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 |
|---|---|---|---|---|
| Crnec sopl xpl/dcmpr crl nrv CPT 61458 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Crnec stpl sctj cmprn/dcmprn CPT 61450 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Crnec treph exc brn abs sttl CPT 61514 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Crnec treph exc cyst sttl CPT 61516 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Crnop skull defect>5 cm diam CPT 62141 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Crnop w/autograft<5 cm diam CPT 62146 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Crnop w/autograft>5 cm diam CPT 62147 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Cromolyn sodium noncomp unit HCPCS J7631 | not published | not published | $0.46 – $0.62 | 3 |
| Cross-over vein graft CPT 34520 | not published | not published | $5,318.00 – $15,575.00 | 5 |
| Crotalidae poly immune fab HCPCS J0840 | $2,882.23 | $5,651.44 | $1,804.20 – $3,774.99 | 4 |
| Crtj pericardial window/prtl resecj w/drg/bx CPT 33025 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Cryoablate prostate CPT 55873 | not published | not published | $8,992.00 – $20,488.00 | 5 |
| Cryocautery of cervix 57511 CPT 57511 | not published | not published | $424.02 – $4,042.00 | 5 |
| Cryofibrinogen qualitative - sendout CPT 82585 | not published | not published | $13.86 – $75.28 | 4 |
| Cryoprecipitate each unit HCPCS P9012 | $267.75 | $525.00 | not published | 0 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $508.15 – $1,256.40 | 4 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $237.06 – $584.13 | 4 |
| Cryopreservation sperm CPT 89259 | not published | not published | $237.06 – $508.15 | 4 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $613.88 – $4,042.00 | 5 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $72.51 – $3,260.01 | 4 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | not published | not published | $279.18 – $4,042.00 | 5 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $82.09 – $1,716.00 | 4 |
| Cryptococcus abs qn - sendout CPT 86641 | $23.97 | $47.00 | $14.12 – $107.89 | 4 |
| Cryptosporidium antigen CPT 87272 | $52.53 | $103.00 | $11.74 – $78.88 | 4 |
| Crystal identification light microscopy CPT 89060 | $94.35 | $185.00 | $7.18 – $62.69 | 4 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $3,423.00 – $9,773.00 | 2 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $3,423.00 – $24,668.00 | 3 |
| Csf leakage imaging CPT 78650 | not published | not published | $1,150.60 – $2,035.50 | 4 |
| Csf shunt reprogram 62252 CPT 62252 | $608.94 | $1,194.00 | $427.37 – $4,042.00 | 5 |
| Csf ventriculography CPT 78635 | not published | not published | $635.84 – $770.94 | 4 |
| Cstb gene detc abnor allele CPT 81188 | not published | not published | $134.26 – $715.60 | 4 |
| Cstb gene full gene sequence CPT 81189 | not published | not published | $269.33 – $1,435.52 | 4 |
| Cstb gene known famil vrnt CPT 81190 | not published | not published | $181.50 – $967.37 | 4 |
| CT 3d report other modality w/workstation CPT 76377 | $518.67 | $1,017.00 | $380.04 – $892.63 | 2 |
| Cta abdomen without & /or w/contrast CPT 74175 | $9,633.39 | $18,889.00 | $244.06 – $2,155.32 | 4 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $9,633.39 | $18,889.00 | $244.06 – $2,155.32 | 4 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $9,732.33 | $19,083.00 | $244.06 – $1,891.97 | 4 |
| Cta neck without &/or w/contrast CPT 70498 | $7,986.60 | $15,660.00 | $244.06 – $1,833.23 | 4 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $13,776.63 | $27,013.00 | $485.45 – $3,158.79 | 4 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,874.47 | $7,597.00 | $244.06 – $2,242.23 | 4 |
| CT Angiogram of the Head CPT 70496 | $7,906.53 | $15,503.00 | $244.06 – $1,833.23 | 4 |
| CT angio hrt w/3d image CPT 75574 | $2,595.39 | $5,089.00 | $291.55 – $1,729.36 | 4 |
| CT angio pelvis CPT 72191 | $9,633.39 | $18,889.00 | $244.06 – $2,155.32 | 4 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $9,633.39 | $18,889.00 | $244.06 – $1,891.97 | 4 |
| CT bone density axial CPT 77078 | not published | not published | $121.09 – $722.40 | 4 |
| CT cerebral perf w cont & prcssng CPT 70473 | not published | not published | $244.06 – $249.04 | 2 |
| CT colonography dx CPT 74261 | $641.07 | $1,257.00 | $145.47 – $1,253.94 | 4 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $244.06 – $1,908.04 | 4 |
| CT colonography screening CPT 74263 | not published | not published | $332.01 – $3,792.14 | 4 |
| CT guidance for needle placement CPT 77012 | $4,276.35 | $8,385.00 | $746.91 – $2,061.60 | 2 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,160.76 | $2,276.00 | $542.05 – $786.57 | 2 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $343.23 – $3,423.00 | 4 |
| CT guid parench tis ablat CPT 77013 | $5,221.89 | $10,239.00 | $2,165.12 – $2,482.19 | 2 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $261.12 | $512.00 | $121.09 – $288.76 | 4 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $266.73 | $523.00 | $291.55 – $1,618.51 | 4 |
| CT hrt w/3d image CPT 75572 | $8,998.95 | $17,645.00 | $291.55 – $1,142.27 | 4 |
| CT limited or localized follow-up study CPT 76380 | $1,779.90 | $3,490.00 | $121.09 – $800.51 | 4 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $3,798.99 | $7,449.00 | $244.06 – $1,472.15 | 4 |
| CT lower extremity without contrast (both sides) CPT 73700 | $3,185.46 | $6,246.00 | $145.47 – $1,237.99 | 4 |
| CT lwr extremity w/o&w/dye CPT 73702 | $3,933.12 | $7,712.00 | $244.06 – $1,847.36 | 4 |
| CT neck soft tissue w/contrast CPT 70491 | $2,857.02 | $5,602.00 | $244.06 – $1,414.78 | 4 |
| CT neck soft tissue without contrast CPT 70490 | $2,617.83 | $5,133.00 | $145.47 – $1,182.15 | 4 |
| CT neck soft tissue without & w/contrast CPT 70492 | $3,142.11 | $6,161.00 | $244.06 – $1,763.57 | 4 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $3,449.13 | $6,763.00 | $244.06 – $1,763.57 | 4 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $3,134.97 | $6,147.00 | $244.06 – $1,414.78 | 4 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $3,024.30 | $5,930.00 | $145.47 – $1,182.15 | 4 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $472.26 | $926.00 | $329.57 – $4,042.00 | 5 |
| CT scan for localization CPT 77011 | $6,093.99 | $11,949.00 | $2,073.13 – $2,965.08 | 2 |
| CT scan for therapy guide CPT 77014 | $704.82 | $1,382.00 | $680.92 – $1,047.13 | 2 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $9,797.10 | $19,210.00 | $485.45 – $2,213.58 | 4 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $8,120.73 | $15,923.00 | $485.45 – $1,674.35 | 4 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $7,523.52 | $14,752.00 | $332.01 – $877.44 | 4 |
| CT thoracic spine w/contrast CPT 72129 | $4,138.14 | $8,114.00 | $244.06 – $1,760.02 | 4 |
| CT thoracic spine without contrast CPT 72128 | $3,828.06 | $7,506.00 | $145.47 – $1,472.15 | 4 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $606.39 | $1,189.00 | $129.44 – $613.44 | 4 |
| CT t-spine w /wo contrast CPT 72130 | $4,251.87 | $8,337.00 | $244.06 – $2,193.13 | 4 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $3,114.06 | $6,106.00 | $485.45 – $1,472.15 | 4 |
| CT upper extremity without contrast (both sides) CPT 73200 | $3,058.47 | $5,997.00 | $145.47 – $1,237.99 | 4 |
| CT uppr extremity w/o&w/dye CPT 73202 | $3,486.87 | $6,837.00 | $244.06 – $1,847.36 | 4 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $237.06 – $3,958.83 | 4 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $237.06 – $1,299.91 | 4 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| Culture aerobic additional method definitive id each CPT 87077 | $167.28 | $328.00 | $7.92 – $70.85 | 4 |
| Culture afb any source CPT 87116 | $159.63 | $313.00 | $10.58 – $94.66 | 4 |
| Culture anaerobic additional method definitive id each CPT 87076 | $147.39 | $289.00 | $7.92 – $110.55 | 4 |
| Culture anaerobic except blood CPT 87075 | $226.95 | $445.00 | $9.28 – $83.02 | 4 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $9.47 – $41.36 | 4 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $38.98 – $108.13 | 3 |
| Culture bact stool aero addl path ea CPT 87046 | $103.02 | $202.00 | $9.25 – $20.68 | 4 |
| Culture body fluid CPT 87070 | $272.85 | $535.00 | $8.45 – $75.51 | 4 |
| Culture fungi definitive id mold CPT 87107 | $44.88 | $88.00 | $10.11 – $90.58 | 4 |
| Culture fungi definitive id yeast CPT 87106 | $167.28 | $328.00 | $10.11 – $90.58 | 4 |
| Culture fungi other (except blood) CPT 87102 | $152.49 | $299.00 | $8.24 – $73.74 | 4 |
| Culture fungi skin/hair/nail CPT 87101 | $104.55 | $205.00 | $7.56 – $67.65 | 4 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $14.32 – $96.08 | 4 |
| Culture mycoplasma any source CPT 87109 | $108.27 | $212.30 | $15.08 – $135.01 | 4 |
| Culture of specimen by kit CPT 87084 | not published | not published | $26.53 – $75.51 | 4 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.69 – $41.36 | 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.