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 |
|---|---|---|---|---|
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $79,310.04 | $145,523.00 | $20,536.25 – $80,502.10 | 11 |
| Icd crtp serena MRI HCPCS C2621 | $25,762.70 | $47,271.00 | $6,992.25 – $27,409.62 | 9 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $19,815.11 | $36,358.00 | $5,378.25 – $21,082.74 | 11 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $755.33 – $1,875.98 | 4 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $199.08 – $4,261.72 | 8 |
| Idarubicin hcl injection HCPCS J9211 | $1,242.60 | $2,280.00 | $39.27 – $598.78 | 11 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $141.41 – $2,129.16 | 8 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $522.92 – $4,263.74 | 8 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $141.83 – $3,603.77 | 8 |
| I&d lacrimal gland CPT 68400 | not published | not published | $209.34 – $1,272.76 | 8 |
| I&d lacrimal sac CPT 68420 | not published | not published | $229.42 – $3,065.74 | 8 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $186.27 – $3,761.02 | 8 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $1,055.67 | $1,937.00 | $24.91 – $61.74 | 12 |
| Igh gene rearrange amp meth CPT 81261 | $146.84 | $269.43 | $180.52 – $264.05 | 12 |
| Igh@ var region somatic mutation analy CPT 81263 | $220.18 | $404.00 | $270.68 – $395.92 | 12 |
| Igk rearrangeabn clonal pop CPT 81264 | $110.75 | $203.21 | $136.16 – $199.15 | 12 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $202.74 | $372.00 | $33.50 – $50.00 | 11 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $68.13 | $125.00 | $83.75 – $125.00 | 13 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $202.20 | $371.00 | $33.50 – $50.00 | 13 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $701.50 – $2,499.13 | 4 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $2,286.49 – $8,145.72 | 4 |
| Iliac revasc add-on 37222 CPT 37222 | $6,175.40 | $11,331.00 | $160.46 – $11,104.38 | 10 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $991.16 – $3,531.05 | 4 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | $22,624.59 | $41,513.00 | $5,085.71 – $10,171.42 | 7 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $191.30 | $351.00 | $11.25 – $45.00 | 12 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $115.00 | $211.00 | $11.25 – $45.00 | 12 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $598.11 – $8,569.85 | 8 |
| Immune complex assay CPT 86332 | $70.51 | $129.36 | $10.84 – $16.17 | 14 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $2,990.42 | $5,487.00 | $50.66 – $2,796.92 | 13 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $6.00 | $11.00 | $7.37 – $11.00 | 14 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $43.60 | $80.00 | $12.86 – $19.18 | 14 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $7.23 | $13.25 | $3.76 – $5.60 | 14 |
| Immunodiffusion nes CPT 86329 | $8.26 | $15.15 | $10.16 – $15.15 | 14 |
| Immunofixation electrophoresis serum CPT 86334 | $10.92 | $20.03 | $8.59 – $12.82 | 14 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $64.09 | $117.59 | $35.60 – $53.13 | 11 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $94.18 | $172.79 | $54.19 – $80.88 | 13 |
| Immunoglobulin assay CPT 86023 | $7.40 | $13.56 | $9.09 – $13.56 | 14 |
| Implant biventricular device 33976 CPT 33976 | not published | not published | $1,611.91 – $5,742.48 | 4 |
| Implant brain electrodes CPT 61531 | not published | not published | $1,078.31 – $3,841.53 | 4 |
| Implant brain electrodes CPT 61533 | not published | not published | $1,332.50 – $4,747.11 | 4 |
| Implant brain electrodes CPT 61760 | not published | not published | $1,137.69 – $4,053.08 | 4 |
| Implant cochlear device CPT 69930 | not published | not published | $1,293.62 – $41,798.66 | 8 |
| Implant eye drug system CPT 67027 | not published | not published | $675.01 – $20,190.92 | 8 |
| Implant hormone pellet(s) 11980 CPT 11980 | not published | not published | $88.44 – $524.38 | 8 |
| Implant nerve end CPT 64787 | not published | not published | $264.45 – $942.13 | 4 |
| Implant neuroelectrde addl CPT 61868 | not published | not published | $303.76 – $754.41 | 4 |
| Implant neuroelectrode CPT 61867 | not published | not published | $916.39 – $2,276.00 | 4 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $891.19 – $28,180.07 | 8 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $163.20 – $16,387.23 | 8 |
| Implant neuroelectrodes CPT 64555 | not published | not published | $8,624.31 – $8,624.31 | 6 |
| Implant neuroelectrodes CPT 64561 | not published | not published | $675.35 – $8,624.31 | 8 |
| Implant neurostim arrays CPT 61886 | not published | not published | $434.49 – $40,045.34 | 8 |
| Implant single ventricular device 33975 CPT 33975 | not published | not published | $1,192.80 – $4,249.41 | 4 |
| Implant spinal canal cath CPT 62351 | not published | not published | $442.60 – $9,387.58 | 8 |
| Implant spine infusion pump CPT 62361 | not published | not published | $229.85 – $23,225.56 | 8 |
| Implant spine infusion pump CPT 62362 | not published | not published | $300.76 – $23,225.56 | 8 |
| Implant tcat pulm vlv perq CPT 33477 | not published | not published | $1,116.16 – $2,522.52 | 4 |
| Implant ureter in bowel CPT 50800 | not published | not published | $939.89 – $3,348.39 | 4 |
| Implant ureth bulk agent HCPCS L8606 | $2,108.61 | $3,869.00 | $146.09 – $1,719.90 | 12 |
| Impl neurostim electr perc CPT 63650 | not published | not published | $500.71 – $8,624.31 | 8 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | not published | not published | $173.49 – $392.09 | 4 |
| Implnt spinl canal catheter 62350 CPT 62350 | not published | not published | $299.48 – $8,415.59 | 8 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $503.77 – $16,908.29 | 8 |
| Implt brain chemotx add-on 61517 CPT 61517 | not published | not published | $43.19 – $97.61 | 4 |
| Impltj ntrstrml crnl rng seg CPT 65785 | not published | not published | $1,946.38 – $5,286.44 | 8 |
| Impres&prep auricular prosth CPT 21086 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep def obt prosth CPT 21080 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep facial prosth CPT 21088 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep intrm obt prosth CPT 21079 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep mndbl res prosth CPT 21081 | not published | not published | $7,773.77 – $7,773.77 | 6 |
| Impres&prep nasal prosth CPT 21087 | not published | not published | $7,773.77 – $7,773.77 | 6 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $305.16 – $305.16 | 6 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $7,773.77 – $7,773.77 | 6 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $4,261.72 – $4,261.72 | 6 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $1,946.55 – $1,946.55 | 6 |
| In-111 autol wbc diag per dose HCPCS A9570 | $2,992.05 | $5,490.00 | $1,355.35 – $5,380.20 | 12 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $501.13 – $1,785.29 | 4 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $415.69 – $9,387.58 | 8 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $622.04 – $4,263.74 | 8 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $1,202.62 – $4,284.42 | 4 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $1,114.20 – $3,969.40 | 4 |
| Incis 1 vertebral seg thorac CPT 22212 | not published | not published | $1,186.40 – $4,226.58 | 4 |
| Incis addl spine segment CPT 22216 | not published | not published | $352.04 – $1,254.14 | 4 |
| Incise bile duct sphincter CPT 47460 | not published | not published | $860.42 – $3,065.31 | 4 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $241.81 – $2,566.14 | 8 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $145.68 – $1,272.76 | 8 |
| Incise flexor carpi radialis CPT 25001 | not published | not published | $251.30 – $4,263.74 | 8 |
| Incise hand/finger tendon CPT 26460 | not published | not published | $197.37 – $2,103.10 | 8 |
| Incise hip/thigh nerve CPT 64763 | not published | not published | $290.51 – $2,566.14 | 8 |
| Incise hip/thigh nerve CPT 64766 | not published | not published | $484.05 – $2,566.14 | 8 |
| Incise inner ear CPT 69801 | not published | not published | $198.23 – $1,946.55 | 8 |
| Incise inner ear nerve CPT 69915 | not published | not published | $1,512.36 – $5,387.89 | 8 |
| Incise inner ear nerve CPT 69950 | not published | not published | $1,739.22 – $6,196.04 | 4 |
| Incise inner eye adhesions CPT 65860 | not published | not published | $361.86 – $1,289.15 | 8 |
| Incise inner eye adhesions CPT 65865 | not published | not published | $474.21 – $2,997.11 | 8 |
| Incise inner eye adhesions CPT 65870 | not published | not published | $449.86 – $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.