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 |
|---|---|---|---|---|
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $275.77 | $506.00 | $1.02 – $63.70 | 12 |
| Fern test HCPCS Q0114 | $70.85 | $130.00 | $9.74 – $124.46 | 12 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $2,367.48 | $4,344.00 | $1.21 – $4,257.12 | 13 |
| Ferritin CPT 82728 | $104.64 | $192.00 | $13.63 – $188.16 | 14 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $2,653.06 | $4,868.00 | $0.33 – $63.70 | 12 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $463.80 | $851.00 | $72.68 – $833.98 | 13 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $215.13 – $486.19 | 8 |
| Fetal fibronectin CPT 82731 | $620.21 | $1,138.00 | $56.19 – $929.04 | 14 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $314.15 – $709.98 | 8 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $191.30 | $351.00 | $7.73 – $47.04 | 14 |
| Fetal hemoglobin rosette CPT 85461 | $51.23 | $94.00 | $5.98 – $92.12 | 14 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $106.83 – $241.44 | 4 |
| Fetal monitor w/report CPT 59050 | not published | not published | $116.29 – $262.82 | 4 |
| Fetal non stress test CPT 59025 | $288.31 | $529.00 | $32.70 – $518.42 | 13 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $82.13 – $399.74 | 8 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $284.26 – $642.43 | 8 |
| Fibrin degradation d dimer quantitative CPT 85379 | $212.55 | $390.00 | $6.14 – $9.16 | 14 |
| Fibrin degradation products CPT 85362 | $180.40 | $331.00 | $6.89 – $34.61 | 14 |
| Fibrinogen activity CPT 85384 | $204.38 | $375.00 | $9.72 – $353.78 | 14 |
| Fibrinolytic antiplasmin CPT 85410 | $4.58 | $8.39 | $5.63 – $8.39 | 14 |
| Fibrinolytic plasminogen CPT 85415 | $10.21 | $18.72 | $12.55 – $18.72 | 14 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $3.34 | $6.12 | $4.11 – $6.12 | 14 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $2,661.17 – $9,480.54 | 4 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $802.24 | $1,472.00 | $0.30 – $901.60 | 12 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $1,004.98 | $1,844.00 | $0.39 – $1,061.34 | 12 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $577.18 – $2,403.79 | 8 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $2,746.80 | $5,040.00 | $1,260.00 – $4,939.20 | 11 |
| Filter vena cava fem denali HCPCS C1880 | $5,332.28 | $9,784.00 | $969.00 – $3,798.48 | 11 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | not published | not published | $259.49 – $924.59 | 8 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | not published | not published | $145.57 – $328.99 | 4 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | not published | not published | $45.05 – $101.81 | 4 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $716.68 | $1,315.00 | $51.75 – $1,288.70 | 10 |
| Fine needle asp without image guide 10021 CPT 10021 | $766.27 | $1,406.00 | $73.34 – $795.76 | 13 |
| Finger tendon transfer CPT 26497 | not published | not published | $484.05 – $4,263.74 | 8 |
| Finger tendon transfer CPT 26498 | not published | not published | $725.85 – $4,263.74 | 8 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $1,453.62 – $3,285.18 | 4 |
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $924.50 – $2,089.37 | 4 |
| Fitting of diaphragm/cap 57170 CPT 57170 | not published | not published | $43.61 – $264.36 | 8 |
| Fixation of ankle joint CPT 27860 | not published | not published | $107.66 – $4,263.74 | 8 |
| Fixation of knee joint CPT 27570 | not published | not published | $89.29 – $2,103.10 | 8 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $1,033.02 – $9,387.58 | 8 |
| Fix g/colon tube w/device CPT 49460 | not published | not published | $679.82 – $1,536.39 | 8 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $520.10 – $4,263.74 | 8 |
| Flecainide (tambocor)-sendout CPT 80181 | $13.74 | $25.21 | $14.91 – $25.21 | 14 |
| Fl exam g/colon tube w contrast CPT 49465 | $1,330.35 | $2,441.00 | $141.10 – $1,629.74 | 13 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $62.80 – $1,198.08 | 8 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $387.06 – $9,387.58 | 8 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $387.06 – $9,387.58 | 8 |
| Floor of mouth biopsy 41108 CPT 41108 | not published | not published | $111.50 – $2,129.16 | 8 |
| Flotufolastat f18 diag 1 mci HCPCS A9608 | $856.74 | $1,572.00 | $770.28 – $1,540.56 | 6 |
| Flow cytometry marker each additional CPT 88185 | $62.51 | $114.68 | $6.70 – $10.00 | 11 |
| Flow cytometry one marker technical component CPT 88184 | $65.40 | $120.00 | $15.54 – $23.18 | 13 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $243.62 | $447.00 | $2.39 – $63.70 | 11 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $1,081.28 | $1,984.00 | $75.95 – $422.38 | 13 |
| Fluid pressure muscle 20950 CPT 20950 | not published | not published | $105.33 – $924.59 | 6 |
| Fluorescent antibody titer dna CPT 86256 | $78.21 | $143.50 | $7.00 – $10.44 | 14 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $1,231.70 | $2,260.00 | $56.88 – $801.64 | 11 |
| Fluoroguide needle placement CPT 77002 | $1,415.91 | $2,598.00 | $66.51 – $812.42 | 11 |
| Fluoroscopy up to 1 hour CPT 76000 | $1,296.01 | $2,378.00 | $40.11 – $633.08 | 13 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $144.43 | $265.00 | $1.82 – $61.74 | 12 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $343.35 | $630.00 | $0.01 – $82.32 | 12 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,235.52 | $2,267.00 | $428.52 – $1,281.84 | 13 |
| Fna bx w/ct gdn ea addl CPT 10010 | not published | not published | $256.89 – $580.57 | 4 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $924.59 – $924.59 | 6 |
| Folic acid CPT 82746 | $104.10 | $191.00 | $14.70 – $186.20 | 14 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $146.61 | $269.00 | $38.22 – $76.44 | 7 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $511.38 – $3,065.74 | 8 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $3,963.79 | $7,273.00 | $2.64 – $3,884.72 | 13 |
| Fondaparinux sodium HCPCS J1652 | $299.75 | $550.00 | $0.76 – $100.94 | 11 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $896.50 – $4,810.88 | 8 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | not published | not published | $319.60 – $319.60 | 6 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $831.67 | $1,526.00 | $0.12 – $177.38 | 12 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $1,098.72 | $2,016.00 | $3.28 – $63.70 | 10 |
| Fracture assessment via dxa CPT 77086 | $73.03 | $134.00 | $30.22 – $131.32 | 13 |
| _fragile x methylation-sendout CPT 81244 | $43.64 | $80.07 | $35.91 – $80.07 | 14 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $769.00 – $4,532.29 | 8 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $2,125.00 – $7,570.41 | 4 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $701.50 – $2,499.13 | 4 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $2,848.50 – $2,848.50 | 1 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $2,121.58 – $7,558.25 | 4 |
| Free omental flap microvasc CPT 49906 | not published | not published | $2,278.42 – $2,278.42 | 1 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $1,287.22 – $4,585.77 | 4 |
| Free skin flap microvasc CPT 15757 | not published | not published | $2,135.68 – $7,608.47 | 4 |
| Frenectomy 41115 CPT 41115 | not published | not published | $1,946.55 – $1,946.55 | 6 |
| Frenotomy 40806 CPT 40806 | not published | not published | $669.21 – $669.21 | 6 |
| Frenulotomy of penis CPT 54164 | not published | not published | $155.25 – $2,691.95 | 8 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $81.21 | $149.00 | $77.93 – $135.00 | 13 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $118.27 | $217.00 | $67.03 – $212.66 | 13 |
| Fresh frozen plasma thawing ea un CPT 86927 | $180.40 | $331.00 | $11.84 – $324.38 | 13 |
| Frozen blood thaw CPT 86931 | $168.95 | $310.00 | $73.28 – $303.80 | 12 |
| Fructosamine glycated protein CPT 82985 | $5.14 | $9.42 | $6.32 – $9.42 | 14 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $213.61 – $761.01 | 4 |
| Fth/gft fr trnk each addl CPT 15201 | not published | not published | $88.00 – $313.55 | 4 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $484.05 – $2,403.79 | 8 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $338.36 – $2,403.79 | 8 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $128.17 – $456.61 | 4 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $387.06 – $2,403.79 | 8 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $53.96 | $99.00 | $31.85 – $63.70 | 7 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $1,463.24 – $5,212.85 | 4 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $1,025.33 – $3,652.79 | 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.