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 |
|---|---|---|---|---|
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $128.54 – $393.47 | 4 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $17.94 – $38.23 | 4 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,499.92 – $7,408.00 | 4 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $2.58 – $4.00 | 2 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.19 – $6.75 | 4 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $50.79 – $111.43 | 4 |
| Inj. asceniv HCPCS J1554 | not published | not published | $490.91 – $1,067.86 | 4 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $55.16 – $116.92 | 4 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $31.31 – $66.39 | 3 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $101.33 – $231.00 | 4 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $79.58 – $167.31 | 4 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $59.21 – $59.21 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $160.09 – $351.10 | 4 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $22.53 – $100.75 | 2 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $2,879,553.60 – $6,338,658.66 | 3 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.03 – $85.72 | 4 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $209.74 – $451.31 | 4 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | $84.15 | $165.00 | $0.28 – $0.39 | 3 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $24.90 – $56.48 | 3 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $3.39 – $65.56 | 4 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $6.83 – $65.56 | 4 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $2.87 – $11.59 | 3 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $106.59 – $106.59 | 1 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $408.87 – $914.61 | 4 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,635.46 – $3,658.48 | 4 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $346.01 – $730.98 | 4 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $2,214.80 – $2,214.80 | 1 |
| Inj, bupivacaine liposome HCPCS J0666 | $116.67 | $228.76 | $1.38 – $3.05 | 4 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.69 – $1.08 | 2 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $69.49 – $323.37 | 4 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $84.15 | $165.00 | $1.48 – $2.56 | 2 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $350.54 – $558.36 | 2 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $2.49 – $3.52 | 3 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $84.15 | $165.00 | $1.96 – $2.13 | 3 |
| Inj cefazolin (wg crit care) HCPCS J0687 | $84.15 | $165.00 | $1.76 – $2.09 | 3 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | $219.71 | $430.80 | $11.61 – $17.25 | 3 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $10.09 – $10.84 | 3 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $722.32 | $1,416.31 | $2.37 – $4.90 | 4 |
| Inj ceftolozane tazobactam HCPCS J0695 | $616.62 | $1,209.06 | $5.94 – $17.29 | 4 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $118.75 – $295.90 | 4 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $16.58 – $33.58 | 4 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $81.81 – $389.21 | 4 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $90.55 – $193.18 | 4 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $5.91 – $8.65 | 2 |
| Inj, clindamycin (baxter) HCPCS J0737 | $145.35 | $285.00 | $5.05 – $6.21 | 3 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $258.57 | $507.00 | $1,716.00 – $12,908.00 | 3 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $109.06 – $191.69 | 2 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $2,859.84 | $5,607.53 | $1,745.57 – $2,243.63 | 3 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $540.48 – $1,185.75 | 4 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $13.65 – $30.83 | 4 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $17.23 – $35.86 | 4 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $3.65 – $12.49 | 4 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $5.19 – $19.46 | 4 |
| Inj cyclophosphamd auromedic HCPCS J9071 | $1,043.72 | $2,046.50 | $0.51 – $5.19 | 4 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | $1,568.93 | $3,076.34 | $0.49 – $3.78 | 3 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $3.58 – $9.33 | 4 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.09 – $0.15 | 3 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.11 – $0.19 | 3 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.06 – $0.19 | 3 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $3.03 – $6.43 | 4 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $1.55 – $7.14 | 3 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $3,254,948.85 – $7,143,317.60 | 3 |
| Inj diclofenac sodium 0.5mg HCPCS J1130 | not published | not published | $0.28 – $0.28 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $1,132.38 – $4,042.00 | 3 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.06 – $8.99 | 4 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $427.11 – $4,042.00 | 5 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $6.60 – $23.28 | 4 |
| Inj dx for sinogram CPT 20501 | $353.94 | $694.00 | $1,716.00 – $12,908.00 | 3 |
| Inject for sacroiliac joint HCPCS G0259 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,395.87 | $2,737.00 | $691.00 – $4,042.00 | 5 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $251.43 | $493.00 | $469.73 – $4,042.00 | 3 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $44.14 – $109.48 | 4 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $486.49 – $1,009.94 | 4 |
| Injection, cangrelor HCPCS C9460 | $1,909.51 | $3,744.13 | $19.62 – $40.23 | 4 |
| Injection, caplacizumab-yhdp HCPCS C9047 | not published | not published | $785.24 – $949.51 | 3 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $589.05 | $1,155.00 | $427.11 – $4,042.00 | 5 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $162.88 – $412.80 | 4 |
| Injection, cimetidine hydroc HCPCS S0023 | not published | not published | $4.27 – $4.27 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $66.21 – $145.40 | 4 |
| Injection, delafloxacin HCPCS C9462 | not published | not published | $0.64 – $0.64 | 1 |
| Injection, doxercalciferol HCPCS J1270 | not published | not published | $0.75 – $7.42 | 3 |
| Injection during cath supravalvular aortography CPT 93567 | $830.79 | $1,629.00 | $1,716.00 – $4,042.00 | 2 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $14.87 – $43.88 | 4 |
| Injection epidural blood patch or clot CPT 62273 | $2,589.27 | $5,077.00 | $982.21 – $4,042.00 | 5 |
| Injection estrone per 1 mg HCPCS J1435 | not published | not published | $0.69 – $1.30 | 2 |
| Injection eye drug CPT 67028 | $1,008.78 | $1,978.00 | $459.61 – $4,042.00 | 5 |
| Injection, famotidine, 20 mg HCPCS S0028 | not published | not published | $1.32 – $1.32 | 1 |
| Injection for arthrography wrist (both sides) CPT 25246 | $197.37 | $387.00 | $501.72 – $4,042.00 | 3 |
| Injection for bladder x-ray CPT 51600 | $334.56 | $656.00 | $339.86 – $4,042.00 | 3 |
| Injection for hip x-ray CPT 27095 | not published | not published | $545.03 – $4,042.00 | 3 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $261.63 | $513.00 | $344.61 – $4,042.00 | 3 |
| Injection for spleen x-ray CPT 38200 | $1,758.48 | $3,448.00 | $969.92 – $4,042.00 | 3 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $360.14 – $4,042.00 | 3 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $389.30 – $4,042.00 | 3 |
| Injection for ureter x-ray CPT 50690 | $334.56 | $656.00 | $542.12 – $4,042.00 | 3 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $74.22 – $74.22 | 1 |
| Injection, fulvestrant HCPCS J9395 | $2,728.69 | $5,350.38 | $13.79 – $117.31 | 3 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $45.16 – $348.69 | 2 |
| Injection, glucarpidase HCPCS C9293 | not published | not published | $321.93 – $449.10 | 3 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $12.36 – $26.38 | 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.