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 |
|---|---|---|---|---|
| Preparation for bladder xray CPT 51605 | not published | not published | $300.34 – $1,069.97 | 4 |
| Preparation palate mold CPT 42280 | not published | not published | $109.37 – $669.21 | 8 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $2,198.05 – $7,830.70 | 4 |
| Prepare penis study CPT 54230 | not published | not published | $70.49 – $251.13 | 4 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $174.31 – $620.98 | 4 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $1,224.12 – $1,224.12 | 1 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $137.75 – $311.32 | 4 |
| Prep skin to 100cm2 other CPT 15004 | not published | not published | $325.02 – $804.40 | 8 |
| Prep skin to 100cm2 trk/ext CPT 15002 | not published | not published | $270.29 – $2,403.79 | 8 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $59.94 – $135.46 | 4 |
| Pressure max expiratory/inspiratory CPT 94799 | $217.46 | $399.00 | $199.50 – $391.02 | 12 |
| Pressure treatment esophagus CPT 43460 | not published | not published | $105.53 – $375.95 | 4 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $95.38 | $175.00 | $23.88 – $175.00 | 14 |
| Pretreat rbc absorption reference CPT 86978 | $68.13 | $125.00 | $28.64 – $82.32 | 14 |
| Pretreat rbc density gradient separation reference CPT 86972 | $200.56 | $368.00 | $23.88 – $360.64 | 14 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $54.50 | $100.00 | $24.79 – $98.00 | 14 |
| Pretreat rbc w enzyme reference CPT 86971 | $81.75 | $150.00 | $24.79 – $150.00 | 14 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | not published | not published | $61.09 – $2,129.16 | 8 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $101.68 – $2,129.16 | 8 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | not published | not published | $96.98 – $525.02 | 8 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $628.88 – $2,240.36 | 4 |
| Prim art mech thrmbc non-intracranial CPT 37184 | not published | not published | $2,325.79 – $23,596.93 | 8 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | not published | not published | $983.90 – $2,443.65 | 4 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $339.54 | $623.00 | $108.67 – $610.54 | 13 |
| Pr incision & drainage abscess simple/single CPT 10060 | $338.45 | $621.00 | $48.70 – $608.58 | 13 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | not published | not published | $130.10 – $399.74 | 8 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | not published | not published | $59.38 – $525.02 | 8 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $677.98 | $1,244.00 | $46.65 – $143.08 | 10 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $512.67 – $2,566.14 | 8 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $15,243.11 | $27,969.00 | $743.00 – $2,912.56 | 11 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $213.19 – $759.47 | 8 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $128.59 – $3,065.74 | 8 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $253.77 – $3,065.74 | 8 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $526.33 – $3,065.74 | 8 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $143.34 | $263.00 | $73.73 – $205.97 | 13 |
| Procalcitonin CPT 84145 | $274.14 | $503.00 | $14.89 – $22.21 | 14 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $42.51 | $78.00 | $2.67 – $63.70 | 12 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $1,258.16 – $4,482.30 | 4 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $1,258.16 – $4,482.30 | 4 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $115.35 – $3,603.77 | 8 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $98.69 – $1,549.43 | 8 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $46.99 – $1,549.43 | 8 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $41.44 – $1,198.08 | 8 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $112.79 – $3,603.77 | 8 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $112.79 – $1,549.43 | 8 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $107.24 – $1,549.43 | 8 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $99.97 – $3,603.77 | 8 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $58.10 – $1,549.43 | 8 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $88.86 – $3,603.77 | 8 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $89.29 – $7,822.59 | 8 |
| Progesterone CPT 84144 | $190.75 | $350.00 | $12.56 – $18.74 | 14 |
| Prolactin CPT 84146 | $6.54 | $12.00 | $8.04 – $12.00 | 14 |
| Prolonged IV inf, req pump HCPCS C8957 | $378.78 | $695.00 | $435.87 – $695.00 | 12 |
| Promethazine hcl injection HCPCS J2550 | $35.43 | $65.00 | $2.18 – $63.70 | 12 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $392.82 – $1,665.06 | 8 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $427.22 – $1,522.00 | 8 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $879.22 – $16,908.29 | 8 |
| Prophylactic tx radius CPT 25490 | not published | not published | $943.73 – $9,387.58 | 8 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $1,129.57 – $4,263.74 | 8 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $951.42 – $16,908.29 | 8 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $310.65 | $570.00 | $0.10 – $63.70 | 12 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $35.43 | $65.00 | $11.69 – $63.70 | 11 |
| Prostate biopsy, any mthd HCPCS G0416 | $196.75 | $361.00 | $241.87 – $361.00 | 13 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $854.44 – $6,680.39 | 8 |
| Prostate laser enucleation CPT 52649 | not published | not published | $798.58 – $6,680.39 | 8 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $2,161.74 – $5,369.01 | 8 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $1,984.88 – $4,929.74 | 8 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $35.43 | $65.00 | $1.74 – $63.70 | 12 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $4,101.67 | $7,526.00 | $1,877.08 – $7,375.48 | 11 |
| Protein c activity CPT 85303 | $9.81 | $18.00 | $10.10 – $15.06 | 14 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $8.13 | $14.90 | $3.35 – $5.00 | 14 |
| Protein s total CPT 85305 | $6.54 | $12.00 | $8.04 – $12.00 | 14 |
| Protein total 24 hour urine CPT 84156 | $58.32 | $107.00 | $2.22 – $3.30 | 14 |
| Protein total body fluid CPT 84157 | $132.98 | $244.00 | $2.28 – $3.39 | 14 |
| Protein total serum plasma whole blood CPT 84155 | $31.07 | $57.00 | $3.35 – $5.00 | 14 |
| Prothrombin complex kcentra HCPCS J7168 | $1,606.12 | $2,947.00 | $1.47 – $2.94 | 7 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $84.48 | $155.00 | $3.94 – $151.90 | 14 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $376.02 – $849.81 | 4 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $475.92 – $4,637.54 | 8 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $521.64 – $9,387.58 | 8 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $366.13 – $2,103.10 | 8 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $484.05 – $9,387.58 | 8 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $453.28 – $9,387.58 | 8 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $154.23 – $9,387.58 | 8 |
| Pr removal drug delivery implant CPT 11982 | $579.34 | $1,063.00 | $89.94 – $1,041.74 | 13 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | not published | not published | $39.73 – $169.39 | 8 |
| Pr removal intrauterine device CPT 58301 | not published | not published | $55.82 – $399.74 | 8 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | not published | not published | $105.10 – $525.02 | 8 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | not published | not published | $83.73 – $298.30 | 8 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | not published | not published | $91.00 – $324.17 | 8 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | not published | not published | $80.31 – $286.14 | 8 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | not published | not published | $85.44 – $304.40 | 8 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $304.61 – $2,403.79 | 8 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $341.78 – $4,263.74 | 8 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $349.04 – $9,387.58 | 8 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $91.96 – $574.50 | 8 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $445.59 – $9,387.58 | 8 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $473.79 – $9,387.58 | 8 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $2,933.74 | $5,383.00 | $150.81 – $2,754.78 | 13 |
| PSA (Prostate) Test CPT 84153 | $113.91 | $209.00 | $11.07 – $16.51 | 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.