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 |
|---|---|---|---|---|
| Cytarabine liposome inj HCPCS J9098 | not published | not published | $466.28 – $879.05 | 2 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,173.98 – $2,320.00 | 4 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $41.53 – $1,837.84 | 4 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $39.89 – $1,565.57 | 4 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,136.80 – $3,454.46 | 4 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $882.00 – $2,281.88 | 4 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,791.81 – $2,527.06 | 4 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $11.74 – $78.88 | 4 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $226.44 | $444.00 | $14.10 – $125.91 | 4 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $45.97 | $90.13 | $16.51 – $141.57 | 4 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.15 – $79.77 | 4 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $965.20 – $3,895.82 | 4 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $29.43 – $170.29 | 4 |
| Cyto/molecular report CPT 88291 | not published | not published | $69.30 – $166.32 | 3 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $24.86 – $130.82 | 4 |
| Cytopath c/v automated CPT 88147 | not published | not published | $49.55 – $101.12 | 4 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $27.09 – $57.20 | 4 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $18.17 – $94.54 | 4 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $14.36 – $52.59 | 4 |
| Cytopath c/v manual CPT 88150 | not published | not published | $18.17 – $45.38 | 4 |
| Cytopath c/v redo CPT 88153 | not published | not published | $23.55 – $57.20 | 4 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $22.58 – $135.90 | 4 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $40.25 – $48.10 | 4 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $275.40 | $540.00 | $72.51 – $388.02 | 4 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | not published | not published | $26.08 – $177.67 | 4 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $130.05 | $255.00 | $19.85 – $124.08 | 4 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $88.23 | $173.00 | $51.97 – $66.86 | 4 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $110.67 | $217.00 | $51.97 – $66.86 | 4 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $44.37 | $87.00 | $14.44 – $38.05 | 3 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $208.08 | $408.00 | $91.29 – $287.00 | 4 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $391.68 | $768.00 | $72.51 – $98.94 | 4 |
| Cytopath smear other source CPT 88160 | $118.83 | $233.00 | $40.25 – $45.98 | 4 |
| Cytopath smear other source CPT 88162 | $99.45 | $195.00 | $72.51 – $98.94 | 4 |
| Cytopath smear oth prep screen & interp CPT 88161 | $98.43 | $193.00 | $40.25 – $45.98 | 4 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $18.17 – $57.20 | 4 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $18.17 – $45.38 | 4 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $41.38 – $84.44 | 4 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $18.17 – $57.20 | 4 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $77.08 – $300.10 | 4 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $29.09 – $260.46 | 4 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $237.06 – $2,053.16 | 4 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $9.01 – $18.36 | 3 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $17.43 – $620.92 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $2,496.02 | $4,894.15 | $14.70 – $33.48 | 4 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $32.09 – $184.82 | 3 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $424.67 | $832.68 | $0.06 – $0.46 | 3 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.10 – $0.74 | 3 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $53.93 – $113.93 | 4 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | not published | not published | $3.01 – $41.73 | 4 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $3.01 – $41.73 | 4 |
| Dark field exam spec collj CPT 87164 | not published | not published | $10.53 – $94.24 | 4 |
| Dark field exam without collj CPT 87166 | not published | not published | $11.07 – $99.09 | 4 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $255.97 – $535.39 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $597.34 | $1,171.26 | $52.79 – $111.65 | 3 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $90.14 – $111.26 | 2 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $279.18 – $1,716.00 | 3 |
| D&c after delivery 59160 CPT 59160 | $6,160.80 | $12,080.00 | $3,423.00 – $6,732.00 | 5 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $6,124.08 | $12,008.00 | $2,995.00 – $6,732.00 | 5 |
| Dch glucoscan CPT 82948 | not published | not published | $4.94 – $27.71 | 4 |
| Dch pulmonary stress test CPT 94621 | not published | not published | $405.34 – $529.83 | 3 |
| Dch validity tests CPT 81002 | $56.61 | $111.00 | $3.41 – $20.86 | 4 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $2,717.15 – $11,377.00 | 5 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $4,613.34 – $11,377.00 | 5 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| D&c of cervical stump CPT 57558 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Deamidated gliadin antibody iga CPT 86258 | $43.35 | $85.00 | $11.81 – $27.24 | 4 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $1,258.68 | $2,468.00 | $565.65 – $4,042.00 | 5 |
| Debridement (>20 cm) charge pt CPT 97598 | $345.78 | $678.00 | $691.00 – $12,908.00 | 3 |
| Debridement bone <= 20 sq cm CPT 11044 | $3,247.68 | $6,368.00 | $2,298.14 – $4,042.00 | 5 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $905.76 | $1,776.00 | $1,716.00 – $12,908.00 | 3 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,359.15 | $2,665.00 | $1,716.00 – $12,908.00 | 3 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $696.15 | $1,365.00 | $565.65 – $4,042.00 | 5 |
| Debride nail1-5 11720 CPT 11720 | $124.95 | $245.00 | $82.09 – $4,042.00 | 5 |
| Debride nail6 or more 11721 CPT 11721 | $124.95 | $245.00 | $82.09 – $4,042.00 | 5 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $1,406.07 | $2,757.00 | $985.34 – $4,042.00 | 5 |
| Debride skin bone at fx site CPT 11012 | $5,595.21 | $10,971.00 | $2,741.00 – $4,124.29 | 5 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $957.78 | $1,878.00 | $1,716.00 – $12,908.00 | 3 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $279.18 – $4,042.00 | 5 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $1,358.64 | $2,664.00 | $985.34 – $4,042.00 | 5 |
| Debr inf skin add-on 11001 CPT 11001 | $278.97 | $547.00 | $691.00 – $12,908.00 | 4 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,034.79 | $2,029.00 | $1,028.39 – $4,042.00 | 5 |
| Decalcification CPT 88311 | $68.34 | $134.00 | $18.04 – $39.80 | 3 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $3.53 – $35.80 | 3 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $648.72 | $1,272.00 | $459.61 – $4,042.00 | 5 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $2,237.46 – $11,377.00 | 5 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Decompress fasciotomyhand 26037 CPT 26037 | $6,486.18 | $12,718.00 | $2,995.00 – $9,773.00 | 5 |
| Decompress fingers/hand CPT 26035 | not published | not published | $2,995.00 – $9,773.00 | 5 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decompression fasct forearm CPT 24495 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Decompression of leg CPT 27892 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decompression of leg CPT 27893 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decompression of leg CPT 27894 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decompression of lower leg CPT 27600 | $6,447.42 | $12,642.00 | $3,423.00 – $6,732.00 | 5 |
| Decompression of lower leg CPT 27601 | not published | not published | $3,423.00 – $6,732.00 | 5 |
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.