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 |
|---|---|---|---|---|
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $117.06 – $525.02 | 8 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $179.00 – $637.73 | 8 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $158.07 – $563.15 | 8 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $373.82 – $1,331.75 | 8 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $106.38 – $379.00 | 8 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $96.55 – $343.97 | 8 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $129.45 – $461.18 | 8 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $261.11 – $1,150.63 | 8 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $261.11 – $1,553.95 | 8 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $69.63 – $387.91 | 8 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $41.01 – $169.39 | 8 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $196.52 – $804.40 | 8 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $144.40 – $525.02 | 8 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,737.54 | $5,023.00 | $122.19 – $4,922.54 | 13 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $146.96 – $523.57 | 8 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $171.86 – $388.40 | 8 |
| Ghs urine, hydroxproline total CPT 83505 | $14.65 | $26.87 | $18.01 – $26.87 | 14 |
| Ghs urine, porphyrins quant CPT 84120 | $13.08 | $24.00 | $14.71 – $24.00 | 14 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $780.72 – $4,178.22 | 8 |
| Ghs windowing of cast CPT 29730 | not published | not published | $32.46 – $207.35 | 8 |
| Gi inhouse confirmation CPT 87045 | $328.09 | $602.00 | $9.44 – $295.96 | 14 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $197.37 – $4,261.72 | 8 |
| Glassia injection HCPCS J0257 | $991.90 | $1,820.00 | $6.06 – $1,783.60 | 13 |
| Glaucoma surgery CPT 66150 | not published | not published | $580.60 – $5,286.44 | 8 |
| Glaucoma surgery CPT 66155 | not published | not published | $580.60 – $5,286.44 | 8 |
| Glaucoma surgery CPT 66160 | not published | not published | $580.60 – $2,997.11 | 8 |
| Glaucoma surgery CPT 66170 | not published | not published | $774.13 – $2,997.11 | 8 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $640.92 | $1,176.00 | $82.32 – $207.54 | 13 |
| Glucagon plasma - sendout CPT 82943 | $10.89 | $19.98 | $13.39 – $19.98 | 14 |
| Glucose 1 hr post dose CPT 82950 | $272.50 | $500.00 | $4.75 – $43.12 | 14 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $140.07 | $257.00 | $6.05 – $32.34 | 14 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $82.84 | $152.00 | $2.87 – $148.96 | 14 |
| Glucose blood quantitative CPT 82947 | $49.60 | $91.00 | $3.93 – $26.07 | 14 |
| Glucose body fluid CPT 82945 | $99.74 | $183.00 | $2.36 – $3.51 | 14 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $212.55 | $390.00 | $12.87 – $69.58 | 14 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $141.70 | $260.00 | $3.92 – $69.58 | 14 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $61.59 | $113.00 | $31.85 – $63.70 | 7 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $4,162.71 | $7,638.00 | $11.69 – $7,485.24 | 13 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $5.45 | $10.00 | $6.12 – $9.12 | 14 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $4.98 | $9.12 | $5.53 – $8.24 | 14 |
| Goniotomy CPT 65820 | not published | not published | $484.05 – $5,286.44 | 8 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $4,736.60 | $8,691.00 | $705.14 – $1,750.28 | 14 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $5,332.28 | $9,784.00 | $30.36 – $7,375.48 | 13 |
| Graft axiofill 1000mg HCPCS J3590 | $6,935.67 | $12,726.00 | $1,692.46 – $3,384.92 | 8 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $2,746.80 | $5,040.00 | $70.30 – $2,912.56 | 13 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $645.54 – $4,263.74 | 8 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $25,762.70 | $47,271.00 | $25.78 – $3,791.62 | 12 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $25,762.70 | $47,271.00 | $152.25 – $596.82 | 11 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $25,762.70 | $47,271.00 | $199.00 – $780.08 | 11 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $9,018.12 | $16,547.00 | $103.77 – $2,912.56 | 13 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $965.52 – $3,439.72 | 4 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $19,815.11 | $36,358.00 | $134.06 – $2,912.56 | 13 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $72,100.23 | $132,294.00 | $51.46 – $5,672.24 | 11 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $44,769.03 | $82,145.00 | $45.00 – $176.40 | 11 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $3,154.46 | $5,788.00 | $87.75 – $343.98 | 11 |
| Granulocyte pheresis ea unit HCPCS P9050 | $2,495.01 | $4,578.00 | $1,387.55 – $4,486.44 | 10 |
| Great toe-hand transfer CPT 26551 | not published | not published | $2,827.35 – $10,072.59 | 4 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $75.62 – $315.23 | 8 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $518.61 – $2,403.79 | 8 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $513.77 – $4,810.88 | 8 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $159.72 – $360.97 | 4 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $424.05 – $4,810.88 | 8 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,094.11 – $3,897.84 | 4 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $907.42 – $3,232.73 | 4 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,197.51 – $4,266.16 | 4 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,167.60 – $4,159.62 | 4 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,162.58 – $2,627.43 | 4 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $555.39 – $2,492.83 | 8 |
| G-tube reposition CPT 43761 | not published | not published | $91.00 – $324.17 | 8 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,850.35 | $5,230.00 | $152.94 – $2,903.74 | 13 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,154.46 | $5,788.00 | $11.25 – $44.10 | 11 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,245.87 | $2,286.00 | $27.00 – $105.84 | 11 |
| Guid loc target vol rad tx CPT 77387 | $287.22 | $527.00 | $113.13 – $516.46 | 10 |
| Gum graft CPT 41870 | not published | not published | $1,946.55 – $1,946.55 | 6 |
| Gw stiffened micro access kit HCPCS C1894 | $2,746.80 | $5,040.00 | $11.25 – $44.10 | 11 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $457.56 – $5,032.06 | 8 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $804.40 – $804.40 | 6 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $525.02 – $525.02 | 6 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $525.02 – $525.02 | 6 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $165.14 | $303.00 | $0.01 – $63.70 | 12 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $39.24 | $72.00 | $0.01 – $63.70 | 12 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $580.60 – $4,263.74 | 8 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $354.60 – $9,387.58 | 8 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $387.06 – $4,263.74 | 8 |
| Haptoglobin quantitative CPT 83010 | $150.97 | $277.00 | $12.58 – $26.60 | 14 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $77.76 – $193.12 | 4 |
| Harvest auto stem cells CPT 38206 | not published | not published | $79.04 – $2,154.18 | 8 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $247.36 – $2,403.79 | 8 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $172.83 – $3,065.74 | 8 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $251.73 – $624.98 | 4 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $36.83 – $574.50 | 6 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $469.05 – $469.05 | 1 |
| Hba1/hba2 full gene sequence CPT 81259 | $254.79 | $467.50 | $313.23 – $467.50 | 14 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $190.75 | $350.00 | $161.92 – $350.00 | 14 |
| Hbb full gene sequence CPT 81364 | $490.50 | $900.00 | $259.66 – $882.00 | 14 |
| Hbb gene dup/del variants CPT 81363 | $251.14 | $460.79 | $161.92 – $451.58 | 14 |
| Hbot, full body chamber, 30m HCPCS G0277 | $321.01 | $589.00 | $50.87 – $589.00 | 11 |
| Hcg qualitative CPT 84703 | $359.70 | $660.00 | $7.52 – $74.48 | 14 |
| Hcg quantitative CPT 84702 | $182.03 | $334.00 | $9.38 – $14.00 | 14 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $96.98 – $2,103.10 | 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.