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 |
|---|---|---|---|---|
| Incision secondary cataract CPT 66820 | not published | not published | $241.81 – $2,997.11 | 8 |
| Incision tendon sheath CPT 26055 | not published | not published | $241.81 – $2,103.10 | 8 |
| Incisn of toe tndn CPT 28010 | not published | not published | $170.04 – $2,103.10 | 8 |
| Incisn windpipe CPT 31600 | $5,610.23 | $10,294.00 | $230.70 – $10,088.12 | 13 |
| Incis spine 3 column adl seg CPT 22208 | not published | not published | $430.01 – $971.82 | 4 |
| Incis spine 3 column lumbar CPT 22207 | not published | not published | $1,702.16 – $3,846.88 | 4 |
| Incis spine 3 column thorac CPT 22206 | not published | not published | $1,723.38 – $3,894.84 | 4 |
| Incobotulinumtoxin a HCPCS J0588 | $1,135.78 | $2,084.00 | $5.63 – $2,042.32 | 13 |
| Inc&subq plmt crnl bone grf CPT 61316 | not published | not published | $71.15 – $177.21 | 4 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $574.25 – $1,326.01 | 4 |
| Induced ab 1+vag supp hyst CPT 59857 | not published | not published | $1,158.14 – $2,674.51 | 4 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $398.18 – $919.39 | 4 |
| Induced abortion 1+njx d&c CPT 59851 | not published | not published | $460.48 – $1,063.49 | 4 |
| Induced abortion 1+njx hyst CPT 59852 | not published | not published | $1,024.27 – $2,365.54 | 4 |
| Induced abortion d&c CPT 59840 | not published | not published | $343.66 – $4,178.22 | 8 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $485.57 – $4,178.22 | 8 |
| Infect ag drug suscept pheno predict CPT 87900 | $125.52 | $230.31 | $77.32 – $115.40 | 14 |
| Infect ag eia influenza a or b ea CPT 87400 | $216.91 | $398.00 | $5.79 – $390.04 | 14 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $76.30 | $140.00 | $93.80 – $140.00 | 14 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $152.76 | $280.28 | $77.32 – $115.40 | 14 |
| Infect ag ia optc obs influenza CPT 87804 | $241.98 | $444.00 | $8.85 – $164.64 | 14 |
| Infect ag if hep delta agent CPT 87380 | $68.13 | $125.00 | $18.36 – $122.50 | 14 |
| Infect ag if influenza a CPT 87276 | $94.29 | $173.00 | $8.56 – $169.54 | 14 |
| Infect ag if influenza b CPT 87275 | $94.29 | $173.00 | $5.93 – $169.54 | 14 |
| Infect ag if legionella pneumophila CPT 87278 | $125.90 | $231.00 | $14.49 – $226.38 | 14 |
| Infect ag if nos ea CPT 87299 | $5.60 | $10.27 | $6.77 – $10.10 | 14 |
| Infect ag if pneumocystis carinii CPT 87281 | $8.18 | $15.00 | $10.05 – $15.00 | 14 |
| Infect ag if varicella zoster CPT 87290 | $5.51 | $10.10 | $6.77 – $10.10 | 14 |
| Infect ag na hpv high-risk types CPT 87624 | $231.63 | $425.00 | $31.19 – $416.50 | 14 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $412.02 | $756.00 | $76.64 – $398.86 | 14 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $226.18 | $415.00 | $45.61 – $406.70 | 14 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $46.33 | $85.00 | $56.95 – $83.30 | 7 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $454.53 | $834.00 | $260.23 – $388.39 | 14 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $376.95 | $691.65 | $77.32 – $115.40 | 14 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $62.90 | $115.40 | $23.17 – $96.77 | 14 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | $67.58 | $124.00 | $41.38 – $121.52 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $104.10 | $191.00 | $11.98 – $180.32 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $5.51 | $10.10 | $6.77 – $10.10 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $8.18 | $15.00 | $10.05 – $15.00 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $168.95 | $310.00 | $8.28 – $56.84 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $40.88 | $75.00 | $11.39 – $17.00 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $63.22 | $116.00 | $10.33 – $113.68 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $43.06 | $79.00 | $7.54 – $11.25 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $98.10 | $180.00 | $20.26 – $176.40 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $85.57 | $157.00 | $6.24 – $9.31 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $104.10 | $191.00 | $8.47 – $12.63 | 14 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $4.81 | $8.82 | $5.91 – $8.82 | 14 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $184.21 | $338.00 | $20.10 – $30.00 | 14 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $128.62 | $236.00 | $20.95 – $31.26 | 14 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $173.86 | $319.00 | $21.85 – $32.60 | 14 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $612.58 | $1,124.00 | $191.62 – $286.00 | 14 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $33.50 | $61.46 | $33.50 – $50.00 | 14 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $194.57 | $357.00 | $30.88 – $120.74 | 14 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $194.57 | $357.00 | $26.00 – $38.80 | 14 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $126.44 | $232.00 | $21.09 – $31.47 | 14 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $52.32 | $96.00 | $50.12 – $74.80 | 14 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $48.51 | $89.00 | $30.54 – $87.22 | 14 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $68.13 | $125.00 | $83.75 – $122.50 | 7 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $528.11 | $969.00 | $210.39 – $949.62 | 14 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $21.73 | $39.86 | $26.71 – $39.86 | 14 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $20.89 | $38.33 | $25.69 – $38.33 | 14 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $21.23 | $38.94 | $25.92 – $38.68 | 14 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $32.70 | $60.00 | $40.20 – $60.00 | 14 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $432.73 | $794.00 | $61.07 – $147.00 | 14 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $2,902.67 | $5,326.00 | $33.05 – $2,122.68 | 13 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,242.60 | $2,280.00 | $22.14 – $2,234.40 | 12 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $2,352.22 | $4,316.00 | $19.06 – $4,229.68 | 12 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,494.55 – $8,886.95 | 4 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,378.34 – $8,472.99 | 4 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,742.37 | $3,197.00 | $72.68 – $908.46 | 14 |
| Inj, adalimumab, 1 mg HCPCS J0139 | $5,083.22 | $9,327.00 | $1,730.19 – $3,460.38 | 7 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $9,125.48 | $16,744.00 | $1,000.09 – $2,000.18 | 7 |
| Inj alymsys 10 mg HCPCS Q5126 | $7,143.86 | $13,108.00 | $1,605.73 – $3,211.46 | 7 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | $3,925.64 | $7,203.00 | $3,529.47 – $7,058.94 | 7 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $11,041.16 | $20,259.00 | $178.22 – $19,853.82 | 13 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $8,698.20 | $15,960.00 | $42.21 – $15,640.80 | 13 |
| Inj, bupivacaine liposome HCPCS J0666 | $721.04 | $1,323.00 | $617.40 – $1,234.80 | 7 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $35.43 | $65.00 | $1.19 – $63.70 | 11 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | $55.05 | $101.00 | $49.49 – $98.98 | 7 |
| Inj, clindamycin (baxter) HCPCS J0737 | $1,276.39 | $2,342.00 | $31.85 – $63.70 | 7 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $304.11 | $558.00 | $130.68 – $337.00 | 10 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $3,021.48 | $5,544.00 | $1,106.79 – $5,433.12 | 13 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | $12.54 | $23.00 | $6.86 – $13.72 | 7 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $147.39 – $525.09 | 4 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $56.60 – $387.91 | 8 |
| Inj dx for sinogram CPT 20501 | not published | not published | $256.33 – $913.20 | 4 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $194.71 – $910.04 | 8 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $320.46 | $588.00 | $231.12 – $369.00 | 10 |
| Injection, caplacizumab-yhdp HCPCS C9047 | $16,709.70 | $30,660.00 | $935.09 – $30,046.80 | 9 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $60.23 – $387.91 | 8 |
| Injection, daratumumab 10 mg HCPCS J9145 | $5,266.34 | $9,663.00 | $74.03 – $2,367.68 | 13 |
| Injection epidural blood patch or clot CPT 62273 | $794.61 | $1,458.00 | $87.15 – $1,428.84 | 13 |
| Injection eye drug CPT 67028 | not published | not published | $417.82 – $1,488.50 | 8 |
| Injection for arthrography wrist (both sides) CPT 25246 | $323.19 | $593.00 | $208.91 – $337.00 | 10 |
| Injection for bladder x-ray CPT 51600 | $323.19 | $593.00 | $235.84 – $352.00 | 10 |
| Injection for hip x-ray CPT 27095 | $275.23 | $505.00 | $237.11 – $505.00 | 10 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $336.27 | $617.00 | $197.80 – $352.00 | 10 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $96.98 – $345.51 | 4 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $278.97 – $993.86 | 4 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $289.66 – $1,031.92 | 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.