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 |
|---|---|---|---|---|
| Established Patient Office Visit (level 1) CPT 99211 | $176.04 | $323.00 | $21.37 – $263.62 | 11 |
| Established Patient Office Visit (level 2) CPT 99212 | $186.94 | $343.00 | $32.25 – $260.68 | 11 |
| Established Patient Office Visit (level 3) CPT 99213 | $186.94 | $343.00 | $42.76 – $273.42 | 11 |
| Established Patient Office Visit (level 4) CPT 99214 | $286.67 | $526.00 | $66.81 – $415.52 | 11 |
| Established Patient Office Visit (level 5) CPT 99215 | $304.66 | $559.00 | $101.90 – $540.96 | 11 |
| Estim aid bone healg invasiv CPT 20975 | not published | not published | $253.09 – $253.09 | 1 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $23.98 | $44.00 | $8.17 – $40.18 | 12 |
| Estrogens total-sendout CPT 82672 | $12.15 | $22.29 | $14.94 – $22.29 | 14 |
| Ethanolamine oleate 100 mg HCPCS J1430 | $701.42 | $1,287.00 | $135.01 – $550.69 | 12 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $628.88 – $4,261.72 | 8 |
| Ethylene glycol -sendout CPT 82693 | $17.29 | $31.72 | $10.18 – $15.18 | 14 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $34.34 | $63.00 | $1.14 – $61.74 | 12 |
| Etoposide 50 mg cap HCPCS J8560 | $147.15 | $270.00 | $80.31 – $182.00 | 11 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $436.09 – $4,178.22 | 8 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $276.32 | $507.00 | $98.11 – $451.78 | 12 |
| Evasc prlng admn rx agnt 1st CPT 61650 | not published | not published | $444.15 – $1,527.78 | 4 |
| Evasc prlng admn rx agnt add CPT 61651 | not published | not published | $188.38 – $1,527.78 | 4 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | not published | not published | $1,044.30 – $2,360.12 | 4 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | not published | not published | $1,030.15 – $2,328.14 | 4 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | not published | not published | $1,538.34 – $3,476.65 | 4 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | not published | not published | $1,919.21 – $4,337.41 | 4 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | not published | not published | $371.93 – $840.56 | 4 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | not published | not published | $1,154.87 – $2,610.01 | 4 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | not published | not published | $1,921.07 – $4,341.62 | 4 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | not published | not published | $959.79 – $2,169.13 | 4 |
| Evasc rpr ilio-iliac rpt CPT 34708 | not published | not published | $1,542.44 – $3,485.91 | 4 |
| Exam of vagina w/scope 57420 CPT 57420 | not published | not published | $109.04 – $399.74 | 8 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | $107.57 – $4,178.22 | 8 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | not published | not published | $387.06 – $3,761.02 | 8 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | not published | not published | $572.23 – $3,761.02 | 8 |
| Exc 1st&/crv rib w/sympth CPT 21616 | not published | not published | $788.66 – $2,809.61 | 4 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $415.69 – $3,761.02 | 8 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | $579.43 – $3,761.02 | 8 |
| Exc abdl tum deep 5 cm/> CPT 22901 | not published | not published | $543.19 – $3,761.02 | 8 |
| Exc abd tum 5 cm or less 49203 CPT 49203 | not published | not published | $1,162.91 – $1,162.91 | 1 |
| Exc abd tum over 10 cm 49205 CPT 49205 | not published | not published | $1,694.39 – $1,694.39 | 1 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $384.07 – $3,761.02 | 8 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | not published | not published | $387.06 – $2,129.16 | 8 |
| Exc aurl glomus tum extended CPT 69554 | not published | not published | $2,185.23 – $7,785.02 | 4 |
| Exc aurl glomus tum trnscanl CPT 69550 | not published | not published | $876.23 – $7,773.77 | 8 |
| Exc aurl glomus tum trnsmstd CPT 69552 | not published | not published | $1,356.85 – $7,773.77 | 8 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $425.94 – $2,129.16 | 8 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $609.08 – $3,761.02 | 8 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $348.87 – $4,178.22 | 8 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $140.98 – $2,129.16 | 8 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | not published | not published | $319.56 – $3,761.02 | 8 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $116.21 – $2,129.16 | 8 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | not published | not published | $66.65 – $924.59 | 8 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $73.91 – $924.59 | 8 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | $91.85 – $924.59 | 8 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | not published | not published | $113.64 – $2,129.16 | 8 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | not published | not published | $76.90 – $924.59 | 8 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $99.55 – $2,129.16 | 8 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $275.55 – $3,761.02 | 8 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | not published | not published | $75.19 – $525.02 | 8 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | not published | not published | $93.13 – $924.59 | 8 |
| Exc breast duct fistula 19112 CPT 19112 | not published | not published | $391.76 – $5,032.06 | 8 |
| Exc carotid body tumor without exc art 60600 CPT 60600 | not published | not published | $822.40 – $2,929.86 | 4 |
| Exc cervix repair bowel 57556 CPT 57556 | not published | not published | $1,053.88 – $6,486.99 | 8 |
| Exc cervix/repair pelvis 57545 CPT 57545 | not published | not published | $956.49 – $2,161.67 | 4 |
| Exc cervix/repair vagina 57555 CPT 57555 | not published | not published | $1,053.88 – $6,486.99 | 8 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $1,021.96 – $3,761.02 | 8 |
| Exc ch wal tum without lymphadec CPT 21602 | not published | not published | $1,384.21 – $3,128.31 | 4 |
| Exc ch wal tum w/lymphadec CPT 21603 | not published | not published | $1,525.69 – $3,448.06 | 4 |
| Exc coa rpr l subcl art/prst CPT 33851 | not published | not published | $1,692.65 – $6,030.15 | 4 |
| Exc coa w/direct anastomosis CPT 33840 | not published | not published | $1,708.89 – $6,087.99 | 4 |
| Exc coccygl pr ulc flap clsr CPT 15922 | not published | not published | $659.20 – $4,810.88 | 8 |
| Exc coccygl pr ulc prim sutr CPT 15920 | not published | not published | $290.51 – $3,761.02 | 8 |
| Exc constrict ring finger w/mlt z-plasties 26596 CPT 26596 | not published | not published | $776.04 – $4,263.74 | 6 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $387.06 – $4,263.74 | 8 |
| Exc/crtg b1 cst/tum hum agrf CPT 24115 | not published | not published | $604.95 – $9,387.58 | 8 |
| Exc/crtg b1 cst/tum hum algr CPT 24116 | not published | not published | $604.95 – $9,387.58 | 8 |
| Exc/crtg b1 cst/tum rds agrf CPT 24125 | not published | not published | $484.05 – $4,263.74 | 8 |
| Exc/crtg b1 cst/tum rds algr CPT 24126 | not published | not published | $484.05 – $9,387.58 | 8 |
| Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106 CPT 28106 | not published | not published | $272.15 – $9,387.58 | 8 |
| Exc/curtg b1 cst/b9 tum hum CPT 24110 | not published | not published | $459.69 – $4,263.74 | 8 |
| Exc/destruct open intra-abd tumors cysts or endometriomas CPT 49204 | not published | not published | $1,481.70 – $1,481.70 | 1 |
| Exc excessive skin buttock CPT 15835 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Exc excessive skin hip CPT 15834 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Exc excessive skin leg CPT 15833 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Exc excessive skin thigh CPT 15832 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Exc excsv skin forearm/hand CPT 15837 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Exc excsv submental fat pad CPT 15838 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | not published | not published | $145.25 – $3,761.02 | 8 |
| Exc face tum deep < 2 cm CPT 21013 | not published | not published | $475.50 – $2,129.16 | 8 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | not published | not published | $496.43 – $3,761.02 | 8 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | not published | not published | $193.53 – $924.59 | 8 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $264.88 – $2,129.16 | 8 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | not published | not published | $371.56 – $3,761.02 | 8 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | $346.48 – $2,129.16 | 8 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $402.87 – $2,129.16 | 8 |
| Exc forearm tum deep < 3 cm CPT 25076 | not published | not published | $197.10 – $2,129.16 | 8 |
| Exc forearm tum deep 3 cm/> CPT 25073 | not published | not published | $439.31 – $3,761.02 | 8 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | $204.21 – $2,129.16 | 8 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | not published | not published | $451.97 – $2,129.16 | 8 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | not published | not published | $329.38 – $2,129.16 | 8 |
| Exchange biliary drg cath CPT 47536 | not published | not published | $752.05 – $4,637.54 | 8 |
| Exchange blood transfusion newborn 36450 CPT 36450 | not published | not published | $149.96 – $574.50 | 8 |
| Exchange drainage catheter CPT 49423 | $3,490.18 | $6,404.00 | $78.61 – $3,558.38 | 13 |
| Exchange lens prosthesis CPT 66986 | not published | not published | $580.60 – $2,997.11 | 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.