Santa Rosa Medical Center
401 BICENTENNIAL WAY, SANTA ROSA, CA · Kaiserpermanente · · NPI 1407925928
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 |
|---|---|---|---|---|
| Frozen blood prep CPT 86930 | $828.80 | $1,480.00 | $184.00 – $184.00 | 1 |
| Frozen blood thaw CPT 86931 | $828.80 | $1,480.00 | $184.00 – $184.00 | 1 |
| Frozen cell preparation CPT 88241 | $103.04 | $184.00 | $11.00 – $11.00 | 1 |
| Fructosamine glycated protein CPT 82985 | $30.80 | $55.00 | $16.00 – $16.00 | 1 |
| Ft arch suprt premold longit HCPCS L3040 | $53.20 | $95.00 | not published | 0 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | $3,808.00 | $6,800.00 | not published | 0 |
| Fth/gft fr trnk each addl CPT 15201 | $3,808.00 | $6,800.00 | not published | 0 |
| Ft insert ucb berkeley shell HCPCS L3000 | $347.20 | $620.00 | not published | 0 |
| Ftl cgen abnor 3 proteins CPT 81509 | $3,399.20 | $6,070.00 | $652.00 – $652.00 | 1 |
| Ftl cgen abnor five anal CPT 81512 | $159.04 | $284.00 | $30.00 – $30.00 | 1 |
| Ftl cgen abnor four anal CPT 81511 | $1,428.00 | $2,550.00 | $67.00 – $67.00 | 1 |
| Ftl cgen abnor three anal CPT 81510 | $126.56 | $226.00 | $24.00 – $24.00 | 1 |
| Ftl cgen abnor two proteins CPT 81508 | $1,428.00 | $2,550.00 | $24.00 – $24.00 | 1 |
| Ft prosth multiaxial ankl/ft HCPCS L5978 | $439.60 | $785.00 | not published | 0 |
| Full field erg w/i&r CPT 92273 | $767.20 | $1,370.00 | not published | 0 |
| Full mouth x-ray of teeth CPT 70320 | $1,540.00 | $2,750.00 | $323.00 – $323.00 | 1 |
| Full sole/heel wedge btween HCPCS L3420 | $61.60 | $110.00 | not published | 0 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | $6,557.60 | $11,710.00 | not published | 0 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | $6,591.20 | $11,770.00 | not published | 0 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | $1,444.80 | $2,580.00 | not published | 0 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $5,504.80 | $9,830.00 | not published | 0 |
| Functional brain mapping CPT 96020 | $352.80 | $630.00 | not published | 0 |
| Fundus photography with i&r 92250 CPT 92250 | $330.40 | $590.00 | not published | 0 |
| Furnsh initial orthosis only HCPCS L1200 | $2,206.40 | $3,940.00 | not published | 0 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $1,716.09 | $3,064.44 | $0.02 – $0.02 | 1 |
| Fuse/graft added joint CPT 26863 | $8,086.40 | $14,440.00 | not published | 0 |
| Fusion/graft of finger joint CPT 26862 | $9,632.00 | $17,200.00 | not published | 0 |
| Fusion/graft of hand joint CPT 26844 | $9,816.80 | $17,530.00 | not published | 0 |
| Fusion of ankle joint open CPT 27870 | $24,768.80 | $44,230.00 | not published | 0 |
| Fusion of big toe joint CPT 28750 | $5,488.00 | $9,800.00 | not published | 0 |
| Fusion of big toe joint CPT 28755 | $10,505.60 | $18,760.00 | not published | 0 |
| Fusion of finger jnt add-on CPT 26861 | $8,086.40 | $14,440.00 | not published | 0 |
| Fusion of finger joint CPT 26860 | $4,631.20 | $8,270.00 | not published | 0 |
| Fusion of finger tendons CPT 26471 | $9,049.60 | $16,160.00 | not published | 0 |
| Fusion of finger tendons CPT 26474 | $8,741.60 | $15,610.00 | not published | 0 |
| Fusion of foot bones CPT 28730 | $23,049.60 | $41,160.00 | not published | 0 |
| Fusion of foot bones CPT 28735 | $20,176.80 | $36,030.00 | not published | 0 |
| Fusion of foot bones CPT 28740 | $19,857.60 | $35,460.00 | not published | 0 |
| Fusion of hand joint CPT 26843 | $8,181.60 | $14,610.00 | not published | 0 |
| Fusion of knuckle CPT 26850 | $9,632.00 | $17,200.00 | not published | 0 |
| Fusion of knuckle joint CPT 26516 | $8,741.60 | $15,610.00 | not published | 0 |
| Fusion of knuckle joints CPT 26517 | $9,564.80 | $17,080.00 | not published | 0 |
| Fusion of knuckle joints CPT 26518 | $7,968.80 | $14,230.00 | not published | 0 |
| Fusion of knuckle with graft CPT 26852 | $9,632.00 | $17,200.00 | not published | 0 |
| Fusion of spermatic ducts CPT 54900 | $6,983.20 | $12,470.00 | not published | 0 |
| Fusion of spermatic ducts CPT 54901 | $9,385.60 | $16,760.00 | not published | 0 |
| Fusion of tendons at wrist CPT 25300 | $2,906.40 | $5,190.00 | not published | 0 |
| Fusion of tendons at wrist CPT 25301 | $9,564.80 | $17,080.00 | not published | 0 |
| Fusion of thumb CPT 26841 | $9,632.00 | $17,200.00 | not published | 0 |
| Fusion of tibiofibular joint CPT 27871 | $20,641.60 | $36,860.00 | not published | 0 |
| Fusion of toes CPT 28280 | $7,285.60 | $13,010.00 | not published | 0 |
| Fxn gene charac alleles CPT 81285 | $627.20 | $1,120.00 | $120.00 – $120.00 | 1 |
| Fxn gene detc abnor alleles CPT 81284 | $313.60 | $560.00 | $61.00 – $61.00 | 1 |
| Fxn gene full gene sequence CPT 81286 | $627.20 | $1,120.00 | $120.00 – $120.00 | 1 |
| Fxn gene known famil variant CPT 81289 | $425.60 | $760.00 | $81.00 – $81.00 | 1 |
| G6pc gene CPT 81250 | $162.40 | $290.00 | $26.00 – $26.00 | 1 |
| G6pd full gene sequence CPT 81249 | $1,372.00 | $2,450.00 | $262.00 – $262.00 | 1 |
| G6pd gene alys cmn variant CPT 81247 | $1,209.60 | $2,160.00 | $77.00 – $77.00 | 1 |
| G6pd known familial variant CPT 81248 | $856.80 | $1,530.00 | $164.00 – $164.00 | 1 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $1,582.24 | $2,825.42 | $29.00 – $29.00 | 1 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $5,726.63 | $10,226.12 | not published | 0 |
| Gabapentin non-blood CPT 80355 | $80.08 | $143.00 | $29.00 – $29.00 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $945.41 | $1,688.24 | $0.26 – $0.26 | 1 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $727.89 | $1,299.80 | $1.48 – $1.48 | 1 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $177.52 | $317.00 | $0.11 – $0.11 | 1 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $250.83 | $447.91 | $15.00 – $15.00 | 1 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $255.92 | $457.00 | $19.00 – $19.00 | 1 |
| Galactokinase - sendout CPT 82759 | $218.40 | $390.00 | $19.00 – $19.00 | 1 |
| Galactose transferase test CPT 82776 | $85.12 | $152.00 | $11.00 – $11.00 | 1 |
| Galectin-3 CPT 82777 | $155.12 | $277.00 | $42.00 – $42.00 | 1 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $19,219.20 | $34,320.00 | not published | 0 |
| Gallium ga-68 dotatoc HCPCS C9067 | $135.00 | $241.07 | not published | 0 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | $187.20 | $334.28 | not published | 0 |
| Galsulfase injection HCPCS J1458 | $4,348.09 | $7,764.44 | $505.00 – $505.00 | 1 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $167.00 – $167.00 | 1 |
| Gamma globulin 1 cc inj HCPCS J1460 | $833.40 | $1,488.22 | $48.00 – $48.00 | 1 |
| Gammaglobulin iga CPT 82784 | $54.88 | $98.00 | $8.00 – $8.00 | 1 |
| Gammaglobulin ige CPT 82785 | $104.72 | $187.00 | $16.00 – $16.00 | 1 |
| Gamma glutamyltransferase CPT 82977 | $98.56 | $176.00 | $6.00 – $6.00 | 1 |
| Gammaplex injection HCPCS J1557 | $8,038.46 | $14,354.40 | $63.00 – $63.00 | 1 |
| Gamunex-c/gammaked HCPCS J1561 | $10,709.64 | $19,124.36 | $48.00 – $48.00 | 1 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $172.75 | $308.48 | $40.00 – $40.00 | 1 |
| Gardner vag dna amp probe CPT 87511 | $352.80 | $630.00 | $32.00 – $32.00 | 1 |
| Gardner vag dna quant CPT 87512 | $504.00 | $900.00 | $38.00 – $38.00 | 1 |
| Gastric analy w/ph ea spec CPT 82930 | $53.76 | $96.00 | $6.00 – $6.00 | 1 |
| Gastric emptying imag study CPT 78265 | $2,727.20 | $4,870.00 | $537.00 – $537.00 | 1 |
| Gastric emptying imag study CPT 78266 | $3,164.00 | $5,650.00 | $719.00 – $719.00 | 1 |
| Gastric motility studies CPT 91020 | $2,732.80 | $4,880.00 | not published | 0 |
| Gastric mucosa imaging CPT 78261 | $2,727.20 | $4,870.00 | $537.00 – $537.00 | 1 |
| Gastrin test CPT 82938 | $215.60 | $385.00 | $16.00 – $16.00 | 1 |
| Gastroesophageal reflux study CPT 78262 | $1,383.20 | $2,470.00 | $537.00 – $537.00 | 1 |
| Gastroesophageal reflux test CPT 91034 | $2,251.20 | $4,020.00 | not published | 0 |
| Gastro/jejuno tube, std HCPCS B4087 | $48,300.00 | $86,250.00 | not published | 0 |
| Gastrostomy open neonatal CPT 43831 | $3,595.20 | $6,420.00 | not published | 0 |
| Gated heart multiple CPT 78473 | $2,234.40 | $3,990.00 | $537.00 – $537.00 | 1 |
| Gba gene CPT 81251 | $160.72 | $287.00 | $21.00 – $21.00 | 1 |
| Gefitinib oral HCPCS J8565 | $456.42 | $815.04 | $67.00 – $67.00 | 1 |
| Gel cap app device for trach HCPCS L8515 | $70.00 | $125.00 | not published | 0 |
| Gel cap for trach voice pros HCPCS L8512 | $2.80 | $5.00 | not published | 0 |
| Gel-one HCPCS J7326 | $2,012.08 | $3,593.00 | $524.00 – $524.00 | 1 |
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.