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 |
|---|---|---|---|---|
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Fit aphakia spectcl monofocl CPT 92352 | not published | not published | $82.09 – $83.76 | 2 |
| Fit aphakia spectcl multifoc CPT 92353 | not published | not published | $82.09 – $83.76 | 2 |
| Fitting of diaphragm/cap 57170 CPT 57170 | not published | not published | $281.31 – $1,716.00 | 4 |
| Fixation of ankle joint CPT 27860 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Fixation of knee joint CPT 27570 | $3,107.43 | $6,093.00 | $2,237.46 – $4,737.00 | 5 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Fix g/colon tube w/device CPT 49460 | $1,798.77 | $3,527.00 | $1,262.04 – $4,737.00 | 5 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $6,493.32 | $12,732.00 | $3,423.00 – $6,732.00 | 5 |
| Flebogamma injection HCPCS J1572 | not published | not published | $60.09 – $119.88 | 4 |
| Flecainide (tambocor)-sendout CPT 80181 | not published | not published | $18.27 – $55.48 | 4 |
| Fl exam g/colon tube w contrast CPT 49465 | $462.57 | $907.00 | $332.01 – $4,042.00 | 5 |
| Flexible Sigmoidoscopy CPT 45330 | $1,612.62 | $3,162.00 | $1,294.00 – $4,042.00 | 5 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Floor of mouth biopsy 41108 CPT 41108 | $3,247.68 | $6,368.00 | $2,238.00 – $4,042.00 | 5 |
| Florbetaben f18 diagnostic HCPCS Q9983 | not published | not published | $1,335.40 – $2,738.58 | 4 |
| Flortaucipir inj 1 millicuri HCPCS A9601 | not published | not published | $363.58 – $7,976.50 | 4 |
| Flotufolastat f18 diag 1 mci HCPCS A9608 | not published | not published | $657.79 – $1,401.09 | 4 |
| Flow cytometry interp 16 or more CPT 88189 | not published | not published | $177.56 – $716.61 | 3 |
| Flow cytometry marker each additional CPT 88185 | $35.86 | $70.31 | $44.76 – $300.97 | 3 |
| Flow cytometry one marker technical component CPT 88184 | $35.87 | $70.33 | $342.35 – $566.82 | 4 |
| Floweramnioflo, 0.1 cc HCPCS Q4177 | not published | not published | $387.00 – $387.00 | 1 |
| Floweramniopatch, per sq cm HCPCS Q4178 | not published | not published | $173.16 – $268.29 | 4 |
| #flow interp 9 - 15 markers CPT 88188 | not published | not published | $132.08 – $544.01 | 3 |
| Floxuridine injection HCPCS J9200 | not published | not published | $162.66 – $8,574.91 | 4 |
| Flt3 gene CPT 81245 | not published | not published | $162.20 – $526.52 | 4 |
| Flt3 gene analysis CPT 81246 | not published | not published | $81.34 – $977.95 | 4 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $145.35 | $285.00 | $7.15 – $116.38 | 3 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $1,119.02 | $2,194.16 | $119.06 – $410.08 | 3 |
| Fluidotherapy charges pt CPT 97022 | not published | not published | $16.24 – $16.57 | 2 |
| Fluid pressure muscle 20950 CPT 20950 | $1,406.07 | $2,757.00 | $691.00 – $4,042.00 | 5 |
| Flulaval vacc, 3 yrs & >, im HCPCS Q2036 | not published | not published | $9.37 – $9.37 | 1 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $499.61 – $1,055.16 | 4 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $332.02 – $26,111.86 | 4 |
| Fluorescein angioscopy i&r CPT 92230 | not published | not published | $519.24 – $529.83 | 2 |
| Fluorescein angrph mltiframe CPT 92235 | not published | not published | $300.45 – $4,042.00 | 3 |
| Fluorescein&icg angiography CPT 92242 | not published | not published | $300.45 – $1,430.67 | 3 |
| Fluorescent antibody titer dna CPT 86256 | $25.50 | $50.00 | $11.81 – $105.82 | 4 |
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $713.78 – $1,072.03 | 4 |
| Fluoroestradiol f 18 HCPCS A9591 | not published | not published | $52.22 – $1,072.14 | 4 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $904.74 | $1,774.00 | $229.89 – $322.73 | 2 |
| Fluoroguide needle placement CPT 77002 | $872.10 | $1,710.00 | $337.11 – $422.47 | 2 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $18.53 – $82.96 | 4 |
| Fluoroscopy up to 1 hour CPT 76000 | $2,740.74 | $5,374.00 | $285.69 – $372.86 | 4 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $244.76 | $479.93 | $2.69 – $4.75 | 3 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $115.88 | $227.21 | $17.66 – $71.50 | 3 |
| Flurpiridaz f18, diag, 1 mci HCPCS A9611 | not published | not published | $519.40 – $1,107.25 | 3 |
| Flutamide 125 mg HCPCS S0175 | not published | not published | $4.49 – $4.49 | 1 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | not published | not published | $1,905.13 – $4,721.56 | 4 |
| Fluvirin vacc, 3 yrs & >, im HCPCS Q2037 | not published | not published | $16.60 – $25.74 | 2 |
| Fluzone vacc, 3 yrs & >, im HCPCS Q2038 | not published | not published | $15.77 – $106.68 | 2 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $332.01 – $3,994.81 | 4 |
| Fmri brain by tech CPT 70554 | not published | not published | $332.01 – $3,270.64 | 4 |
| Fna bx w/ct gdn 1st les CPT 10009 | $3,140.58 | $6,158.00 | $691.00 – $4,042.00 | 5 |
| Fna bx w/ct gdn ea addl CPT 10010 | $3,838.26 | $7,526.00 | $1,716.00 – $12,908.00 | 3 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $691.00 – $4,042.00 | 5 |
| Fna bx w/mr gdn ea addl CPT 10012 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | $61.00 | $119.60 | not published | 0 |
| Foam drg <=16 sq in w/border HCPCS A6212 | $25.40 | $49.80 | not published | 0 |
| Foam stability fetal lung CPT 83662 | not published | not published | $18.53 – $165.98 | 4 |
| Folic acid CPT 82746 | $164.22 | $322.00 | $14.41 – $129.05 | 4 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $84.15 | $165.00 | $0.13 – $0.13 | 2 |
| Follow-up angiography CPT 75898 | not published | not published | $226.24 – $4,393.52 | 4 |
| Followup eval of foot pt lop HCPCS G0246 | not published | not published | $185.25 – $189.04 | 2 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $1,533.82 | $3,007.49 | $1.58 – $13.24 | 4 |
| Fondaparinux sodium HCPCS J1652 | $159.13 | $312.02 | $1.71 – $10.39 | 3 |
| Foot X-ray CPT 73630 | $988.89 | $1,939.00 | $121.09 – $133.18 | 4 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | $7,088.49 | $13,899.00 | $3,423.00 – $11,377.00 | 5 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $1,151.26 – $3,244.31 | 2 |
| Forensic cytopathology CPT 88125 | not published | not published | $10.22 – $98.94 | 4 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $1,066.92 | $2,092.00 | $347.66 – $4,042.00 | 5 |
| Formoterol fumarate, inh HCPCS J7606 | not published | not published | $3.40 – $7.42 | 3 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,019.68 | $1,999.37 | $0.24 – $2.32 | 3 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $43.26 – $97.00 | 3 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $188.34 | $369.29 | $1.31 – $16.51 | 4 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $27.93 – $230.85 | 4 |
| Fracture assessment via dxa CPT 77086 | not published | not published | $121.09 – $322.26 | 4 |
| _fragile x methylation-sendout CPT 81244 | not published | not published | $43.99 – $165.15 | 4 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $4,904.88 – $15,575.00 | 5 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $4,812.00 – $19,505.00 | 4 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $2,238.00 – $25,815.00 | 4 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $4,812.00 – $19,505.00 | 4 |
| Free omental flap microvasc CPT 49906 | not published | not published | $2,238.00 – $6,732.00 | 2 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Free skin flap microvasc CPT 15757 | not published | not published | $4,812.00 – $19,505.00 | 4 |
| Frenectomy 41115 CPT 41115 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Frenotomy 40806 CPT 40806 | not published | not published | $750.46 – $4,042.00 | 5 |
| Frenulotomy of penis CPT 54164 | not published | not published | $2,908.69 – $6,732.00 | 5 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $55.59 | $109.00 | not published | 0 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $64.77 | $127.00 | not published | 0 |
| Fresh frozen plasma thawing ea un CPT 86927 | $228.99 | $449.00 | $79.00 – $287.00 | 4 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $51.97 – $354.52 | 4 |
| Frozen blood prep CPT 86930 | not published | not published | $237.06 – $566.82 | 4 |
| Frozen blood thaw CPT 86931 | not published | not published | $237.06 – $566.82 | 4 |
| Frozen cell preparation CPT 88241 | not published | not published | $11.85 – $40.06 | 4 |
| Frozen plasma, pooled, sd HCPCS P9023 | not published | not published | $1.22 – $55.96 | 3 |
| Fructosamine glycated protein CPT 82985 | $19.38 | $38.00 | $16.42 – $132.30 | 4 |
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.