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 |
|---|---|---|---|---|
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $1,157.77 – $2,997.11 | 8 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $594.09 – $5,286.44 | 6 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $387.06 – $2,403.79 | 8 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $290.51 – $2,403.79 | 8 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $315.71 – $713.50 | 4 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $365.70 – $908.27 | 4 |
| X-ray abdomen 1 view CPT 74018 | $555.36 | $1,019.00 | $24.60 – $287.14 | 13 |
| X-ray abdomen 2 views CPT 74019 | $622.39 | $1,142.00 | $30.06 – $320.46 | 13 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $622.39 | $1,142.00 | $56.54 – $320.46 | 13 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $560.81 | $1,029.00 | $37.15 – $1,008.42 | 13 |
| X-ray bone age studies CPT 77072 | $625.66 | $1,148.00 | $19.67 – $407.68 | 13 |
| X-ray bone length studies CPT 77073 | $613.67 | $1,126.00 | $32.05 – $1,103.48 | 13 |
| X-ray bone survey complete CPT 77075 | $749.92 | $1,376.00 | $78.50 – $291.06 | 13 |
| X-ray bone survey infant CPT 77076 | $749.92 | $1,376.00 | $63.60 – $291.06 | 13 |
| X-ray cervical spine 2-3 views CPT 72040 | $662.72 | $1,216.00 | $37.27 – $287.14 | 13 |
| X-ray cervical spine 4-5 views CPT 72050 | $736.30 | $1,351.00 | $57.38 – $320.46 | 13 |
| X-ray cervical spine >= 6 views CPT 72052 | $736.30 | $1,351.00 | $72.16 – $320.46 | 13 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $826.22 | $1,516.00 | $74.46 – $474.32 | 13 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $826.22 | $1,516.00 | $90.14 – $474.32 | 13 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $918.33 | $1,685.00 | $54.64 – $474.32 | 13 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $639.83 | $1,174.00 | $61.12 – $1,150.52 | 13 |
| X-ray exam entire spi 6/> vw CPT 72084 | $639.83 | $1,174.00 | $73.11 – $291.06 | 13 |
| X-ray exam of eye sockets CPT 70200 | $625.66 | $1,148.00 | $54.35 – $407.68 | 13 |
| X-ray facial bones complete > 3 views CPT 70150 | $609.86 | $1,119.00 | $53.47 – $291.06 | 13 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $671.44 | $1,232.00 | $34.80 – $320.46 | 13 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $671.44 | $1,232.00 | $43.85 – $320.46 | 13 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $671.44 | $1,232.00 | $51.04 – $320.46 | 13 |
| X-ray knee ap standing bilateral CPT 73565 | $549.91 | $1,009.00 | $27.28 – $260.68 | 13 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $742.84 | $1,363.00 | $49.64 – $291.06 | 13 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $742.84 | $1,363.00 | $62.90 – $320.46 | 13 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $742.84 | $1,363.00 | $75.89 – $320.46 | 13 |
| X-ray mandible complete > 4 views CPT 70110 | $612.58 | $1,124.00 | $48.83 – $320.46 | 13 |
| X-ray mandible ltd <4 views CPT 70100 | $551.54 | $1,012.00 | $36.00 – $260.68 | 13 |
| X-ray nasal bones complete > 3 views CPT 70160 | $577.70 | $1,060.00 | $35.56 – $365.54 | 13 |
| X-ray neck soft tissue CPT 70360 | $555.36 | $1,019.00 | $24.82 – $287.14 | 13 |
| X-ray nose to rectum for foreign body child CPT 76010 | $560.81 | $1,029.00 | $33.48 – $1,008.42 | 13 |
| X-ray pelvis 1-2 views CPT 72170 | $619.67 | $1,137.00 | $31.01 – $320.46 | 13 |
| X-ray pelvis complete > 3 views CPT 72190 | $619.67 | $1,137.00 | $45.26 – $320.46 | 13 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,269.31 | $2,329.00 | $80.93 – $675.22 | 13 |
| X-ray ribs 3 views bilateral CPT 71110 | $619.12 | $1,136.00 | $47.78 – $291.06 | 13 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $619.12 | $1,136.00 | $60.82 – $320.46 | 13 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $622.39 | $1,142.00 | $42.42 – $320.46 | 13 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $555.36 | $1,019.00 | $35.89 – $287.14 | 13 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $534.10 | $980.00 | $47.84 – $347.90 | 13 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,197.91 | $2,198.00 | $59.94 – $780.08 | 13 |
| X-ray skull < 4 views CPT 70250 | $551.54 | $1,012.00 | $37.27 – $320.46 | 13 |
| X-ray skull > 4 views complete CPT 70260 | $551.54 | $1,012.00 | $57.69 – $291.06 | 13 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $1,009.89 | $1,853.00 | $129.63 – $474.32 | 13 |
| X-ray small intestine follow-through study CPT 74248 | $1,212.08 | $2,224.00 | $74.76 – $569.38 | 11 |
| X-ray spine single view CPT 72020 | $504.67 | $926.00 | $24.82 – $268.52 | 13 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $597.32 | $1,096.00 | $37.27 – $260.68 | 13 |
| X-ray sternum > 2 views CPT 71120 | $597.32 | $1,096.00 | $37.27 – $287.14 | 13 |
| X-ray surgical specimen CPT 76098 | $759.19 | $1,393.00 | $20.77 – $444.00 | 13 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $794.61 | $1,458.00 | $74.46 – $474.32 | 13 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $616.94 | $1,132.00 | $54.64 – $365.54 | 13 |
| X-ray thoracic spine 3 views CPT 72072 | $681.80 | $1,251.00 | $44.22 – $320.46 | 13 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $555.36 | $1,019.00 | $39.29 – $287.14 | 13 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $576.61 | $1,058.00 | $34.72 – $260.68 | 13 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $639.83 | $1,174.00 | $56.31 – $291.06 | 13 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $927.05 | $1,701.00 | $157.89 – $603.68 | 13 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $901.98 | $1,655.00 | $139.78 – $474.32 | 13 |
| Xylose absorption test blood &/or urine CPT 84620 | $7.04 | $12.90 | $8.65 – $12.90 | 14 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $67.04 | $123.00 | $0.01 – $63.70 | 11 |
| Zika virus dna/rna amp probe CPT 87662 | $71.94 | $132.00 | $45.61 – $129.36 | 14 |
| Zika virus igm antibody CPT 86794 | $40.77 | $74.80 | $14.97 – $73.31 | 14 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $125.35 | $230.00 | $3.33 – $63.70 | 12 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $9,919.00 | $18,200.00 | $5.52 – $91.14 | 12 |
| Zoster vaccine-live inj CPT 90736 | $487.23 | $894.00 | $219.35 – $673.00 | 9 |
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.