Santa Rosa Memorial Hospital
1165 Montgomery Dr, Santa Rosa, CA · Providence · · NPI 1134152549
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | not published | not published | $28.69 – $256.85 | 4 |
| 17-hydroxypregnenolone CPT 84143 | not published | not published | $22.35 – $200.30 | 4 |
| 17-ketosteroids CPT 83586 | not published | not published | $12.54 – $112.38 | 4 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | not published | not published | $185.25 – $189.04 | 2 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $35.20 – $117.46 | 4 |
| 24 hr ambulatory b/p monitor CPT 93786 | not published | not published | $185.13 – $351.57 | 3 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,453.50 | $2,850.00 | $1,090.80 – $1,726.40 | 3 |
| 2d tte w or without fol w/con,co HCPCS C8923 | not published | not published | $1,090.80 – $1,712.75 | 3 |
| 2nd order venous cath CPT 36012 | $1,710.03 | $3,353.00 | $1,716.00 – $12,908.00 | 3 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $140.88 – $182.70 | 3 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $179.04 – $250.34 | 3 |
| 3d ech img cgen car anomal CPT 93319 | $795.60 | $1,560.00 | $145.67 – $497.16 | 2 |
| 3-d radiotherapy plan CPT 77295 | $3,715.35 | $7,285.00 | $1,925.97 – $6,126.26 | 3 |
| 3d recon without postprocess indpndt CPT 76376 | $136.68 | $268.00 | $432.46 – $846.60 | 2 |
| 5' nucleotidase - sendout CPT 83915 | not published | not published | $10.93 – $97.85 | 4 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $96.39 | $189.00 | $36.08 – $131.62 | 3 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | not published | not published | $26.89 – $93.27 | 4 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $21.96 | $43.05 | $11.77 – $108.72 | 4 |
| Abciximab injection HCPCS J0130 | not published | not published | $715.46 – $1,201.03 | 2 |
| Abd aorta w/runoff s&i CPT 75630 | $4,415.58 | $8,658.00 | $1,132.92 – $4,434.05 | 4 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Abd/low ext cath 1st CPT 36245 | $1,398.42 | $2,742.00 | $1,716.00 – $5,318.00 | 3 |
| Abd/low ext cath 2nd CPT 36246 | $1,755.93 | $3,443.00 | $1,716.00 – $5,318.00 | 3 |
| Abd/low ext cath 3rd CPT 36247 | $1,675.35 | $3,285.00 | $1,716.00 – $5,318.00 | 3 |
| Abd/low ext cath addl CPT 36248 | $287.64 | $564.00 | $370.63 – $4,042.00 | 3 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $5,110.20 | $10,020.00 | $244.06 – $2,107.93 | 4 |
| Abdominal CT scan (with contrast) CPT 74160 | $4,872.54 | $9,554.00 | $244.06 – $1,702.71 | 4 |
| Abdominal CT scan (without contrast) CPT 74150 | $4,145.28 | $8,128.00 | $145.47 – $1,411.94 | 4 |
| Abdominal MRI (with and without contrast) CPT 74183 | $5,752.80 | $11,280.00 | $485.45 – $6,283.55 | 4 |
| Abdominal MRI (with contrast) CPT 74182 | $4,774.11 | $9,361.00 | $485.45 – $3,396.03 | 4 |
| Abdominal MRI (without contrast) CPT 74181 | $4,299.81 | $8,431.00 | $332.01 – $2,780.99 | 4 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,670.76 | $3,276.00 | $1,262.04 – $4,737.00 | 5 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,407.60 | $2,760.00 | $145.47 – $496.21 | 4 |
| Abdominal Ultrasound (limited) CPT 76705 | $894.54 | $1,754.00 | $145.47 – $357.30 | 4 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,163.31 | $2,281.00 | $691.00 – $4,737.00 | 5 |
| Abl1 gene CPT 81170 | not published | not published | $294.00 – $2,813.37 | 4 |
| Ablat 1/+thyr ndul addl prq rf CPT 60661 | not published | not published | $691.00 – $1,716.00 | 2 |
| Ablate arrhythmia add on CPT 93655 | $3,190.05 | $6,255.00 | $1,716.00 – $12,908.00 | 4 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | not published | not published | $4,042.00 – $15,575.00 | 5 |
| Ablate bone tumor(s) perq CPT 20982 | $8,803.62 | $17,262.00 | $4,042.00 – $24,397.68 | 5 |
| Ablate heart dysrhythm focus CPT 93650 | $13,824.57 | $27,107.00 | $10,852.95 – $15,575.00 | 4 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Ablate inf turbinate superf 30801 CPT 30801 | $3,006.96 | $5,896.00 | $2,158.97 – $4,737.00 | 5 |
| Ablate pulm tumor perq crybl CPT 32994 | $7,270.56 | $14,256.00 | $2,995.00 – $15,575.00 | 5 |
| Ablate pulm tumor perq rf CPT 32998 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $5,608.47 | $10,997.00 | $179.04 – $1,716.00 | 3 |
| Ablation cryo abd perit om CPT 49999 | not published | not published | $1,262.04 – $4,737.00 | 4 |
| Ablation cryo adrenal tumor CPT 60699 | $11,066.49 | $21,699.00 | $6,682.00 – $15,575.00 | 4 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $5,436.60 | $10,660.00 | $343.23 – $2,238.00 | 4 |
| Ablation cryo pq liver tumor(s) CPT 47383 | not published | not published | $6,682.00 – $15,575.00 | 5 |
| Ablation cryo retro lymph node CPT 38999 | not published | not published | $613.88 – $2,238.00 | 4 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $343.23 – $2,238.00 | 4 |
| Ablation ire liver 1+ tumor(s) w/image pq CPT 47384 | not published | not published | $14,791.03 – $15,092.89 | 2 |
| Ablation of upper extremity nerves rf CPT 64999 | $3,299.19 | $6,469.00 | $427.11 – $2,238.00 | 4 |
| Abltj 1/+thyr ndul 1lobe prq CPT 60660 | not published | not published | $691.00 – $9,773.00 | 5 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $2,238.00 – $13,441.06 | 5 |
| Ablt trurl prst8 tis trnsdcr CPT 55882 | not published | not published | $691.00 – $20,488.00 | 5 |
| Abobotulinumtoxina HCPCS J0586 | not published | not published | $8.72 – $19.44 | 4 |
| Abortion CPT 59850 | not published | not published | $3,423.00 – $15,202.00 | 4 |
| Abortion (mpr) CPT 59866 | not published | not published | $424.02 – $4,042.00 | 5 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $691.00 – $4,042.00 | 3 |
| Abrasion lesion single CPT 15786 | not published | not published | $279.18 – $4,042.00 | 5 |
| Abscess drain retroperitoneal surg code CPT 49406 | $2,506.14 | $4,914.00 | $2,238.00 – $4,737.00 | 5 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $4,993.41 | $9,791.00 | $1,716.00 – $12,908.00 | 4 |
| Access thoracic lymph duct CPT 38794 | $2,153.22 | $4,222.00 | $1,716.00 – $4,042.00 | 2 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $145.35 | $285.00 | $0.10 – $0.19 | 3 |
| Acetaminophen level CPT 80143 | $600.78 | $1,178.00 | $18.27 – $55.48 | 4 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $186.68 | $366.03 | $38.12 – $43.49 | 3 |
| Acetone qualitative CPT 82009 | $84.66 | $166.00 | $4.43 – $39.71 | 4 |
| Acetylcholine receptor modulating antibody CPT 86043 | $22.57 | $44.25 | $11.81 – $28.48 | 4 |
| Acetylcholinesterase assay CPT 82013 | not published | not published | $12.04 – $98.32 | 4 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $363.50 | $712.75 | $0.89 – $16.04 | 3 |
| Acetylcysteine non-comp unit HCPCS J7608 | $49.28 | $96.62 | $9.46 – $18.15 | 3 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $68.25 – $1,716.00 | 4 |
| Acne surgery 10040 CPT 10040 | $391.68 | $768.00 | $279.18 – $4,042.00 | 5 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $177.43 – $181.05 | 2 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $166.16 – $169.55 | 2 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | not published | not published | $141.36 – $144.24 | 2 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | not published | not published | $246.98 – $252.02 | 2 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | not published | not published | $185.25 – $416.50 | 3 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | not published | not published | $12.45 – $12.70 | 2 |
| Acoustic immitance testing CPT 92570 | not published | not published | $179.04 – $182.70 | 2 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $4,552.87 – $11,377.00 | 5 |
| Actigraphy testing CPT 95803 | not published | not published | $82.09 – $632.41 | 3 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $40.25 – $41.07 | 2 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $40.25 – $41.07 | 2 |
| Acute hepatitis panel CPT 80074 | $435.54 | $854.00 | $46.68 – $354.94 | 4 |
| Acute venous thrombus image CPT 78456 | not published | not published | $996.62 – $2,035.50 | 4 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $110.71 | $217.08 | $0.07 – $0.19 | 3 |
| #acylcarnitineprfl CPT 82017 | $87.72 | $172.00 | $16.53 – $147.36 | 4 |
| Acylcarnitines qual CPT 82016 | not published | not published | $16.16 – $121.13 | 4 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $246.98 – $691.00 | 3 |
| Adapter b 8 channel 10cm HCPCS C1883 | $14,481.71 | $28,395.50 | not published | 0 |
| Adding walker to prev cast CPT 29440 | $315.69 | $619.00 | $226.11 – $4,042.00 | 5 |
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.