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 |
|---|---|---|---|---|
| Great toe with reduction 28495 CPT 28495 | $678.81 | $1,331.00 | $343.23 – $4,042.00 | 5 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $2,238.00 – $5,318.00 | 5 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $4,930.97 – $11,377.00 | 5 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $4,930.97 – $11,377.00 | 5 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $12.45 – $12.70 | 2 |
| Group train without patient HCPCS G0543 | not published | not published | $40.25 – $41.07 | 2 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.43 – $138.09 | 4 |
| Growth hormone panel CPT 80428 | not published | not published | $65.37 – $496.63 | 4 |
| Growth hormone panel CPT 80430 | not published | not published | $126.74 – $584.43 | 4 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $74.09 – $151.20 | 4 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $52.14 – $691.00 | 3 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $52.14 – $691.00 | 3 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $2,238.00 – $11,377.00 | 3 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| G-tube reposition CPT 43761 | $477.36 | $936.00 | $347.66 – $4,042.00 | 5 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $587.28 – $2,908.69 | 4 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,629.56 | $5,156.00 | $985.34 – $4,042.00 | 5 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $13,679.07 | $26,821.70 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $8,007.94 | $15,701.84 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $23,952.15 | $46,965.00 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $1,662.09 | $3,259.00 | $398.07 – $398.07 | 1 |
| Gum graft CPT 41870 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Gw stiffened micro access kit HCPCS C1894 | $27,660.87 | $54,237.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $4,233.00 – $9,773.00 | 5 |
| Hair analysis HCPCS P2031 | not published | not published | $9.90 – $555.62 | 3 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $691.00 – $1,716.00 | 4 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $565.65 – $4,042.00 | 5 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $565.65 – $4,042.00 | 5 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | not published | not published | $9.22 – $43.03 | 3 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $84.15 | $165.00 | $1.55 – $10.02 | 3 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $11.54 – $11.54 | 1 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $10,177.05 | $19,955.00 | $9,773.00 – $9,773.00 | 1 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $4,233.00 – $10,302.82 | 5 |
| Hand tendon reconstruction CPT 26502 | $6,447.42 | $12,642.00 | $4,233.00 – $11,377.00 | 5 |
| Hand X-ray CPT 73130 | $993.99 | $1,949.00 | $121.09 – $133.18 | 4 |
| Haptoglobin quantitative CPT 83010 | $135.15 | $265.00 | $12.33 – $110.37 | 4 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $1,716.00 – $4,042.00 | 3 |
| Harvest auto stem cells CPT 38206 | not published | not published | $2,167.10 – $4,737.00 | 5 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $613.88 – $4,042.00 | 5 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $1,716.00 – $6,682.00 | 3 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $185.13 – $301.52 | 3 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $185.13 – $452.90 | 3 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $588.00 – $3,768.57 | 4 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $198.35 – $1,271.26 | 4 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $367.74 – $2,356.92 | 4 |
| Hbb full gene sequence CPT 81364 | not published | not published | $318.09 – $2,038.68 | 4 |
| Hbb gene com variants CPT 81361 | not published | not published | $171.31 – $1,097.95 | 4 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $198.35 – $1,271.26 | 4 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $367.74 – $2,356.92 | 4 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.52 – $85.20 | 4 |
| Hbot, full body chamber, 30m HCPCS G0277 | not published | not published | $191.48 – $2,995.00 | 3 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $244.06 – $329.41 | 4 |
| Hcg free betachain test CPT 84704 | $3.57 | $7.00 | $14.98 – $132.06 | 4 |
| Hcg qualitative CPT 84703 | $201.96 | $396.00 | $7.37 – $65.94 | 4 |
| Hcg quantitative CPT 84702 | $413.61 | $811.00 | $14.75 – $126.45 | 4 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | not published | not published | $34.48 – $203.07 | 2 |
| Hc metata joint dislocation anes CPT 28635 | $3,107.43 | $6,093.00 | $2,237.46 – $4,737.00 | 5 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $1,028.39 – $4,042.00 | 5 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $1,028.39 – $4,042.00 | 5 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $742.56 | $1,456.00 | $755.17 – $1,302.45 | 4 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $556.27 – $589.01 | 3 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $556.27 – $882.11 | 4 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $755.52 – $2,035.50 | 4 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $1,801.46 – $5,908.70 | 4 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $9,271.29 | $18,179.00 | $691.00 – $12,908.00 | 4 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $4,555.83 | $8,933.00 | $969.12 – $1,841.86 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $969.12 – $3,354.25 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $969.12 – $5,292.60 | 3 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $536.68 – $1,423.88 | 3 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $536.68 – $2,339.61 | 3 |
| Head CT scan (with and without contrast) CPT 70470 | $3,158.94 | $6,194.00 | $244.06 – $1,760.67 | 4 |
| Head CT scan (with contrast) CPT 70460 | $2,965.65 | $5,815.00 | $244.06 – $1,411.29 | 4 |
| Head CT scan (without contrast) CPT 70450 | $2,395.47 | $4,697.00 | $145.47 – $1,176.42 | 4 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $665.98 – $18,093.86 | 4 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,592.50 – $18,093.86 | 4 |
| Heart first pass add-on CPT 78496 | not published | not published | $389.53 – $425.31 | 2 |
| Heart first pass multiple CPT 78483 | not published | not published | $755.17 – $1,885.70 | 4 |
| Heart image spect CPT 78494 | not published | not published | $556.27 – $1,393.80 | 4 |
| Heart infarct image CPT 78466 | $1,757.97 | $3,447.00 | $556.27 – $658.70 | 4 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $755.17 – $912.89 | 4 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Heavy metal qual any number CPT 83015 | not published | not published | $20.52 – $140.33 | 4 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.12 – $36.81 | 4 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.68 – $59.86 | 4 |
| Helicobacter pylori antibody igm CPT 86677 | $227.46 | $446.00 | $16.51 – $130.70 | 4 |
| Helicoll, per square cm HCPCS Q4164 | not published | not published | $173.16 – $1,770.61 | 4 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.03 – $71.79 | 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.