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 |
|---|---|---|---|---|
| Biopsy of upper nose/throat CPT 42804 | not published | not published | $71.78 – $4,261.72 | 8 |
| Biopsy of urethra CPT 53200 | not published | not published | $152.09 – $2,691.95 | 8 |
| Biopsy of wrist joint CPT 25100 | not published | not published | $241.81 – $4,263.74 | 8 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | $169.60 – $5,032.06 | 8 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | not published | not published | $241.81 – $5,032.06 | 8 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $2,850.35 | $5,230.00 | $81.18 – $2,903.74 | 13 |
| Biopsy roof of mouth CPT 42100 | not published | not published | $67.07 – $1,946.55 | 8 |
| Biopsy skin incisional single lesion CPT 11106 | $695.97 | $1,277.00 | $108.71 – $458.00 | 13 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $2,648.16 | $4,859.00 | $85.44 – $2,711.66 | 13 |
| Biopsy thigh soft tissues CPT 27324 | not published | not published | $221.72 – $3,761.02 | 8 |
| Biopsy tongue anterior two-thirds CPT 41100 | not published | not published | $77.76 – $669.21 | 8 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | not published | not published | $133.97 – $4,178.22 | 8 |
| Biopsy vestibule of mouth 40808 CPT 40808 | not published | not published | $54.25 – $669.21 | 8 |
| Biopsy vrt bdy open lmbr/crv CPT 20251 | not published | not published | $414.40 – $9,387.58 | 8 |
| Biopsy vrt bdy open thoracic CPT 20250 | not published | not published | $332.38 – $4,263.74 | 8 |
| Biospy of bladder CPT 53899 | not published | not published | $319.60 – $319.60 | 6 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $556.99 | $1,022.00 | $90.15 – $791.84 | 13 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $132.87 – $574.50 | 8 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $40.59 – $574.50 | 8 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $263.78 | $484.00 | $22.15 – $113.68 | 12 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $512.67 – $2,403.79 | 8 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $387.06 – $2,403.79 | 8 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $387.06 – $2,403.79 | 8 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $597.26 – $2,403.79 | 8 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $2,746.80 | $5,040.00 | $152.25 – $596.82 | 11 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $11,724.59 | $21,513.00 | $33.75 – $132.30 | 11 |
| Bln dil 900ml preperitnl HCPCS C1727 | $1,619.74 | $2,972.00 | $337.50 – $1,323.00 | 11 |
| Bln press regulation 71-80cm HCPCS C1815 | $19,815.11 | $36,358.00 | $1,881.50 – $7,375.48 | 11 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | not published | not published | $122.61 – $1,169.93 | 8 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | not published | not published | $105.26 – $1,169.93 | 8 |
| Block paracervical nrv CPT 64435 | not published | not published | $83.73 – $910.04 | 8 |
| Block plantar digital nerve CPT 64455 | not published | not published | $22.63 – $387.91 | 8 |
| Block tap inj(s) w/wo img bi CPT 64488 | not published | not published | $160.74 – $160.74 | 1 |
| Block tap inj(s) w/wo img uni CPT 64486 | not published | not published | $130.85 – $130.85 | 1 |
| Blood Clotting (PT/INR) Test CPT 85610 | $184.21 | $338.00 | $2.37 – $3.53 | 14 |
| Blood Clotting (PTT) Test CPT 85730 | $135.16 | $248.00 | $3.64 – $5.43 | 14 |
| Blood Count (CBC) Test CPT 85025 | $301.39 | $553.00 | $7.77 – $261.66 | 14 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $220.18 | $404.00 | $6.47 – $196.98 | 14 |
| Blood count spun microhematocrit CPT 85013 | $254.52 | $467.00 | $2.91 – $55.86 | 14 |
| Blood Culture Test CPT 87040 | $402.76 | $739.00 | $10.32 – $425.32 | 14 |
| Blood draw capillary 36416 CPT 36416 | $19.62 | $36.00 | $3.77 – $35.28 | 7 |
| Blood gases o2 saturation direct measurement CPT 82805 | $366.79 | $673.00 | $34.86 – $659.54 | 14 |
| Blood gases ph venous CPT 82800 | $333.54 | $612.00 | $9.57 – $81.34 | 14 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $85.02 | $156.00 | $14.14 – $147.00 | 14 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $64.31 | $118.00 | $2.56 – $115.64 | 14 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $107.91 | $198.00 | $4.19 – $34.30 | 14 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $49.05 | $90.00 | $2.76 – $4.11 | 14 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $69.76 | $128.00 | $3.80 – $125.44 | 14 |
| Blood split unit HCPCS P9011 | $125.35 | $230.00 | $149.20 – $230.00 | 13 |
| Blood typing abo CPT 86900 | $168.41 | $309.00 | $3.41 – $31.00 | 14 |
| Blood typing ag donor ea ag CPT 86902 | $169.50 | $311.00 | $3.28 – $53.00 | 14 |
| Blood typing patient serum CPT 86904 | $28.89 | $53.00 | $9.37 – $53.00 | 14 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $422.38 | $775.00 | $2.79 – $4.16 | 14 |
| Blood typing rh (d) CPT 86901 | $142.25 | $261.00 | $3.53 – $21.00 | 14 |
| Blood typing rh phenotype complete reference CPT 86906 | $40.88 | $75.00 | $7.47 – $73.50 | 14 |
| Bone biopsy open superficial CPT 20240 | $2,218.70 | $4,071.00 | $145.25 – $3,989.58 | 13 |
| Bone Density Scan (DEXA) CPT 77080 | $346.62 | $636.00 | $34.27 – $623.28 | 13 |
| Bone imaging multiple areas CPT 78305 | $2,013.23 | $3,694.00 | $161.97 – $1,092.70 | 13 |
| Bone/joint imaging ltd area CPT 78300 | $2,013.23 | $3,694.00 | $116.06 – $1,092.70 | 13 |
| Bone marrow;aspiration only 38220 CPT 38220 | not published | not published | $210.62 – $2,129.16 | 8 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $4,178.52 | $7,667.00 | $224.72 – $3,980.76 | 13 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $253.77 – $2,154.18 | 8 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $150.04 – $6,156.78 | 8 |
| Bone marrow interpretation CPT 85097 | $362.97 | $666.00 | $50.56 – $666.00 | 14 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $2,926.04 – $10,424.18 | 8 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $2,550.94 – $9,387.58 | 8 |
| Bone tendon board add on HCPCS C9356 | $6,935.67 | $12,726.00 | $193.45 – $12,471.48 | 11 |
| Boot j walker l HCPCS L4386 | $191.30 | $351.00 | $68.25 – $267.54 | 12 |
| Boot softgait shrt m HCPCS L4387 | $148.79 | $273.00 | $68.25 – $267.54 | 12 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $1,619.74 | $2,972.00 | $68.25 – $267.54 | 12 |
| Borrelia antibody CPT 86619 | $50.20 | $92.10 | $13.38 – $90.26 | 14 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $27.25 | $50.00 | $16.75 – $25.00 | 14 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $3,983.95 | $7,310.00 | $1.68 – $188.16 | 12 |
| Brace ank aftr bioskn med lg HCPCS L1906 | $98.10 | $180.00 | $45.00 – $176.40 | 12 |
| Brace ank air stirrup univ HCPCS L4350 | $98.10 | $180.00 | $33.75 – $132.30 | 12 |
| Brace ankle stablizing lg HCPCS L1902 | $98.10 | $180.00 | $45.00 – $176.40 | 11 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | $148.79 | $273.00 | $45.00 – $180.00 | 12 |
| Brace back t-lso custom HCPCS L0486 | $5,332.28 | $9,784.00 | $1,354.09 – $9,588.32 | 12 |
| Brace cust back lso HCPCS L0631 | $735.75 | $1,350.00 | $337.50 – $1,323.00 | 12 |
| Brace knee extender plus 22-30in HCPCS L1832 | $2,112.42 | $3,876.00 | $115.25 – $461.00 | 12 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | $565.71 | $1,038.00 | $152.25 – $596.82 | 12 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $565.71 | $1,038.00 | $259.50 – $1,017.24 | 12 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $735.75 | $1,350.00 | $337.50 – $1,323.00 | 12 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $115.00 | $211.00 | $45.00 – $176.40 | 11 |
| Brace wrist classic lft sm HCPCS L3908 | $73.58 | $135.00 | $11.25 – $45.00 | 12 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $3,761.02 – $3,761.02 | 6 |
| Brach/thor cath 1st CPT 36215 | not published | not published | $206.77 – $736.65 | 4 |
| Brach/thor cath 2nd CPT 36216 | not published | not published | $251.20 – $894.94 | 4 |
| Brach/thor cath 3rd CPT 36217 | not published | not published | $301.61 – $1,074.54 | 4 |
| Brach/thor cath addl CPT 36218 | not published | not published | $49.56 – $176.55 | 4 |
| Braf gene CPT 81210 | $43.60 | $80.00 | $52.24 – $77.96 | 14 |
| Brain biopsy w/ct/mr guide CPT 61751 | not published | not published | $1,388.48 – $4,946.51 | 4 |
| Brain cavity shunt w/scope CPT 62201 | not published | not published | $1,367.11 – $4,870.39 | 4 |
| Brain image w/flow 4 + views CPT 78606 | $4,120.20 | $7,560.00 | $228.33 – $3,835.72 | 13 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,935.92 | $5,387.00 | $210.94 – $1,385.72 | 13 |
| Brain MRI (with and without contrast) CPT 70553 | $4,365.45 | $8,010.00 | $446.18 – $2,123.66 | 13 |
| Brain MRI (with contrast) CPT 70552 | $4,365.45 | $8,010.00 | $379.01 – $2,123.66 | 13 |
| Brain MRI (without contrast) CPT 70551 | $2,834.55 | $5,201.00 | $272.77 – $1,385.72 | 13 |
| Bra surgical elizabeth pink sm HCPCS L8000 | $251.25 | $461.00 | $44.05 – $176.40 | 12 |
| Breast augmentation 19325 CPT 19325 | not published | not published | $769.00 – $12,574.69 | 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.