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 |
|---|---|---|---|---|
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $577.07 – $1,304.18 | 8 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $348.47 – $787.54 | 4 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $527.18 – $1,191.43 | 8 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $68.13 – $153.97 | 4 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $322.78 – $729.48 | 4 |
| Head CT scan (with and without contrast) CPT 70470 | $4,017.20 | $7,371.00 | $233.94 – $1,822.80 | 13 |
| Head CT scan (with contrast) CPT 70460 | $4,017.20 | $7,371.00 | $204.88 – $1,822.80 | 13 |
| Head CT scan (without contrast) CPT 70450 | $2,678.13 | $4,914.00 | $139.74 – $1,215.20 | 13 |
| Heinz bodies direct CPT 85441 | $30.93 | $56.75 | $4.20 – $55.62 | 14 |
| Heinz bodies induced CPT 85445 | $30.93 | $56.75 | $6.82 – $55.62 | 14 |
| Helicobacter pylori antibody igm CPT 86677 | $268.14 | $492.00 | $10.75 – $16.04 | 14 |
| Hematocrit CPT 85014 | $70.31 | $129.00 | $1.46 – $2.17 | 14 |
| Hemicrt intrclry algrft prtl CPT 20933 | not published | not published | $556.96 – $1,258.73 | 4 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $338.78 – $4,263.74 | 8 |
| Hemodialysis one evaluation CPT 90935 | $1,566.33 | $2,874.00 | $64.95 – $2,338.28 | 13 |
| Hemoglobin CPT 85018 | $53.41 | $98.00 | $2.37 – $96.04 | 14 |
| Hemoglobin fetal qualitative CPT 83033 | $3.54 | $6.49 | $4.35 – $6.49 | 14 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $65.40 | $120.00 | $8.20 – $117.60 | 14 |
| Hemoglobin plasma CPT 83051 | $7.63 | $14.00 | $7.31 – $14.00 | 14 |
| Hemoglobin urine CPT 83069 | $8.35 | $15.31 | $3.95 – $15.01 | 14 |
| Hemolysins/agglutinins auto CPT 86940 | $54.50 | $100.00 | $8.77 – $98.00 | 14 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | not published | not published | $390.17 – $3,603.77 | 8 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | not published | not published | $88.44 – $1,198.08 | 8 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $208.07 – $3,603.77 | 8 |
| Heparin assay CPT 85520 | $261.60 | $480.00 | $7.81 – $11.65 | 14 |
| Heparin bolus from bag HCPCS J1644 | $498.68 | $915.00 | $0.23 – $63.70 | 12 |
| Heparin neutralization CPT 85525 | $244.71 | $449.00 | $5.21 – $7.77 | 14 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $35.43 | $65.00 | $0.02 – $8.00 | 12 |
| Heparin-protamine tolerance CPT 85530 | $218.55 | $401.00 | $13.09 – $392.98 | 14 |
| Hepatectomy removal of liver 47120 CPT 47120 | not published | not published | $919.38 – $3,275.33 | 4 |
| Hepatitis a antibody igm CPT 86709 | $57.23 | $105.00 | $5.36 – $8.00 | 14 |
| Hepatitis b core antibody igm CPT 86705 | $55.05 | $101.00 | $11.77 – $98.98 | 14 |
| Hepatitis b core antibody total CPT 86704 | $57.23 | $105.00 | $12.05 – $102.90 | 14 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,547.26 | $2,839.00 | $129.85 – $259.70 | 12 |
| Hepatitis b surface antibody CPT 86706 | $53.41 | $98.00 | $4.36 – $6.50 | 14 |
| Hepatitis c antibody CPT 86803 | $85.02 | $156.00 | $8.43 – $12.57 | 14 |
| Hepatobiliary system imaging CPT 78226 | $2,093.89 | $3,842.00 | $291.01 – $1,202.46 | 13 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $394.76 – $4,637.54 | 8 |
| Herpes simplex 1 ag if CPT 87274 | $62.13 | $114.00 | $11.98 – $111.72 | 14 |
| Herpes simplex 2 ag if CPT 87273 | $62.13 | $114.00 | $10.10 – $111.72 | 14 |
| Herpes simplex type 1 antibody igg CPT 86695 | $12.05 | $22.11 | $9.05 – $13.50 | 14 |
| Herpes simplex type 2 antibody igg CPT 86696 | $9.42 | $17.27 | $9.05 – $13.50 | 14 |
| Herpes simplex virus isolation CPT 87255 | $13.61 | $24.97 | $16.73 – $24.97 | 14 |
| Heterophile antibodies screening CPT 86308 | $116.09 | $213.00 | $5.18 – $202.86 | 14 |
| Heterophile antibodies titer CPT 86309 | $3.85 | $7.05 | $4.73 – $7.05 | 14 |
| Hfo nontorsion jnts pre cst HCPCS L3929 | $24.53 | $45.00 | $11.25 – $45.00 | 12 |
| Hhv-6 dna quant CPT 87533 | $40.88 | $75.00 | $41.76 – $75.00 | 14 |
| Hi enrgy eswt plantar fascia CPT 28890 | not published | not published | $340.49 – $2,103.10 | 8 |
| Hip arthr0 w/debridement CPT 29862 | not published | not published | $695.95 – $9,387.58 | 8 |
| Hip arthr0 w/synovectomy CPT 29863 | not published | not published | $672.45 – $4,263.74 | 8 |
| Hip arthro acetabuloplasty CPT 29915 | not published | not published | $884.58 – $9,387.58 | 8 |
| Hip arthroscopy dx CPT 29860 | not published | not published | $448.59 – $9,387.58 | 8 |
| Hip arthro w/fb removal CPT 29861 | not published | not published | $652.79 – $9,387.58 | 8 |
| Hip arthro w/femoroplasty CPT 29914 | not published | not published | $868.20 – $9,387.58 | 8 |
| Hip arthro w/labral repair CPT 29916 | not published | not published | $884.58 – $9,387.58 | 8 |
| Histamine CPT 83088 | $13.63 | $25.00 | $16.16 – $24.11 | 14 |
| Histochemical stains add-on CPT 88314 | $88.29 | $162.00 | $44.22 – $66.00 | 11 |
| Hizentra injection HCPCS J1559 | $374.42 | $687.00 | $14.97 – $673.26 | 13 |
| Hla class i/ii antibody qual CPT 86829 | $59.95 | $110.00 | $23.37 – $107.80 | 14 |
| Hla ii typing 1 loc hr CPT 81382 | $114.45 | $210.00 | $109.94 – $210.00 | 14 |
| Hla i low res one antigen equiv ea CPT 81374 | $32.70 | $60.00 | $40.20 – $60.00 | 14 |
| Hla i typing complete hr CPT 81379 | $343.35 | $630.00 | $298.12 – $630.00 | 14 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $19.77 | $36.26 | $24.30 – $36.26 | 14 |
| Hla typing a b or c CPT 86813 | $128.08 | $235.00 | $58.00 – $230.30 | 14 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $519.93 | $954.00 | $0.21 – $29.40 | 11 |
| Home sleep test/type 3 porta HCPCS G0399 | $1,360.87 | $2,497.00 | $199.24 – $2,447.06 | 12 |
| Homocysteine CPT 83090 | $8.31 | $15.24 | $8.71 – $13.00 | 14 |
| Homogenization tissue CPT 87176 | $72.49 | $133.00 | $5.88 – $130.34 | 14 |
| Homovanillic acid (hva) CPT 83150 | $8.02 | $14.70 | $7.64 – $11.40 | 14 |
| Htt gene detc abnor alleles CPT 81271 | $102.76 | $188.54 | $109.60 – $188.54 | 14 |
| Human epididymis protein 4 (he4) CPT 86305 | $12.35 | $22.66 | $15.19 – $22.66 | 14 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $183.12 | $336.00 | $31.85 – $65.00 | 11 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $244.16 | $448.00 | $5.50 – $63.70 | 12 |
| Hydration IV infusion each additional hour CPT 96361 | $468.70 | $860.00 | $18.13 – $159.74 | 14 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $468.70 | $860.00 | $63.71 – $775.18 | 14 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $35.97 | $66.00 | $7.31 – $63.70 | 12 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $490.50 | $900.00 | $31.85 – $63.70 | 7 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $190.75 | $350.00 | $31.85 – $63.70 | 10 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $35.43 | $65.00 | $17.94 – $63.70 | 12 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $24.34 | $44.66 | $17.90 – $44.66 | 14 |
| Hymenotomy CPT 56442 | not published | not published | $87.15 – $4,178.22 | 8 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $486.02 – $7,773.77 | 8 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $901.01 – $3,209.90 | 4 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $1,308.26 – $2,956.67 | 4 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $1,308.26 – $2,956.67 | 4 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $1,003.00 – $2,266.78 | 4 |
| Hysterosalpingography s&i CPT 74740 | $751.56 | $1,379.00 | $67.02 – $489.02 | 13 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $2,328.97 – $6,486.99 | 8 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $251.48 – $4,178.22 | 8 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $231.12 – $4,178.22 | 8 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $377.22 – $6,486.99 | 8 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $261.65 – $4,178.22 | 8 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $545.83 – $6,486.99 | 8 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $393.93 – $6,486.99 | 8 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $1,017.53 – $6,486.99 | 8 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $161.32 | $296.00 | $89.33 – $290.08 | 10 |
| Iaadi respiratory synctial virus CPT 87280 | $125.90 | $231.00 | $5.93 – $8.84 | 14 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $1,178.29 | $2,162.00 | $32.65 – $1,029.00 | 12 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $1,035.50 | $1,900.00 | $287.86 – $1,279.88 | 12 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $49,246.20 | $90,360.00 | $18,669.25 – $73,183.46 | 11 |
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.