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 |
|---|---|---|---|---|
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $178.50 | $350.00 | $34.39 – $301.34 | 4 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $71.40 | $140.00 | $34.39 – $104.52 | 4 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $396.78 | $778.00 | $34.39 – $298.03 | 4 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | not published | not published | $34.39 – $70.18 | 4 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $174.42 | $342.00 | $41.98 – $227.07 | 4 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $147.26 | $288.75 | $70.75 – $377.09 | 4 |
| Mayo infliximab therapeutic drug level CPT 80230 | not published | not published | $37.80 – $114.87 | 4 |
| Mayo inhab inhibin a CPT 86336 | $86.70 | $170.00 | $15.28 – $198.53 | 4 |
| Mayo insft insulin free CPT 83527 | $70.69 | $138.60 | $12.69 – $114.63 | 4 |
| Mayo insulin antibodies CPT 86337 | $76.04 | $149.10 | $20.98 – $159.53 | 4 |
| Mayo iodine CPT 83789 | not published | not published | $23.63 – $157.82 | 4 |
| Mayo itraconazole therapeutic drug level CPT 80189 | not published | not published | $26.57 – $80.71 | 4 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $79.56 | $156.00 | $26.57 – $80.71 | 4 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $38.22 | $74.95 | $12.98 – $67.00 | 4 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $26.78 | $52.50 | $12.53 – $112.15 | 4 |
| Mayo legionella antibody CPT 86713 | $37.23 | $73.00 | $14.99 – $132.35 | 4 |
| Mayo leptospira antibody igm CPT 86720 | not published | not published | $15.88 – $75.40 | 4 |
| Mayo lipoprotein electrophoresis CPT 83700 | $12.57 | $24.64 | $11.03 – $97.32 | 4 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $52.54 | $103.02 | $15.18 – $189.55 | 4 |
| Mayo manganese CPT 83785 | not published | not published | $26.12 – $215.79 | 4 |
| Mayo metanephrines plasma CPT 83835 | $94.35 | $185.00 | $16.60 – $148.72 | 4 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $55.45 | $108.73 | $0.07 – $131.65 | 2 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $114.60 | $224.70 | $11.81 – $43.49 | 4 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $22.57 | $44.25 | $18.03 – $43.49 | 4 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $42.02 | $82.40 | $14.26 – $128.51 | 4 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $145.35 | $285.00 | $18.27 – $127.81 | 4 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $280.50 | $550.00 | $134.26 – $274.00 | 4 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $181.50 – $551.52 | 4 |
| Mayo muramidase CPT 85549 | $49.14 | $96.35 | $18.38 – $164.62 | 4 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $499.80 | $980.00 | $18.03 – $43.49 | 4 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $83.64 | $164.00 | $17.69 – $91.23 | 4 |
| Mayo myoglobin CPT 83874 | $62.35 | $122.25 | $12.66 – $113.68 | 4 |
| Mayo nickel CPT 83885 | not published | not published | $24.02 – $215.08 | 4 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $51.00 | $100.00 | $0.07 – $156.82 | 2 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | not published | not published | $0.07 – $156.82 | 2 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $5.56 | $10.91 | $0.07 – $156.82 | 2 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $101.36 | $198.75 | $20.79 – $144.41 | 4 |
| Mayo organic acids qualitative each specimen CPT 83919 | not published | not published | $16.12 – $143.82 | 4 |
| Mayo oxalate 24 hour urine CPT 83945 | $17.85 | $35.00 | $14.16 – $112.97 | 4 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $20.40 | $40.00 | $11.30 – $79.89 | 4 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $35.70 | $70.00 | $14.73 – $132.12 | 4 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $76.50 | $150.00 | $11.81 – $105.82 | 4 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | not published | not published | $34.39 – $298.03 | 4 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $52.02 | $102.00 | $17.62 – $119.77 | 4 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $30.29 | $59.40 | $13.48 – $123.02 | 4 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $31.75 | $62.26 | $8.27 – $74.15 | 4 |
| Mayo pregnenolone CPT 84140 | $51.28 | $100.55 | $20.26 – $177.56 | 4 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $15.81 | $31.00 | $16.26 – $145.71 | 4 |
| Mayo proinsulin CPT 84206 | $87.21 | $171.00 | $26.16 – $151.26 | 4 |
| Mayo psaft prostate specific antigen free CPT 84154 | $249.90 | $490.00 | $18.02 – $160.72 | 4 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $499.80 | $980.00 | $18.03 – $118.59 | 4 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | not published | not published | $13.09 – $117.23 | 4 |
| Mayo receptor assay transferrin soluble CPT 84238 | $112.20 | $220.00 | $35.84 – $310.50 | 4 |
| Mayo renin CPT 84244 | $40.47 | $79.35 | $21.55 – $193.04 | 4 |
| Mayo repu protein electrophoresis urine CPT 84166 | $132.60 | $260.00 | $17.47 – $153.33 | 4 |
| Mayo selenium CPT 84255 | $56.61 | $111.00 | $25.02 – $224.12 | 4 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $15.19 – $135.96 | 4 |
| Mayo serotonin CPT 84260 | $79.25 | $155.40 | $30.36 – $271.86 | 4 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $38.25 | $75.00 | $18.96 – $169.76 | 4 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $65.87 | $129.15 | $13.46 – $117.82 | 4 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | not published | not published | $23.46 – $92.03 | 3 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $22.26 | $43.65 | $4.18 – $37.46 | 4 |
| Mayo tau phosphorylated 217 each CPT 84393 | not published | not published | $126.34 – $162.25 | 3 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | not published | not published | $204.74 – $932.57 | 4 |
| Mayo tgrp testosterone free CPT 84402 | $52.38 | $102.71 | $24.96 – $228.25 | 4 |
| Mayo tgrp testosterone total CPT 84403 | $232.05 | $455.00 | $25.29 – $226.54 | 4 |
| Mayo thiopurine s-methyltransferase CPT 84433 | not published | not published | $21.73 – $117.64 | 4 |
| Mayo thyroglobulin CPT 84432 | $16.96 | $33.25 | $15.74 – $143.76 | 4 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | not published | not published | $9.98 – $89.22 | 4 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $95.37 | $187.00 | $12.14 – $107.66 | 4 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $5.56 | $10.91 | $0.07 – $156.82 | 2 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | not published | not published | $50.25 – $372.07 | 4 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | not published | not published | $13.88 – $91.29 | 4 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $20.99 | $41.15 | $13.27 – $85.44 | 4 |
| Mayo vasoactive intestinal peptide CPT 84586 | $15.30 | $30.00 | $34.62 – $102.75 | 4 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $71.76 | $140.70 | $19.84 – $150.79 | 4 |
| Mayo vitamin b3 (niacin) CPT 84591 | $87.72 | $172.00 | $16.72 – $101.69 | 4 |
| Mayo vitamin k CPT 84597 | $112.46 | $220.50 | $13.45 – $116.40 | 4 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $52.75 | $103.44 | $12.98 – $67.00 | 4 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Mcoln1 gene CPT 81290 | not published | not published | $38.52 – $485.22 | 4 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $2,237.46 – $11,377.00 | 5 |
| Mcrscp xm hair pluck/clipped CPT 96902 | not published | not published | $162.97 – $162.97 | 1 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $192.74 – $529.83 | 3 |
| Measure kidney pressure CPT 50396 | not published | not published | $970.26 – $4,042.00 | 5 |
| Measurement post void urine by ultrasound CPT 51798 | $223.89 | $439.00 | $82.09 – $4,042.00 | 5 |
| Measure ureter pressure CPT 50686 | not published | not published | $179.04 – $4,042.00 | 5 |
| Mecasermin injection HCPCS J2170 | not published | not published | $16.79 – $948.47 | 2 |
| Mechlorethamine hcl inj HCPCS J9230 | not published | not published | $15.12 – $272.62 | 2 |
| #mec-opiates CPT 80356 | $5.56 | $10.91 | $0.07 – $156.82 | 2 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $147.00 – $352.87 | 4 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $517.31 – $1,939.29 | 4 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $52.65 – $240.00 | 4 |
| Medial canthopexy CPT 21280 | not published | not published | $4,613.34 – $11,377.00 | 5 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $5,318.00 – $11,377.00 | 5 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $5,318.00 – $11,377.00 | 5 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $202.99 – $529.83 | 3 |
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.