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 |
|---|---|---|---|---|
| Decompression of thigh/knee CPT 27496 | $6,447.42 | $12,642.00 | $4,042.00 – $11,377.00 | 5 |
| Decompression of thigh/knee CPT 27497 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Decompression of thigh/knee CPT 27498 | not published | not published | $2,237.46 – $11,377.00 | 5 |
| Decompression of thigh/knee CPT 27499 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $2,717.15 – $9,773.00 | 5 |
| Decompression unspecified nerve 64722 CPT 64722 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Decompressive craniotomy CPT 61322 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Decompress optic nerve CPT 67570 | not published | not published | $5,470.40 – $11,377.00 | 5 |
| Decompres spinal cord;thoracic 63055 CPT 63055 | not published | not published | $6,682.00 – $15,575.00 | 5 |
| Decompress small bowel CPT 44021 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $6,682.00 – $15,575.00 | 5 |
| Decompress spinal cord thrc CPT 63064 | not published | not published | $6,682.00 – $15,575.00 | 5 |
| Decompress spine cord add-on CPT 63066 | not published | not published | $1,716.00 – $12,568.00 | 3 |
| Decomp spinal cord/transped/ad seg 63057 CPT 63057 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $188.95 | $370.49 | $16.42 – $19.38 | 3 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $2,160.56 | $4,236.40 | $0.56 – $9.37 | 4 |
| Delayed breast prosthesis 19342 CPT 19342 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Delay flap arms/legs CPT 15610 | not published | not published | $2,870.98 – $6,732.00 | 5 |
| Delay flap eye/nos/ear/lip CPT 15630 | not published | not published | $2,870.98 – $5,318.00 | 5 |
| Delay flap fccnaxghf 15620 CPT 15620 | not published | not published | $2,870.98 – $5,318.00 | 5 |
| Delay flap trunk 15600 CPT 15600 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Delivery of placenta 59414 CPT 59414 | $6,916.62 | $13,562.00 | $2,995.00 – $6,732.00 | 5 |
| Delivery only failed vbac 59620 CPT 59620 | not published | not published | $3,423.00 – $9,773.00 | 2 |
| Delivery only/pp care/failed vbac 59622 CPT 59622 | not published | not published | $3,423.00 – $9,773.00 | 2 |
| Delivery transcath fxtn dvc to endogrft w/s&i CPT 34712 | $7,746.90 | $15,190.00 | $2,238.00 – $19,505.00 | 4 |
| Demonstrate use home inr mon HCPCS G0248 | not published | not published | $185.25 – $189.04 | 2 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $385.56 | $756.00 | $159.24 – $310.92 | 3 |
| Denervation of hip joint CPT 27035 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Dengue vacc quad 3 dose subq CPT 90587 | not published | not published | $141.61 – $170.28 | 2 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $4,207.50 | $8,250.00 | $26.62 – $59.79 | 4 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $544.68 | $1,068.00 | $185.13 – $4,042.00 | 5 |
| Depo-estradiol cypionate inj HCPCS J1000 | not published | not published | $6.12 – $90.99 | 3 |
| Dermabrasion other than face CPT 15782 | not published | not published | $2,238.00 – $4,124.29 | 5 |
| Dermabrasion segmental face 15781 CPT 15781 | not published | not published | $985.34 – $4,042.00 | 5 |
| Dermabrasion suprfl any site CPT 15783 | not published | not published | $565.65 – $4,042.00 | 5 |
| Dermabrasion total face CPT 15780 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Derma-fat-fascia graft 15770 CPT 15770 | $7,088.49 | $13,899.00 | $3,423.00 – $11,377.00 | 5 |
| Derma-gide, 1 sq cm HCPCS Q4203 | not published | not published | $173.16 – $691.00 | 4 |
| Dermagraft HCPCS Q4106 | not published | not published | $50.91 – $109.52 | 2 |
| Dermal filler injection(s) HCPCS G0429 | not published | not published | $2,870.98 – $4,042.00 | 3 |
| Dermapure 1 square cm HCPCS Q4152 | not published | not published | $117.43 – $176.69 | 4 |
| Derm autograft face/nck/hf/g CPT 15135 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Derm autograft trnk/arm/leg CPT 15130 | not published | not published | $2,870.98 – $6,732.00 | 5 |
| Dermavest, plurivest sq cm HCPCS Q4153 | not published | not published | $173.16 – $275.37 | 3 |
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $173.16 – $3,536.73 | 3 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Description not available HCPCS S0013 | not published | not published | $76.22 – $76.22 | 1 |
| Design custom breast implant CPT 19396 | not published | not published | $5,318.00 – $11,377.00 | 5 |
| Design mlc device for imrt CPT 77338 | $1,983.90 | $3,890.00 | $521.01 – $2,128.20 | 3 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $95.74 | $187.73 | $8.98 – $26.71 | 3 |
| Desoxycorticosterone CPT 82633 | not published | not published | $30.36 – $263.06 | 4 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | not published | not published | $5,318.00 – $6,732.00 | 2 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | $2,261.34 | $4,434.00 | $5,318.00 – $6,732.00 | 2 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $279.18 – $4,042.00 | 5 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $279.18 – $4,042.00 | 5 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $3,437.91 | $6,741.00 | $2,717.15 – $6,732.00 | 5 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $1,462.17 | $2,867.00 | $1,716.00 – $12,908.00 | 3 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $1,665.08 – $4,042.00 | 5 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $391.68 | $768.00 | $279.18 – $4,042.00 | 5 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $279.18 – $4,042.00 | 5 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $691.00 – $4,042.00 | 5 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $808.35 | $1,585.00 | $565.65 – $4,042.00 | 5 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $691.00 – $4,737.00 | 5 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $691.00 – $12,908.00 | 4 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $808.35 | $1,585.00 | $565.65 – $4,042.00 | 5 |
| Destruction benign lesions < 14 lesions CPT 17110 | $391.68 | $768.00 | $279.18 – $4,042.00 | 5 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $1,230.71 – $4,042.00 | 5 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $1,462.17 | $2,867.00 | $1,716.00 – $12,908.00 | 3 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $3,437.91 | $6,741.00 | $2,717.15 – $6,732.00 | 5 |
| Destruction ciliary body CPT 66700 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Destruction ciliary body CPT 66720 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Destruction ciliary body CPT 66740 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $279.18 – $4,042.00 | 5 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $565.65 – $4,042.00 | 5 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $565.65 – $4,042.00 | 5 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $565.65 – $4,042.00 | 5 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $565.65 – $4,042.00 | 5 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $565.65 – $4,042.00 | 5 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $565.65 – $4,042.00 | 5 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $3,862.23 – $8,992.00 | 5 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Destruction vag lesions simple 57061 CPT 57061 | $6,055.74 | $11,874.00 | $3,423.00 – $6,732.00 | 5 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $2,870.98 – $4,737.00 | 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.