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 |
|---|---|---|---|---|
| Mast rad urban type CPT 19306 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Mast simple complete CPT 19303 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $173.16 – $691.00 | 4 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $5,518.34 – $5,518.34 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $14,292.65 | $28,024.80 | $29.58 – $176.69 | 4 |
| M.avium-intra dna amp prob CPT 87561 | $191.76 | $376.00 | $34.39 – $298.03 | 4 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $26.74 – $170.29 | 4 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $41.98 – $227.07 | 4 |
| Maxillofacial fixation CPT 21100 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $61.58 | $120.75 | $14.17 – $126.86 | 4 |
| Mayo aathr protein s free CPT 85306 | $97.46 | $191.10 | $15.01 – $134.54 | 4 |
| Mayo activated protein c resistance assay CPT 85307 | $53.30 | $104.50 | $15.01 – $134.42 | 4 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | not published | not published | $37.80 – $114.87 | 4 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $30.60 | $60.00 | $0.07 – $87.09 | 2 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $600.78 | $1,178.00 | $0.07 – $87.09 | 2 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $18.48 | $36.23 | $14.48 – $129.81 | 4 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $39.78 | $78.00 | $0.07 – $241.96 | 2 |
| Mayo alpha 1 antitrypsin CPT 82103 | $157.59 | $309.00 | $13.17 – $117.82 | 4 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $55.85 | $109.50 | $14.78 – $132.30 | 4 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $0.07 – $137.79 | 2 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $5.56 | $10.91 | $0.07 – $125.26 | 2 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $175.95 | $345.00 | $119.20 – $1,085.66 | 4 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $249.90 | $490.00 | $89.83 – $406.40 | 4 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | not published | not published | $134.26 – $715.60 | 4 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,224.00 | $2,400.00 | $99.09 – $2,320.00 | 4 |
| Mayo androstenedione CPT 82157 | $92.13 | $180.65 | $28.69 – $256.85 | 4 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $49.55 | $97.15 | $14.31 – $128.10 | 4 |
| Mayo antithrombin iii antigen CPT 85301 | $100.22 | $196.50 | $10.59 – $94.89 | 4 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $20.00 | $39.22 | $14.75 – $132.12 | 4 |
| Mayo avwpr vw factor activity CPT 85397 | $130.05 | $255.00 | $30.24 – $192.27 | 4 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | not published | not published | $34.39 – $186.18 | 4 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $55.45 | $108.73 | $0.07 – $92.29 | 2 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $19.97 | $39.15 | $9.98 – $89.22 | 4 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $43.35 | $85.00 | $141.94 – $339.40 | 4 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | not published | not published | $210.33 – $983.38 | 4 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $10.71 | $21.00 | $12.64 – $115.75 | 4 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $5.56 | $10.91 | $0.07 – $149.08 | 2 |
| Mayo bordetella pertussis antibody igg CPT 86615 | not published | not published | $12.93 – $115.75 | 4 |
| Mayo brcmg brucella antibody igm CPT 86622 | $46.41 | $91.00 | $8.75 – $70.79 | 4 |
| Mayo c1 esterase inhibitor CPT 83883 | $15.81 | $31.00 | $13.33 – $119.47 | 4 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $30.60 | $60.00 | $0.07 – $190.91 | 2 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $85.17 | $167.00 | $16.53 – $147.36 | 4 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | not published | not published | $26.24 – $234.99 | 4 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $26.14 | $51.25 | $119.78 – $635.48 | 4 |
| Mayo ceruloplasmin CPT 82390 | $114.24 | $224.00 | $10.53 – $94.24 | 4 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $32.13 | $63.00 | $13.84 – $124.02 | 4 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $46.80 | $91.76 | $12.62 – $113.09 | 4 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $10.24 | $20.07 | $11.58 – $113.27 | 4 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $10.23 | $20.06 | $12.43 – $113.27 | 4 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $161.93 | $317.50 | $114.16 – $868.05 | 4 |
| Mayo chromium CPT 82495 | $23.97 | $47.00 | $19.87 – $177.97 | 4 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $30.60 | $60.00 | $0.07 – $122.19 | 2 |
| Mayo coccidioides antibody CPT 86635 | $38.91 | $76.30 | $11.24 – $102.10 | 4 |
| Mayo cocou cortisone urine CPT 82542 | $84.15 | $165.00 | $23.61 – $157.82 | 4 |
| Mayo cortisol free CPT 82530 | $64.80 | $127.05 | $16.38 – $148.84 | 4 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $143.31 | $281.00 | $41.29 – $248.93 | 4 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $30.28 | $59.37 | $11.88 – $110.79 | 4 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | not published | not published | $0.07 – $163.97 | 2 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $5.56 | $10.91 | $0.07 – $188.19 | 2 |
| Mayo cyanide CPT 82600 | not published | not published | $19.01 – $170.29 | 4 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | not published | not published | $237.06 – $2,446.32 | 4 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $49.14 | $96.35 | $12.98 – $116.28 | 4 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $51.69 | $101.35 | $24.76 – $221.81 | 4 |
| Mayo dihydrotestosterone CPT 82642 | $93.18 | $182.70 | $28.69 – $169.93 | 4 |
| Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 | not published | not published | $9.45 – $84.49 | 4 |
| Mayo efpo chloride stool CPT 82438 | $26.86 | $52.66 | $4.90 – $42.90 | 4 |
| Mayo estriol CPT 82677 | $4.85 | $9.50 | $23.70 – $213.13 | 4 |
| Mayo estrone CPT 82679 | $85.73 | $168.10 | $24.45 – $219.04 | 4 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $43.76 | $85.80 | $16.01 – $143.40 | 4 |
| Mayo everolimus therapeutic drug level CPT 80169 | $57.12 | $112.00 | $13.46 – $69.37 | 4 |
| Mayo factor ii CPT 85210 | $102.06 | $200.12 | $12.72 – $113.98 | 4 |
| Mayo factor v CPT 85220 | $93.87 | $184.05 | $17.30 – $154.93 | 4 |
| Mayo factor vii CPT 85230 | $93.87 | $184.05 | $17.54 – $157.17 | 4 |
| Mayo factor viii vw factor antigen CPT 85246 | $89.38 | $175.25 | $22.48 – $201.37 | 4 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $109.14 | $214.00 | $22.48 – $201.37 | 4 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $76.34 | $149.69 | $22.48 – $201.37 | 4 |
| Mayo factor x CPT 85260 | $93.87 | $184.05 | $17.54 – $157.17 | 4 |
| Mayo factor xi CPT 85270 | $93.87 | $184.05 | $17.54 – $157.17 | 4 |
| Mayo fat/lipids feces quantitative CPT 82710 | $71.71 | $140.60 | $16.46 – $147.48 | 4 |
| Mayo fbl culture fungi blood CPT 87103 | $4.28 | $8.39 | $20.05 – $79.12 | 4 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $67.52 – $160.92 | 4 |
| Mayo ffspg allergen clam igg CPT 86001 | $18.89 | $37.04 | $7.66 – $45.85 | 4 |
| Mayo fibrinogen antigen CPT 85385 | not published | not published | $14.17 – $74.10 | 4 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | not published | not published | $21.24 – $67.00 | 4 |
| Mayo gamma-globin full gene sequencing CPT 81479 | not published | not published | $302.04 – $302.04 | 1 |
| Mayo hemosiderin qualitative urine CPT 83070 | not published | not published | $4.66 – $41.66 | 4 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $181.55 | $355.98 | $34.39 – $298.03 | 4 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | not published | not published | $34.39 – $298.03 | 4 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $13.65 | $26.77 | $13.51 – $110.79 | 4 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $68.85 | $135.00 | $25.29 – $208.52 | 4 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $39.93 | $78.30 | $8.71 – $77.94 | 4 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $39.93 | $78.30 | $13.25 – $120.54 | 4 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $6.50 | $12.75 | $26.63 – $238.42 | 4 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $210.80 | $413.33 | $16.92 – $113.62 | 4 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $32.61 | $63.95 | $14.69 – $131.59 | 4 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $168.30 | $330.00 | $20.39 – $182.52 | 4 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $46.59 | $91.35 | $20.39 – $182.64 | 4 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $34.39 – $70.18 | 4 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $155.04 | $304.00 | $15.75 – $78.88 | 4 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $58.78 | $115.26 | $11.74 – $79.77 | 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.