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 |
|---|---|---|---|---|
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | not published | not published | $512.67 – $2,691.95 | 8 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $619.48 – $4,532.29 | 8 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $734.39 – $4,532.29 | 8 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $299.06 – $4,532.29 | 8 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $413.12 – $4,532.29 | 8 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $375.10 – $6,680.39 | 8 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $451.15 – $6,680.39 | 8 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $354.06 – $6,680.39 | 8 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $406.72 – $6,680.39 | 8 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $495.58 – $6,680.39 | 8 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $351.60 – $4,532.29 | 8 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $440.46 – $4,532.29 | 8 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $200.56 – $4,532.29 | 8 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | not published | not published | $145.25 – $2,691.95 | 8 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $156.79 – $2,691.95 | 8 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $879.37 – $1,987.38 | 4 |
| Cystourethro w/implant CPT 52441 | not published | not published | $1,137.00 – $2,569.62 | 4 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $386.63 – $4,532.29 | 8 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $349.04 – $4,532.29 | 8 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $322.56 – $4,532.29 | 8 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $53.41 | $98.00 | $0.85 – $61.74 | 12 |
| Cytogenom microarray copy nmbr var CPT 81228 | $912.77 | $1,674.80 | $900.00 – $1,641.31 | 12 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $17.44 | $32.00 | $5.86 – $8.74 | 14 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $8.22 | $15.07 | $6.48 – $9.66 | 14 |
| Cytopath fl nongyn filter CPT 88106 | $93.74 | $172.00 | $29.60 – $48.00 | 13 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $124.26 | $228.00 | $28.62 – $42.71 | 13 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $201.65 | $370.00 | $29.48 – $44.00 | 13 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $97.01 | $178.00 | $30.46 – $45.46 | 13 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $21.26 | $39.00 | $8.80 – $38.00 | 11 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $166.23 | $305.00 | $40.58 – $278.32 | 13 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $177.13 | $325.00 | $59.71 – $168.51 | 13 |
| Cytopath smear other source CPT 88160 | $22.89 | $42.00 | $28.14 – $42.00 | 13 |
| Cytopath smear other source CPT 88162 | $75.76 | $139.00 | $59.71 – $139.00 | 13 |
| Cytopath smear oth prep screen & interp CPT 88161 | $31.61 | $58.00 | $29.60 – $58.00 | 13 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $243.62 | $447.00 | $225.18 – $435.00 | 13 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $57.77 | $106.00 | $4.05 – $61.74 | 12 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $3,818.82 | $7,007.00 | $29.24 – $321.10 | 13 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $3,410.61 | $6,258.00 | $16.48 – $6,132.84 | 13 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $1,020.24 | $1,872.00 | $0.03 – $79.38 | 12 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $18,823.21 | $34,538.00 | $57.95 – $33,847.24 | 13 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $8,858.43 | $16,254.00 | $3.17 – $796.74 | 13 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $333.54 | $612.00 | $20.95 – $306.74 | 13 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $290.72 – $4,178.22 | 8 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $255.84 – $4,178.22 | 8 |
| Dch validity tests CPT 81002 | $72.49 | $133.00 | $3.08 – $130.34 | 14 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $1,068.05 – $2,566.14 | 8 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $1,258.16 – $4,482.30 | 8 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $232.41 – $2,566.14 | 8 |
| D&c of cervical stump CPT 57558 | not published | not published | $202.68 – $4,178.22 | 8 |
| Deamidated gliadin antibody iga CPT 86258 | $5.30 | $9.71 | $6.03 – $8.82 | 7 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $489.14 – $1,214.93 | 4 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | not published | not published | $22.64 – $804.40 | 8 |
| Debridement (>20 cm) charge pt CPT 97598 | $312.29 | $573.00 | $61.36 – $467.46 | 10 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,719.48 | $3,155.00 | $232.41 – $3,091.90 | 13 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $457.80 | $840.00 | $35.88 – $823.20 | 10 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $798.43 | $1,465.00 | $62.38 – $1,435.70 | 10 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $586.97 | $1,077.00 | $119.19 – $1,024.10 | 13 |
| Debride nail1-5 11720 CPT 11720 | $249.61 | $458.00 | $22.64 – $448.84 | 13 |
| Debride nail6 or more 11721 CPT 11721 | not published | not published | $38.02 – $135.46 | 8 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | not published | not published | $324.27 – $1,155.20 | 8 |
| Debride skin bone at fx site CPT 11012 | not published | not published | $441.75 – $3,761.02 | 8 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $389.15 – $966.62 | 4 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $520.88 – $1,293.44 | 4 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $422.38 | $775.00 | $16.75 – $759.50 | 10 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $48.28 – $261.11 | 8 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | not published | not published | $258.47 – $924.59 | 8 |
| Debr inf skin add-on 11001 CPT 11001 | not published | not published | $11.96 – $42.62 | 4 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,197.37 | $2,197.00 | $179.86 – $1,055.46 | 13 |
| Decalcification CPT 88311 | $104.64 | $192.00 | $10.46 – $112.70 | 11 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $4,040.63 | $7,414.00 | $1.69 – $446.88 | 12 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $386.95 | $710.00 | $33.51 – $695.80 | 13 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $338.78 – $4,263.74 | 8 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $571.63 – $2,103.10 | 8 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $931.87 – $2,106.03 | 8 |
| Decompress fasciotomyhand 26037 CPT 26037 | not published | not published | $356.30 – $4,263.74 | 8 |
| Decompress fingers/hand CPT 26035 | not published | not published | $939.04 – $4,263.74 | 8 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $557.10 – $4,263.74 | 8 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $578.18 – $4,263.74 | 8 |
| Decompression fasct forearm CPT 24495 | not published | not published | $666.04 – $9,387.58 | 8 |
| Decompression of leg CPT 27892 | not published | not published | $297.35 – $4,263.74 | 8 |
| Decompression of leg CPT 27893 | not published | not published | $290.51 – $9,387.58 | 8 |
| Decompression of leg CPT 27894 | not published | not published | $387.06 – $4,263.74 | 8 |
| Decompression of lower leg CPT 27600 | not published | not published | $265.31 – $4,263.74 | 8 |
| Decompression of lower leg CPT 27601 | not published | not published | $497.71 – $4,263.74 | 8 |
| Decompression of thigh/knee CPT 27496 | not published | not published | $293.93 – $4,263.74 | 8 |
| Decompression of thigh/knee CPT 27497 | not published | not published | $358.86 – $4,263.74 | 8 |
| Decompression of thigh/knee CPT 27498 | not published | not published | $409.27 – $2,103.10 | 8 |
| Decompression of thigh/knee CPT 27499 | not published | not published | $471.65 – $9,387.58 | 8 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $425.94 – $2,566.14 | 8 |
| Decompression unspecified nerve 64722 CPT 64722 | not published | not published | $461.77 – $2,566.14 | 6 |
| Decompressive craniotomy CPT 61322 | not published | not published | $1,052.24 – $2,613.42 | 4 |
| Decompress optic nerve CPT 67570 | not published | not published | $576.32 – $4,955.47 | 8 |
| Decompres spinal cord;thoracic 63055 CPT 63055 | not published | not published | $1,514.50 – $9,387.58 | 8 |
| Decompress small bowel CPT 44021 | not published | not published | $691.24 – $2,462.59 | 4 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $1,303.88 – $9,387.58 | 8 |
| Decompress spinal cord thrc CPT 63064 | not published | not published | $1,548.26 – $9,387.58 | 8 |
| Decomp spinal cord/transped/ad seg 63057 CPT 63057 | not published | not published | $347.76 – $1,238.89 | 4 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $125.17 – $3,761.02 | 8 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $61.59 | $113.00 | $9.56 – $63.70 | 12 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $1,894.42 | $3,476.00 | $0.93 – $1,879.64 | 13 |
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.