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 |
|---|---|---|---|---|
| Chromatography CPT 83021 | $4.75 | $9.32 | $17.70 – $157.82 | 4 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $11.65 – $103.58 | 4 |
| Chromo high res and frag x - sendout CPT 81243 | not published | not published | $55.90 – $411.25 | 4 |
| Chromosome analys amniotic CPT 88269 | not published | not published | $170.19 – $1,459.63 | 4 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $169.71 – $1,513.04 | 4 |
| Chromosome analysis 15-20 cell count CPT 88262 | $161.93 | $317.50 | $122.98 – $1,093.88 | 4 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $169.71 – $1,264.17 | 4 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $147.28 – $1,276.16 | 4 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $259.05 – $1,316.75 | 4 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $169.71 – $1,470.62 | 4 |
| Chromosome analys placenta CPT 88267 | not published | not published | $184.80 – $1,577.74 | 4 |
| Chromosome banding study CPT 88283 | not published | not published | $67.23 – $137.20 | 4 |
| Chromosome count additional CPT 88285 | not published | not published | $26.37 – $141.63 | 4 |
| Chromosome karyotype study CPT 88280 | not published | not published | $32.80 – $220.28 | 4 |
| Chromosome study additional CPT 88289 | not published | not published | $33.74 – $77.94 | 4 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $12.21 – $105.82 | 4 |
| Chylomicron screen, bf - sendout CPT 82664 | not published | not published | $60.27 – $255.96 | 4 |
| Cidofovir injection HCPCS J0740 | not published | not published | $549.57 – $1,121.93 | 4 |
| Cilastatin sodium injection HCPCS J0743 | $84.15 | $165.00 | $14.67 – $20.31 | 3 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $576,724.91 – $1,189,314.00 | 3 |
| Cinacalcet 30 mg tablet HCPCS J0604 | not published | not published | $1.30 – $2.13 | 2 |
| Cine/video x-rays CPT 76120 | not published | not published | $145.47 – $264.89 | 4 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $197.59 – $222.85 | 2 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $145.35 | $285.00 | $4.20 – $19.10 | 3 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $40.53 – $73.06 | 2 |
| Circum 28 days or older CPT 54161 | $3,765.84 | $7,384.00 | $2,908.69 – $6,732.00 | 5 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $970.26 – $6,732.00 | 5 |
| Circumcision (newborn) CPT 54150 | $3,145.68 | $6,168.00 | $2,238.00 – $6,732.00 | 5 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $283.72 | $556.32 | $5.72 – $57.31 | 3 |
| C-kit mutation liquid tumor - sendout CPT 81272 | not published | not published | $322.92 – $2,159.22 | 4 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | not published | not published | $8.55 – $73.91 | 4 |
| C-laminoplasty w/graft/plate CPT 63051 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $40,177.80 | $78,780.00 | not published | 0 |
| Clamp neck artery CPT 61703 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Claviculectomy partial CPT 23120 | not published | not published | $4,552.87 – $11,377.00 | 5 |
| Claviculectomy total CPT 23125 | not published | not published | $4,552.87 – $11,377.00 | 5 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $750.46 – $5,318.00 | 5 |
| Clearance of airways CPT 31720 | $425.85 | $835.00 | $304.70 – $4,042.00 | 5 |
| Clearance of airways CPT 31725 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Clearance of tear duct CPT 68530 | not published | not published | $441.66 – $4,042.00 | 5 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $185.13 – $188.91 | 2 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $185.13 – $188.91 | 2 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $185.13 – $188.91 | 2 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $145.35 | $285.00 | $1.67 – $3.46 | 3 |
| Clip ligating vesolock lg HCPCS C1760 | $6,434.67 | $12,617.00 | not published | 0 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Cllr miami j sm HCPCS L0174 | $928.84 | $1,821.26 | not published | 0 |
| Cl mult vsd w/rem pul band CPT 33677 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | not published | not published | $10.72 – $167.67 | 4 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $104.31 | $204.52 | $32.40 – $69.27 | 3 |
| Close bladder-uterus fistula CPT 51920 | not published | not published | $2,238.00 – $19,505.00 | 4 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Close chest after drainage CPT 32810 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $1,446.87 | $2,837.00 | $343.23 – $4,042.00 | 5 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $3,102.84 | $6,084.00 | $1,716.00 – $4,042.00 | 5 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | $3,066.12 | $6,012.00 | $2,237.46 – $4,737.00 | 5 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | $451.35 | $885.00 | $343.23 – $4,042.00 | 5 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $5,397.33 | $10,583.00 | $2,237.46 – $6,732.00 | 5 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $448.80 | $880.00 | $343.23 – $4,042.00 | 5 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $2,437.29 | $4,779.00 | $1,716.00 – $4,042.00 | 5 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $836.40 | $1,640.00 | $343.23 – $4,042.00 | 5 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $2,158.97 – $6,682.00 | 5 |
| Closed tx orbit without manipulj CPT 21400 | $989.91 | $1,941.00 | $750.46 – $4,042.00 | 5 |
| Closed tx orbit w/manipulj CPT 21401 | $3,006.96 | $5,896.00 | $2,158.97 – $4,737.00 | 5 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $1,958.40 | $3,840.00 | $2,237.46 – $4,737.00 | 5 |
| Closed tx septal&nose fx CPT 21337 | $6,161.82 | $12,082.00 | $2,995.00 – $4,737.00 | 5 |
| Closed tx sesamoid fx 28530 CPT 28530 | $448.80 | $880.00 | $343.23 – $4,042.00 | 5 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $448.80 | $880.00 | $343.23 – $4,042.00 | 5 |
| Closed tx vert fx w/manj CPT 22315 | $6,486.18 | $12,718.00 | $2,995.00 – $4,737.00 | 5 |
| Close kidney-skin fistula CPT 50520 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $894.54 | $1,754.00 | $329.57 – $4,042.00 | 5 |
| Close mastoid fistula CPT 69700 | not published | not published | $2,158.97 – $5,318.00 | 5 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $2,238.00 – $15,575.00 | 5 |
| Close mult vsd CPT 33675 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Close mult vsd w/resection CPT 33676 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Close nephrovisceral fistula CPT 50525 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Close nephrovisceral fistula CPT 50526 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Close tear duct opening CPT 68760 | not published | not published | $441.66 – $4,042.00 | 5 |
| Close tear duct opening CPT 68761 | not published | not published | $441.66 – $4,042.00 | 5 |
| Close tear system fistula CPT 68770 | not published | not published | $2,741.00 – $4,233.00 | 5 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $15.68 – $78.88 | 4 |
| Clos txnose fx without stablz 21315 CPT 21315 | $3,369.57 | $6,607.00 | $2,158.97 – $4,737.00 | 5 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $1,063.86 | $2,086.00 | $750.46 – $4,042.00 | 5 |
| Closure of eyelid by suture CPT 67875 | $1,890.57 | $3,707.00 | $1,387.12 – $4,737.00 | 5 |
| Closure of salivary fistula CPT 42600 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Closure of valve CPT 33600 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Closure of valve CPT 33602 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Closure paravalvlr leak pq CPT 33999 | $24,176.55 | $47,405.00 | $872.87 – $2,741.00 | 4 |
| Closure ureter/bowel fistula CPT 50930 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Closure ureter/skin fistula CPT 50920 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $18.55 – $160.83 | 4 |
| Clot factor viii reltd antgn CPT 85244 | $91.80 | $180.00 | $20.01 – $173.42 | 4 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $18.55 – $160.83 | 4 |
| Clot factor xii hageman CPT 85280 | not published | not published | $18.96 – $169.82 | 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.