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 |
|---|---|---|---|---|
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $9,018.12 | $16,547.00 | $967.25 – $3,791.62 | 11 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $11,724.59 | $21,513.00 | $2,446.00 – $9,588.32 | 11 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $25,762.70 | $47,271.00 | $30.59 – $21,082.74 | 13 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $25,762.70 | $47,271.00 | $151.60 – $2,240.28 | 13 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $6,935.67 | $12,726.00 | $95.72 – $12,471.48 | 12 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $9,018.12 | $16,547.00 | $223.73 – $7,375.48 | 13 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $752.10 | $1,380.00 | $0.98 – $5.50 | 13 |
| Alpha-fetoprotein tumor marker CPT 82105 | $4.36 | $8.00 | $5.36 – $8.00 | 14 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $17,779.54 | $32,623.00 | $75.13 – $299.88 | 13 |
| Alt/sgpt CPT 84460 | $51.23 | $94.00 | $5.30 – $26.07 | 14 |
| Aluminum - quest CPT 82108 | $10.75 | $19.72 | $13.22 – $19.72 | 14 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $220.01 – $4,261.72 | 8 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $129.17 | $237.00 | $0.65 – $63.70 | 12 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $5,951.40 | $10,920.00 | $31.85 – $63.70 | 7 |
| Aminolevulinic acid delta CPT 82135 | $24.04 | $44.11 | $16.45 – $44.11 | 14 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $35.43 | $65.00 | $4.82 – $63.70 | 11 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $108.46 | $199.00 | $67.13 – $134.26 | 7 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $35.43 | $65.00 | $0.54 – $63.70 | 11 |
| Ammonia CPT 82140 | $171.13 | $314.00 | $14.57 – $307.72 | 14 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $65.71 – $1,144.24 | 8 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $111.88 – $399.74 | 8 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $356.73 – $4,263.74 | 8 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $87.20 | $160.00 | $36.17 – $86.00 | 12 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $583.15 | $1,070.00 | $23.97 – $673.26 | 13 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $148.79 | $273.00 | $0.52 – $63.70 | 12 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $77.39 | $142.00 | $1.58 – $63.70 | 11 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $290.51 – $4,263.74 | 8 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $810.87 – $2,888.75 | 4 |
| Amputate hand at wrist CPT 25922 | not published | not published | $314.43 – $2,103.10 | 8 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $390.05 – $4,263.74 | 8 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $701.50 – $2,499.13 | 4 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $299.90 – $4,263.74 | 8 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $421.24 – $4,263.74 | 8 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $442.17 – $9,387.58 | 8 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $306.32 – $2,403.79 | 8 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $484.05 – $4,263.74 | 8 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $302.90 – $4,263.74 | 8 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $669.89 – $4,263.74 | 8 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $580.60 – $2,068.40 | 4 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $712.61 – $2,538.70 | 4 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $580.60 – $9,387.58 | 8 |
| Amputation of lower leg CPT 27882 | not published | not published | $507.96 – $1,809.67 | 4 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $484.05 – $1,724.40 | 4 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $484.05 – $4,263.74 | 8 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $232.41 – $4,263.74 | 8 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $261.89 – $4,263.74 | 8 |
| Amylase CPT 82150 | $331.91 | $609.00 | $3.93 – $5.86 | 14 |
| Ana ds-dna CPT 86226 | $7.19 | $13.18 | $8.84 – $13.18 | 14 |
| Anal/urinary muscle study CPT 51784 | not published | not published | $83.31 – $296.78 | 8 |
| Anal/urinary muscle study CPT 51785 | not published | not published | $72.63 – $319.60 | 8 |
| Analysis gene f2 20210g>a variant CPT 81240 | $21.80 | $40.00 | $26.80 – $40.00 | 12 |
| Analysis gene f5 leiden variant CPT 81241 | $19.08 | $35.00 | $23.45 – $35.00 | 12 |
| Anastamo/extrahep bil duct/gi trac 47760 CPT 47760 | not published | not published | $967.66 – $3,447.34 | 4 |
| Anastamo/roux-en-y/extrahep bil/gi 47780 CPT 47780 | not published | not published | $1,064.63 – $3,792.80 | 4 |
| Anastomosis of facial/other nerve 64868 CPT 64868 | not published | not published | $1,110.78 – $3,957.19 | 4 |
| Anca screen with reflex to titer -quest CPT 86021 | $34.26 | $62.86 | $15.05 – $61.61 | 14 |
| An cholangiogram percutaneous compl CPT 47531 | $1,496.57 | $2,746.00 | $341.03 – $1,527.00 | 13 |
| An fluoro guide for cvp CPT 77001 | $1,104.17 | $2,026.00 | $63.56 – $572.32 | 11 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | not published | not published | $665.67 – $1,504.41 | 4 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $11,889.72 | $21,816.00 | $389.43 – $21,379.68 | 13 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $10,207.85 | $18,730.00 | $353.31 – $18,355.40 | 13 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | not published | not published | $171.63 – $387.88 | 4 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $37,609.36 | $69,008.00 | $3.92 – $7.84 | 8 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $12,672.89 | $23,253.00 | $475.43 – $22,787.94 | 13 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | not published | not published | $789.65 – $1,784.61 | 4 |
| Angio trnslmnl balloon same artery ini CPT 37246 | not published | not published | $1,960.53 – $7,492.37 | 8 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | not published | not published | $577.07 – $1,304.18 | 4 |
| Angio trnslmnl balloon same vein ini CPT 37248 | not published | not published | $1,351.82 – $7,492.37 | 8 |
| Ankle arthroscopy/surgery CPT 29891 | not published | not published | $622.89 – $4,263.74 | 8 |
| Ankle arthroscopy/surgery CPT 29892 | not published | not published | $650.23 – $9,387.58 | 8 |
| Ankle arthroscopy/surgery CPT 29894 | not published | not published | $484.05 – $4,263.74 | 8 |
| Ankle arthroscopy/surgery CPT 29895 | not published | not published | $409.71 – $4,263.74 | 8 |
| Ankle arthroscopy/surgery CPT 29897 | not published | not published | $430.64 – $4,263.74 | 8 |
| Ankle arthroscopy/surgery CPT 29898 | not published | not published | $477.21 – $4,263.74 | 8 |
| Ankle arthroscopy/surgery CPT 29899 | not published | not published | $738.27 – $9,387.58 | 8 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | not published | not published | $45.26 – $394.11 | 8 |
| Anorectal myomectomy CPT 45108 | not published | not published | $393.90 – $3,603.77 | 8 |
| Anoscopy CPT 46611 | not published | not published | $87.58 – $1,198.08 | 8 |
| Anoscopy ablation lesion 46615 CPT 46615 | not published | not published | $156.36 – $3,603.77 | 8 |
| Anoscopy and biopsy CPT 46606 | not published | not published | $33.32 – $1,549.43 | 8 |
| Anoscopy and dilation 46604 CPT 46604 | not published | not published | $45.28 – $1,549.43 | 8 |
| Anoscopy control bleeding 46614 CPT 46614 | not published | not published | $137.14 – $1,549.43 | 8 |
| Anoscopy remove fb 46608 CPT 46608 | not published | not published | $123.90 – $1,198.08 | 8 |
| Anoscopy remove lesion 46610 CPT 46610 | not published | not published | $104.24 – $3,603.77 | 8 |
| Anoscopy remove lesions w/cautery/snare 46612 CPT 46612 | not published | not published | $175.16 – $3,603.77 | 8 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | not published | not published | $617.80 – $6,486.99 | 8 |
| Antibody elution rbc reference CPT 86860 | $100.28 | $184.00 | $28.44 – $87.00 | 14 |
| Antibody htlv/hiv confirm test CPT 86689 | $9.66 | $17.72 | $11.88 – $17.72 | 14 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $86.11 | $158.00 | $13.40 – $20.00 | 14 |
| Antibody id rbc panel CPT 86870 | $309.56 | $568.00 | $23.70 – $105.00 | 14 |
| Antibody influenza virus CPT 86710 | $6.63 | $12.15 | $8.15 – $12.15 | 14 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $7.64 | $14.01 | $9.39 – $14.01 | 14 |
| Antibody screen rbc CPT 86850 | $220.18 | $404.00 | $3.73 – $85.26 | 14 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $1,181.56 | $2,168.00 | $0.01 – $5.88 | 13 |
| Antihemophilic viii/vwf comp HCPCS J7186 | $2.73 | $5.00 | $0.01 – $3.92 | 13 |
| Anti mog serum - sendout CPT 86362 | $79.03 | $145.00 | $97.15 – $142.10 | 7 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $5.91 | $10.84 | $7.04 – $10.29 | 7 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | not published | not published | $410.56 – $1,462.65 | 4 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | not published | not published | $542.15 – $1,931.44 | 4 |
| Antinuclear antibodies CPT 86038 | $2.18 | $4.00 | $2.68 – $4.00 | 14 |
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.