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 |
|---|---|---|---|---|
| Hla i & ii typing lr CPT 81370 | not published | not published | $394.08 – $1,388.90 | 4 |
| Hla ii typing 1 loc hr CPT 81382 | $26.14 | $51.25 | $121.21 – $707.68 | 4 |
| Hla ii typing ag equiv lr CPT 81375 | not published | not published | $216.33 – $1,112.08 | 4 |
| Hla i low res one antigen equiv ea CPT 81374 | $43.86 | $86.00 | $72.84 – $1,015.23 | 4 |
| Hla i typing 1 locus hr CPT 81380 | not published | not published | $173.70 – $901.43 | 4 |
| Hla i typing complete hr CPT 81379 | not published | not published | $328.67 – $3,147.45 | 4 |
| Hla i typing complete lr CPT 81372 | not published | not published | $395.52 – $2,999.37 | 4 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $76.50 | $150.00 | $166.50 – $1,015.23 | 4 |
| Hla i typing low res one locus ea CPT 81373 | not published | not published | $124.88 – $1,015.23 | 4 |
| Hla typing a b or c CPT 86813 | $172.38 | $338.00 | $56.84 – $508.92 | 4 |
| Hla typing dr/dq CPT 86816 | not published | not published | $29.57 – $236.94 | 4 |
| Hla x-match noncytotoxc addl CPT 86826 | not published | not published | $35.80 – $198.71 | 4 |
| Hla x-math non-cytotoxic CPT 86825 | not published | not published | $107.30 – $596.13 | 4 |
| Hlth bhv assmt/reassessment CPT 96156 | not published | not published | $141.36 – $144.24 | 2 |
| Hlth bhv ivntj indiv 1st 30 CPT 96158 | not published | not published | $246.98 – $252.02 | 2 |
| Hocm 200-249mg/ml iodine,1ml HCPCS Q9960 | not published | not published | $0.21 – $0.21 | 1 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | $45.90 | $90.00 | $0.37 – $0.62 | 2 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | not published | not published | $0.37 – $0.47 | 2 |
| Home sleep test/type 2 porta HCPCS G0398 | not published | not published | $300.45 – $306.58 | 2 |
| Home sleep test/type 3 porta HCPCS G0399 | $828.75 | $1,625.00 | $282.03 – $300.45 | 2 |
| Home sleep test/type 4 porta HCPCS G0400 | $828.75 | $1,625.00 | $235.02 – $300.45 | 2 |
| Homocysteine CPT 83090 | $197.88 | $388.00 | $17.56 – $147.95 | 4 |
| Homogenization tissue CPT 87176 | not published | not published | $5.76 – $51.64 | 4 |
| Homovanillic acid (hva) CPT 83150 | $6.63 | $13.00 | $21.96 – $144.11 | 4 |
| Hopd covid-19 spec collect HCPCS C9803 | not published | not published | $135.78 – $157.46 | 2 |
| Hopd mntl hlt, 15-29 min HCPCS C7900 | not published | not published | $52.14 – $691.00 | 3 |
| Hopd mntl hlt, 30-60 min HCPCS C7901 | not published | not published | $141.36 – $691.00 | 3 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-1 genotyping CPT 81105 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $119.78 – $1,029.77 | 4 |
| Hpv combo assay ca screen HCPCS G0476 | not published | not published | $34.39 – $186.12 | 4 |
| Hpv low-risk types CPT 87623 | not published | not published | $34.39 – $221.22 | 4 |
| Hpv types 16 & 18 only CPT 87625 | $269.79 | $529.00 | $39.74 – $221.22 | 4 |
| H pylori ag ia CPT 87339 | not published | not published | $15.68 – $81.48 | 4 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $66.01 – $579.05 | 4 |
| H pylori (c-13) breath CPT 83013 | $408.51 | $801.00 | $66.01 – $561.44 | 4 |
| H pylori drug admin CPT 83014 | not published | not published | $7.70 – $68.66 | 4 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $1,277.87 – $3,603.07 | 4 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | not published | not published | $2,328.97 – $2,328.97 | 1 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $573.20 – $4,114.94 | 4 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $573.20 – $4,535.46 | 4 |
| Hrv skn cll ssp agrft 1st 25 CPT 15011 | not published | not published | $691.00 – $4,737.00 | 5 |
| Hsv dna dir probe CPT 87528 | not published | not published | $19.65 – $170.29 | 4 |
| Htt gene charac alleles CPT 81274 | not published | not published | $269.33 – $1,435.52 | 4 |
| Htt gene detc abnor alleles CPT 81271 | not published | not published | $134.26 – $715.60 | 4 |
| Human epididymis protein 4 (he4) CPT 86305 | $130.56 | $256.00 | $20.39 – $223.17 | 4 |
| Human ig IV CPT 90283 | not published | not published | $122.88 – $199.31 | 2 |
| Human ig sc CPT 90284 | not published | not published | $19.85 – $49.77 | 2 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $4,160.07 | $8,157.00 | $1.68 – $4.54 | 4 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $25.87 – $69.17 | 3 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $0.19 – $1.08 | 3 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $188.21 | $369.04 | $0.65 – $0.77 | 3 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $180.58 | $354.08 | $8.80 – $10.20 | 3 |
| Hydration IV infusion each additional hour CPT 96361 | $188.70 | $370.00 | $65.16 – $99.20 | 3 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $1,095.99 | $2,149.00 | $295.97 – $452.98 | 3 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | $16.17 | $31.70 | not published | 0 |
| Hydrocortisone acetate inj HCPCS J1700 | not published | not published | $12.61 – $12.61 | 1 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $202.29 | $396.65 | $4.36 – $44.25 | 3 |
| Hydrocortisone sodium ph inj HCPCS J1710 | not published | not published | $12.61 – $12.61 | 1 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $344.94 | $676.36 | $0.27 – $0.56 | 3 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $1,188.79 | $2,330.96 | not published | 0 |
| Hydromorphone 250 mg HCPCS S0092 | not published | not published | $97.12 – $97.12 | 1 |
| Hydromorphone injection HCPCS J1170 | not published | not published | $2.13 – $2.13 | 1 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.02 – $0.09 | 3 |
| Hydroxyurea 500 mg HCPCS S0176 | not published | not published | $2.76 – $2.76 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | not published | not published | $15.12 – $38.18 | 3 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | $5.61 | $11.00 | $0.28 – $4.17 | 2 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | not published | not published | $17.54 – $148.78 | 4 |
| Hymenotomy CPT 56442 | $6,160.80 | $12,080.00 | $2,238.00 – $6,732.00 | 5 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $17.77 – $37.63 | 4 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $2,238.00 – $9,773.00 | 5 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $10.39 – $19.48 | 2 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $9.98 – $89.28 | 4 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $969.12 – $1,022.50 | 3 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $536.68 – $657.28 | 3 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $765.24 – $784.53 | 3 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $767.54 – $784.53 | 3 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $768.84 – $1,022.50 | 3 |
| Hypnotherapy CPT 90880 | not published | not published | $141.36 – $144.24 | 2 |
| Hypothermia ill neonate CPT 99184 | $6,890.61 | $13,511.00 | $691.00 – $691.00 | 1 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $18.43 – $37.78 | 4 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $2,238.00 – $25,815.00 | 4 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $2,995.00 – $9,773.00 | 2 |
| Hysterosalpingography s&i CPT 74740 | $686.97 | $1,347.00 | $325.45 – $372.86 | 4 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $2,995.00 – $7,102.79 | 5 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $6,682.00 – $9,773.00 | 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.