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 |
|---|---|---|---|---|
| Install spinal shunt CPT 63740 | not published | not published | $1,110.78 – $3,957.19 | 4 |
| Install spinal shunt 63741 CPT 63741 | not published | not published | $888.62 – $8,415.59 | 8 |
| Inst fibrinolysis agent ini day CPT 32561 | not published | not published | $79.67 – $812.46 | 8 |
| Inst fibrinolysis agent sbsq d CPT 32562 | not published | not published | $71.11 – $812.46 | 8 |
| Instillation anticarcinogenic agent bladder CPT 51720 | not published | not published | $114.50 – $877.12 | 8 |
| Instll rx agnt into rnal tub CPT 50391 | not published | not published | $136.77 – $339.54 | 8 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | not published | not published | $249.86 – $7,103.63 | 8 |
| Ins tun cv cath wo subq prt/pm CPT 36557 | not published | not published | $158.83 – $7,103.63 | 8 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $282.31 | $518.00 | $155.64 – $518.00 | 13 |
| Ins tun intraperit dia cath CPT 49421 | not published | not published | $300.34 – $4,637.54 | 8 |
| Inst via cath agent pleurds CPT 32560 | not published | not published | $225.99 – $812.46 | 8 |
| Insulin total CPT 83525 | $5.61 | $10.29 | $5.36 – $8.00 | 14 |
| Ins vag brachytx device CPT 57156 | not published | not published | $118.06 – $399.74 | 8 |
| Integra meshed bil wound mat HCPCS C9363 | $11,724.59 | $21,513.00 | $14.30 – $12,471.48 | 12 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $4,101.67 | $7,526.00 | $1,260.00 – $4,939.20 | 11 |
| Intercalary algrft compl CPT 20934 | not published | not published | $606.85 – $1,371.48 | 4 |
| Interdental fixation CPT 21110 | not published | not published | $379.79 – $1,946.55 | 8 |
| Interdental wirg oth/thn fx CPT 21497 | not published | not published | $305.89 – $1,946.55 | 8 |
| Interdiscal perq aspir dx CPT 62267 | not published | not published | $116.53 – $924.59 | 8 |
| Internal nerve revision 64727 CPT 64727 | not published | not published | $202.08 – $719.90 | 4 |
| Interrog dev eval icpms ip CPT 93290 | $68.67 | $126.00 | $27.40 – $123.48 | 13 |
| Interthoracoscplr amputation CPT 23900 | not published | not published | $1,161.19 – $4,136.79 | 4 |
| Intestinal stricturoplasty CPT 44615 | not published | not published | $649.81 – $2,314.96 | 4 |
| Intestine transplnt cadaver CPT 44135 | not published | not published | $1,191.83 – $1,191.83 | 1 |
| Int hrhc lig 1 hroid without img CPT 46945 | not published | not published | $117.91 – $3,603.77 | 8 |
| Int hrhc lig 2+hroid without img CPT 46946 | not published | not published | $290.51 – $3,603.77 | 8 |
| Intracranial complete study CPT 93886 | $1,486.22 | $2,727.00 | $224.78 – $967.26 | 13 |
| Intracranial limited study CPT 93888 | $997.35 | $1,830.00 | $139.74 – $1,793.40 | 13 |
| Intracranial vessel surgery CPT 61680 | not published | not published | $1,922.92 – $6,850.51 | 4 |
| Intracranial vessel surgery CPT 61682 | not published | not published | $3,750.15 – $13,360.10 | 4 |
| Intracranial vessel surgery CPT 61684 | not published | not published | $2,500.53 – $8,908.24 | 4 |
| Intracranial vessel surgery CPT 61686 | not published | not published | $3,953.94 – $14,086.08 | 4 |
| Intracranial vessel surgery CPT 61690 | not published | not published | $1,927.20 – $6,865.72 | 4 |
| Intracranial vessel surgery CPT 61692 | not published | not published | $3,143.93 – $11,200.38 | 4 |
| Intranasal biopsy 30100 CPT 30100 | not published | not published | $41.44 – $1,946.55 | 8 |
| Intranasal reconstruction CPT 30620 | not published | not published | $434.91 – $7,773.77 | 8 |
| Intraop colon lavage add-on CPT 44701 | not published | not published | $140.39 – $349.10 | 4 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | not published | not published | $65.79 – $669.21 | 8 |
| Intrauterine transfusion ftl CPT 36460 | not published | not published | $424.36 – $1,004.14 | 8 |
| Intrinsic factor antibody CPT 86340 | $10.90 | $20.00 | $13.40 – $20.00 | 14 |
| Intro cath dialysis circuit CPT 36901 | not published | not published | $518.24 – $2,041.38 | 8 |
| Intro cath dialysis circuit w/pta CPT 36902 | not published | not published | $1,112.06 – $7,492.37 | 8 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | not published | not published | $5,174.97 – $14,902.64 | 8 |
| Intro catheter aorta CPT 36200 | not published | not published | $170.89 – $608.80 | 4 |
| Intro cath svc/ivc CPT 36010 | not published | not published | $96.98 – $345.51 | 4 |
| Intro long gi tube CPT 44500 | not published | not published | $22.22 – $1,232.05 | 8 |
| Intro long gi tube w/mult fluo CPT 74340 | $785.35 | $1,441.00 | $90.63 – $511.56 | 11 |
| Intro windpipe wire/tube CPT 31730 | not published | not published | $167.04 – $2,266.13 | 8 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | not published | not published | $1,301.19 – $2,940.69 | 4 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | not published | not published | $195.46 – $441.74 | 4 |
| Intubation endotracheal emergency procedure CPT 31500 | $409.84 | $752.00 | $67.93 – $460.60 | 13 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $141.16 | $259.00 | $0.47 – $125.44 | 11 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $1,121.61 | $2,058.00 | $0.16 – $3.92 | 11 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $71,312.71 | $130,849.00 | $194.42 – $32,058.74 | 13 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $572.25 | $1,050.00 | $1.48 – $23.52 | 12 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $7,222.34 | $13,252.00 | $69.17 – $7,240.24 | 13 |
| Iron CPT 83540 | $67.58 | $124.00 | $3.86 – $5.75 | 14 |
| Iron binding capacity CPT 83550 | $321.55 | $590.00 | $8.74 – $94.08 | 14 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $86.11 | $158.00 | $19.11 – $114.66 | 13 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $262.69 | $482.00 | $0.24 – $204.82 | 12 |
| Irradiation of blood product each unit reference CPT 86945 | $28.89 | $53.00 | $35.51 – $53.00 | 14 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $176.58 | $324.00 | $14.65 – $317.52 | 13 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $73.91 – $1,946.55 | 8 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $29.08 – $78.06 | 8 |
| Island pedicle flap graft CPT 15740 | not published | not published | $580.60 – $2,403.79 | 8 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $473.61 | $869.00 | $35.63 – $704.00 | 14 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $557.54 | $1,023.00 | $20.61 – $635.00 | 12 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $468.70 | $860.00 | $22.11 – $704.00 | 14 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $468.70 | $860.00 | $71.83 – $733.04 | 14 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $118.77 – $524.38 | 8 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $8,379.38 | $15,375.00 | $146.99 – $4,704.00 | 13 |
| Jak2 targeted sequence analysis CPT 81279 | $160.78 | $295.00 | $148.16 – $295.00 | 14 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $383.10 – $4,263.74 | 8 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $460.91 – $4,263.74 | 8 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $275.13 – $2,492.83 | 8 |
| J-tube placement CPT 44015 | not published | not published | $249.96 – $249.96 | 1 |
| Keratoprosthesis CPT 65770 | not published | not published | $1,277.40 – $18,777.58 | 8 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $91.02 | $167.00 | $4.80 – $7.15 | 14 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $50.69 | $93.00 | $0.37 – $63.70 | 13 |
| Kidney endoscopy CPT 50551 | not published | not published | $199.94 – $6,680.39 | 8 |
| Kidney endoscopy CPT 50553 | not published | not published | $454.13 – $6,680.39 | 8 |
| Kidney endoscopy CPT 50570 | not published | not published | $251.63 – $4,532.29 | 8 |
| Kidney endoscopy CPT 50575 | not published | not published | $686.11 – $6,680.39 | 8 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $385.78 – $12,151.68 | 8 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $289.66 – $4,532.29 | 8 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $501.56 – $12,151.68 | 8 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $484.47 – $6,680.39 | 8 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $290.51 – $12,151.68 | 8 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $313.16 – $6,680.39 | 8 |
| Kidney imag w/bld flow multi CPT 78709 | $3,091.79 | $5,673.00 | $261.96 – $2,011.94 | 13 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,030.60 | $1,891.00 | $115.78 – $509.60 | 13 |
| Kit lead specify 5-6-5 HCPCS C1778 | $19,815.11 | $36,358.00 | $1,881.50 – $7,375.48 | 11 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $2,112.42 | $3,876.00 | $571.50 – $2,240.28 | 11 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,746.80 | $5,040.00 | $1,260.00 – $4,939.20 | 11 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $547.70 – $4,263.74 | 8 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $387.06 – $4,263.74 | 8 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $319.56 – $4,263.74 | 8 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $790.35 – $4,263.74 | 8 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $553.68 – $2,103.10 | 8 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $732.26 – $2,608.70 | 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.