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 |
|---|---|---|---|---|
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $1,850.79 | $3,629.00 | $349.04 – $681.63 | 2 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $451.35 | $885.00 | $194.63 – $203.72 | 2 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,422.90 | $2,790.00 | $332.01 – $934.52 | 4 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $1,245.42 | $2,442.00 | $145.47 – $241.25 | 4 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $966.96 | $1,896.00 | $145.47 – $341.52 | 4 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $544.17 | $1,067.00 | $145.47 – $393.16 | 4 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $145.47 – $342.23 | 4 |
| Ultrasound retroperitoneal limited CPT 76775 | $985.83 | $1,933.00 | $145.47 – $357.24 | 4 |
| Ultrasound scrotum and contents CPT 76870 | $1,263.27 | $2,477.00 | $145.47 – $345.13 | 4 |
| Ultrasound spinal canal and contents CPT 76800 | $812.94 | $1,594.00 | $145.47 – $361.61 | 4 |
| Ultrasound transabd ea addl gest CPT 76812 | $518.16 | $1,016.00 | $324.80 – $437.20 | 2 |
| Ultrasound transvaginal non obstetric CPT 76830 | $918.00 | $1,800.00 | $145.47 – $385.19 | 4 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $291.55 – $2,249.44 | 4 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $1,263.94 – $1,642.44 | 2 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.95 – $9.13 | 2 |
| Umbilical artery cath newborn 36660 CPT 36660 | $591.09 | $1,159.00 | $2,238.00 – $6,732.00 | 3 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $424.02 – $5,318.00 | 5 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $1,716.00 – $19,505.00 | 3 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $40.25 – $41.07 | 2 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $40.25 – $41.07 | 2 |
| Unlisted chemotherapy px CPT 96549 | $44.37 | $87.00 | $65.16 – $66.49 | 2 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $329.57 – $2,995.00 | 4 |
| Unlisted CT procedure CPT 76497 | not published | not published | $121.09 – $127.70 | 3 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $556.27 – $589.01 | 3 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $72.51 – $98.94 | 3 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $72.51 – $98.94 | 3 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $179.04 – $1,716.00 | 3 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $556.27 – $589.01 | 3 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $281.31 – $2,238.00 | 4 |
| Unlisted fluoroscopic px CPT 76496 | $135.15 | $265.00 | $121.09 – $127.70 | 3 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $556.27 – $589.01 | 3 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $556.27 – $589.01 | 3 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | $281.31 – $3,423.00 | 4 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $6,682.00 – $11,377.00 | 4 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $4,233.00 – $11,377.00 | 4 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px esoph CPT 43289 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px lymphtc sys CPT 38589 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px ovidct ovry CPT 58679 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px renal CPT 50549 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px spleen CPT 38129 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px testis CPT 54699 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px ureter CPT 50949 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted laps px uterus CPT 58578 | not published | not published | $5,530.00 – $11,377.00 | 4 |
| Unlisted maxlfcl prosth px CPT 21089 | not published | not published | $329.57 – $2,995.00 | 4 |
| Unlisted misc path test CPT 89240 | $185.64 | $364.00 | $72.51 – $98.94 | 3 |
| Unlisted mr procedure CPT 76498 | $275.40 | $540.00 | $121.09 – $127.70 | 3 |
| Unlisted muscskel px dx nuc CPT 78399 | not published | not published | $556.27 – $589.01 | 3 |
| Unlisted muscskel px head CPT 21499 | not published | not published | $329.57 – $2,995.00 | 4 |
| Unlisted neurological dx px CPT 95999 | not published | not published | $179.04 – $182.70 | 2 |
| Unlisted nrvs sys px dx nuc CPT 78699 | not published | not published | $556.27 – $589.01 | 3 |
| Unlisted oph svc/procedure CPT 92499 | not published | not published | $40.25 – $41.07 | 2 |
| Unlisted orl service/px CPT 92700 | not published | not published | $40.25 – $41.07 | 2 |
| Unlisted procedure colon CPT 45399 | not published | not published | $1,294.00 – $4,737.00 | 4 |
| Unlisted procedure esophagus CPT 43499 | not published | not published | $1,262.04 – $4,737.00 | 4 |
| Unlisted procedure eyelids CPT 67999 | not published | not published | $441.66 – $2,995.00 | 4 |
| Unlisted procedure larynx CPT 31599 | not published | not published | $329.57 – $4,233.00 | 4 |
| Unlisted procedure liver CPT 47399 | not published | not published | $985.34 – $2,741.00 | 4 |
| Unlisted procedure microbiology CPT 87999 | $544.68 | $1,068.00 | not published | 0 |
| Unlisted procedure orbit CPT 67599 | not published | not published | $441.66 – $2,238.00 | 4 |
| Unlisted procedure pancreas CPT 48999 | not published | not published | $985.34 – $2,741.00 | 4 |
| Unlisted procedure rectum CPT 45999 | $1,901.28 | $3,728.00 | $1,294.00 – $2,741.00 | 4 |
| Unlisted procedure spine CPT 22899 | not published | not published | $343.23 – $2,238.00 | 4 |
| Unlisted procedure urinary 58750 CPT 58750 | not published | not published | $2,238.00 – $24,668.00 | 4 |
| Unlisted px abdomen muscskel CPT 22999 | not published | not published | $343.23 – $3,423.00 | 4 |
| Unlisted px accessory sinus CPT 31299 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted px ant segment eye CPT 66999 | not published | not published | $2,238.00 – $4,737.00 | 4 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | $343.23 – $4,812.00 | 4 |
| Unlisted px biliary tract CPT 47999 | not published | not published | $1,262.04 – $4,737.00 | 4 |
| Unlisted px casting/strpg CPT 29799 | not published | not published | $226.11 – $1,716.00 | 4 |
| Unlisted px conjunctiva CPT 68399 | not published | not published | $441.66 – $2,238.00 | 4 |
| Unlisted px diaphragm CPT 39599 | not published | not published | $2,238.00 – $6,732.00 | 2 |
| Unlisted px exc pressure ulc CPT 15999 | not published | not published | $985.34 – $3,423.00 | 4 |
| Unlisted px external ear CPT 69399 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted px extraocular musc CPT 67399 | not published | not published | $441.66 – $4,233.00 | 4 |
| Unlisted px foot/toes CPT 28899 | not published | not published | $343.23 – $2,238.00 | 4 |
| Unlisted px forearm/wrist CPT 25999 | not published | not published | $343.23 – $2,238.00 | 4 |
| Unlisted px hands/fingers CPT 26989 | $5,523.81 | $10,831.00 | $343.23 – $2,238.00 | 4 |
| Unlisted px inner ear CPT 69949 | not published | not published | $329.57 – $2,995.00 | 4 |
| Unlisted px lacrimal system CPT 68899 | not published | not published | $441.66 – $2,238.00 | 4 |
| Unlisted px leg/ankle CPT 27899 | not published | not published | $343.23 – $1,716.00 | 4 |
| Unlisted px male genital sys CPT 55899 | not published | not published | $347.66 – $2,238.00 | 4 |
| Unlisted px mediastinum CPT 39499 | not published | not published | $2,238.00 – $6,732.00 | 2 |
| Unlisted px med radj physics CPT 77399 | not published | not published | $187.03 – $190.84 | 2 |
| Unlisted px middle ear CPT 69799 | not published | not published | $329.57 – $2,995.00 | 4 |
| Unlisted px neck/thorax CPT 21899 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted px palate uvula CPT 42299 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted px pelvis/hip joint CPT 27299 | not published | not published | $343.23 – $2,238.00 | 4 |
| Unlisted px posterior segmnt CPT 67299 | not published | not published | $2,238.00 – $4,737.00 | 4 |
| Unlisted px salivry glnd/dux CPT 42699 | $4,027.47 | $7,897.00 | $329.57 – $2,995.00 | 4 |
| Unlisted px small intestine CPT 44799 | $1,652.40 | $3,240.00 | $1,262.04 – $4,737.00 | 4 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $187.03 – $190.84 | 2 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $329.57 – $2,238.00 | 4 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $72.51 – $295.44 | 4 |
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.