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, hercessi, 10 mg HCPCS Q5146 | not published | not published | $37.11 – $227.58 | 4 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $54.90 – $158.91 | 4 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $830.79 | $1,629.00 | $1,716.00 – $4,042.00 | 2 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.30 – $3.18 | 4 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | not published | not published | $5.33 – $11.14 | 4 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | not published | not published | $22.07 – $73.38 | 2 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $76.12 – $165.44 | 4 |
| Inj, idacio, 1 mg HCPCS Q5144 | not published | not published | $20.79 – $32.18 | 2 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | not published | not published | $3.17 – $5.38 | 3 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $77.85 – $166.20 | 4 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | not published | not published | $0.28 – $0.30 | 3 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $485.63 – $1,041.46 | 4 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $1,230.71 – $4,042.00 | 5 |
| Inj. infugem, 100 mg HCPCS J9198 | not published | not published | $54.37 – $54.37 | 1 |
| Inj. insulin (fiasp) HCPCS J1812 | not published | not published | $2.04 – $4.13 | 2 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $391.68 | $768.00 | $279.18 – $4,042.00 | 5 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $279.18 – $4,042.00 | 5 |
| Inj, invega hafyera/trinza HCPCS J2427 | not published | not published | $12.69 – $27.24 | 4 |
| Inj ivig privigen 500 mg HCPCS J1459 | not published | not published | $48.54 – $105.74 | 4 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $1.93 – $4.13 | 4 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.60 – $5.27 | 4 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $1.53 – $3.20 | 4 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | not published | not published | $2.76 – $4.27 | 3 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $85.11 – $182.32 | 4 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $31.55 – $106.00 | 4 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $1.31 – $2.86 | 4 |
| Inj lefamulin 1 mg HCPCS J0691 | not published | not published | $0.98 – $1.76 | 2 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $21.85 – $47.36 | 4 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $182.65 | $358.13 | $48.75 – $52.42 | 3 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.03 – $1.85 | 3 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $250.28 | $490.75 | $6.82 – $15.86 | 4 |
| Inj, levothyroxine, hikma HCPCS J0652 | not published | not published | $10.27 – $11.05 | 3 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $84.15 | $165.00 | $0.09 – $0.09 | 2 |
| Inj, linezolid (hospira) HCPCS J2021 | not published | not published | $12.68 – $30.23 | 3 |
| Inj, lovotibeglogene autotem HCPCS J3394 | not published | not published | $3,180,473.76 – $7,064,900.00 | 3 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $321.16 – $685.53 | 4 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $22.93 – $50.29 | 4 |
| Inj luxturna 1 billion vec g HCPCS J3398 | not published | not published | $3,008.69 – $6,764.46 | 4 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | not published | not published | $691.00 – $1,716.00 | 2 |
| Inj. meloxicam 1 mg HCPCS J1738 | not published | not published | $4.48 – $8.08 | 2 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $118.25 – $549.28 | 4 |
| Inj, melphalan (apotex) 1 mg HCPCS J9249 | not published | not published | $63.48 – $157.51 | 3 |
| Inj, melphalan flufenami 1mg HCPCS J9247 | not published | not published | $679.66 – $679.66 | 1 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $779.10 – $1,663.67 | 4 |
| Inj menotropins 75 iu HCPCS S0122 | not published | not published | $191.47 – $191.47 | 1 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | not published | not published | $7.25 – $19.94 | 3 |
| Inj, meropenem (b. braun) HCPCS J2184 | not published | not published | $4.17 – $5.10 | 3 |
| Inj., meropenem, vaborbactam HCPCS J2186 | not published | not published | $2.13 – $4.54 | 4 |
| Inj meropenem (wg crit care) HCPCS J2183 | $159.91 | $313.54 | $2.32 – $3.44 | 3 |
| Inj metaraminol bitartrate HCPCS J0380 | not published | not published | $2.09 – $14.10 | 2 |
| Inj, micafungin (par pharm) HCPCS J2247 | not published | not published | $0.61 – $2.13 | 3 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | not published | not published | $41.25 – $102.28 | 4 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $248.40 – $523.80 | 4 |
| Inj, motixafortide, 0.25 mg HCPCS J2277 | not published | not published | $25.95 – $54.22 | 4 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | not published | not published | $13.08 – $18.43 | 3 |
| Inj moxifloxacin (fres kabi) HCPCS J2281 | not published | not published | $14.21 – $16.41 | 3 |
| Inj multihance HCPCS A9577 | not published | not published | $3.91 – $7.83 | 2 |
| Inj multihance multipack HCPCS A9578 | not published | not published | $3.89 – $8.24 | 2 |
| Inj. mycophenolate mofetil HCPCS J7519 | $243.79 | $478.01 | $0.61 – $1.67 | 3 |
| Inj naloxone hydrochloride HCPCS J2310 | not published | not published | $5.66 – $19.80 | 3 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | not published | not published | $672.37 – $1,379.93 | 4 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $727.77 | $1,427.00 | $524.98 – $4,042.00 | 5 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | not published | not published | $2.12 – $4.67 | 4 |
| Inj, nogapendekin pmln, 1mcg HCPCS J9028 | not published | not published | $92.71 – $203.35 | 4 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Inj, nyposi 1 mcg HCPCS Q5148 | not published | not published | $1.01 – $1.16 | 3 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | not published | not published | $45.86 – $97.16 | 3 |
| Inj, ocriplasmin, 0.125 mg HCPCS J7316 | not published | not published | $1,412.93 – $1,412.93 | 1 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | not published | not published | $61.11 – $90.04 | 3 |
| Inj ogivri 10 mg HCPCS Q5114 | $2,210.24 | $4,333.80 | $35.07 – $125.96 | 4 |
| Inj, olaratumab, 10 mg HCPCS J9285 | not published | not published | $67.51 – $126.72 | 2 |
| Inj, oliceridine 0.1 mg HCPCS C9101 | not published | not published | $1.85 – $2.80 | 2 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $387.69 – $819.67 | 4 |
| Inj, omacetaxine mep, 0.01mg HCPCS J9262 | not published | not published | $3.43 – $16.10 | 2 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $4.05 – $8.32 | 4 |
| Inj onase abepar-xioi treat HCPCS J3399 | not published | not published | $2,535,345.51 – $5,209,732.14 | 3 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $29.21 – $126.35 | 4 |
| Inj, pafolacianine, 0.1 mg HCPCS A9603 | not published | not published | $190.03 – $190.03 | 1 |
| Inj, palonosetron (posfrea) HCPCS J2468 | not published | not published | $54.18 – $128.81 | 4 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $84.15 | $165.00 | $9.27 – $16.77 | 2 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $72.35 – $151.42 | 4 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $385.23 – $1,132.92 | 4 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $98.88 – $212.94 | 4 |
| Inj, pedmark, 100 mg HCPCS J0208 | not published | not published | $93.54 – $205.11 | 4 |
| Inj, pegcetacoplan, 1mg HCPCS J2781 | not published | not published | $144.85 – $309.58 | 4 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | not published | not published | $49.42 – $468.05 | 4 |
| Inj, pegulicianine, 1 mg HCPCS A9615 | not published | not published | $36.76 – $80.65 | 4 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $7.83 – $105.53 | 4 |
| Inj pemetrexed (accord) 10mg HCPCS J9296 | not published | not published | $9.46 – $20.94 | 4 |
| Inj, pemetrexed (avyxa) 10mg HCPCS J9292 | not published | not published | $80.38 – $174.95 | 4 |
| Inj pemetrexed (bluepoint) HCPCS J9322 | not published | not published | $10.39 – $13.72 | 3 |
| Inj pemetrexed ditromethamin HCPCS J9323 | not published | not published | $15.77 – $22.23 | 3 |
| Inj pemetrexed, hospira 10mg HCPCS J9294 | $565.97 | $1,109.74 | $5.09 – $15.77 | 4 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | not published | not published | $3.48 – $13.72 | 3 |
| Inj pemetrexed (teva) 10mg HCPCS J9314 | not published | not published | $10.77 – $28.38 | 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.