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 |
|---|---|---|---|---|
| F-18 fluciclovine per mci HCPCS A9588 | not published | not published | $315.82 – $577.10 | 4 |
| F-18 sodium fluoride HCPCS A9580 | not published | not published | $563.32 – $563.32 | 1 |
| F9 full gene sequence CPT 81238 | not published | not published | $588.00 – $3,768.57 | 4 |
| Face bone graft CPT 21210 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Facial bones <3 CPT 70140 | $1,233.18 | $2,418.00 | $121.09 – $155.46 | 4 |
| Facial nerve function test CPT 92516 | not published | not published | $300.45 – $306.58 | 2 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $691.00 – $6,732.00 | 4 |
| Factor ix CPT 85250 | $93.87 | $184.05 | $18.66 – $167.10 | 4 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $3.51 – $7.63 | 4 |
| Factor ix complex HCPCS J7194 | $3,192.16 | $6,259.13 | $0.56 – $3.57 | 4 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $5.21 – $11.14 | 4 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.34 – $2.97 | 4 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $4.41 – $9.29 | 4 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.71 – $3.50 | 4 |
| Factor ix recombinant nos HCPCS J7195 | $6,931.33 | $13,590.85 | $1.58 – $3.98 | 4 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $2.15 – $5.14 | 4 |
| Factor viii CPT 85240 | $103.03 | $202.02 | $17.54 – $157.17 | 4 |
| Factor viii HCPCS J7190 | not published | not published | $1.37 – $2.41 | 4 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $2.41 – $4.99 | 4 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $1.16 – $2.56 | 4 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $2.10 – $4.52 | 4 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.54 – $3.35 | 4 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.38 – $3.01 | 4 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $3.17 – $7.42 | 4 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $10.56 – $22.53 | 4 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $17.96 – $37.28 | 4 |
| Fallopian tube recnl CPT 58345 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Fam adapt bhv tx gdn phy/qhp CPT 97156 | not published | not published | $52.14 – $691.00 | 3 |
| Family therapy without pt 50min 90846 CPT 90846 | not published | not published | $246.98 – $252.02 | 2 |
| Family therapy with patient 50 min 90847 CPT 90847 | $671.67 | $1,317.00 | $246.98 – $252.02 | 2 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $84.15 | $165.00 | $0.02 – $0.02 | 2 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $30.64 – $62.14 | 4 |
| Fancc gene CPT 81242 | not published | not published | $35.89 – $406.40 | 4 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $2,238.00 – $15,575.00 | 5 |
| Fat/lipids feces qualitative CPT 82705 | $16.17 | $31.70 | $5.00 – $44.73 | 4 |
| Fatty acids nonesterified CPT 82725 | not published | not published | $18.39 – $116.87 | 4 |
| Fda ide #g240020 carry bag HCPCS Q0499 | $1,145.66 | $2,246.40 | not published | 0 |
| Fecal bilirubin test CPT 82252 | not published | not published | $4.47 – $38.58 | 4 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $31,209.89 | $61,195.86 | $63.04 – $239.07 | 4 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $1,294.00 – $5,318.00 | 3 |
| #fecal-sodium CPT 84302 | $26.86 | $52.66 | $4.76 – $42.48 | 4 |
| Feeding tube reposition CPT 74355 | not published | not published | $658.11 – $729.31 | 2 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $79.72 – $81.35 | 2 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $39.45 | $77.36 | $18.27 – $55.48 | 4 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Fem/popl revasc w/stent CPT 37226 | $17,340.51 | $34,001.00 | $4,233.00 – $62,607.00 | 5 |
| Feno poc CPT 95012 | not published | not published | $51.97 – $138.15 | 3 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $169.97 | $333.27 | $1.39 – $1.81 | 3 |
| Fern test HCPCS Q0114 | not published | not published | $9.55 – $62.99 | 4 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $1.08 – $2.43 | 4 |
| Ferritin CPT 82728 | $190.74 | $374.00 | $13.36 – $119.59 | 4 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $471.85 | $925.20 | $0.22 – $1.11 | 4 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.22 – $1.11 | 4 |
| Fetal aneuploidy trisom risk CPT 81507 | not published | not published | $779.10 – $2,363.48 | 4 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $1,422.90 | $2,790.00 | $145.47 – $350.15 | 4 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $743.87 – $4,114.94 | 4 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | not published | not published | $743.87 – $2,626.06 | 4 |
| Fetal contract stress test 59020 - 26 CPT 59020 | not published | not published | $281.31 – $1,716.00 | 5 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $424.02 – $4,042.00 | 5 |
| Fetal fibronectin CPT 82731 | $1,085.79 | $2,129.00 | $63.12 – $1,181.74 | 4 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $424.02 – $4,042.00 | 5 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $518.16 | $1,016.00 | $7.58 – $67.89 | 4 |
| Fetal hemoglobin rosette CPT 85461 | $95.37 | $187.00 | $9.17 – $134.25 | 4 |
| Fetal lung maturity assess lam body dnst CPT 83664 | not published | not published | $18.93 – $41.42 | 4 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $691.00 – $6,732.00 | 2 |
| Fetal monitor w/report CPT 59050 | not published | not published | $691.00 – $1,716.00 | 2 |
| Fetal non stress test CPT 59025 | $1,047.03 | $2,053.00 | $281.31 – $1,716.00 | 5 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $424.02 – $4,042.00 | 5 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $424.02 – $4,042.00 | 5 |
| #_fet/norfentcnfrmur CPT 80354 | $30.60 | $60.00 | $0.07 – $156.82 | 2 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $13.34 – $20.68 | 3 |
| Fibrin degradation d dimer quantitative CPT 85379 | $377.91 | $741.00 | $9.98 – $89.28 | 4 |
| Fibrin degradation products CPT 85362 | $41.31 | $81.00 | $6.75 – $60.39 | 4 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $9.53 – $65.35 | 4 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $9.98 – $93.18 | 4 |
| Fibrinogen activity CPT 85384 | $383.01 | $751.00 | $9.53 – $74.10 | 4 |
| Fibrinogen test CPT 85370 | not published | not published | $12.18 – $99.68 | 4 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $58.65 | $115.00 | $15.17 – $45.26 | 4 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $7.56 – $65.53 | 4 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $7.56 – $75.10 | 4 |
| Fibrinolytic plasminogen CPT 85415 | $58.91 | $115.50 | $16.85 – $150.97 | 4 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $9.98 – $86.44 | 4 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | not published | not published | $6.40 – $57.43 | 4 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $441.63 | $865.94 | $0.28 – $1.02 | 4 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $1.00 – $2.11 | 4 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | not published | not published | $0.35 – $1.30 | 4 |
| Filleted finger/toe flap CPT 14350 | $3,738.30 | $7,330.00 | $2,870.98 – $5,318.00 | 5 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $11,080.26 | $21,726.00 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $5,330.52 | $10,452.00 | not published | 0 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $2,238.00 – $24,668.00 | 4 |
| Finasteride, 5 mg HCPCS S0138 | not published | not published | $6.72 – $6.72 | 1 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | not published | not published | $691.00 – $4,042.00 | 5 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $450.84 | $884.00 | $1,716.00 – $12,908.00 | 3 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $1,608.54 | $3,154.00 | $1,716.00 – $12,908.00 | 3 |
| Fine needle asp without image guide 10021 CPT 10021 | $909.84 | $1,784.00 | $565.65 – $4,042.00 | 5 |
| Finger tendon transfer CPT 26497 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Finger tendon transfer CPT 26498 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $3,423.00 – $9,773.00 | 3 |
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.