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 |
|---|---|---|---|---|
| Partial removal of radius CPT 25151 | not published | not published | $405.43 – $4,263.74 | 8 |
| Partial removal of radius CPT 25230 | not published | not published | $241.81 – $4,263.74 | 8 |
| Partial removal of rectum CPT 45111 | not published | not published | $948.00 – $3,377.32 | 4 |
| Partial removal of rectum CPT 45114 | not published | not published | $1,416.67 – $5,046.94 | 4 |
| Partial removal of rectum CPT 45116 | not published | not published | $1,249.63 – $4,451.86 | 4 |
| Partial removal of rib CPT 21600 | not published | not published | $312.30 – $9,387.58 | 8 |
| Partial removal of sternum CPT 21620 | not published | not published | $642.54 – $2,289.09 | 4 |
| Partial removal of thyroid CPT 60220 | not published | not published | $635.70 – $7,666.93 | 8 |
| Partial removal of thyroid CPT 60225 | not published | not published | $677.58 – $7,666.93 | 8 |
| Partial removal of tibia CPT 27640 | not published | not published | $580.60 – $4,263.74 | 8 |
| Partial removal of toe CPT 28160 | not published | not published | $201.22 – $4,263.74 | 8 |
| Partial removal of tongue CPT 41120 | not published | not published | $387.06 – $7,773.77 | 8 |
| Partial removal of tongue CPT 41130 | not published | not published | $580.60 – $2,068.40 | 4 |
| Partial removal of ulna CPT 25119 | not published | not published | $484.05 – $4,263.74 | 8 |
| Partial removal of ulna CPT 25150 | not published | not published | $344.77 – $4,263.74 | 8 |
| Partial removal of ulna CPT 25240 | not published | not published | $290.51 – $4,263.74 | 8 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $423.74 – $4,178.22 | 8 |
| Partial removal tear gland CPT 68505 | not published | not published | $580.60 – $4,955.47 | 8 |
| Partial thyroid excision CPT 60210 | not published | not published | $648.95 – $7,666.93 | 8 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $839.92 – $7,666.93 | 8 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $6,935.67 | $12,726.00 | $1.86 – $1,719.90 | 13 |
| Part removal hip bone deep CPT 27071 | not published | not published | $580.60 – $2,068.40 | 4 |
| Part removal of metatarsal CPT 28110 | not published | not published | $215.32 – $4,263.74 | 8 |
| Part removal of metatarsal CPT 28113 | not published | not published | $233.27 – $4,263.74 | 8 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $228.14 – $4,263.74 | 8 |
| Part remove hip bone super CPT 27070 | not published | not published | $535.73 – $1,908.57 | 4 |
| Passy muir valve metal trach HCPCS L8501 | $433.82 | $796.00 | $152.25 – $596.82 | 11 |
| Pdgfra gene CPT 81314 | $272.50 | $500.00 | $263.60 – $404.25 | 14 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $666.04 – $2,403.79 | 8 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $362.71 – $2,403.79 | 8 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $11,801.43 | $21,654.00 | $10,610.46 – $21,220.92 | 7 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $9,556.58 | $17,535.00 | $144.21 – $17,184.30 | 12 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $9,556.58 | $17,535.00 | $109.93 – $17,184.30 | 12 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $5,722.50 | $10,500.00 | $5,145.00 – $10,290.00 | 7 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $4,279.89 | $7,853.00 | $233.94 – $1,657.18 | 13 |
| Pelvic CT scan (with contrast) CPT 72193 | $4,279.89 | $7,853.00 | $233.94 – $1,822.80 | 13 |
| Pelvic CT scan (without contrast) CPT 72192 | $2,853.62 | $5,236.00 | $139.74 – $1,215.20 | 13 |
| Pelvic exenteration CPT 45126 | not published | not published | $2,003.67 – $7,138.19 | 4 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,111.48 | $7,544.00 | $332.91 – $2,123.66 | 13 |
| Pelvic MRI (without contrast) CPT 72195 | $2,672.68 | $4,904.00 | $226.34 – $1,385.72 | 13 |
| Pelvic Ultrasound (complete) CPT 76856 | $988.09 | $1,813.00 | $97.04 – $509.60 | 13 |
| Pelvic Ultrasound (limited) CPT 76857 | $414.75 | $761.00 | $60.49 – $212.66 | 13 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $12,509.93 | $22,954.00 | $62.08 – $18,873.82 | 13 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $8,406.63 | $15,425.00 | $3.96 – $123.48 | 13 |
| Peng benzathine/procaine inj HCPCS J0558 | $314.47 | $577.00 | $7.62 – $128.38 | 13 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $738.48 | $1,355.00 | $9.64 – $374.36 | 13 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $80.66 | $148.00 | $0.93 – $63.70 | 12 |
| Penicillin g procaine inj HCPCS J2510 | $46.33 | $85.00 | $19.13 – $85.00 | 13 |
| Penile injection CPT 54235 | not published | not published | $319.60 – $319.60 | 6 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $19,815.11 | $36,358.00 | $27.00 – $105.84 | 11 |
| Penile venous occlusion CPT 37790 | not published | not published | $4,532.29 – $4,532.29 | 6 |
| Penis plastic surgery CPT 54360 | not published | not published | $610.93 – $4,532.29 | 8 |
| Penis study CPT 54240 | not published | not published | $90.57 – $409.21 | 8 |
| Perc cryo ablate renal tum CPT 50593 | not published | not published | $3,895.37 – $13,681.38 | 8 |
| Perc rf ablate renal tumor CPT 50592 | not published | not published | $65.21 – $7,666.93 | 6 |
| Percut ablate liver rf CPT 47382 | not published | not published | $553.98 – $7,666.93 | 8 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $431.10 | $791.00 | $43.67 – $431.20 | 13 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $193.22 – $436.68 | 4 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $1,549.53 – $5,520.30 | 4 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,933.74 | $5,383.00 | $200.67 – $5,275.34 | 13 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $887.77 – $3,162.71 | 4 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $484.05 – $5,032.06 | 8 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $356.13 – $4,178.22 | 8 |
| Peripheral vascular rehab CPT 93668 | $115.00 | $211.00 | $78.06 – $211.00 | 11 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $243.68 – $7,103.63 | 8 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $662.32 – $1,496.84 | 4 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $678.70 – $1,533.86 | 4 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $118.76 – $924.59 | 8 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $244.60 – $924.59 | 8 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $725.85 – $12,151.68 | 8 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $648.52 – $12,151.68 | 8 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $4,189.49 – $9,468.25 | 8 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $4,570.73 – $10,329.85 | 8 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $4,746.45 – $10,726.98 | 8 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | not published | not published | $303.05 – $684.89 | 8 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $392.78 – $4,263.74 | 8 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $320.18 – $4,263.74 | 8 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $83.31 – $83.31 | 1 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $182.42 – $4,263.74 | 8 |
| Perq tx malar fracture CPT 21355 | not published | not published | $147.82 – $4,261.72 | 8 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $381.94 – $7,773.77 | 8 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $850.60 – $4,261.72 | 8 |
| Pertussis ag if CPT 87265 | $125.90 | $231.00 | $6.77 – $10.10 | 14 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $12,457.61 | $22,858.00 | $17.91 – $22,400.84 | 13 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $31,579.48 | $57,944.00 | $67.19 – $37,855.44 | 13 |
| Pet fdg brain metoblic eval sb CPT 78608 | $2,974.61 | $5,458.00 | $1,426.42 – $5,348.84 | 12 |
| Pet image skull-thigh CPT 78812 | $3,957.79 | $7,262.00 | $1,916.73 – $7,116.76 | 13 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $95,961.97 | $176,077.00 | $11.25 – $44.10 | 11 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $214.90 – $4,263.74 | 8 |
| Ph body fluid CPT 83986 | $87.20 | $160.00 | $2.28 – $3.39 | 14 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $292.12 | $536.00 | $7.47 – $65.00 | 12 |
| Phenobarbital therapeutic drug level CPT 80184 | $483.96 | $888.00 | $7.10 – $10.59 | 14 |
| Phentolaine mesylate inj HCPCS J2760 | $961.38 | $1,764.00 | $69.99 – $525.00 | 13 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $16,633.40 | $30,520.00 | $31.85 – $63.70 | 7 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $35.43 | $65.00 | $0.70 – $63.70 | 12 |
| Phenytoin total therapeutic drug level CPT 80185 | $184.21 | $338.00 | $8.24 – $12.29 | 14 |
| Phlebotomy therapeutic CPT 99195 | $307.93 | $565.00 | $18.82 – $282.24 | 14 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $230.45 – $4,136.13 | 8 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $288.53 – $4,136.13 | 8 |
| Phosphorus CPT 84100 | $101.37 | $186.00 | $4.74 – $175.42 | 14 |
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.