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 |
|---|---|---|---|---|
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $106.46 – $398.93 | 2 |
| Vaccine mmr live subcutaneous CPT 90707 | $314.81 | $617.28 | $58.05 – $244.65 | 2 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $155.89 – $716.36 | 2 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $24.39 – $286.96 | 2 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $164.05 – $554.68 | 2 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $309.00 – $561.47 | 2 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $720.50 | $1,412.75 | $333.20 – $672.74 | 2 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $203.56 | $399.13 | $38.67 – $115.09 | 2 |
| Vaccine rabies im CPT 90675 | $911.02 | $1,786.31 | $204.58 – $682.99 | 4 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $866.76 | $1,699.52 | $422.04 – $791.54 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $1,529.98 | $2,999.97 | $708.22 – $2,869.65 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $1,289.51 | $2,528.45 | $708.22 – $1,434.82 | 2 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $400.62 – $758.52 | 2 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $152.55 – $252.67 | 2 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $94.13 – $254.62 | 2 |
| Vaccine tdap >=7 years im CPT 90715 | $212.65 | $416.97 | $57.68 – $84.00 | 2 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $195.37 | $383.08 | $28.56 – $73.01 | 2 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $61.39 – $254.02 | 2 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $90.60 – $471.82 | 2 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $100.15 – $379.65 | 2 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.09 | 4 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | $1,917.61 | $3,760.02 | not published | 0 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | $24,032.51 | $47,122.56 | not published | 0 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vag hyst including t/o CPT 58262 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $12,568.00 – $12,568.00 | 1 |
| Vaginal bx CPT 58999 | $4,806.75 | $9,425.00 | $281.31 – $2,238.00 | 4 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | $6,160.80 | $12,080.00 | $2,995.00 – $9,773.00 | 5 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $2,995.00 – $9,773.00 | 2 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $4,504.34 – $9,773.00 | 5 |
| Vag inser rectal control sys HCPCS A4563 | not published | not published | $1,607.49 – $1,640.30 | 2 |
| Vagnc compl rmvl paravag tis CPT 57111 | not published | not published | $2,995.00 – $19,505.00 | 4 |
| Vagnc compl rmvl vag wall CPT 57110 | not published | not published | $2,238.00 – $19,505.00 | 4 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Vagotomy & pylorus repair CPT 43641 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Valproic acid total therapeutic drug level CPT 80164 | $427.38 | $838.00 | $13.27 – $118.88 | 4 |
| Valrubicin injection HCPCS J9357 | not published | not published | $661.02 – $3,105.78 | 4 |
| Valvuloplasty aortic CPT 92986 | $5,525.85 | $10,835.00 | $7,919.61 – $15,575.00 | 5 |
| Valvuloplasty aortic valve CPT 33390 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Valvuloplasty aortic valve CPT 33391 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Valvuloplasty mitral CPT 92987 | not published | not published | $8,992.00 – $16,391.15 | 5 |
| Valvuloplasty pulmonary CPT 92990 | not published | not published | $8,992.00 – $16,391.15 | 5 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $676.55 | $1,326.56 | not published | 0 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $130.18 | $255.26 | not published | 0 |
| Vancomycin hcl injection HCPCS J3370 | not published | not published | $3.90 – $22.07 | 3 |
| Vancomycin peak therapeutic drug level CPT 80202 | $415.14 | $814.00 | $13.27 – $118.88 | 4 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $34.39 – $308.02 | 4 |
| Vantas implant HCPCS J9225 | not published | not published | $7,153.93 – $9,805.85 | 2 |
| Varicella zoster antibody igg CPT 86787 | $184.11 | $361.00 | $12.62 – $113.09 | 4 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $170.63 – $4,846.64 | 4 |
| Vasc emb/occ w/prs cath HCPCS C9797 | not published | not published | $20,488.00 – $26,028.38 | 3 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Vasectomy CPT 55250 | not published | not published | $2,908.69 – $6,732.00 | 5 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $593.54 | $1,163.80 | $2.84 – $5.75 | 3 |
| Vbac delivery 59610 CPT 59610 | not published | not published | $2,995.00 – $9,773.00 | 2 |
| Vbac/include postpartum care 59614 CPT 59614 | not published | not published | $2,995.00 – $9,773.00 | 2 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $20,227.98 | $39,662.71 | $20.56 – $45.49 | 4 |
| Veeg cont 2-12 hrs CPT 95713 | $2,564.28 | $5,028.00 | $519.24 – $3,795.69 | 3 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $5,128.56 | $10,056.00 | $1,194.91 – $8,719.29 | 3 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $1,230.63 | $2,413.00 | $519.24 – $3,795.69 | 3 |
| Veeg unmon 12-26 hrs CPT 95714 | $2,564.28 | $5,028.00 | $519.24 – $1,921.63 | 3 |
| Veeg unmon 2-12 hrs CPT 95711 | $1,230.63 | $2,413.00 | $300.45 – $3,795.69 | 3 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Vein byp pop-tibl peroneal CPT 35587 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Vein x-ray adrenal gland CPT 75840 | not published | not published | $1,054.25 – $4,434.05 | 4 |
| Vein x-ray adrenal glands CPT 75842 | not published | not published | $1,182.97 – $7,353.90 | 3 |
| Vein x-ray eye socket CPT 75880 | not published | not published | $236.58 – $1,008.82 | 4 |
| Vein x-ray kidney CPT 75831 | $3,191.58 | $6,258.00 | $1,075.75 – $4,434.05 | 4 |
| Vein x-ray liver CPT 75891 | not published | not published | $1,078.13 – $4,434.05 | 4 |
| Vein x-ray liver w/hemodynam CPT 75885 | $4,627.74 | $9,074.00 | $1,075.75 – $4,434.05 | 4 |
| Vein x-ray liver w/hemodynam CPT 75889 | $4,624.68 | $9,068.00 | $1,075.75 – $4,434.05 | 4 |
| Vein x-ray liver without hemodyn CPT 75887 | $4,627.23 | $9,073.00 | $1,092.36 – $4,393.52 | 4 |
| Vein x-ray skull CPT 75870 | not published | not published | $1,078.13 – $4,393.52 | 4 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $872.87 – $3,164.05 | 4 |
| Vein x-ray spleen/liver CPT 75810 | not published | not published | $2,609.81 – $4,483.19 | 4 |
| Velaglucerase alfa 400 unit intravenous solution HCPCS J3385 | not published | not published | $380.39 – $804.87 | 4 |
| Vemp test i&r cervical CPT 92517 | not published | not published | $179.04 – $182.70 | 2 |
| Vemp test i&r ocular CPT 92518 | not published | not published | $179.04 – $182.70 | 2 |
| Vemp tst i&r cervical&ocular CPT 92519 | not published | not published | $300.45 – $306.58 | 2 |
| Ven-artl shunt det mbubb njx CPT 93898 | not published | not published | $1,027.23 – $1,027.23 | 1 |
| Ven blood coll snf/hha HCPCS G0471 | not published | not published | $11.11 – $11.34 | 2 |
| Vendaje, per square centimet HCPCS Q4252 | not published | not published | $173.16 – $213.09 | 3 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $3,902.52 | $7,652.00 | not published | 0 |
| Venipuncture <3 yrs other vein CPT 36406 | $83.13 | $163.00 | not published | 0 |
| Venogram ext bil s&i CPT 75822 | $1,567.74 | $3,074.00 | $369.83 – $2,609.81 | 4 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $1,567.74 | $3,074.00 | $236.58 – $2,190.38 | 4 |
| Venous mech thrombectomy CPT 37187 | $14,433.51 | $28,301.00 | $3,423.00 – $16,391.15 | 5 |
| Venous m-thrombectomy add-on CPT 37188 | $10,723.26 | $21,026.00 | $3,423.00 – $11,377.00 | 5 |
| Venous sampling s&i CPT 75893 | not published | not published | $1,068.56 – $7,742.78 | 4 |
| Venous thrombosis imaging CPT 78457 | not published | not published | $666.62 – $2,035.50 | 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.