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 |
|---|---|---|---|---|
| Apply interstit radiat compl CPT 77778 | $2,240.94 | $4,394.00 | $969.12 – $1,323.19 | 3 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $969.12 – $1,156.39 | 3 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $768.84 – $927.25 | 3 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $645.82 – $784.53 | 3 |
| Apply of finger splint 29131 CPT 29131 | $1,148.01 | $2,251.00 | $82.09 – $4,042.00 | 5 |
| Apply rem fixation device CPT 20660 | $3,107.43 | $6,093.00 | $2,237.46 – $4,737.00 | 5 |
| Apply rigid leg cast 29445 CPT 29445 | not published | not published | $389.18 – $4,042.00 | 5 |
| Apply short leg castambul type 29425 CPT 29425 | $519.69 | $1,019.00 | $389.18 – $4,042.00 | 5 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $97.43 – $144.87 | 3 |
| App mltpln uni xtrnl fix 1st CPT 20696 | not published | not published | $3,423.00 – $37,756.02 | 5 |
| App mltpln uni xtrnl fix xch CPT 20697 | not published | not published | $2,237.46 – $9,773.00 | 5 |
| App skn cll ssp f/n/g/hf 1st CPT 15017 | not published | not published | $691.00 – $4,737.00 | 5 |
| App skn cl ssp agrft t/a/l 1 CPT 15015 | not published | not published | $691.00 – $4,737.00 | 5 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | not published | not published | $1.66 – $3.68 | 4 |
| #aptt mix-1:1 incubated CPT 87532 | not published | not published | $34.39 – $298.03 | 4 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | not published | not published | $24.10 – $37.73 | 4 |
| Aquaporin-4 antibody cba each CPT 86052 | not published | not published | $11.81 – $28.48 | 4 |
| Aquaporin-4 antibody elisa CPT 86051 | $285.60 | $560.00 | $11.30 – $27.24 | 4 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | not published | not published | $38.46 – $39.24 | 2 |
| Aquatic exercise - group charge CPT 97150 | $150.45 | $295.00 | $18.55 – $18.93 | 2 |
| Aqueous shunt eye w/graft CPT 66180 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Aqueous shunt eye without graft CPT 66179 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Argatroban nonesrd (accord) HCPCS J0891 | not published | not published | $1.78 – $5.66 | 4 |
| Argatroban nonesrd (auromed) HCPCS J0898 | $285.98 | $560.75 | $2.68 – $5.56 | 3 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $421.77 | $827.00 | $0.99 – $6.49 | 4 |
| Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 | not published | not published | $3.25 – $7.01 | 4 |
| Aripiprazole injection HCPCS J0400 | not published | not published | $0.46 – $0.69 | 2 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | not published | not published | $9.58 – $39.41 | 3 |
| Art byp aor celiac msn and renal 35631 CPT 35631 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Art byp aortofemoral 35647 CPT 35647 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art byp aortoiliac 35637 CPT 35637 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Art bypass aorsubcl/carot/innom 35626 CPT 35626 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass aortobifemoral 35646 CPT 35646 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Art bypass aortobi-iliac 35638 CPT 35638 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Art bypass axillary-femoral 35621 CPT 35621 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass axill-fem-femoral 35654 CPT 35654 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass carotid-subclavian 35606 CPT 35606 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass common ipsi carotid 35601 CPT 35601 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass fem-ant-post tib/prl 35666 CPT 35666 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass femoral-femoral 35661 CPT 35661 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass femoral-popliteal 35656 CPT 35656 | $4,717.50 | $9,250.00 | $2,238.00 – $9,773.00 | 3 |
| Art bypass iliofemoral 35665 CPT 35665 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art bypass subclav-subclavian 35612 CPT 35612 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art byp axillary-axillary 35650 CPT 35650 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art byp grft aortbifemoral 35540 CPT 35540 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Art byp grft aortobi-iliac 35538 CPT 35538 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Art byp grft fem-femoral 35558 CPT 35558 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art byp grft fem-popliteal 35556 CPT 35556 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art byp ilioiliac 35663 CPT 35663 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Art byp pop-tibl-prl-other 35571 CPT 35571 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Arterial blood draw/perc 36620 CPT 36620 | $1,263.27 | $2,477.00 | $1,716.00 – $12,908.00 | 3 |
| Artery by graft; iliofemoral 35565 CPT 35565 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Artery to vein shunt CPT 36835 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Artery transpose/endovas taa CPT 33889 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Artery-vein nonautograft CPT 36830 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Artery xray each vessel 7577426 CPT 75774 | $1,747.26 | $3,426.00 | $989.97 – $3,146.56 | 2 |
| Artery xray of abdomen 75726-26 CPT 75726 | $5,316.24 | $10,424.00 | $1,225.83 – $7,742.78 | 4 |
| Artery x-rays adrenal gland CPT 75731 | $4,624.68 | $9,068.00 | $1,244.88 – $4,393.52 | 4 |
| Artery x-rays adrenals CPT 75733 | not published | not published | $1,425.95 – $4,434.05 | 4 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $3,921.90 | $7,690.00 | $1,244.88 – $4,434.05 | 4 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $4,691.49 | $9,199.00 | $1,430.77 – $4,434.05 | 4 |
| Artery x-rays chest CPT 75756 | not published | not published | $1,247.25 – $4,434.05 | 4 |
| Artery x-rays lung CPT 75741 | $3,191.58 | $6,258.00 | $1,078.13 – $4,434.05 | 4 |
| Artery x-rays lung CPT 75746 | $4,627.23 | $9,073.00 | $1,173.40 – $4,393.52 | 4 |
| Artery x-rays lungs CPT 75743 | $3,191.58 | $6,258.00 | $1,137.67 – $4,434.05 | 4 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $5,316.24 | $10,424.00 | $1,223.45 – $7,742.78 | 4 |
| Artery x-rays spine CPT 75705 | $7,949.88 | $15,588.00 | $1,240.14 – $7,742.78 | 4 |
| Art expos/graft artery perfusion 33987 CPT 33987 | not published | not published | $691.00 – $9,773.00 | 3 |
| Arthrd ant ntrbd min dsc crv CPT 22554 | not published | not published | $4,812.00 – $18,229.15 | 5 |
| Arthrd ant ntrbd min dsc lum CPT 22558 | not published | not published | $3,423.00 – $37,756.02 | 5 |
| Arthrd ant ntrbdy cervical CPT 22551 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Arthrd cmbn 1ntrspc lumbar CPT 22633 | not published | not published | $5,530.00 – $37,756.02 | 5 |
| Arthrd dst rad/ul jt sgm rsc CPT 25830 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Arthrd elbow jt autog graft CPT 24802 | not published | not published | $4,812.00 – $18,229.15 | 5 |
| Arthrd glenohumeral jt w/grf CPT 23802 | not published | not published | $6,682.00 – $18,229.15 | 5 |
| Arthrd pst tq 1ntrspc lum CPT 22630 | not published | not published | $3,423.00 – $37,756.02 | 5 |
| Arthrd si jt perq/min nvas CPT 27279 | not published | not published | $3,423.00 – $24,668.00 | 5 |
| Arthrd si jt prq wo tfxj dev CPT 27278 | not published | not published | $691.00 – $24,668.00 | 5 |
| Arthrd wrist complete wo grf CPT 25800 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Arthrd wrist lmtd without b1 grf CPT 25820 | $14,326.92 | $28,092.00 | $4,233.00 – $11,377.00 | 5 |
| Arthrd wrist with autograft CPT 25825 | not published | not published | $4,812.00 – $15,575.00 | 5 |
| Arthrd wrist w/sliding graft CPT 25805 | not published | not published | $4,812.00 – $15,575.00 | 5 |
| Arthrd wrst iliac/oth agrft CPT 25810 | not published | not published | $4,812.00 – $18,229.15 | 5 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $850.17 | $1,667.00 | $427.11 – $4,042.00 | 5 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $2,573.46 | $5,046.00 | $691.00 – $4,042.00 | 5 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $2,573.46 | $5,046.00 | $427.11 – $5,318.00 | 5 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $850.17 | $1,667.00 | $427.11 – $4,042.00 | 5 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $850.17 | $1,667.00 | $427.11 – $5,318.00 | 5 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $850.17 | $1,667.00 | $427.11 – $4,042.00 | 5 |
| Arthrodes/ant/cerv below c2 ea add 22552 CPT 22552 | not published | not published | $9,773.00 – $12,908.00 | 3 |
| Arthrodesis big toe joint 28760 CPT 28760 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Arthrodesis/cerv/thor/lumb/ea add 22585 CPT 22585 | not published | not published | $2,238.00 – $15,575.00 | 3 |
| Arthrodesis/combine app/ea add 22634 CPT 22634 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Arthrodesis elbw joint local CPT 24800 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Arthrodesis glenohumeral jt CPT 23800 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Arthrodesis pantalar CPT 28705 | not published | not published | $4,233.00 – $24,895.59 | 5 |
| Arthrodesis/post interbdy/ea add 22632 CPT 22632 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Arthrodesis presacral intrbod with instr l5-s1 22586 CPT 22586 | not published | not published | $5,530.00 – $24,397.68 | 5 |
| Arthrodesis/sg level/cerv/below c2 22600 CPT 22600 | not published | not published | $2,995.00 – $24,397.68 | 5 |
| Arthrodesis/sng lev/ea add ver seg 22614 CPT 22614 | not published | not published | $1,716.00 – $12,908.00 | 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.