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 |
|---|---|---|---|---|
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $293.08 – $3,761.02 | 8 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $677.58 – $2,413.91 | 4 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $872.17 – $4,178.22 | 8 |
| Drain ovary abscess open CPT 58820 | not published | not published | $329.25 – $4,178.22 | 8 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $729.70 – $2,599.59 | 4 |
| Drain penis lesion CPT 54015 | not published | not published | $252.91 – $2,129.16 | 8 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $874.95 – $3,117.06 | 8 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $158.93 – $3,761.02 | 8 |
| Drain shoulder lesion CPT 23030 | not published | not published | $322.12 – $3,761.02 | 8 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $404.16 – $3,761.02 | 8 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $77.76 – $1,946.55 | 8 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $667.32 – $2,377.36 | 4 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $388.04 | $712.00 | $69.21 – $697.76 | 13 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $388.04 | $712.00 | $36.32 – $697.76 | 13 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $350.44 | $643.00 | $93.56 – $630.14 | 13 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $804.40 – $804.40 | 6 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $580.60 – $2,068.40 | 4 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $1,404.47 | $2,577.00 | $448.58 – $2,525.46 | 10 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $338.78 – $1,206.93 | 4 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $293.93 – $4,263.74 | 8 |
| Drng of eyelid abscess 67700 CPT 67700 | not published | not published | $143.12 – $509.86 | 8 |
| Drng of finger abscess comp 26011 CPT 26011 | not published | not published | $162.78 – $2,129.16 | 8 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $64.09 – $924.59 | 8 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $176.02 – $669.21 | 8 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $329.25 – $4,178.22 | 8 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $621.61 – $4,263.74 | 8 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $298.63 – $4,263.74 | 8 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $159.78 – $1,549.43 | 8 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $218.32 – $4,261.72 | 8 |
| Drng of scrotum abscess 55100 CPT 55100 | not published | not published | $223.87 – $2,129.16 | 8 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $532.32 – $1,896.41 | 4 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $580.60 – $2,068.40 | 4 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $872.17 – $1,971.10 | 4 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $532.32 – $1,896.41 | 4 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $85.02 – $1,946.55 | 8 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $73.91 – $669.21 | 8 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $35.43 | $65.00 | $5.68 – $63.70 | 12 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $4,101.67 | $7,526.00 | $259.50 – $1,017.24 | 11 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $735.75 | $1,350.00 | $7.00 – $170.52 | 13 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $1,619.74 | $2,972.00 | $2.63 – $22.54 | 13 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $19,815.11 | $36,358.00 | $11.87 – $7,375.48 | 13 |
| Drug assay caffeine CPT 80155 | $8.40 | $15.40 | $10.32 – $15.40 | 14 |
| Drug assay voriconazole CPT 80285 | $28.89 | $53.00 | $21.69 – $51.94 | 14 |
| Drug test def 15-21 classes HCPCS G0482 | $68.13 | $125.00 | $50.25 – $75.00 | 14 |
| Drug test def 1-7 classes HCPCS G0480 | $213.64 | $392.00 | $6.56 – $9.78 | 14 |
| Drug test def 22+ classes HCPCS G0483 | $98.10 | $180.00 | $120.60 – $180.00 | 14 |
| Drug test def 8-14 classes HCPCS G0481 | $200.56 | $368.00 | $98.39 – $360.64 | 14 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $339.54 | $623.00 | $8.67 – $12.94 | 14 |
| Drvvt confirm - quest CPT 85597 | $10.67 | $19.57 | $13.12 – $19.57 | 14 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $293.93 – $4,955.47 | 8 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | not published | not published | $374.91 – $2,566.14 | 8 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $143.12 – $525.02 | 8 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $117.48 – $525.02 | 8 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $153.38 – $804.40 | 8 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $199.08 – $804.40 | 8 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,469.32 | $2,696.00 | $106.73 – $761.46 | 13 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $25,762.70 | $47,271.00 | $45.60 – $12,471.48 | 11 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $8,841.54 | $16,223.00 | $90.37 – $3,816.12 | 13 |
| Dxa bone density axl vrt fx CPT 77085 | $346.62 | $636.00 | $47.10 – $623.28 | 13 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $242.67 – $2,266.13 | 8 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $244.80 – $2,266.13 | 8 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $189.26 – $2,266.13 | 8 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $51.81 – $1,232.05 | 8 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $74.04 – $1,232.05 | 8 |
| Dx gastr intub w/asp spec CPT 43754 | $552.09 | $1,013.00 | $31.41 – $992.74 | 13 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $56.77 – $205.60 | 8 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $116.21 – $510.28 | 8 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $158.50 – $2,266.13 | 8 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $319.60 – $319.60 | 6 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $42.30 – $1,946.55 | 8 |
| Ear cartilage graft CPT 21235 | not published | not published | $580.60 – $7,773.77 | 8 |
| Ear irrigation 69209 CPT 69209 | not published | not published | $13.24 – $78.06 | 8 |
| Ecg 12 lead tracing only CPT 93005 | $331.91 | $609.00 | $18.82 – $596.82 | 13 |
| Ecg < 30 days transmission & analysis CPT 93271 | $161.32 | $296.00 | $79.80 – $290.08 | 13 |
| Ecg external < 48 hours recording CPT 93225 | $311.74 | $572.00 | $42.77 – $560.56 | 13 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $458.35 | $841.00 | $55.94 – $824.18 | 13 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $81.21 | $149.00 | $14.03 – $146.02 | 13 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $81.21 | $149.00 | $14.03 – $146.02 | 13 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,167.47 | $3,977.00 | $239.76 – $3,897.46 | 13 |
| Echocardiography doppler color flow mapping CPT 93325 | $317.74 | $583.00 | $89.37 – $571.34 | 10 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,600.74 | $4,772.00 | $1,038.22 – $4,676.56 | 11 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $666.54 | $1,223.00 | $107.65 – $1,198.54 | 13 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $666.54 | $1,223.00 | $469.30 – $1,198.54 | 11 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $330.82 | $607.00 | $44.68 – $594.86 | 10 |
| Echo exam uterus 76831- CPT 76831 | $1,409.92 | $2,587.00 | $108.33 – $2,091.32 | 13 |
| Echo stress CPT 93350 | $2,433.97 | $4,466.00 | $137.87 – $4,376.68 | 13 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,482.40 | $2,720.00 | $223.39 – $1,706.18 | 13 |
| Echo transthoracic CPT 93303 | $1,310.73 | $2,405.00 | $175.17 – $2,356.90 | 13 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,546.17 | $2,837.00 | $215.30 – $2,780.26 | 13 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | not published | not published | $163.44 – $369.37 | 4 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | $2,967.53 | $5,445.00 | $167.91 – $5,336.10 | 10 |
| Ecmo/ecls initiation artery 33947 CPT 33947 | not published | not published | $234.18 – $529.25 | 4 |
| Ecmo/ecls initiation venous 33946 CPT 33946 | not published | not published | $212.21 – $479.59 | 4 |
| Ecmo/ecls insj cent cannula 0-5yrs 33955 CPT 33955 | not published | not published | $611.69 – $1,382.42 | 4 |
| Ecmo/ecls insj cent cannula 6yrs&older 33956 CPT 33956 | not published | not published | $574.83 – $1,299.12 | 4 |
| Ecmo/ecls insj prph cannula 0-5yrs opn 33953 CPT 33953 | not published | not published | $337.68 – $763.16 | 4 |
| Ecmo/ecls insj prph cannula 0-5yrs perq 33951 CPT 33951 | not published | not published | $302.31 – $683.22 | 4 |
| Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 | not published | not published | $328.00 – $741.28 | 4 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | not published | not published | $293.74 – $663.85 | 4 |
| Ecmo/ecls remove cent cannula 0-5yrs 33985 CPT 33985 | not published | not published | $377.51 – $853.17 | 4 |
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.