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 |
|---|---|---|---|---|
| Mayo leptospira antibody igm CPT 86720 | $6.67 | $12.23 | $8.20 – $12.23 | 14 |
| Mayo lipoprotein electrophoresis CPT 83700 | $11.09 | $20.34 | $10.01 – $20.34 | 14 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $9.19 | $16.86 | $10.05 – $15.00 | 14 |
| Mayo manganese CPT 83785 | $7.69 | $14.11 | $9.46 – $14.11 | 14 |
| Mayo metanephrines plasma CPT 83835 | $10.90 | $20.00 | $13.40 – $20.00 | 14 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $7.18 | $13.16 | $4.36 – $6.50 | 14 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $56.96 | $104.50 | $8.49 – $12.66 | 14 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $207.10 | $380.00 | $42.92 – $64.05 | 14 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $122.63 | $225.00 | $148.16 – $225.00 | 14 |
| Mayo muramidase CPT 85549 | $11.13 | $20.42 | $9.73 – $14.52 | 14 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $160.78 | $295.00 | $197.65 – $289.10 | 7 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $10.90 | $20.00 | $13.40 – $20.00 | 14 |
| Mayo myoglobin CPT 83874 | $350.98 | $644.00 | $7.91 – $11.80 | 14 |
| Mayo nickel CPT 83885 | $14.54 | $26.67 | $17.87 – $26.67 | 14 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $8.01 | $14.68 | $9.84 – $14.68 | 14 |
| Mayo oxalate 24 hour urine CPT 83945 | $9.86 | $18.08 | $12.12 – $18.08 | 14 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $8.09 | $14.84 | $9.95 – $14.84 | 14 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $76.38 | $140.13 | $7.29 – $10.87 | 14 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $24.53 | $45.00 | $30.15 – $45.00 | 14 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $21.80 | $40.00 | $13.12 – $19.57 | 14 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $8.17 | $14.98 | $10.04 – $14.98 | 14 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $15.26 | $28.00 | $8.44 – $27.44 | 14 |
| Mayo pregnenolone CPT 84140 | $15.81 | $29.00 | $19.43 – $29.00 | 14 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $7.81 | $14.33 | $9.61 – $14.33 | 14 |
| Mayo proinsulin CPT 84206 | $10.57 | $19.39 | $13.00 – $19.39 | 14 |
| Mayo psaft prostate specific antigen free CPT 84154 | $58.32 | $107.00 | $18.39 – $100.94 | 14 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $66.49 | $122.00 | $7.71 – $11.50 | 14 |
| Mayo receptor assay transferrin soluble CPT 84238 | $21.71 | $39.82 | $26.68 – $39.82 | 14 |
| Mayo renin CPT 84244 | $6.54 | $12.00 | $8.04 – $12.00 | 14 |
| Mayo repu protein electrophoresis urine CPT 84166 | $10.80 | $19.81 | $11.17 – $16.67 | 14 |
| Mayo selenium CPT 84255 | $7.09 | $13.00 | $8.46 – $12.62 | 14 |
| Mayo serotonin CPT 84260 | $18.39 | $33.73 | $19.30 – $28.80 | 14 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $11.49 | $21.07 | $14.12 – $21.07 | 14 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $16.35 | $30.00 | $11.99 – $29.40 | 14 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $181.49 | $333.00 | $2.58 – $3.84 | 14 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $141.70 | $260.00 | $174.20 – $260.00 | 14 |
| Mayo tgrp testosterone free CPT 84402 | $12.37 | $22.68 | $2.01 – $3.00 | 14 |
| Mayo tgrp testosterone total CPT 84403 | $7.09 | $13.00 | $2.01 – $3.00 | 14 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $32.70 | $60.00 | $40.20 – $58.80 | 7 |
| Mayo thyroglobulin CPT 84432 | $32.70 | $60.00 | $16.06 – $58.80 | 14 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $8.18 | $15.00 | $8.04 – $12.00 | 14 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $10.90 | $20.00 | $6.70 – $9.99 | 14 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $6.18 | $11.33 | $7.59 – $11.32 | 14 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $17.99 | $33.00 | $20.24 – $33.00 | 14 |
| Mayo vitamin b3 (niacin) CPT 84591 | $43.60 | $80.00 | $12.63 – $78.40 | 14 |
| Mayo vitamin k CPT 84597 | $16.35 | $30.00 | $13.72 – $30.00 | 14 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $10.90 | $20.00 | $11.78 – $20.00 | 14 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $679.08 – $1,534.72 | 4 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $331.35 – $4,263.74 | 8 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $406.55 – $4,263.74 | 8 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $435.96 – $2,103.10 | 8 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $1,393.89 – $4,810.88 | 8 |
| Measure kidney pressure CPT 50396 | not published | not published | $52.54 – $877.12 | 8 |
| Measurement post void urine by ultrasound CPT 51798 | $113.36 | $208.00 | $59.20 – $203.84 | 13 |
| Measure ureter pressure CPT 50686 | not published | not published | $121.33 – $432.25 | 8 |
| Medial canthopexy CPT 21280 | not published | not published | $449.44 – $4,261.72 | 8 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $346.61 – $7,666.93 | 8 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $266.19 – $7,666.93 | 8 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $288.31 | $529.00 | $0.47 – $109.76 | 11 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | $5,332.28 | $9,784.00 | $571.50 – $2,240.28 | 11 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $970.50 – $9,387.58 | 8 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $67.58 | $124.00 | $1.40 – $63.70 | 12 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $153.69 | $282.00 | $0.46 – $63.70 | 11 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $168.73 – $381.33 | 4 |
| Mesh tiss ovitex lpr 15x15x25cm 6mm oval HCPCS C9364 | $40,698.97 | $74,677.00 | $14.14 – $3,791.62 | 12 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $126.99 | $233.00 | $1.41 – $90.16 | 12 |
| Metabolic Blood Panel (Basic) CPT 80048 | $455.62 | $836.00 | $8.46 – $298.90 | 14 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $668.17 | $1,226.00 | $10.56 – $364.56 | 14 |
| Metabolic panel ionized ca CPT 80047 | $185.30 | $340.00 | $8.17 – $333.20 | 14 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $221.27 | $406.00 | $5.07 – $63.70 | 12 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $13.08 | $24.00 | $0.21 – $13.72 | 11 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $116.63 | $214.00 | $2.40 – $61.74 | 12 |
| Methotrexate therapeutic drug level CPT 80204 | $17.32 | $31.77 | $21.29 – $31.77 | 14 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $2,336.96 | $4,288.00 | $0.62 – $63.70 | 11 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $62.13 | $114.00 | $8.24 – $63.70 | 12 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $352.62 | $647.00 | $0.93 – $149.94 | 10 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $4.91 | $9.00 | $0.25 – $7.84 | 11 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $45.24 | $83.00 | $31.85 – $63.70 | 7 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $130.26 | $239.00 | $31.85 – $63.70 | 7 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $35.43 | $65.00 | $1.06 – $63.70 | 12 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $35.43 | $65.00 | $31.85 – $63.70 | 7 |
| Mgmt promoter methylation analysis CPT 81287 | $174.40 | $320.00 | $124.64 – $313.60 | 14 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $525.93 | $965.00 | $0.33 – $63.70 | 12 |
| Microsatellite instability CPT 81301 | $258.88 | $475.00 | $256.67 – $475.00 | 14 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $210.62 – $750.34 | 4 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $5,134.45 | $9,421.00 | $0.17 – $63.70 | 12 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $331.36 | $608.00 | $1.49 – $63.70 | 11 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $3,402.98 | $6,244.00 | $29.97 – $250.88 | 13 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $783.71 | $1,438.00 | $31.38 – $163.66 | 13 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $2,221.55 – $7,914.38 | 4 |
| Mlh1 gene CPT 81288 | $198.93 | $365.00 | $192.32 – $365.00 | 14 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $677.58 – $16,908.29 | 8 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | not published | not published | $72.60 – $164.08 | 4 |
| Mnl prep&insj i-artic rx dev CPT 20704 | not published | not published | $125.47 – $283.56 | 4 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $120.63 – $272.62 | 4 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $110.66 – $2,103.10 | 8 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $301.94 – $2,103.10 | 8 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $276.25 – $1,946.55 | 8 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $115.35 – $410.96 | 4 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,165.67 – $2,634.41 | 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.