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 |
|---|---|---|---|---|
| Antibody htlv-ii CPT 86688 | not published | not published | $13.72 – $116.70 | 4 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $219.30 | $430.00 | $18.00 – $136.79 | 4 |
| Antibody id rbc panel CPT 86870 | $324.87 | $637.00 | $173.44 – $566.82 | 4 |
| Antibody influenza virus CPT 86710 | $50.62 | $99.25 | $13.28 – $121.25 | 4 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $43.76 | $85.81 | $12.61 – $112.97 | 4 |
| Antibody screen rbc CPT 86850 | $226.44 | $444.00 | $19.54 – $94.78 | 4 |
| Antibody tetanus CPT 86774 | $46.50 | $91.18 | $14.50 – $130.70 | 4 |
| Antidepressant not specified CPT 80338 | $5.56 | $10.91 | $0.07 – $144.29 | 2 |
| Antigen therapy services CPT 95145 | not published | not published | $65.16 – $66.49 | 2 |
| Antigen therapy services CPT 95146 | not published | not published | $65.16 – $66.49 | 2 |
| Antigen therapy services CPT 95147 | not published | not published | $100.19 – $102.23 | 2 |
| Antigen therapy services CPT 95148 | not published | not published | $100.19 – $102.23 | 2 |
| Antigen therapy services CPT 95149 | not published | not published | $100.19 – $102.23 | 2 |
| Antigen therapy services CPT 95165 | not published | not published | $65.16 – $66.49 | 2 |
| Antigen therapy services CPT 95170 | not published | not published | $65.16 – $66.49 | 2 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $2,503.03 | $4,907.90 | $1.46 – $3.12 | 4 |
| Antihemophilic viii/vwf comp HCPCS J7186 | $2,408.91 | $4,723.36 | $1.23 – $2.58 | 4 |
| Anti-inhibitor HCPCS J7198 | $4,372.18 | $8,572.91 | $1.85 – $5.16 | 4 |
| Anti mog serum - sendout CPT 86362 | not published | not published | $11.81 – $28.48 | 4 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $51.00 | $100.00 | $11.81 – $28.48 | 4 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | not published | not published | $11.81 – $28.48 | 4 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | not published | not published | $2,238.00 – $15,575.00 | 4 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | not published | not published | $2,238.00 – $15,575.00 | 4 |
| Antinuclear antibodies CPT 86038 | $10.20 | $20.00 | $11.85 – $106.06 | 4 |
| Antinuclear antibodies titer CPT 86039 | $126.99 | $249.00 | $10.94 – $97.85 | 4 |
| Antiphosphatidylserine antibody CPT 86148 | $4.59 | $9.00 | $15.75 – $141.81 | 4 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.65 – $50.76 | 4 |
| Antistreptolysin o titer CPT 86060 | $22.87 | $44.85 | $7.15 – $64.05 | 4 |
| Antithrombin iii activity CPT 85300 | $100.22 | $196.50 | $11.61 – $103.99 | 4 |
| Antithrombin iii injection HCPCS J7197 | not published | not published | $1.67 – $8.47 | 4 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $364.36 – $9,409.02 | 4 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $351.10 – $2,019.60 | 4 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $185.13 – $598.49 | 3 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $108.78 – $188.91 | 3 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $493.92 – $18,093.86 | 4 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,323.19 – $18,093.86 | 4 |
| Aortic hemiarch graft 33866 CPT 33866 | not published | not published | $1,716.00 – $12,568.00 | 2 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $114.39 – $400.00 | 4 |
| Apc gene full sequence CPT 81201 | not published | not published | $200.25 – $1,560.00 | 4 |
| Apc gene known fam variants CPT 81202 | not published | not published | $110.08 – $560.00 | 4 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $82.09 – $83.76 | 2 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Apheresis plasma CPT 36514 | $2,901.90 | $5,690.00 | $2,167.10 – $4,737.00 | 5 |
| Apheresis platelets CPT 36513 | not published | not published | $613.88 – $4,042.00 | 5 |
| Apheresis rbc CPT 36512 | not published | not published | $2,167.10 – $4,737.00 | 5 |
| Apheresis wbc CPT 36511 | not published | not published | $2,167.10 – $4,737.00 | 5 |
| Apl(pml-rara) quant - sendout CPT 81315 | not published | not published | $203.16 – $448.65 | 4 |
| Appendectomy CPT 44950 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Appendectomy add-on 44955 CPT 44955 | not published | not published | $1,716.00 – $4,042.00 | 3 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $5,318.00 – $15,575.00 | 5 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | not published | not published | $691.00 – $12,908.00 | 4 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | not published | not published | $691.00 – $12,908.00 | 4 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $2,870.98 – $11,377.00 | 5 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $1,164.33 | $2,283.00 | $691.00 – $12,908.00 | 4 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | not published | not published | $691.00 – $12,908.00 | 4 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $226.11 – $4,042.00 | 5 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $389.18 – $4,042.00 | 5 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $389.18 – $4,042.00 | 5 |
| Appl body cast sho to hips CPT 29035 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Appl cast figure-of-eight CPT 29049 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Appl cast plaster velpeau CPT 29058 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Appl cast shoulder spica CPT 29055 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Appl halo type body cast CPT 29000 | not published | not published | $389.18 – $4,042.00 | 5 |
| Appl hip spica cast1&1/2 CPT 29325 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Appl hip spica cast 1 leg CPT 29305 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Application clubfoot cast CPT 29450 | $315.69 | $619.00 | $226.11 – $4,042.00 | 5 |
| Application finger splntstatic 29130 CPT 29130 | $831.81 | $1,631.00 | $185.13 – $4,042.00 | 5 |
| Application halo femoral CPT 20663 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Application halo pelvic CPT 20662 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Application long leg splint 29505 CPT 29505 | $1,260.21 | $2,471.00 | $226.11 – $4,042.00 | 5 |
| Application lower leg splint 29515 CPT 29515 | $927.69 | $1,819.00 | $226.11 – $4,042.00 | 5 |
| Application multi layer compression below knee (both sides) CPT 29581 | $315.69 | $619.00 | $226.11 – $4,042.00 | 5 |
| Application of body cast CPT 29010 | not published | not published | $389.18 – $4,042.00 | 5 |
| Application of body cast CPT 29015 | not published | not published | $389.18 – $4,042.00 | 5 |
| Application of cylinder cast 29365 CPT 29365 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Application of forearm cast 29075 CPT 29075 | $1,049.58 | $2,058.00 | $389.18 – $4,042.00 | 5 |
| Application of long arm cast 29065 CPT 29065 | $1,080.18 | $2,118.00 | $389.18 – $4,042.00 | 5 |
| Application of long leg cast CPT 29355 | not published | not published | $389.18 – $4,042.00 | 5 |
| Application of long leg cast 29345 CPT 29345 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Application of paste boot 29580 CPT 29580 | $761.94 | $1,494.00 | $226.11 – $4,042.00 | 5 |
| Application short leg cast 29405 CPT 29405 | $1,026.63 | $2,013.00 | $389.18 – $4,042.00 | 5 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | not published | not published | $1,028.39 – $4,737.00 | 5 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $3,760.74 | $7,374.00 | $1,028.39 – $4,737.00 | 5 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $981.75 | $1,925.00 | not published | 0 |
| Appl long leg cast brace CPT 29358 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $215.22 | $422.00 | $6.12 – $6.24 | 2 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $82.11 | $161.00 | $12.27 – $12.52 | 2 |
| Appl modality 1+lllt po pain CPT 97037 | not published | not published | $51.97 – $691.00 | 3 |
| Appl multlay comprs arm/hand CPT 29584 | $328.44 | $644.00 | $226.11 – $4,042.00 | 5 |
| Appl patllr tdn bearing cast CPT 29435 | not published | not published | $389.18 – $4,042.00 | 5 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Apply finger cast 29086 CPT 29086 | $335.07 | $657.00 | $226.11 – $4,042.00 | 5 |
| Apply forearm splintdynamic 29126 CPT 29126 | $240.72 | $472.00 | $185.13 – $4,042.00 | 5 |
| Apply halo w/removal cranial CPT 20661 | $2,567.34 | $5,034.00 | $1,716.00 – $5,318.00 | 5 |
| Apply hand/wrist cast 29085 CPT 29085 | $315.69 | $619.00 | $226.11 – $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.