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 |
|---|---|---|---|---|
| Augmentation of facial bones CPT 21208 | not published | not published | $710.90 – $7,773.77 | 8 |
| Augment injectable kit 3.0cc HCPCS C1734 | $9,018.12 | $16,547.00 | $1,447.00 – $5,672.24 | 11 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $4,120.75 | $7,561.00 | $195.09 – $7,409.78 | 10 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $12,790.06 | $23,468.00 | $466.86 – $22,998.64 | 13 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $566.22 – $9,387.58 | 8 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $957.58 – $9,387.58 | 8 |
| Autologous blood process CPT 86890 | $286.13 | $525.00 | $178.99 – $514.50 | 12 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $3,265.64 | $5,992.00 | $106.32 – $5,872.16 | 13 |
| Av fistula revision CPT 36833 | not published | not published | $625.88 – $7,103.63 | 8 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $624.17 – $7,103.63 | 8 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $467.22 – $7,103.63 | 8 |
| Av fusion direct any site CPT 36821 | not published | not published | $498.56 – $4,136.13 | 8 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $767.29 – $7,103.63 | 8 |
| Avul nail plate addl CPT 11732 | not published | not published | $17.09 – $60.88 | 4 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $354.25 | $650.00 | $36.74 – $637.00 | 13 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $387.06 – $7,666.93 | 8 |
| Azacitidine injection HCPCS J9025 | $1,279.12 | $2,347.00 | $0.22 – $209.72 | 12 |
| Azathioprine 50 mg tablet HCPCS J7500 | $15.81 | $29.00 | $1.96 – $8.00 | 11 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $74.12 | $136.00 | $2.77 – $63.70 | 12 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $267.60 | $491.00 | $31.85 – $63.70 | 7 |
| Bacterial meningitis antigen CPT 86403 | $888.90 | $1,631.00 | $6.42 – $9.57 | 14 |
| Bacterial vaginosis pcr CPT 87801 | $143.88 | $264.00 | $38.80 – $258.72 | 14 |
| Bactericidal level serum CPT 87197 | $8.09 | $14.83 | $9.94 – $14.83 | 14 |
| #bac vag cand-c. albicans naa CPT 87481 | $47.96 | $88.00 | $35.09 – $88.00 | 14 |
| Balloon dilate urtrl strix CPT 50706 | not published | not published | $699.92 – $1,581.82 | 4 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | not published | not published | $232.58 – $4,178.22 | 8 |
| Bartonella dna pcr-sendout CPT 87471 | $20.83 | $38.21 | $25.61 – $38.21 | 14 |
| Basiliximab HCPCS J0480 | $5,358.99 | $9,833.00 | $3,373.51 – $9,833.00 | 13 |
| Bausch health Ultrasound surg HCPCS V2788 | $2,112.42 | $3,876.00 | $1,085.28 – $3,798.48 | 11 |
| B cells total count CPT 86355 | $10.33 | $18.94 | $10.40 – $15.51 | 14 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $2,138.04 | $3,923.00 | $4.12 – $3,844.54 | 13 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $3,844.98 | $7,055.00 | $59.37 – $2,074.66 | 13 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $80.12 | $147.00 | $2.94 – $13.91 | 13 |
| Benign lesion paring 2-4 CPT 11056 | not published | not published | $29.06 – $261.11 | 8 |
| Benign lesion paring 4+ CPT 11057 | not published | not published | $30.77 – $261.11 | 8 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $320.46 | $588.00 | $0.01 – $161.70 | 12 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $11.25 | $20.63 | $5.03 – $7.50 | 14 |
| Beta-2 microglobulin CPT 82232 | $8.02 | $14.70 | $7.37 – $11.00 | 14 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $35.43 | $65.00 | $7.30 – $63.70 | 12 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $7,055.03 | $12,945.00 | $77.43 – $3,172.26 | 13 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $6,734.02 | $12,356.00 | $30.58 – $3,027.22 | 12 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $6,098.01 | $11,189.00 | $25.37 – $2,742.04 | 12 |
| Bilateral laminotomy addl lumbar 63044 CPT 63044 | not published | not published | $280.68 – $697.12 | 4 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $183.67 | $337.00 | $80.31 – $337.00 | 13 |
| Bilateral n block inj occipital 64405 CPT 64405 | not published | not published | $72.20 – $387.91 | 8 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | not published | not published | $64.94 – $387.91 | 8 |
| Bile duct endoscopy add-on 47550 CPT 47550 | not published | not published | $126.88 – $452.02 | 4 |
| Biliary endo perq dx w/speci CPT 47552 | not published | not published | $190.55 – $8,199.66 | 8 |
| Biliary endoscopy thru skin CPT 47553 | not published | not published | $277.70 – $8,199.66 | 8 |
| Biliary endoscopy thru skin CPT 47554 | not published | not published | $348.18 – $13,681.38 | 8 |
| Biliary endoscopy thru skin CPT 47555 | not published | not published | $264.88 – $4,637.54 | 8 |
| Biliary endoscopy thru skin CPT 47556 | not published | not published | $394.76 – $13,681.38 | 8 |
| Bilirubin direct CPT 82248 | $76.30 | $140.00 | $5.02 – $137.20 | 14 |
| Bilirubin total CPT 82247 | $68.67 | $126.00 | $3.29 – $4.90 | 14 |
| Bilobectomy 32482 CPT 32482 | not published | not published | $878.79 – $3,130.76 | 4 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $24.53 | $45.00 | $11.25 – $44.10 | 12 |
| Biopsy abdominal mass CPT 49180 | $2,714.65 | $4,981.00 | $286.66 – $2,765.56 | 13 |
| Biopsy arm/elbow soft tissue CPT 24066 | not published | not published | $252.49 – $3,761.02 | 8 |
| Biopsy, bone open deep CPT 20245 | not published | not published | $241.81 – $3,761.02 | 8 |
| Biopsy bone trocar/needle superficial CPT 20220 | $2,041.57 | $3,746.00 | $97.84 – $2,034.00 | 13 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | not published | not published | $46.52 – $1,144.24 | 8 |
| Biopsy conjunctiva CPT 68100 | not published | not published | $149.10 – $3,065.74 | 8 |
| Biopsy/excision of lymph node(s); open deep 38530 CPT 38530 | not published | not published | $338.78 – $5,032.06 | 8 |
| Biopsy external ear 69100 CPT 69100 | not published | not published | $46.14 – $305.16 | 8 |
| Biopsy eyelid & lid margin CPT 67810 | not published | not published | $124.32 – $442.89 | 8 |
| Biopsy eye muscle CPT 67346 | not published | not published | $153.02 – $4,955.47 | 8 |
| Biopsy finger joint lining CPT 26105 | not published | not published | $277.26 – $4,263.74 | 8 |
| Biopsy finger joint lining CPT 26110 | not published | not published | $261.89 – $2,103.10 | 8 |
| Biopsy forearm soft tissues CPT 25066 | not published | not published | $217.88 – $3,761.02 | 8 |
| Biopsy hand joint lining CPT 26100 | not published | not published | $241.81 – $4,263.74 | 8 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $4,979.67 | $9,137.00 | $154.13 – $5,145.98 | 13 |
| Biopsy knee joint lining CPT 27330 | not published | not published | $512.67 – $4,263.74 | 8 |
| Biopsy lower leg soft tissue CPT 27613 | $2,673.77 | $4,906.00 | $152.94 – $2,997.82 | 13 |
| Biopsy lower leg soft tissue 27610 CPT 27610 | not published | not published | $435.33 – $4,263.74 | 8 |
| Biopsy muscle percutaneous needle CPT 20206 | $2,714.65 | $4,981.00 | $75.62 – $2,765.56 | 13 |
| Biopsy needle liver percutaneous CPT 47000 | $2,935.92 | $5,387.00 | $193.10 – $2,765.56 | 13 |
| Biopsy needle lymph node superficial CPT 38505 | $2,825.28 | $5,184.00 | $81.18 – $2,765.56 | 13 |
| Biopsy of cornea CPT 65410 | not published | not published | $61.94 – $3,065.74 | 8 |
| Biopsy of epididymis CPT 54800 | not published | not published | $157.22 – $2,129.16 | 8 |
| Biopsy of foot joint lining CPT 28050 | not published | not published | $290.51 – $4,263.74 | 8 |
| Biopsy of foot joint lining CPT 28052 | not published | not published | $193.10 – $4,263.74 | 8 |
| Biopsy of hip joint CPT 27052 | not published | not published | $598.11 – $2,130.80 | 8 |
| Biopsy of inestine 44100 CPT 44100 | not published | not published | $128.17 – $1,232.05 | 8 |
| Biopsy of lip 40490 CPT 40490 | not published | not published | $55.54 – $305.16 | 8 |
| Biopsy of nail unit 11755 CPT 11755 | not published | not published | $70.92 – $924.59 | 8 |
| Biopsy of nerve CPT 64795 | not published | not published | $182.85 – $2,566.14 | 8 |
| Biopsy of ovary(s) 58900 CPT 58900 | not published | not published | $872.17 – $4,178.22 | 8 |
| Biopsy of penis CPT 54105 | not published | not published | $186.27 – $3,761.02 | 8 |
| Biopsy of penis 54100 CPT 54100 | not published | not published | $106.38 – $2,129.16 | 8 |
| Biopsy of prostate CPT 55700 | not published | not published | $100.40 – $2,691.95 | 8 |
| Biopsy of prostate CPT 55705 | not published | not published | $341.78 – $4,532.29 | 8 |
| Biopsy of rectum wall anal approach 45100 CPT 45100 | not published | not published | $193.53 – $3,603.77 | 8 |
| Biopsy of sacroiliac joint CPT 27050 | not published | not published | $290.51 – $2,103.10 | 8 |
| Biopsy of salivary gland 42400 CPT 42400 | $1,318.90 | $2,420.00 | $57.67 – $1,345.54 | 13 |
| Biopsy of salivary glnd;incisional 42405 CPT 42405 | not published | not published | $126.03 – $1,946.55 | 8 |
| Biopsy of tear gland CPT 68510 | not published | not published | $546.41 – $3,065.74 | 8 |
| Biopsy of tear sac CPT 68525 | not published | not published | $294.35 – $3,065.74 | 8 |
| Biopsy of testis CPT 54500 | not published | not published | $136.28 – $3,761.02 | 8 |
| Biopsy of testis CPT 54505 | not published | not published | $145.25 – $4,532.29 | 8 |
| Biopsy of toe joint lining CPT 28054 | not published | not published | $183.71 – $4,263.74 | 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.