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 |
|---|---|---|---|---|
| Exc ischial pr ulc prim sutr CPT 15940 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Exc isch pr ulc prm sut ostc CPT 15941 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Exc isch pr ulc skn flp clsr CPT 15944 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Exc isch pr ulc skn flp ostc CPT 15945 | not published | not published | $2,870.98 – $9,773.00 | 5 |
| Excise anal ext tag/papilla CPT 46220 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Excise epiphyseal bar CPT 20150 | not published | not published | $4,552.87 – $11,377.00 | 5 |
| Excise foot tendon sheath CPT 28086 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excise foot tendon sheath CPT 28088 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excise ileoanal reservior CPT 45136 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Excise inferior turbinate CPT 30130 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excise intestine lesion(s) 44110 CPT 44110 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excise intraspinl lesion crv CPT 63265 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Excise intrspinl lesion crvl CPT 63270 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $2,238.00 – $10,302.82 | 5 |
| Excise intrspinl lesion lmbr CPT 63272 | not published | not published | $3,423.00 – $20,488.00 | 3 |
| Excise intrspinl lesion scrl CPT 63268 | not published | not published | $2,238.00 – $15,575.00 | 5 |
| Excise intrspinl lesion scrl CPT 63273 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Excise intrspinl lesion thrc CPT 63271 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Excise lesion testis CPT 54512 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excise lip or cheek fold CPT 40819 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Excise mandible lesion CPT 21040 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $4,042.00 – $8,405.34 | 5 |
| Excise max/zygoma mal tumor CPT 21034 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Excise oral mucosa for graft 40818 CPT 40818 | not published | not published | $750.46 – $4,042.00 | 5 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Excise parotid gland/lesion CPT 42425 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Excise parotid gland/lesion CPT 42426 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Excise pharynx lesion CPT 42808 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excise/repair mouth lesion CPT 40812 | $3,006.96 | $5,896.00 | $2,158.97 – $4,737.00 | 5 |
| Excise sacral spine tumor CPT 49215 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Excise sublingual gland CPT 42450 | not published | not published | $2,995.00 – $8,405.34 | 5 |
| Excise submaxillary gland CPT 42440 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | not published | not published | $2,298.14 – $4,737.00 | 5 |
| Excise tendon forearm/wrist CPT 25109 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Excision addl breast lesion 19126 CPT 19126 | not published | not published | $1,716.00 – $19,505.00 | 4 |
| Excision aural polyp CPT 69540 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $1,406.07 | $2,757.00 | $985.34 – $4,042.00 | 5 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $3,247.68 | $6,368.00 | $2,238.00 – $4,042.00 | 5 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $1,406.07 | $2,757.00 | $985.34 – $4,042.00 | 5 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $3,247.68 | $6,368.00 | $2,298.14 – $4,737.00 | 5 |
| Excision breast lesion CPT 19125 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excision coa w/graft CPT 33845 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Excision floor mouth lesion 41116 CPT 41116 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Excision graft abdomen CPT 35907 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Excision graft extremity CPT 35903 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Excision graft neck CPT 35901 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Excision graft thorax 35905 CPT 35905 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Excision gum each quadrant CPT 41820 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Excision hand/finger tendon CPT 26415 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Excision lesion mouth roof CPT 42107 | not published | not published | $2,995.00 – $8,405.34 | 5 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Excision of bile duct cyst CPT 47715 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of bile duct tumor CPT 47711 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of bile duct tumor CPT 47712 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Excision of bowel lesion(s) CPT 44111 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of brain tumor CPT 61545 | not published | not published | $5,530.00 – $12,568.00 | 3 |
| Excision of esophagus lesion CPT 43100 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of esophagus lesion CPT 43101 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Excision of gum flap CPT 41821 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Excision of gum lesion CPT 41822 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Excision of gum lesion CPT 41823 | not published | not published | $4,042.00 – $8,405.34 | 5 |
| Excision of gum lesion CPT 41826 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excision of gum lesion CPT 41827 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Excision of gum lesion CPT 41828 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Excision of gum lesion 41825 CPT 41825 | $6,161.82 | $12,082.00 | $2,995.00 – $4,737.00 | 5 |
| Excision of lesion of mesentery 44820 CPT 44820 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of lingual tonsil CPT 42870 | not published | not published | $3,423.00 – $8,405.34 | 5 |
| Excision of meckels diverticulum 44800 CPT 44800 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of mouth lesion complex 40816 CPT 40816 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excision of neck cyst CPT 42815 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excision of penis lesion(s) 54060 CPT 54060 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Excision of rectal lesion CPT 45160 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excision of rectal prolapse CPT 45135 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision of rectal stricture CPT 45150 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Excision of salivary cyst CPT 42408 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excision of skull/sutures CPT 61558 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Excision of skull/sutures CPT 61559 | not published | not published | $4,233.00 – $12,568.00 | 3 |
| Excision of skull tumor CPT 61563 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Excision of skull tumor CPT 61564 | not published | not published | $4,233.00 – $9,773.00 | 3 |
| Excision of stomach lesion CPT 43610 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Excision of stomach lesion CPT 43611 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Excision of tongue lesion CPT 41112 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Excision of tongue lesion CPT 41114 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Excision of tonsil tags CPT 42860 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Excision of uvula CPT 42140 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Excision of vaginal septum 57130 CPT 57130 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Excision olecranon bursa CPT 24105 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Excision perinephric cyst CPT 50290 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Excision radial head CPT 24130 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Excision tongue lesion without closure 41110 CPT 41110 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $2,298.14 – $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.