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 |
|---|---|---|---|---|
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,318.00 – $15,575.00 | 5 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $2,238.00 – $15,202.00 | 4 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.07 – $145.24 | 2 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $273.42 – $1,480.37 | 4 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $269.33 – $1,435.52 | 4 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $134.26 – $715.60 | 4 |
| Dna antibody native/double stranded CPT 86225 | $3.88 | $7.60 | $13.47 – $120.60 | 4 |
| Dna gardnerella CPT 87510 | not published | not published | $19.65 – $170.29 | 4 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.30 – $170.29 | 4 |
| Dna probe gc CPT 87590 | not published | not published | $26.34 – $170.29 | 4 |
| Dna trichomonas CPT 87660 | not published | not published | $19.65 – $176.61 | 4 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $154.02 | $302.00 | $15.95 – $17.52 | 3 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $307.24 | $602.43 | $1.22 – $27.73 | 3 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $1.11 – $110.98 | 4 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $7.65 – $20.68 | 2 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $88.01 – $309.11 | 2 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $145.35 | $285.00 | $0.46 – $1.53 | 3 |
| Doppler echo complete CPT 93320 | $972.06 | $1,906.00 | $265.32 – $526.11 | 2 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $5,060.22 | $9,922.00 | $1,620.56 – $1,716.00 | 2 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $4,159.05 | $8,155.00 | $300.45 – $697.76 | 3 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $2,034.39 | $3,989.00 | $185.13 – $369.77 | 3 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $1.21 – $1.40 | 2 |
| Dornase alfa non-comp unit HCPCS J7639 | $386.42 | $757.68 | $18.27 – $115.22 | 3 |
| Dornhoffer fixed part w/window HCPCS L8614 | $43,731.99 | $85,749.00 | not published | 0 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $242.14 – $516.30 | 4 |
| Double transfer toe-hand CPT 26554 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $751.49 | $1,473.51 | $6.31 – $71.13 | 3 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $900.74 | $1,766.16 | $70.42 – $693.20 | 4 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $126.66 | $248.36 | $0.24 – $0.26 | 2 |
| Dpyd gene common variants CPT 81232 | not published | not published | $171.31 – $1,097.95 | 4 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,160.76 | $2,276.00 | $691.00 – $4,042.00 | 5 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $1,406.07 | $2,757.00 | $691.00 – $4,042.00 | 5 |
| Drainage external ear complex 69005 CPT 69005 | $3,247.68 | $6,368.00 | $2,238.00 – $4,737.00 | 5 |
| Drainage external ear simple 69000 CPT 69000 | $1,641.18 | $3,218.00 | $691.00 – $4,042.00 | 5 |
| Drainage lymph node lesion 38300 CPT 38300 | $5,595.21 | $10,971.00 | $2,238.00 – $4,737.00 | 5 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Drainage mouth roof lesion CPT 42000 | $364.14 | $714.00 | $329.57 – $4,042.00 | 5 |
| Drainage of abdomen CPT 48000 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Drainage of arm bursa 23931 CPT 23931 | $2,022.15 | $3,965.00 | $2,298.14 – $4,737.00 | 5 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $2,238.00 – $5,318.00 | 5 |
| Drainage of bone lesion CPT 26992 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Drainage of bone lesion CPT 27303 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Drainage of eye CPT 65800 | $6,547.89 | $12,839.00 | $1,716.00 – $4,042.00 | 5 |
| Drainage of eye CPT 65810 | not published | not published | $3,211.25 – $6,732.00 | 5 |
| Drainage of eye CPT 65815 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Drainage of kidney lesion CPT 50390 | $1,712.07 | $3,357.00 | $985.34 – $4,042.00 | 5 |
| Drainage of mouth lesion CPT 41005 | $450.33 | $883.00 | $329.57 – $4,042.00 | 5 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Drainage of mouth lesion CPT 41007 | $3,006.96 | $5,896.00 | $2,158.97 – $4,737.00 | 5 |
| Drainage of mouth lesion CPT 41008 | $7,271.58 | $14,258.00 | $2,238.00 – $4,737.00 | 5 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $750.46 – $4,042.00 | 5 |
| Drainage of mouth lesion CPT 41015 | $989.91 | $1,941.00 | $750.46 – $4,042.00 | 5 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $2,238.00 – $8,405.34 | 5 |
| Drainage of mouth lesion CPT 41017 | $6,161.82 | $12,082.00 | $2,238.00 – $4,737.00 | 5 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Drainage of nose lesion int 30000 CPT 30000 | $450.33 | $883.00 | $329.57 – $4,042.00 | 5 |
| Drainage of nose lesion sept 30020 CPT 30020 | $989.91 | $1,941.00 | $750.46 – $4,042.00 | 5 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Drainage of pelvis lesion 26990 CPT 26990 | $6,447.42 | $12,642.00 | $2,238.00 – $6,732.00 | 5 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Drainage of rectal abscess CPT 45005 | $2,346.00 | $4,600.00 | $1,665.08 – $4,737.00 | 5 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Drainage of salivary gland CPT 42305 | $6,161.82 | $12,082.00 | $2,995.00 – $6,732.00 | 5 |
| Drainage of salivary gland CPT 42320 | $989.91 | $1,941.00 | $750.46 – $4,042.00 | 5 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Drainage of spinal cyst CPT 63173 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Drainage of throat abscess CPT 42725 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Drainage of urethra abscess 53060 CPT 53060 | $4,017.78 | $7,878.00 | $2,908.69 – $6,732.00 | 5 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $970.26 – $6,732.00 | 5 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Drain bladder by trocar/cath CPT 51101 | $2,024.19 | $3,969.00 | $1,194.91 – $4,737.00 | 5 |
| Drain blood from under nail 11740 CPT 11740 | $684.42 | $1,342.00 | $185.13 – $4,042.00 | 5 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $2,695.86 | $5,286.00 | $2,238.00 – $4,737.00 | 5 |
| Drain cath image guided visceral pq CPT 49405 | $2,022.15 | $3,965.00 | $2,238.00 – $4,737.00 | 5 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,066.92 | $2,092.00 | $982.21 – $4,042.00 | 5 |
| Drain chest lesion CPT 21502 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Drain finger abscess;simple 26010 CPT 26010 | $544.68 | $1,068.00 | $279.18 – $4,042.00 | 5 |
| Drain lower leg bursa CPT 27604 | $6,486.18 | $12,718.00 | $2,995.00 – $6,732.00 | 5 |
| Drain lower leg lesion 27603 CPT 27603 | $5,595.21 | $10,971.00 | $2,995.00 – $6,732.00 | 5 |
| Drain neck/chest lesion 21501 CPT 21501 | $5,595.21 | $10,971.00 | $2,995.00 – $6,732.00 | 5 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $2,238.00 – $9,773.00 | 5 |
| Drain ovary abscess open CPT 58820 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Drain penis lesion CPT 54015 | $3,247.68 | $6,368.00 | $2,298.14 – $4,737.00 | 5 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Drain shoulder lesion CPT 23030 | $5,595.21 | $10,971.00 | $2,238.00 – $6,732.00 | 5 |
| Drain thigh/knee lesion 27301 CPT 27301 | $5,595.21 | $10,971.00 | $3,423.00 – $6,732.00 | 5 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $414.12 | $812.00 | $279.18 – $4,042.00 | 5 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $414.12 | $812.00 | $279.18 – $4,042.00 | 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.