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 |
|---|---|---|---|---|
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $300.84 | $552.00 | $4.20 – $63.70 | 12 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $4,520.78 | $8,295.00 | $1,516.36 – $8,295.00 | 13 |
| Digoxin total therapeutic drug level CPT 80162 | $140.07 | $257.00 | $13.28 – $251.86 | 14 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $2,693.94 | $4,943.00 | $60.27 – $123.00 | 12 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $469.47 – $1,061.00 | 4 |
| Dilate esophagus CPT 43453 | not published | not published | $115.35 – $2,492.83 | 8 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $53.41 – $1,232.05 | 8 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $615.99 – $615.99 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $156.79 – $558.58 | 8 |
| Dilate urethra stricture CPT 53600 | not published | not published | $99.97 – $356.13 | 8 |
| Dilate urethra stricture CPT 53601 | not published | not published | $94.42 – $336.36 | 8 |
| Dilate urethra stricture CPT 53605 | not published | not published | $33.75 – $4,532.29 | 8 |
| Dilate urethra stricture CPT 53621 | not published | not published | $140.12 – $499.23 | 8 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $85.87 – $305.91 | 8 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $173.02 – $1,549.43 | 8 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $39.54 – $4,178.22 | 8 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $121.33 – $1,549.43 | 8 |
| Dilation of salivary duct CPT 42660 | not published | not published | $44.86 – $669.21 | 8 |
| Dilation of urethra CPT 53661 | not published | not published | $87.15 – $310.50 | 8 |
| Dilation of urethra CPT 53665 | not published | not published | $20.08 – $2,691.95 | 8 |
| Dilation of vagina CPT 57400 | not published | not published | $86.49 – $4,178.22 | 8 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $34.61 – $1,946.55 | 8 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $145.68 – $877.12 | 8 |
| Dilator fascial 10fx20cm HCPCS C2627 | $956.48 | $1,755.00 | $68.25 – $267.54 | 11 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $131.42 – $4,532.29 | 8 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $218.91 – $4,532.29 | 8 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $35.43 | $65.00 | $0.96 – $63.70 | 12 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $130.80 | $240.00 | $27.75 – $171.00 | 9 |
| Disability dlco CPT 94727 | $293.76 | $539.00 | $37.62 – $528.22 | 13 |
| Disaccharidases CPT 82657 | $71.94 | $132.00 | $13.18 – $19.66 | 14 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $387.06 – $2,403.79 | 8 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,379.50 – $4,914.55 | 4 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $223.87 – $797.53 | 4 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $786.88 – $7,103.63 | 8 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $677.58 – $7,773.77 | 8 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $634.03 – $1,432.91 | 4 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $247.21 – $558.69 | 4 |
| Dna antibody native/double stranded CPT 86225 | $6.76 | $12.39 | $6.70 – $10.00 | 14 |
| Dna gardnerella CPT 87510 | $41.97 | $77.00 | $12.24 – $18.26 | 14 |
| Dna probe gc CPT 87590 | $143.34 | $263.00 | $18.09 – $257.74 | 14 |
| Dna trichomonas CPT 87660 | $41.97 | $77.00 | $12.24 – $18.26 | 14 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $178.76 | $328.00 | $8.32 – $63.70 | 12 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $5,202.03 | $9,545.00 | $0.40 – $15.68 | 12 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $53.96 | $99.00 | $0.70 – $63.70 | 12 |
| Doppler echo complete CPT 93320 | $661.09 | $1,213.00 | $87.87 – $1,188.74 | 10 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $989.72 | $1,816.00 | $111.72 – $1,779.68 | 13 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $673.08 | $1,235.00 | $59.79 – $271.46 | 13 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $25,770.33 | $47,285.00 | $23,169.65 – $46,339.30 | 7 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $117.18 | $215.00 | $2.89 – $61.74 | 12 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $7,760.26 | $14,239.00 | $115.84 – $2,963.52 | 12 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $99.74 | $183.00 | $31.85 – $63.70 | 7 |
| Dpyd gene common variants CPT 81232 | $131.89 | $242.00 | $139.85 – $242.00 | 14 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $56.83 – $924.59 | 8 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $67.50 – $924.59 | 8 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $131.74 – $2,129.16 | 8 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $64.94 – $924.59 | 8 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $107.66 – $3,761.02 | 8 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $306.89 – $3,761.02 | 8 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $66.65 – $305.16 | 8 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $130.73 – $2,129.16 | 8 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $387.06 – $3,761.02 | 8 |
| Drainage of eye CPT 65800 | not published | not published | $90.15 – $2,997.11 | 8 |
| Drainage of eye CPT 65810 | not published | not published | $387.06 – $2,997.11 | 8 |
| Drainage of eye CPT 65815 | not published | not published | $261.46 – $2,997.11 | 8 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $470.37 – $2,103.10 | 8 |
| Drainage of kidney lesion CPT 50390 | not published | not published | $81.18 – $924.59 | 8 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $61.94 – $305.16 | 8 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $254.20 – $1,946.55 | 8 |
| Drainage of mouth lesion CPT 41007 | not published | not published | $240.96 – $1,946.55 | 8 |
| Drainage of mouth lesion CPT 41008 | not published | not published | $251.20 – $4,261.72 | 8 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $263.17 – $937.54 | 8 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $153.80 – $669.21 | 8 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $281.97 – $7,773.77 | 8 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $290.51 – $4,261.72 | 8 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $352.04 – $1,946.55 | 8 |
| Drainage of nose lesion int 30000 CPT 30000 | not published | not published | $71.34 – $305.16 | 8 |
| Drainage of nose lesion sept 30020 CPT 30020 | not published | not published | $75.62 – $669.21 | 8 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $343.91 – $2,103.10 | 8 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $774.98 – $4,263.74 | 8 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $387.06 – $4,532.29 | 8 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $387.06 – $4,532.29 | 8 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $598.11 – $4,532.29 | 8 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $145.25 – $1,549.43 | 8 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $232.41 – $3,603.77 | 8 |
| Drainage of salivary gland CPT 42305 | not published | not published | $470.37 – $4,261.72 | 8 |
| Drainage of salivary gland CPT 42320 | not published | not published | $101.68 – $669.21 | 8 |
| Drainage of throat abscess CPT 42725 | not published | not published | $702.78 – $7,773.77 | 8 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $310.59 – $4,532.29 | 8 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $170.04 – $2,691.95 | 8 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $289.66 – $1,031.92 | 8 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $815.99 – $2,907.04 | 8 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $122.19 – $1,336.95 | 8 |
| Drain blood from under nail 11740 CPT 11740 | $225.63 | $414.00 | $22.48 – $405.72 | 13 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | not published | not published | $594.94 – $2,129.16 | 8 |
| Drain cath image guided visceral pq CPT 49405 | $2,850.35 | $5,230.00 | $183.92 – $5,125.40 | 13 |
| Drain cerebro spinal fluid 62272 CPT 62272 | not published | not published | $94.42 – $910.04 | 8 |
| Drain chest lesion CPT 21502 | not published | not published | $296.50 – $4,263.74 | 8 |
| Drain finger abscess;simple 26010 CPT 26010 | not published | not published | $120.05 – $427.68 | 8 |
| Drain lower leg bursa CPT 27604 | not published | not published | $268.73 – $4,263.74 | 8 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $687.82 – $3,761.02 | 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.