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 |
|---|---|---|---|---|
| Excision of tongue lesion CPT 41114 | not published | not published | $534.46 – $4,261.72 | 8 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $292.39 – $4,261.72 | 6 |
| Excision of tonsil tags CPT 42860 | not published | not published | $135.43 – $4,261.72 | 8 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $4,637.54 – $4,637.54 | 6 |
| Excision of uvula CPT 42140 | not published | not published | $93.13 – $4,261.72 | 8 |
| Excision of vaginal septum 57130 CPT 57130 | not published | not published | $232.57 – $4,178.22 | 8 |
| Excision olecranon bursa CPT 24105 | not published | not published | $232.41 – $4,263.74 | 8 |
| Excision perinephric cyst CPT 50290 | not published | not published | $834.36 – $2,972.44 | 4 |
| Excision radial head CPT 24130 | not published | not published | $387.06 – $4,263.74 | 8 |
| Excision tongue lesion without closure 41110 CPT 41110 | not published | not published | $153.38 – $4,261.72 | 8 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $386.08 – $2,129.16 | 8 |
| Excis partial tal calc CPT 28120 | not published | not published | $317.85 – $4,263.74 | 8 |
| Excis uppr jaw cyst w/repair CPT 21049 | not published | not published | $646.29 – $7,773.77 | 8 |
| Exc leg/ankle tum dep 5 cm/ > 27634 CPT 27634 | not published | not published | $554.73 – $3,761.02 | 8 |
| Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 | not published | not published | $423.38 – $3,761.02 | 8 |
| Exc les conjunctiva <1 cm CPT 68110 | not published | not published | $172.17 – $3,065.74 | 8 |
| Exc les conjunctiva >1 cm CPT 68115 | not published | not published | $178.58 – $3,065.74 | 8 |
| Exc les conjunctiva adj scl CPT 68130 | not published | not published | $271.71 – $3,065.74 | 8 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | not published | not published | $145.25 – $924.59 | 8 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | not published | not published | $213.61 – $924.59 | 8 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | not published | not published | $320.42 – $2,129.16 | 8 |
| Exc malig feenl >4cm 11646 CPT 11646 | not published | not published | $406.72 – $3,761.02 | 8 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | not published | not published | $96.98 – $2,129.16 | 8 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | not published | not published | $145.25 – $924.59 | 8 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | not published | not published | $210.62 – $2,129.16 | 8 |
| Exc malig tal <0.5cm 11600 CPT 11600 | not published | not published | $79.47 – $924.59 | 8 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | not published | not published | $91.00 – $924.59 | 8 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | $96.98 – $525.02 | 8 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | not published | not published | $193.10 – $924.59 | 8 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | not published | not published | $208.48 – $924.59 | 8 |
| Exc mandible 21025 CPT 21025 | not published | not published | $339.64 – $7,773.77 | 8 |
| Exc neck tum deep < 5 cm CPT 21556 | not published | not published | $457.99 – $3,761.02 | 8 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | $605.36 – $3,761.02 | 8 |
| Exc of facial bones/osteomy/abcess 21026 CPT 21026 | not published | not published | $343.05 – $7,773.77 | 6 |
| Exc of rectal prlpse 45130 CPT 45130 | not published | not published | $701.50 – $2,499.13 | 4 |
| Exc of residual cervix 57540 CPT 57540 | not published | not published | $872.17 – $1,971.10 | 4 |
| Exc of residual cervix via aginal approach 57550 CPT 57550 | not published | not published | $872.17 – $6,486.99 | 8 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | not published | not published | $111.50 – $3,761.02 | 8 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | $239.67 – $4,263.74 | 8 |
| Exc rect tum transanal full CPT 45172 | not published | not published | $673.12 – $3,603.77 | 8 |
| Exc rect tum transanal part CPT 45171 | not published | not published | $494.41 – $3,603.77 | 8 |
| Exc sac pr ulc prim str ostc CPT 15933 | not published | not published | $619.48 – $3,761.02 | 8 |
| Exc sac pr ulc skn flp ostc CPT 15935 | not published | not published | $954.84 – $4,810.88 | 8 |
| Exc sacral pr ulc prim sutr CPT 15931 | not published | not published | $435.33 – $3,761.02 | 8 |
| Exc sacral pr ulc skn flap CPT 15934 | not published | not published | $777.97 – $4,810.88 | 8 |
| Exc shoulder tum deep < 5 cm CPT 23076 | not published | not published | $560.94 – $3,761.02 | 8 |
| Exc skn hdrdnt ax complex CPT 11451 | not published | not published | $178.58 – $3,761.02 | 8 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | not published | not published | $135.01 – $3,761.02 | 8 |
| Exc skn hdrdnt ing complex CPT 11463 | not published | not published | $185.84 – $3,761.02 | 8 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | not published | not published | $191.39 – $924.59 | 8 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | not published | not published | $240.52 – $2,129.16 | 8 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | not published | not published | $309.31 – $3,761.02 | 8 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | not published | not published | $570.34 – $2,129.16 | 8 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | $370.07 – $3,761.02 | 8 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | not published | not published | $379.79 – $2,129.16 | 8 |
| Exc sq tumor/foot or toe < 1.5 cm 28039 CPT 28039 | not published | not published | $465.79 – $3,761.02 | 8 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | $376.81 – $2,129.16 | 8 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | not published | not published | $391.76 – $3,761.02 | 8 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | not published | not published | $395.18 – $2,129.16 | 8 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | $396.03 – $3,761.02 | 8 |
| Exc sq tum/vasc malform/hand/fngr 26111 CPT 26111 | not published | not published | $393.90 – $2,129.16 | 8 |
| Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 | not published | not published | $385.70 – $3,761.02 | 8 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | $188.40 – $2,103.10 | 8 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | not published | not published | $441.32 – $2,129.16 | 8 |
| Exc thigh/knee tum deep <5cm CPT 27328 | not published | not published | $443.46 – $3,761.02 | 8 |
| Exc thigh/knee tum dep 5cm/> CPT 27339 | not published | not published | $618.76 – $3,761.02 | 8 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | not published | not published | $106.38 – $1,549.43 | 8 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | not published | not published | $138.85 – $2,129.16 | 8 |
| Exc torus mandibularis 21031 CPT 21031 | not published | not published | $238.82 – $4,261.72 | 8 |
| Exc trchntric pr ulcer w/prim sutr w/ostectomy 15951 CPT 15951 | not published | not published | $728.41 – $3,761.02 | 8 |
| Exc trchntr pr ulc flp clsr CPT 15952 | not published | not published | $727.99 – $2,593.49 | 8 |
| Exc trchntr pr ulc flp ostc CPT 15953 | not published | not published | $909.98 – $4,810.88 | 8 |
| Exc trchntr pr ulc prep flap CPT 15956 | not published | not published | $933.91 – $3,327.10 | 8 |
| Exc trchntr pr ulc prep ostc CPT 15958 | not published | not published | $962.53 – $4,810.88 | 8 |
| Exc trchntr pr ulc prim sutr CPT 15950 | not published | not published | $475.50 – $2,129.16 | 8 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | $260.60 – $2,129.16 | 8 |
| Exc/unroofing cyst kidney CPT 50280 | not published | not published | $871.11 – $3,103.36 | 4 |
| Exc vagina lesion 57135 CPT 57135 | not published | not published | $158.15 – $4,178.22 | 8 |
| Ex palate/uvula lesion without closure 42104 CPT 42104 | not published | not published | $138.85 – $4,261.72 | 8 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $4,101.67 | $7,526.00 | $231.28 – $4,939.20 | 11 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $4,101.67 | $7,526.00 | $571.50 – $2,240.28 | 11 |
| Expl lap celiotomy w/wo bx 49000 CPT 49000 | not published | not published | $484.05 – $1,724.40 | 4 |
| Exploration carotid artery 35701 CPT 35701 | not published | not published | $427.22 – $1,522.00 | 4 |
| Exploration for testis CPT 54550 | not published | not published | $377.24 – $4,637.54 | 8 |
| Exploration for testis CPT 54560 | not published | not published | $570.76 – $2,691.95 | 8 |
| Exploration maxillary sinus CPT 31030 | not published | not published | $512.67 – $7,773.77 | 8 |
| Exploration maxillary sinus CPT 31256 | not published | not published | $194.39 – $4,845.02 | 8 |
| Exploration of ankle joint CPT 27612 | not published | not published | $484.05 – $4,263.74 | 8 |
| Exploration of bile ducts CPT 47700 | not published | not published | $701.50 – $2,499.13 | 4 |
| Exploration of chest 39000 CPT 39000 | not published | not published | $328.11 – $1,168.92 | 4 |
| Exploration of chest 39010 CPT 39010 | not published | not published | $580.60 – $2,068.40 | 4 |
| Exploration of foot joint CPT 28020 | not published | not published | $290.51 – $4,263.74 | 8 |
| Exploration of foot joint CPT 28022 | not published | not published | $218.32 – $4,263.74 | 8 |
| Exploration of frontal sinus CPT 31070 | not published | not published | $427.22 – $7,773.77 | 8 |
| Exploration of frontal sinus CPT 31075 | not published | not published | $683.55 – $7,773.77 | 8 |
| Exploration of knee joint CPT 27310 | not published | not published | $580.60 – $4,263.74 | 8 |
| Exploration of middle ear CPT 69440 | not published | not published | $484.05 – $4,261.72 | 8 |
| Exploration of sinuses CPT 31090 | not published | not published | $1,110.78 – $7,773.77 | 8 |
| Exploration of spinal fusion CPT 22830 | not published | not published | $767.29 – $2,733.49 | 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.