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 |
|---|---|---|---|---|
| Gastric emptying imag study CPT 78265 | not published | not published | $556.27 – $2,832.57 | 4 |
| Gastric emptying imag study CPT 78266 | not published | not published | $755.17 – $3,390.94 | 4 |
| Gastric motility studies CPT 91020 | not published | not published | $198.12 – $1,716.00 | 4 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $556.27 – $1,031.07 | 4 |
| Gastrin test CPT 82938 | not published | not published | $17.34 – $150.32 | 4 |
| Gastroduodenostomy CPT 43810 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $556.27 – $1,068.12 | 4 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $519.24 – $1,716.00 | 4 |
| Gastrointestinal repair CPT 43360 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Gastrointestinal repair CPT 43361 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Gastrojejunostomy w/vagotomy CPT 43825 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Gastro/jejuno tube, std HCPCS B4087 | $1,237.18 | $2,425.85 | not published | 0 |
| Gastroplasty duodenal switch CPT 43845 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $1,262.04 – $4,737.00 | 5 |
| Gated heart multiple CPT 78473 | $2,980.95 | $5,845.00 | $556.27 – $2,016.28 | 4 |
| Gba gene CPT 81251 | not published | not published | $46.30 – $945.57 | 4 |
| Gefitinib oral HCPCS J8565 | not published | not published | $78.55 – $625.65 | 2 |
| Gel-one HCPCS J7326 | not published | not published | $516.25 – $1,645.40 | 4 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $0.67 – $2.94 | 4 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $358.33 | $702.60 | $5.95 – $151.90 | 3 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | not published | not published | $235.36 – $501.21 | 4 |
| General health panel CPT 80050 | $364.14 | $714.00 | $94.56 – $263.41 | 3 |
| Generator barostim neo2 2014 HCPCS C1767 | $115,409.80 | $226,293.72 | not published | 0 |
| Generator emblem MRI sicd subq HCPCS C1722 | $64,287.95 | $126,054.80 | not published | 0 |
| Genetic tstg severe inh cond CPT 81443 | not published | not published | $2,399.59 – $12,789.56 | 4 |
| Genioplasty augmentation CPT 21120 | not published | not published | $4,042.00 – $8,405.34 | 5 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $4,613.34 – $9,773.00 | 5 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $4,042.00 – $6,732.00 | 5 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $4,042.00 – $8,405.34 | 5 |
| Genome re-evaluation CPT 81427 | not published | not published | $0.07 – $9,046.93 | 4 |
| Genome sequence analysis CPT 81425 | not published | not published | $0.07 – $18,093.86 | 4 |
| Genome sequence analysis CPT 81426 | not published | not published | $0.07 – $18,093.86 | 4 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $145.35 | $285.00 | $4.93 – $5.31 | 3 |
| Gentamicin peak therapeutic drug level CPT 80170 | $476.85 | $935.00 | $16.05 – $130.29 | 4 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $3.60 – $13.57 | 4 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $1,194.91 – $3,412.27 | 4 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Ghs abscess perianal iandd CPT 46050 | $2,852.94 | $5,594.00 | $1,294.00 – $4,042.00 | 5 |
| Ghs abscess postoperative iandd complex CPT 10180 | $3,053.37 | $5,987.00 | $2,995.00 – $6,732.00 | 5 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $9.61 – $67.42 | 4 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | not published | not published | $16.77 – $141.04 | 4 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $234.60 | $460.00 | $100.21 – $827.75 | 4 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $150.14 – $188.91 | 3 |
| Ghs antibodies (torch) igm CPT 86694 | not published | not published | $14.10 – $125.91 | 4 |
| Ghs aspiration bladder - needle CPT 51100 | $465.63 | $913.00 | $347.66 – $4,042.00 | 5 |
| Ghs bladder cath - complex-foley CPT 51703 | $821.10 | $1,610.00 | $179.04 – $4,042.00 | 5 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $4.72 – $39.59 | 4 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,741.65 | $3,415.00 | $982.21 – $4,042.00 | 5 |
| Ghs central line insert < age 5, failed CPT 36555 | $6,452.52 | $12,652.00 | $2,238.00 – $4,483.19 | 5 |
| Ghs change cysto/gastrost CPT 43762 | $1,574.88 | $3,088.00 | $347.66 – $4,042.00 | 5 |
| Ghs chemo >8 hrs CPT 96416 | $355.47 | $697.00 | $459.61 – $468.99 | 2 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $459.61 – $468.99 | 2 |
| Ghs chemo IV push, ea addtl CPT 96411 | $175.95 | $345.00 | $100.19 – $102.23 | 2 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $158.77 | $311.31 | $34.39 – $298.03 | 4 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $1,066.92 | $2,092.00 | $343.23 – $4,042.00 | 5 |
| Ghs closed reduction ankle dislocation CPT 27840 | $639.03 | $1,253.00 | $343.23 – $4,042.00 | 5 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,958.40 | $3,840.00 | $2,237.46 – $4,042.00 | 5 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $448.80 | $880.00 | $343.23 – $4,042.00 | 5 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $3,568.98 | $6,998.00 | $2,237.46 – $4,737.00 | 5 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $3,738.30 | $7,330.00 | $2,995.00 – $5,031.60 | 5 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $448.80 | $880.00 | $343.23 – $4,042.00 | 5 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $3,568.98 | $6,998.00 | $2,237.46 – $4,737.00 | 5 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $3,409.86 | $6,686.00 | $2,237.46 – $4,737.00 | 5 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $1,066.92 | $2,092.00 | $343.23 – $4,042.00 | 5 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $1,066.92 | $2,092.00 | $343.23 – $4,042.00 | 5 |
| Ghs community re-entry 15 minutes CPT 97537 | $105.57 | $207.00 | $34.35 – $35.05 | 2 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $1,144.95 | $2,245.00 | $621.60 – $4,042.00 | 5 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $1,144.95 | $2,245.00 | $185.13 – $4,042.00 | 5 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $1,144.95 | $2,245.00 | $621.60 – $4,042.00 | 5 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $860.88 | $1,688.00 | $185.13 – $4,042.00 | 5 |
| Ghs cricothyroidotomy CPT 31605 | $1,119.96 | $2,196.00 | $329.57 – $4,042.00 | 5 |
| Ghs cutdown placement age 1 and over CPT 36425 | $818.04 | $1,604.00 | $621.60 – $4,042.00 | 5 |
| Ghs cutdown placement under 1 yr CPT 36420 | $251.94 | $494.00 | $185.13 – $4,042.00 | 5 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $46.50 | $91.17 | $14.91 – $103.82 | 4 |
| Ghs dislocation elbow closed treatment CPT 24600 | $1,066.92 | $2,092.00 | $343.23 – $4,042.00 | 5 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $2,181.27 | $4,277.00 | $1,262.04 – $4,737.00 | 5 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $2,490.33 | $4,883.00 | $982.21 – $4,042.00 | 5 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $300.45 – $2,233.49 | 3 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $67.83 – $691.00 | 4 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $179.04 – $182.70 | 2 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | not published | not published | $565.65 – $4,042.00 | 5 |
| Ghs excision ingrown nail CPT 11765 | $1,705.95 | $3,345.00 | $565.65 – $4,042.00 | 5 |
| Ghs eye exam CPT 92002 | $234.60 | $460.00 | $185.25 – $189.04 | 2 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $762.45 | $1,495.00 | $441.66 – $4,042.00 | 5 |
| Ghs fat & muscle CPT 89160 | not published | not published | $4.75 – $32.38 | 4 |
| Ghs fb removal foot - deep - left CPT 28192 | $3,247.68 | $6,368.00 | $2,298.14 – $4,737.00 | 5 |
| Ghs fb removal from muscle - complicated CPT 20525 | $5,595.21 | $10,971.00 | $3,423.00 – $6,732.00 | 5 |
| Ghs fb removal - incisional CPT 10121 | $3,776.04 | $7,404.00 | $2,298.14 – $4,737.00 | 5 |
| Ghs fb removal - non-incisional CPT 20520 | $3,247.68 | $6,368.00 | $2,238.00 – $4,042.00 | 5 |
| Ghs febrile agglutinns(mayo) CPT 86000 | not published | not published | $6.84 – $55.31 | 4 |
| Ghs fish cytogen CPT 88271 | not published | not published | $20.99 – $1,488.99 | 4 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | not published | not published | $50.17 – $2,297.30 | 4 |
| Ghs flow volume loop CPT 94375 | not published | not published | $148.90 – $306.58 | 3 |
| Ghs gastric intub aspiration lavage CPT 43753 | $606.39 | $1,189.00 | $300.45 – $4,042.00 | 5 |
| Ghs hcv amplificaiton CPT 87521 | $30.09 | $59.00 | $34.39 – $298.03 | 4 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $22.51 – $146.18 | 4 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $15.18 – $131.53 | 4 |
| Ghs hgb stability-thal CPT 83068 | not published | not published | $9.28 – $71.97 | 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.