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 |
|---|---|---|---|---|
| Lengthening of thigh tendons CPT 27395 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $4,233.00 – $18,229.15 | 5 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Lens, intraocular (new tech) HCPCS C1780 | $1,213.80 | $2,380.00 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $3,202.80 | $6,280.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $3,202.80 | $6,280.00 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $368.48 | $722.50 | not published | 0 |
| Lepirudin HCPCS J1945 | not published | not published | $173.60 – $312.27 | 2 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $327.88 | $642.91 | $7.03 – $28.75 | 3 |
| Leukacyte transfusion CPT 86950 | not published | not published | $237.06 – $420.17 | 4 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $10.18 – $67.83 | 4 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | not published | not published | $172.68 – $767.58 | 4 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $642.75 – $3,591.15 | 4 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $6,777.15 – $6,777.15 | 1 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $123.25 – $325.73 | 2 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $441.49 – $679.69 | 4 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $39.15 – $132.89 | 4 |
| Lev 1 hosp type b ed visit HCPCS G0380 | $131.07 | $257.00 | not published | 0 |
| Lev 2 hosp type b ed visit HCPCS G0381 | $238.17 | $467.00 | not published | 0 |
| Lev 3 hosp type b ed visit HCPCS G0382 | $416.67 | $817.00 | not published | 0 |
| Lev 4 hosp type b ed visit HCPCS G0383 | $598.74 | $1,174.00 | not published | 0 |
| Lev 5 hosp type b ed visit HCPCS G0384 | $738.99 | $1,449.00 | not published | 0 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $3.15 – $4.17 | 2 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.57 – $1.76 | 3 |
| Levalbuterol non-comp unit HCPCS J7614 | $5.61 | $11.00 | $0.17 – $1.76 | 3 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $153.61 | $301.20 | $0.10 – $1.02 | 3 |
| Levetiracetam therapeutic drug level CPT 80177 | $33.28 | $65.25 | $12.98 – $67.00 | 4 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $145.35 | $285.00 | $2.05 – $26.24 | 3 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $89.68 – $808.12 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $1,582.49 | $3,102.93 | $14.52 – $15.61 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $4,511.03 – $11,377.00 | 4 |
| Liberta rc ipg HCPCS C1820 | $69,293.60 | $135,869.80 | not published | 0 |
| Lidocaine injection HCPCS J2001 | not published | not published | $1.02 – $1.02 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $84.15 | $165.00 | $0.09 – $0.13 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $65.33 | $128.10 | $0.01 – $0.09 | 3 |
| Lidocaine therapeutic drug level CPT 80176 | $50.97 | $99.95 | $14.40 – $128.87 | 4 |
| Ligate esophagus veins CPT 43400 | not published | not published | $2,238.00 – $15,575.00 | 3 |
| Ligate leg veins open CPT 37761 | not published | not published | $2,741.00 – $5,318.00 | 5 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $4,504.34 – $6,732.00 | 5 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $3,523.59 | $6,909.00 | $2,298.14 – $4,737.00 | 5 |
| Ligation common iliac vein CPT 37660 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $4,393.52 – $11,377.00 | 5 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $2,741.00 – $4,483.19 | 5 |
| Ligation major artery chest CPT 37616 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Ligation/major artery/extremity 37618 CPT 37618 | $5,057.67 | $9,917.00 | $2,238.00 – $6,732.00 | 3 |
| Ligation major artery neck CPT 37615 | $5,780.85 | $11,335.00 | $2,741.00 – $5,530.00 | 5 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Ligation of femoral vein CPT 37650 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $5,530.00 – $15,575.00 | 5 |
| Ligation of neck artery CPT 37606 | not published | not published | $4,393.52 – $11,377.00 | 5 |
| Ligation of salivary duct CPT 42665 | not published | not published | $4,042.00 – $6,732.00 | 5 |
| Ligation of shunt CPT 49428 | not published | not published | $2,238.00 – $4,737.00 | 3 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $894.25 – $2,403.87 | 2 |
| Limb exercise test CPT 95875 | not published | not published | $126.15 – $182.70 | 3 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $1,716.00 – $15,202.00 | 4 |
| Limited autopsy CPT 88036 | not published | not published | $207.16 – $583.54 | 2 |
| Limited autopsy CPT 88037 | not published | not published | $184.06 – $518.30 | 2 |
| Limited visual field xm CPT 92081 | not published | not published | $82.09 – $83.76 | 2 |
| Lincomycin injection HCPCS J2010 | not published | not published | $6.77 – $13.42 | 3 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $274.02 | $537.30 | $6.94 – $50.54 | 3 |
| Lipase CPT 83690 | $145.35 | $285.00 | $6.75 – $60.39 | 4 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.18 – $213.13 | 4 |
| Lipoprotein blood quant CPT 83704 | $32.02 | $62.79 | $33.51 – $270.85 | 4 |
| Lipoprotein direct measurement hdl CPT 83718 | $184.11 | $361.00 | $8.03 – $71.79 | 4 |
| Lipoprotein direct measurement ldl CPT 83721 | $145.86 | $286.00 | $10.29 – $82.78 | 4 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $33.51 – $183.11 | 4 |
| Lip surgery procedure CPT 40799 | not published | not published | $329.57 – $2,995.00 | 4 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $551,015.62 – $1,110,350.92 | 3 |
| Listeria monocytogenes CPT 86723 | not published | not published | $12.93 – $115.75 | 4 |
| Lithium therapeutic drug level CPT 80178 | $198.90 | $390.00 | $6.48 – $57.96 | 4 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $3,079.89 | $6,039.00 | $691.00 – $12,908.00 | 2 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $172.67 – $416.45 | 4 |
| Liver elastography 91200 CPT 91200 | not published | not published | $179.04 – $257.26 | 4 |
| Liver Function Test CPT 80076 | $297.33 | $583.00 | $8.01 – $71.73 | 4 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Liver image (3d) with flow CPT 78206 | not published | not published | $1,462.99 – $1,462.99 | 1 |
| Liver imaging CPT 78201 | not published | not published | $589.33 – $2,035.50 | 4 |
| Liver imaging (3d) CPT 78205 | not published | not published | $1,465.00 – $1,465.00 | 1 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $716.73 – $2,035.50 | 4 |
| Liver/spleen imag static only CPT 78215 | $1,771.74 | $3,474.00 | $556.27 – $728.96 | 4 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $556.27 – $866.39 | 4 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $3,308.19 – $6,732.00 | 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.