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 |
|---|---|---|---|---|
| Bx bone trocar/ndl deep CPT 20225 | $2,295.00 | $4,500.00 | $2,298.14 – $4,737.00 | 5 |
| Bx breast 1st lesion mr imag CPT 19085 | $2,808.57 | $5,507.00 | $2,298.14 – $4,737.00 | 5 |
| Bx breast 1st lesion strtctc CPT 19081 | $2,808.57 | $5,507.00 | $2,298.14 – $4,737.00 | 5 |
| Bx breast add lesion mr imag CPT 19086 | $900.66 | $1,766.00 | $1,716.00 – $12,908.00 | 3 |
| Bx breast add lesion strtctc CPT 19082 | $900.66 | $1,766.00 | $1,716.00 – $12,908.00 | 3 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $900.66 | $1,766.00 | $1,716.00 – $12,908.00 | 3 |
| Bx breast perq without image 19100 CPT 19100 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Bx breast pq tomo guide CPT 19499 | not published | not published | $2,995.00 – $6,732.00 | 4 |
| Bx/curett of cervix w/scope 57454 CPT 57454 | not published | not published | $424.02 – $4,042.00 | 5 |
| Bx/exc idrl spine lesn crvl CPT 63280 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Bx/exc lymph node/open/deep cervic 38510 CPT 38510 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx/exc lymph node/open/superfic 38500 CPT 38500 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx/exc xdrl spine lesn lmbr CPT 63277 | not published | not published | $2,995.00 – $20,488.00 | 3 |
| Bx leg/ankle soft tissue deep 27614 CPT 27614 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx liver with other CPT 47001 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Bx muscle CPT 20200 | not published | not published | $2,298.14 – $4,737.00 | 5 |
| Bx nasopharynx/unknown pri lesion 42806 CPT 42806 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx of breast open 19101 CPT 19101 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx of cervix w/scope leep 57460 CPT 57460 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx pancreas pq ndl CPT 48102 | $2,022.15 | $3,965.00 | $2,238.00 – $4,737.00 | 5 |
| Bx perianal mass CPT 46999 | $4,489.02 | $8,802.00 | $1,294.00 – $2,741.00 | 4 |
| Bx pleura pq ndl CPT 32400 | $2,022.15 | $3,965.00 | $2,238.00 – $4,737.00 | 5 |
| Bx prostate trnsrctl u/s guid CPT 55707 | not published | not published | $4,904.88 – $5,004.98 | 2 |
| Bx prst8 ndl sat sampling CPT 55706 | not published | not published | $2,995.00 – $5,004.98 | 5 |
| Bx shoulder tissues deep 23066 CPT 23066 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Bx shoulder tissues supf 23065 CPT 23065 | $2,598.45 | $5,095.00 | $2,238.00 – $4,042.00 | 5 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $231.03 | $453.00 | $1,716.00 – $12,908.00 | 3 |
| Bx skin punch ea sep/ addl les CPT 11105 | $260.10 | $510.00 | $1,716.00 – $12,908.00 | 3 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $303.45 | $595.00 | $1,716.00 – $12,908.00 | 3 |
| Bx/soft tis/forearm/wrist/superfic 25065 CPT 25065 | not published | not published | $2,238.00 – $4,042.00 | 5 |
| Bx soft tiss pelvis+hip area supf 27040 CPT 27040 | $2,504.10 | $4,910.00 | $2,238.00 – $4,042.00 | 5 |
| Bx soft tiss pelvis/hip deep 27041 CPT 27041 | $2,642.82 | $5,182.00 | $2,298.14 – $4,042.00 | 5 |
| Bx soft tissue back/flank deep 21925 CPT 21925 | $2,729.01 | $5,351.00 | $2,298.14 – $6,732.00 | 5 |
| Bx soft tissue back/flank supf 21920 CPT 21920 | not published | not published | $2,238.00 – $4,042.00 | 5 |
| Bx spinal cord pq ndl CPT 62269 | $2,642.82 | $5,182.00 | $2,238.00 – $4,737.00 | 5 |
| Bx thigh/knee soft tiss supf 27323 CPT 27323 | not published | not published | $2,238.00 – $4,042.00 | 5 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $1,804.38 | $3,538.00 | $691.00 – $4,042.00 | 5 |
| Bx vag mucos smpl (sep proc) CPT 57100 | not published | not published | $691.00 – $4,042.00 | 5 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $1,552.44 | $3,044.00 | $1,281.61 – $4,042.00 | 5 |
| Bx vulva or perineum/ea add lesion 56606 CPT 56606 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Bypass temp external fem-fem CPT 37799 | $5,139.27 | $10,077.00 | $872.87 – $2,741.00 | 4 |
| C-1 esterase, berinert HCPCS J0597 | $8,888.84 | $17,429.09 | $49.34 – $155.38 | 4 |
| C-1 esterase, cinryze HCPCS J0598 | not published | not published | $49.34 – $137.34 | 4 |
| C1 esterase inhibitor func - sendout CPT 86161 | $34.55 | $67.75 | $11.76 – $105.35 | 4 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | not published | not published | $192.71 – $476.68 | 4 |
| Cabergoline, oral 0.25mg HCPCS J8515 | not published | not published | $4.19 – $39.41 | 2 |
| Cabg 2 arterial grafts 33534 CPT 33534 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg 3 arterial grafts 33535 CPT 33535 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg arterial four or more 33536 CPT 33536 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabgsingle artery graft 33533 CPT 33533 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabgsingle coronary venous graft 33510 CPT 33510 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg/valve reop >1 mo p org proced 33530 CPT 33530 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg/vein only/2 cor venous gfts 33511 CPT 33511 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg/vein only/3 cor venous gfts 33512 CPT 33512 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg/vein only/4 cor venous gfts 33513 CPT 33513 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg venous & art 1 vein graft 33517 CPT 33517 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg venous & art 2 vein graft 33518 CPT 33518 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg venous & art 3 vein graft 33519 CPT 33519 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg venous & art 4 vein graft 33521 CPT 33521 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg venous & art 5 vein graft 33522 CPT 33522 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cabg venous & art 6 vein graft 33523 CPT 33523 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Cable cath 22-pin diag HCPCS C1730 | $10,924.20 | $21,420.00 | not published | 0 |
| Cable centrimag pressure HCPCS Q0508 | $16,576.88 | $32,503.68 | not published | 0 |
| Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er HCPCS J0741 | not published | not published | $23.70 – $49.73 | 4 |
| Cacna1a gene full gene seq CPT 81185 | not published | not published | $829.34 – $4,420.30 | 4 |
| Cad breast MRI w/r&i HCPCS C8937 | $107.10 | $210.00 | $3.98 – $3.98 | 1 |
| Cadd pump refill CPT 96521 | $227.97 | $447.00 | $295.97 – $302.01 | 2 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $107.76 | $211.29 | $4.27 – $4.36 | 2 |
| Calaspargase pegol-mknl 750 unit/ml intravenous solution HCPCS J9118 | not published | not published | $80.43 – $164.54 | 4 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $1,459.58 | $2,861.93 | $61.76 – $1,933.30 | 2 |
| Calcium 24 hour urine CPT 82340 | $187.17 | $367.00 | $5.91 – $52.94 | 4 |
| Calcium acetate(phosphate binders) 667 mg tablet HCPCS J0615 | not published | not published | $0.06 – $0.19 | 2 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $84.15 | $165.00 | $0.09 – $0.28 | 3 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $145.35 | $285.00 | $0.15 – $0.28 | 3 |
| Calcium ionized CPT 82330 | $170.85 | $335.00 | $13.41 – $119.95 | 4 |
| Calcium total CPT 82310 | $142.29 | $279.00 | $5.06 – $45.14 | 4 |
| Calculi urinary-sendout CPT 82360 | $97.92 | $192.00 | $12.61 – $112.97 | 4 |
| Calculus analysis qual CPT 82355 | not published | not published | $11.35 – $101.57 | 4 |
| Caloric vstblr test w/rec CPT 92538 | not published | not published | $36.40 – $691.00 | 4 |
| Calprotectin fecal CPT 83993 | $89.25 | $175.00 | $19.24 – $172.24 | 4 |
| Campylobacter antibody CPT 86625 | $81.52 | $159.84 | $12.86 – $115.40 | 4 |
| Canakinumab injection HCPCS J0638 | not published | not published | $125.84 – $293.60 | 4 |
| Candida dna CPT 87480 | not published | not published | $19.65 – $170.29 | 4 |
| Candida skin test CPT 86485 | not published | not published | $40.25 – $79.00 | 4 |
| Cannula declotting 36861 CPT 36861 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $546,210.00 | $1,071,000.00 | not published | 0 |
| Cantharidin top, applicator HCPCS J7354 | not published | not published | $653.73 – $1,466.86 | 4 |
| Canthotomy 67715 CPT 67715 | $5,300.94 | $10,394.00 | $2,238.00 – $6,732.00 | 5 |
| Capecitabine, oral, 50 mg HCPCS J8522 | $5.61 | $11.00 | $0.03 – $0.28 | 4 |
| Cap nerve 2x15mm HCPCS C1763 | $86,262.79 | $169,142.73 | not published | 0 |
| Capsaicin 8% patch HCPCS J7336 | not published | not published | $3.35 – $7.27 | 4 |
| Capsular contracture release CPT 23020 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Capsulotomy; interphalangeal joint, each joint (separate proc) CPT 28272 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Cap trach decann 15mm HCPCS C1750 | $8,293.82 | $16,262.40 | not published | 0 |
| Carbamazepine free CPT 80157 | not published | not published | $12.98 – $87.21 | 4 |
| Carbamazepine free -sendout CPT 80161 | not published | not published | $18.27 – $55.48 | 4 |
| Carbamazepine total therapeutic drug level CPT 80156 | $468.69 | $919.00 | $14.28 – $127.81 | 4 |
| Carbidopa levodopa ent 100ml HCPCS J7340 | not published | not published | $2.87 – $506.91 | 4 |
| Carbohydrate deficient transf - sendout CPT 82373 | not published | not published | $17.70 – $63.16 | 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.