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 |
|---|---|---|---|---|
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $84.15 | $165.00 | $10.02 – $23.09 | 3 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $658.23 | $1,290.65 | $1.21 – $8.58 | 4 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $145.35 | $285.00 | $3.20 – $9.46 | 3 |
| Ceftazidime and avibactam HCPCS J0714 | $1,195.07 | $2,343.28 | $101.92 – $216.08 | 4 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $84.15 | $165.00 | $0.99 – $19.66 | 3 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $84.15 | $165.00 | $4.03 – $9.00 | 3 |
| #celiac hla-dq2 CPT 81377 | not published | not published | $92.85 – $444.28 | 4 |
| #celiac hla-dq8 CPT 81383 | not published | not published | $106.95 – $440.26 | 4 |
| Cell count body fluid CPT 89050 | $330.48 | $648.00 | $4.63 – $41.54 | 4 |
| Cell count w differential body fluid CPT 89051 | $345.78 | $678.00 | $5.49 – $48.39 | 4 |
| Cell cryopreserve/storage CPT 88240 | not published | not published | $12.81 – $40.06 | 4 |
| Cell enumeration & id CPT 86152 | not published | not published | $245.76 – $716.78 | 4 |
| Cell function assay w/stim CPT 86352 | not published | not published | $133.14 – $595.30 | 4 |
| Cell marker study CPT 88182 | not published | not published | $72.51 – $104.88 | 4 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | not published | not published | $29.17 – $62.18 | 4 |
| Centralization wrist on ulna CPT 25335 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Centruroides immune f(ab) HCPCS J0716 | not published | not published | $5,216.40 – $10,438.90 | 2 |
| Cerclage cervix pregnancy abdominal 59325 CPT 59325 | not published | not published | $2,995.00 – $25,242.00 | 4 |
| Cerclage of uterine cervix nonob 57700 CPT 57700 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Cerebrospinal fld flw imag CPT 78645 | not published | not published | $755.17 – $854.22 | 4 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | not published | not published | $3.71 – $9.00 | 4 |
| Cervical lymphadenectomy 38720 CPT 38720 | not published | not published | $3,423.00 – $9,773.00 | 5 |
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | not published | not published | $141.36 – $144.24 | 2 |
| Cesarean section delivery only 59514 CPT 59514 | not published | not published | $3,423.00 – $9,773.00 | 2 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | not published | not published | $71.59 – $166.67 | 4 |
| #cf-97variants CPT 81220 | $285.60 | $560.00 | $545.47 – $3,562.24 | 4 |
| Cftr gene dup/delet variants CPT 81222 | not published | not published | $426.37 – $870.14 | 4 |
| Cftr gene intron poly t CPT 81224 | not published | not published | $165.38 – $417.15 | 4 |
| Cftr gene known fam variants CPT 81221 | not published | not published | $95.28 – $537.16 | 4 |
| Change cystostomy tube; complex 51710 CPT 51710 | $3,199.23 | $6,273.00 | $970.26 – $4,042.00 | 5 |
| Change cystostomy tube simple CPT 51705 | $821.10 | $1,610.00 | $347.66 – $4,042.00 | 5 |
| Change gastric port open CPT 43888 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Change g-tube to g-j perc CPT 49446 | $4,340.10 | $8,510.00 | $2,670.09 – $4,737.00 | 5 |
| Change nephroureteral cath CPT 50387 | $3,395.07 | $6,657.00 | $2,908.69 – $4,737.00 | 5 |
| Change of ureter tube/stent CPT 50688 | $5,834.40 | $11,440.00 | $2,238.00 – $4,737.00 | 5 |
| Change of windpipe airway 31502 CPT 31502 | $462.57 | $907.00 | $329.57 – $4,042.00 | 5 |
| Change stent via transureth CPT 50385 | $4,496.16 | $8,816.00 | $2,908.69 – $6,732.00 | 5 |
| Change ureter stent percut CPT 50382 | $6,086.85 | $11,935.00 | $2,908.69 – $6,732.00 | 5 |
| Chct for mal hyperthermia CPT 89049 | not published | not published | $237.06 – $1,203.48 | 4 |
| Chemical exfoliation acne 17360 CPT 17360 | not published | not published | $279.18 – $4,042.00 | 5 |
| Chemical peel face epiderm 15788 CPT 15788 | not published | not published | $565.65 – $1,716.00 | 4 |
| Chemical peel nonfacial 15793 CPT 15793 | not published | not published | $565.65 – $1,716.00 | 4 |
| Chemical peel nonfacial; epidermal CPT 15792 | not published | not published | $691.00 – $2,741.00 | 4 |
| Chemo adm cns w/lmbr punct CPT 96450 | $355.47 | $697.00 | $390.55 – $459.61 | 2 |
| Chemodener muscle larynx emg CPT 64617 | not published | not published | $691.00 – $4,042.00 | 5 |
| Chemodenerv 1 extrem 1-4 ea 64643 CPT 64643 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Chemodenerv 1 extrem 5/> ea 64645 CPT 64645 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | not published | not published | $982.21 – $4,042.00 | 5 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | not published | not published | $982.21 – $4,042.00 | 5 |
| Chemodenervation anal musc CPT 46505 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | not published | not published | $427.11 – $4,042.00 | 5 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $441.66 – $4,042.00 | 5 |
| Chemodenerv eccrine glands CPT 64653 | not published | not published | $427.11 – $4,042.00 | 5 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $427.11 – $4,042.00 | 5 |
| Chemodenerv musc migraine 64615 CPT 64615 | not published | not published | $427.11 – $4,042.00 | 5 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | not published | not published | $427.11 – $4,042.00 | 5 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | not published | not published | $427.11 – $4,042.00 | 5 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $982.21 – $4,042.00 | 5 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | not published | not published | $982.21 – $4,042.00 | 5 |
| Chemo extend IV infus w/pump HCPCS G0498 | $355.47 | $697.00 | $459.61 – $468.99 | 2 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $65.16 – $66.49 | 2 |
| Chemo ia infusion up to 1 hr CPT 96422 | not published | not published | $459.61 – $468.99 | 2 |
| Chemo ia push tecnique CPT 96420 | $491.64 | $964.00 | $459.61 – $468.99 | 2 |
| Chemo intralesional over 7 CPT 96406 | not published | not published | $201.08 – $295.97 | 2 |
| Chemo intralesional up to 7 96405 CPT 96405 | not published | not published | $100.19 – $102.23 | 2 |
| Chemotaxis assay CPT 86155 | not published | not published | $15.67 – $135.66 | 4 |
| Chemotherapy injection 96542 CPT 96542 | not published | not published | $201.55 – $459.61 | 2 |
| Chemotx admn pertl cav impl CPT 96446 | not published | not published | $94.32 – $459.61 | 2 |
| Chest 2 vws w oblique CPT 71048 | $1,137.30 | $2,230.00 | $145.47 – $255.26 | 4 |
| Chest apical lordotic proj CPT 71047 | $852.72 | $1,672.00 | $121.09 – $248.11 | 4 |
| Chest CT scan (with and without contrast) CPT 71270 | $5,775.24 | $11,324.00 | $244.06 – $2,194.61 | 4 |
| Chest CT scan (with contrast) CPT 71260 | $5,232.09 | $10,259.00 | $244.06 – $1,760.67 | 4 |
| Chest CT scan (without contrast) CPT 71250 | $3,627.12 | $7,112.00 | $145.47 – $1,472.15 | 4 |
| Chest X-ray CPT 71046 | $852.72 | $1,672.00 | $121.09 – $194.63 | 4 |
| Chest X-ray (single view) CPT 71045 | $741.54 | $1,454.00 | $74.23 – $127.70 | 4 |
| Chg pr pul rehab for copd patients CPT 94626 | not published | not published | $82.09 – $83.76 | 2 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $800.70 | $1,570.00 | $244.06 – $472.22 | 4 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $203.31 – $4,604.65 | 4 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $255.57 – $2,163.47 | 4 |
| Chlamydia culture CPT 87110 | $34.97 | $68.57 | $19.21 – $172.00 | 4 |
| Chlamydia trachomatis ag if CPT 87270 | $9.05 | $17.74 | $11.74 – $78.88 | 4 |
| Chlamydia type CPT 87140 | $34.98 | $68.58 | $5.46 – $48.98 | 4 |
| Chlnggrphy intraop addl s&i CPT 74301 | not published | not published | $141.81 – $171.82 | 2 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $7.60 – $125.52 | 2 |
| Chloride CPT 82435 | $138.72 | $272.00 | $4.51 – $40.71 | 4 |
| Chloride 24 hour urine CPT 82436 | $5.49 | $10.76 | $5.64 – $44.08 | 4 |
| Chloroprocaine hcl injection HCPCS J2401 | $84.15 | $165.00 | $0.08 – $0.09 | 3 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $1.02 – $1.29 | 3 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $333.70 | $654.31 | $13.17 – $69.83 | 3 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $141.28 | $277.02 | $12.24 – $62.44 | 3 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | not published | not published | $0.65 – $0.65 | 1 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $459.61 – $468.99 | 2 |
| Cholangiogram percutaneous compl CPT 47532 | $3,547.05 | $6,955.00 | $1,639.46 – $11,377.00 | 5 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $990.93 | $1,943.00 | $232.34 – $232.34 | 1 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $2,238.00 – $20,652.00 | 4 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $2,238.00 – $24,668.00 | 4 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $5,587.56 | $10,956.00 | $2,238.00 – $11,377.00 | 5 |
| Cholesterol CPT 82465 | $153.00 | $300.00 | $4.26 – $38.17 | 4 |
| Cholesterol body fluid CPT 84999 | $36.36 | $71.30 | not published | 0 |
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.