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 |
|---|---|---|---|---|
| Insrt/redo neurostim 1 array CPT 61885 | not published | not published | $2,995.00 – $42,937.38 | 5 |
| Ins sk-mnt crnl nstm pg/rcvr CPT 61889 | not published | not published | $691.00 – $12,568.00 | 3 |
| Ins subq extnsn pertneal cath CPT 49435 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Install spinal shunt CPT 63740 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Install spinal shunt 63741 CPT 63741 | not published | not published | $8,992.00 – $12,460.49 | 5 |
| Inst fibrinolysis agent ini day CPT 32561 | $1,132.71 | $2,221.00 | $872.87 – $4,042.00 | 5 |
| Inst fibrinolysis agent sbsq d CPT 32562 | $1,132.71 | $2,221.00 | $691.00 – $4,042.00 | 5 |
| Insti hexaminolevulinate hcl HCPCS A9589 | not published | not published | $1,538.09 – $2,963.58 | 2 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $971.04 | $1,904.00 | $297.38 – $4,042.00 | 5 |
| Instill, bupivac and meloxic HCPCS C9088 | not published | not published | $0.95 – $1.66 | 2 |
| Instill pharm renal pelvis HCPCS C9789 | not published | not published | $1,703.14 – $6,732.00 | 4 |
| Instll rx agnt into rnal tub CPT 50391 | not published | not published | $347.66 – $4,042.00 | 5 |
| Ins trurl ablt trnsdc thr Ultrasound CPT 51721 | not published | not published | $691.00 – $12,568.00 | 3 |
| Inst tauro 1.35mg/hep 100u HCPCS J0911 | not published | not published | $4.92 – $18.47 | 4 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | not published | not published | $5,318.00 – $15,575.00 | 5 |
| Ins tun cv cath wo subq prt/pm CPT 36557 | $11,132.79 | $21,829.00 | $2,238.00 – $15,575.00 | 5 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $6,153.66 | $12,066.00 | $2,238.00 – $11,377.00 | 5 |
| Ins tun intraperit dia cath CPT 49421 | $7,717.83 | $15,133.00 | $2,238.00 – $11,377.00 | 5 |
| Inst via cath agent pleurds CPT 32560 | $909.33 | $1,783.00 | $872.87 – $4,042.00 | 5 |
| Insulin for insulin pump use HCPCS J1817 | $19.03 | $37.32 | $4.17 – $5.35 | 3 |
| Insulin suppression panel CPT 80432 | not published | not published | $162.30 – $863.38 | 4 |
| Insulin tolerance panel CPT 80434 | not published | not published | $279.33 – $754.25 | 4 |
| Insulin tolerance panel CPT 80435 | not published | not published | $100.94 – $767.07 | 4 |
| Insulin total CPT 83525 | $13.80 | $27.05 | $11.20 – $100.33 | 4 |
| Ins vag brachytx device CPT 57156 | $750.72 | $1,472.00 | $424.02 – $4,042.00 | 5 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $18,177.26 | $35,641.68 | $1,033.36 – $3,212.85 | 2 |
| Integra meshed bil wound mat HCPCS C9363 | $53,973.90 | $105,831.18 | $77.75 – $176.69 | 3 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $4,469.64 | $8,764.00 | not published | 0 |
| Intens cardiac rehab no exer HCPCS G0423 | not published | not published | $179.37 – $409.89 | 3 |
| Intens cardiac rehab w/exerc HCPCS G0422 | not published | not published | $179.37 – $409.89 | 3 |
| Intercalary algrft compl CPT 20934 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Interdental fixation CPT 21110 | $3,396.09 | $6,659.00 | $2,158.97 – $4,737.00 | 5 |
| Interdental wirg oth/thn fx CPT 21497 | not published | not published | $2,158.97 – $4,737.00 | 5 |
| Interdiscal perq aspir dx CPT 62267 | $1,867.11 | $3,661.00 | $985.34 – $4,042.00 | 5 |
| Interferon alfa-2a inj HCPCS J9213 | not published | not published | $44.98 – $73.01 | 2 |
| Interferon alfa-2b inj HCPCS J9214 | not published | not published | $16.97 – $27.13 | 2 |
| Interferon alfacon-1 inj HCPCS J9212 | not published | not published | $5.47 – $13.22 | 2 |
| Interferon alfa-n3 inj HCPCS J9215 | not published | not published | $11.04 – $77.70 | 2 |
| Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper) HCPCS Q3027 | not published | not published | $54.16 – $117.54 | 2 |
| Interferon beta-1a inj HCPCS J1826 | not published | not published | $974.38 – $4,736.75 | 2 |
| Interferon beta-1b / .25 mg HCPCS J1830 | not published | not published | $101.27 – $1,059.05 | 2 |
| Interferon gamma 1-b inj HCPCS J9216 | not published | not published | $423.99 – $21,825.90 | 2 |
| Interfyl, 1 mg HCPCS Q4171 | $6,410.32 | $12,569.26 | $26.08 – $46.46 | 2 |
| Intermediate visual field xm CPT 92082 | not published | not published | $82.09 – $83.76 | 2 |
| Internal nerve revision 64727 CPT 64727 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Interrogate subq defib CPT 93261 | not published | not published | $51.93 – $237.83 | 3 |
| Interrogation vad in person CPT 93750 | not published | not published | $132.29 – $1,716.00 | 4 |
| Interrog dev eval icpms ip CPT 93290 | not published | not published | $51.93 – $73.21 | 3 |
| Interrog dev eval scrms ip CPT 93291 | not published | not published | $40.25 – $120.36 | 3 |
| Interrog device eval heart CPT 93289 | $86.19 | $169.00 | $51.93 – $162.55 | 3 |
| Interrog evl pm/ldls pm ip CPT 93288 | $86.19 | $169.00 | $51.93 – $134.42 | 3 |
| Interrog&prgrmg ipnss CPT 93151 | not published | not published | $132.29 – $691.00 | 3 |
| Interrog&prgrmg ipnss polysm CPT 93152 | not published | not published | $427.37 – $691.00 | 3 |
| Interrog without prgrmg ipnss CPT 93153 | not published | not published | $120.81 – $691.00 | 3 |
| Interthoracoscplr amputation CPT 23900 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Intestinal stricturoplasty CPT 44615 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Intestine transplnt cadaver CPT 44135 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Int hrhc lig 1 hroid without img CPT 46945 | $5,565.63 | $10,913.00 | $2,238.00 – $6,732.00 | 5 |
| Int hrhc lig 2+hroid without img CPT 46946 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Intra-atrial pacing CPT 93610 | not published | not published | $4,042.00 – $11,074.44 | 4 |
| Intra-atrial recording CPT 93602 | $10,451.94 | $20,494.00 | $4,042.00 – $11,074.44 | 4 |
| Intracard echo interv w/s&i CPT 93662 | $3,282.87 | $6,437.00 | $572.43 – $1,716.00 | 2 |
| Intracran angioplsty w/stent CPT 61635 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Intracranial angioplasty CPT 61630 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Intracranial complete study CPT 93886 | not published | not published | $332.01 – $1,152.31 | 3 |
| Intracranial limited study CPT 93888 | not published | not published | $145.47 – $759.80 | 3 |
| Intracranial vessel surgery CPT 61680 | not published | not published | $4,233.00 – $12,568.00 | 3 |
| Intracranial vessel surgery CPT 61682 | not published | not published | $6,682.00 – $12,568.00 | 3 |
| Intracranial vessel surgery CPT 61684 | not published | not published | $4,812.00 – $12,568.00 | 3 |
| Intracranial vessel surgery CPT 61686 | not published | not published | $6,682.00 – $12,568.00 | 3 |
| Intracranial vessel surgery CPT 61690 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Intracranial vessel surgery CPT 61692 | not published | not published | $6,682.00 – $12,568.00 | 3 |
| Intranasal biopsy 30100 CPT 30100 | $3,006.96 | $5,896.00 | $2,158.97 – $4,737.00 | 5 |
| Intranasal reconstruction CPT 30620 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Intraop colon lavage add-on CPT 44701 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Intraop epicard/endocard/pace/map/ 93631 CPT 93631 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Intraop hipec px 1st 60 min CPT 96547 | not published | not published | $1,716.00 – $2,238.00 | 2 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | $807.33 | $1,583.00 | $750.46 – $4,042.00 | 5 |
| Intraoral periapical first HCPCS D0220 | not published | not published | $121.09 – $123.56 | 2 |
| Intrapul surf admin endo tube CPT 94610 | $221.85 | $435.00 | $304.70 – $310.92 | 2 |
| Intrauterine transfusion ftl CPT 36460 | not published | not published | $613.88 – $4,042.00 | 5 |
| Intraventricular pacing CPT 93612 | not published | not published | $4,042.00 – $11,074.44 | 4 |
| Intrinsic factor antibody CPT 86340 | $48.20 | $94.50 | $14.78 – $132.30 | 4 |
| Intrm oph exam est patient CPT 92012 | not published | not published | $185.25 – $189.04 | 2 |
| Intro cath dialysis circuit CPT 36901 | $1,567.74 | $3,074.00 | $2,190.38 – $6,682.00 | 5 |
| Intro cath dialysis circuit w/pta CPT 36902 | $5,525.85 | $10,835.00 | $6,682.00 – $15,575.00 | 5 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $11,198.58 | $21,958.00 | $6,682.00 – $20,488.00 | 5 |
| Intro catheter aorta CPT 36200 | $1,039.89 | $2,039.00 | $1,104.53 – $5,318.00 | 3 |
| Intro cath svc/ivc CPT 36010 | $812.43 | $1,593.00 | $871.73 – $4,042.00 | 3 |
| Intro long gi tube CPT 44500 | $1,787.55 | $3,505.00 | $1,262.04 – $4,737.00 | 5 |
| Intro long gi tube w/mult fluo CPT 74340 | $1,372.41 | $2,691.00 | $564.85 – $657.99 | 2 |
| Intro windpipe wire/tube CPT 31730 | $3,483.81 | $6,831.00 | $2,238.00 – $4,737.00 | 5 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $6,545.85 | $12,835.00 | $661.58 – $4,042.00 | 3 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $3,452.19 | $6,769.00 | $528.20 – $4,042.00 | 3 |
| Intubation endotracheal emergency procedure CPT 31500 | $1,108.74 | $2,174.00 | $329.57 – $4,042.00 | 5 |
| Io anal gast n-stim init CPT 95980 | not published | not published | $232.86 – $232.86 | 1 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $82.09 – $92.23 | 3 |
| Iodine i-123 sod iodide mil HCPCS A9509 | not published | not published | $362.34 – $2,002.66 | 2 |
| Iodine i-125 sodium iodide HCPCS A9527 | not published | not published | $388.39 – $448.45 | 3 |
| Iodine i-131 iobenguane 1mci HCPCS A9590 | not published | not published | $432.10 – $2,442.09 | 2 |
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.