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 |
|---|---|---|---|---|
| Egd balloon dil esoph30 mm/> CPT 43233 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Egd control bleeding any CPT 43255 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd dilate stricture CPT 43245 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd endo mucosal resection CPT 43254 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Egd endoscopic stent place CPT 43266 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Egd esophagogastrc fndoplsty CPT 43210 | not published | not published | $2,238.00 – $15,092.89 | 5 |
| Egd flx trnsorl dplmnt balo CPT 43290 | not published | not published | $691.00 – $4,737.00 | 5 |
| Egd flx trnsorl rmvl balo CPT 43291 | not published | not published | $691.00 – $4,737.00 | 5 |
| Egd guide wire insertion CPT 43248 | not published | not published | $1,262.04 – $4,737.00 | 5 |
| Egd injection varices CPT 43243 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd lesion ablation CPT 43270 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd optical endomicroscopy CPT 43252 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd remove foreign body CPT 43247 | $1,601.91 | $3,141.00 | $1,262.04 – $4,737.00 | 5 |
| Egd remove lesion snare CPT 43251 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | $3,379.77 | $6,627.00 | $2,670.09 – $4,737.00 | 5 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Egd varices ligation CPT 43244 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Egd w/thrml txmnt gerd CPT 43257 | not published | not published | $4,042.00 – $6,732.00 | 5 |
| Egd w/transmural drain cyst CPT 43240 | not published | not published | $2,995.00 – $8,619.83 | 5 |
| Egfr gene com variants CPT 81235 | not published | not published | $72.91 – $649.16 | 4 |
| Ehrlicha chaffeensis amp prb CPT 87484 | not published | not published | $34.39 – $186.18 | 4 |
| Eia hiv-1/hiv-2 screen HCPCS G0432 | not published | not published | $19.18 – $91.41 | 4 |
| EKG (Electrocardiogram) CPT 93000 | not published | not published | $117.54 – $234.93 | 2 |
| EKG for initial prevent exam g0403 HCPCS G0403 | not published | not published | $234.93 – $234.93 | 1 |
| EKG interpret & report preve g0405 HCPCS G0405 | not published | not published | $90.17 – $90.17 | 1 |
| EKG tracing for initial prev HCPCS G0404 | not published | not published | $40.25 – $157.17 | 3 |
| Elbow arthroscopy CPT 29830 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Elbow arthroscopy/surgery CPT 29834 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Elbow arthroscopy/surgery CPT 29835 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Elbow arthroscopy/surgery CPT 29836 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Elbow arthroscopy/surgery CPT 29837 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Elbow arthroscopy/surgery CPT 29838 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Elec analys infus pump w/reprog 62368 CPT 62368 | $778.77 | $1,527.00 | $427.37 – $4,042.00 | 5 |
| Elec stim unattend for press HCPCS G0281 | not published | not published | $11.91 – $12.15 | 2 |
| Elect analysis of infusion pump 62367 CPT 62367 | not published | not published | $427.37 – $4,042.00 | 5 |
| Elect anlys sp inf pmp w/reprg&fill 62369 CPT 62369 | not published | not published | $427.37 – $4,042.00 | 5 |
| Electrd sq emblem s-icd HCPCS C1896 | $16,379.04 | $32,115.77 | not published | 0 |
| Electrical bone stim 20974 CPT 20974 | not published | not published | $50.05 – $4,042.00 | 5 |
| Electrical stimulation/unattended 97014 CPT 97014 | $130.05 | $255.00 | not published | 0 |
| Electric stim/w chemodenervation 95873 CPT 95873 | not published | not published | $56.25 – $56.25 | 1 |
| Electrocochleography CPT 92584 | not published | not published | $179.04 – $182.70 | 2 |
| Electroconvulsive therapy 90870 CPT 90870 | not published | not published | $1,194.91 – $1,219.29 | 2 |
| Electrocorticography durng sx CPT 95829 | not published | not published | $10,946.58 – $10,946.58 | 1 |
| Electrode stimulation brain CPT 95961 | not published | not published | $385.07 – $1,219.29 | 3 |
| Electroejaculation CPT 55870 | not published | not published | $1,281.61 – $4,042.00 | 5 |
| Electrogastrography CPT 91132 | not published | not published | $300.45 – $1,716.00 | 4 |
| Electrogastrography w/test CPT 91133 | not published | not published | $185.13 – $1,716.00 | 4 |
| Electrolyte panel CPT 80051 | $201.45 | $395.00 | $6.87 – $61.57 | 4 |
| Electromagntic tx for ulcers HCPCS G0329 | not published | not published | $11.14 – $11.37 | 2 |
| Electronic analysis with brain program ea add 15 min 95984 CPT 95984 | not published | not published | $300.69 – $300.69 | 1 |
| Electronic analysis with brain program first 15 min 95983 CPT 95983 | not published | not published | $132.29 – $344.95 | 3 |
| Electron microscopy diagnostic CPT 88348 | $1,205.13 | $2,363.00 | $291.65 – $1,256.40 | 4 |
| Electro-oculography w/i&r CPT 92270 | not published | not published | $79.83 – $188.91 | 3 |
| Electrophysiologic study CPT 93624 | not published | not published | $9,773.00 – $15,575.00 | 4 |
| Electrophysiology evaluation CPT 93619 | $16,984.53 | $33,303.00 | $9,773.00 – $15,575.00 | 4 |
| Electrophysiology evaluation CPT 93620 | $21,239.46 | $41,646.00 | $9,773.00 – $15,575.00 | 4 |
| Electrophysiology evaluation CPT 93621 | $13,014.18 | $25,518.00 | $1,716.00 – $25,815.00 | 3 |
| Electrophysiology evaluation CPT 93622 | $8,966.31 | $17,581.00 | $1,716.00 – $25,815.00 | 3 |
| Electrophysiology evaluation CPT 93641 | $33,471.30 | $65,630.00 | $1,716.00 – $25,815.00 | 3 |
| Electrophysiology evaluation CPT 93642 | $26,546.52 | $52,052.00 | $1,694.16 – $4,737.00 | 4 |
| Electrophysiology evaluation CPT 93644 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Electrophys map 3d add-on CPT 93613 | $8,725.08 | $17,108.00 | $1,716.00 – $4,042.00 | 2 |
| Elisa hiv-1/hiv-2 screen HCPCS G0433 | not published | not published | $17.92 – $91.41 | 4 |
| Elliotts b solution per ml HCPCS J9175 | not published | not published | $4.92 – $24.81 | 2 |
| Elosulfase alfa, injection HCPCS J1322 | not published | not published | $305.66 – $631.97 | 4 |
| Elotuzumab 300 mg intravenous solution HCPCS J9176 | not published | not published | $7.88 – $16.62 | 4 |
| Elranatamab-bcmm 40 mg/ml subcutaneous solution HCPCS J1323 | not published | not published | $183.06 – $393.41 | 4 |
| Embedded ip cath exit-site 49436 CPT 49436 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Emboli detcj wo IV mbubb njx CPT 93897 | not published | not published | $1,003.12 – $1,003.12 | 1 |
| Embolization s&i CPT 75894 | $4,319.19 | $8,469.00 | $6,026.76 – $6,206.11 | 2 |
| Embo or occlude vascular arterial s&i CPT 37242 | $22,849.02 | $44,802.00 | $691.00 – $25,507.82 | 5 |
| Embo or occlude vascular hemorrhage s&i CPT 37244 | $22,849.02 | $44,802.00 | $691.00 – $20,488.00 | 5 |
| Embo or occlude vascular tumor/organ/infarct s&i CPT 37243 | $14,433.51 | $28,301.00 | $691.00 – $20,488.00 | 5 |
| Embo or occlude vascular venous s&i CPT 37241 | $22,849.02 | $44,802.00 | $691.00 – $20,488.00 | 5 |
| Embryo hatching CPT 89253 | not published | not published | $237.06 – $1,181.74 | 4 |
| Embryo transfer intrauterine CPT 58974 | not published | not published | $1,281.61 – $4,042.00 | 5 |
| Emb/throm/fempop/aor/ilia/leg inc 34201 CPT 34201 | $7,978.95 | $15,645.00 | $6,682.00 – $15,575.00 | 5 |
| Emb/throm/pop-tib-pero art/leg inc 34203 CPT 34203 | not published | not published | $6,682.00 – $15,575.00 | 5 |
| Emb w/colposcopy 58110 CPT 58110 | not published | not published | $691.00 – $12,908.00 | 4 |
| Emb without cervical dilation 58100 CPT 58100 | $385.56 | $756.00 | $281.31 – $4,042.00 | 5 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | not published | not published | $185.13 – $233.28 | 3 |
| Emg 3 ext w-w/o paraspinal area 95863 CPT 95863 | not published | not published | $179.04 – $294.90 | 3 |
| Emg cranial nerve bilateral CPT 95868 | not published | not published | $217.97 – $306.58 | 3 |
| Emg needle test 1-extremity CPT 95860 | not published | not published | $119.95 – $188.91 | 3 |
| Emg needle test 4-extremities CPT 95864 | not published | not published | $179.04 – $557.96 | 3 |
| Emg thor paraspinal without t1/t2 CPT 95869 | not published | not published | $67.42 – $306.58 | 3 |
| Encephalitis, california igg/igm CPT 86651 | $43.79 | $85.86 | $12.93 – $115.75 | 4 |
| Encephalitis, st louis igg/igm CPT 86653 | $43.76 | $85.81 | $12.93 – $115.75 | 4 |
| Encephalitis, western equine igg/igm CPT 86654 | $68.89 | $135.08 | $12.93 – $115.75 | 4 |
| Endo abl/incom vein/ext/laser/#1 36478 CPT 36478 | not published | not published | $4,393.52 – $11,377.00 | 5 |
| Endo abl/incom vein/ext/rad fre/#1 36475 CPT 36475 | not published | not published | $4,393.52 – $11,377.00 | 5 |
| Endo assay seven anal CPT 81506 | not published | not published | $67.54 – $365.69 | 4 |
| Endo cath bile duct s&i CPT 74328 | $1,398.93 | $2,743.00 | $574.34 – $786.57 | 2 |
| Endo cath panc duct s&i CPT 74329 | not published | not published | $457.56 – $786.57 | 2 |
| Endocerv curettage w/scope 57456 CPT 57456 | not published | not published | $424.02 – $4,042.00 | 5 |
| Endocervical curettage 57505 CPT 57505 | not published | not published | $691.00 – $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.