 – $1,184.10 | 4 |
| Abd/low ext cath addl CPT 36248 | not published | not published | $52.98 – $188.73 | 4 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,567.03 | $6,545.00 | $233.94 – $1,822.80 | 13 |
| Abdominal CT scan (with contrast) CPT 74160 | $3,567.03 | $6,545.00 | $233.94 – $1,822.80 | 13 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,389.83 | $4,385.00 | $139.74 – $1,215.20 | 13 |
| Abdominal MRI (with and without contrast) CPT 74183 | $4,111.48 | $7,544.00 | $333.52 – $2,123.66 | 13 |
| Abdominal MRI (without contrast) CPT 74181 | $2,672.68 | $4,904.00 | $273.91 – $1,385.72 | 13 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,518.45 | $4,621.00 | $103.10 – $2,920.40 | 13 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,030.60 | $1,891.00 | $119.34 – $509.60 | 13 |
| Abdominal Ultrasound (limited) CPT 76705 | $1,030.60 | $1,891.00 | $87.13 – $509.60 | 13 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $8,569.85 – $8,569.85 | 6 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,611.57 | $2,957.00 | $67.21 – $2,897.86 | 13 |
| Abl1 gene CPT 81170 | $355.45 | $652.19 | $240.00 – $420.00 | 14 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $1,165.67 – $2,634.41 | 4 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $1,674.23 – $3,783.76 | 4 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $519.73 – $1,174.59 | 4 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $1,592.70 – $3,599.50 | 4 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | not published | not published | $393.47 – $9,387.58 | 8 |
| Ablate bone tumor(s) perq CPT 20982 | not published | not published | $4,220.73 – $16,908.29 | 8 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $93.99 – $1,946.55 | 8 |
| Ablate inf turbinate superf 30801 CPT 30801 | not published | not published | $65.79 – $1,946.55 | 8 |
| Ablate pulm tumor perq crybl CPT 32994 | not published | not published | $5,758.36 – $13,681.38 | 8 |
| Ablate pulm tumor perq rf CPT 32998 | not published | not published | $2,589.72 – $7,666.93 | 8 |
| Ablation cryo abd perit om CPT 49999 | not published | not published | $1,232.05 – $1,232.05 | 6 |
| Ablation cryo adrenal tumor CPT 60699 | not published | not published | $7,666.93 – $7,666.93 | 6 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | not published | not published | $315.23 – $315.23 | 6 |
| Ablation cryo pq liver tumor(s) CPT 47383 | not published | not published | $416.98 – $13,681.38 | 8 |
| Ablation cryo retro lymph node CPT 38999 | not published | not published | $574.50 – $574.50 | 6 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $315.23 – $315.23 | 6 |
| Ablation of upper extremity nerves rf CPT 64999 | not published | not published | $132.42 – $387.91 | 6 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $837.68 – $12,151.68 | 8 |
| Abortion CPT 59850 | not published | not published | $460.48 – $1,063.49 | 4 |
| Abortion (mpr) CPT 59866 | not published | not published | $399.74 – $399.74 | 6 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $11.96 – $42.62 | 4 |
| Abrasion lesion single CPT 15786 | not published | not published | $73.91 – $263.29 | 8 |
| Abscess drain retroperitoneal surg code CPT 49406 | $2,957.17 | $5,426.00 | $184.29 – $5,125.40 | 13 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | not published | not published | $107.59 – $243.15 | 4 |
| Access thoracic lymph duct CPT 38794 | not published | not published | $193.53 – $689.46 | 4 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $93.20 | $171.00 | $0.06 – $63.70 | 12 |
| Acetaminophen level CPT 80143 | $39.79 | $73.00 | $14.91 – $71.54 | 14 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $95.38 | $175.00 | $18.26 – $136.22 | 12 |
| Acetone qualitative CPT 82009 | $80.66 | $148.00 | $4.52 – $145.04 | 14 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $667.63 | $1,225.00 | $0.39 – $152.88 | 12 |
| Acne surgery 10040 CPT 10040 | not published | not published | $55.12 – $261.11 | 8 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $8.18 | $15.00 | $10.05 – $17.22 | 14 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $411.41 – $4,263.74 | 8 |
| Acute hepatitis panel CPT 80074 | $186.94 | $343.00 | $47.63 – $336.14 | 14 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $103.01 | $189.00 | $0.03 – $0.98 | 12 |
| #acylcarnitineprfl CPT 82017 | $40.88 | $75.00 | $16.87 – $73.50 | 14 |
| Adapter b 8 channel 10cm HCPCS C1883 | $4,101.67 | $7,526.00 | $438.75 – $1,719.90 | 11 |
| Adding walker to prev cast CPT 29440 | not published | not published | $58.10 – $207.35 | 8 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $82.84 | $152.00 | $0.48 – $63.70 | 12 |
| Adenovirus antibody,serum - quest CPT 86603 | $43.06 | $79.00 | $12.87 – $77.42 | 14 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $1,017.53 – $2,299.62 | 4 |
| Adh-sendout CPT 84588 | $24.53 | $45.00 | $30.15 – $45.00 | 14 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $1,232.05 – $1,232.05 | 6 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $322.98 – $9,387.58 | 8 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $484.05 – $2,403.79 | 8 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $568.98 | $1,044.00 | $0.27 – $63.70 | 11 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $379.87 | $697.00 | $21.49 – $252.84 | 14 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $520.48 | $955.00 | $32.81 – $252.84 | 14 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $688.88 | $1,264.00 | $32.81 – $935.90 | 14 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $520.48 | $955.00 | $20.61 – $767.34 | 14 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $267.60 | $491.00 | $12.23 – $250.88 | 14 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $597.32 | $1,096.00 | $12.23 – $250.88 | 14 |
| Administration immunization 1 vaccine CPT 90471 | $175.49 | $322.00 | $6.11 – $315.56 | 11 |
| Administration immunization each additional vaccine CPT 90472 | $175.49 | $322.00 | $6.11 – $315.56 | 7 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $11,881.00 | $21,800.00 | $44.37 – $13,352.50 | 13 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $1,064.63 – $3,792.80 | 4 |
| _afb id by dna probe rflx ast CPT 87149 | $207.10 | $380.00 | $10.89 – $16.24 | 14 |
| #afb mycobacteria suscep. #1 CPT 87190 | $220.18 | $404.00 | $6.25 – $395.92 | 14 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $86.93 | $159.50 | $69.86 – $104.26 | 14 |
| After cataract laser surgery CPT 66821 | not published | not published | $213.61 – $761.01 | 8 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $48.28 – $171.96 | 4 |
| Albumin body fluid quantitative each specimen CPT 82042 | $91.02 | $167.00 | $1.90 – $2.83 | 14 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $3,178.99 | $5,833.00 | $53.08 – $190.12 | 12 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $460.53 | $845.00 | $53.08 – $411.60 | 13 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $35.43 | $65.00 | $10.62 – $63.70 | 12 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $31.61 | $58.00 | $5.78 – $23.52 | 14 |
| Albumin serum plasma or whole blood CPT 82040 | $58.86 | $108.00 | $4.95 – $7.50 | 14 |
| Alkaline phosphatase CPT 84075 | $53.96 | $99.00 | $2.77 – $4.13 | 14 |
| Allergen alpha lactalbumin ige CPT 86008 | $2.40 | $4.40 | $2.95 – $4.40 | 14 |
| Allergen egg white ige CPT 86003 | $24.53 | $45.00 | $2.95 – $4.40 | 14 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $4.01 | $7.35 | $3.82 – $5.70 | 12 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $689.06 – $16,908.29 | 8 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.