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 |
|---|---|---|---|---|
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $91.15 | $178.72 | $0.28 – $1.16 | 2 |
| Megestrol 20 mg tabs 100 each bottle HCPCS S0179 | not published | not published | $1.42 – $1.42 | 1 |
| Meg evoked each addl CPT 95967 | not published | not published | $1,756.60 – $1,756.60 | 1 |
| Meg evoked single CPT 95966 | not published | not published | $1,194.91 – $1,724.75 | 3 |
| Meg spontaneous CPT 95965 | not published | not published | $1,194.91 – $3,417.24 | 3 |
| Melphalan oral 2 mg HCPCS J8600 | not published | not published | $6.21 – $27.74 | 2 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $3,683.22 | $7,222.00 | $173.16 – $869.96 | 4 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $22,135.74 | $43,403.41 | $173.16 – $293.43 | 3 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | $4,118.45 | $8,075.40 | $56.57 – $56.57 | 1 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $173.16 – $391.69 | 3 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | not published | not published | $74,761.35 – $169,820.76 | 2 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $173.16 – $363.18 | 3 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $154.41 – $176.69 | 3 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | $50,691.06 | $99,394.24 | $116.25 – $176.69 | 4 |
| Menacwy-tt menb-fhbp vacc im CPT 90623 | not published | not published | $329.12 – $593.40 | 2 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $8,992.00 – $15,575.00 | 5 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $85.68 | $168.00 | $0.83 – $21.80 | 3 |
| Meperidine/promethazine inj HCPCS J2180 | not published | not published | $10.94 – $16.00 | 2 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | not published | not published | $31.19 – $65.66 | 4 |
| Mercaptopurine 50 mg HCPCS S0108 | not published | not published | $8.78 – $8.78 | 1 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $84.15 | $165.00 | $0.86 – $6.86 | 3 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $1,716.00 – $25,815.00 | 4 |
| Mesh tiss ovitex lpr 15x15x25cm 6mm oval HCPCS C9364 | $46,235.38 | $90,657.60 | $25.79 – $25.79 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $245.66 | $481.69 | $2.72 – $50.26 | 3 |
| Metabolic Blood Panel (Basic) CPT 80048 | $262.65 | $515.00 | $8.29 – $74.27 | 4 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $452.88 | $888.00 | $10.35 – $92.88 | 4 |
| Metabolic panel ionized ca CPT 80047 | $262.65 | $515.00 | $13.46 – $191.62 | 4 |
| Metered dose inhaler drug HCPCS J3535 | not published | not published | $139.10 – $139.10 | 1 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | not published | not published | $0.65 – $3.50 | 3 |
| Methadone injection HCPCS J1230 | not published | not published | $0.74 – $44.96 | 3 |
| Methadone oral 5mg HCPCS S0109 | not published | not published | $0.44 – $0.44 | 1 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $84.15 | $165.00 | $6.31 – $13.67 | 3 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $9.40 | $18.44 | $0.40 – $3.99 | 3 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $192.35 | $377.15 | $5.17 – $21.24 | 3 |
| Methotrexate therapeutic drug level CPT 80204 | $148.41 | $291.00 | $37.80 – $114.87 | 4 |
| Methyl aminolevulinate, top HCPCS J7309 | not published | not published | $98.02 – $98.02 | 1 |
| Methyldopate hcl injection HCPCS J0210 | not published | not published | $14.93 – $107.50 | 2 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $962.69 | $1,887.63 | $0.37 – $16.30 | 4 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $122.78 | $240.75 | $4.92 – $45.77 | 3 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $372.89 | $731.16 | $0.56 – $4.11 | 2 |
| Methylphenidate CPT 80360 | $5.56 | $10.91 | $0.07 – $125.26 | 2 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $5.61 | $11.00 | $0.49 – $0.56 | 3 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $95.42 | $187.10 | $0.22 – $0.28 | 3 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $260.23 | $510.26 | $0.28 – $0.54 | 3 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $84.15 | $165.00 | $2.25 – $3.80 | 3 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $145.35 | $285.00 | $0.05 – $0.09 | 3 |
| Metyrapone panel CPT 80436 | not published | not published | $89.34 – $679.26 | 4 |
| Mgmt promoter methylation analysis CPT 81287 | not published | not published | $122.15 – $1,059.13 | 4 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $588.16 | $1,153.25 | $0.56 – $2.87 | 3 |
| Microalbumin urine screen CPT 82044 | not published | not published | $6.11 – $38.82 | 4 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $39.37 – $80.34 | 4 |
| Microdissection laser CPT 88380 | not published | not published | $160.24 – $615.22 | 3 |
| Microdissection manual CPT 88381 | not published | not published | $313.98 – $1,061.38 | 3 |
| Microfluid analy tears CPT 83861 | not published | not published | $22.03 – $111.62 | 4 |
| Microsatellite instability CPT 81301 | not published | not published | $341.59 – $1,389.19 | 4 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $179.04 – $2,147.04 | 3 |
| Microwave bronch, 3d, ebus HCPCS C9751 | not published | not published | $691.00 – $25,815.00 | 4 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $85.68 | $168.00 | $0.26 – $1.21 | 3 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $150.72 | $295.52 | $0.34 – $0.56 | 3 |
| Middle cerebral artery echo CPT 76821 | not published | not published | $145.47 – $401.79 | 4 |
| Mifepristone 200 mg ta HCPCS S0190 | not published | not published | $107.31 – $107.31 | 1 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $145.35 | $285.00 | $3.14 – $44.79 | 3 |
| Minocycline hydrochloride HCPCS J2265 | $860.40 | $1,687.06 | $0.74 – $5.57 | 4 |
| Minoxidil, 10 mg HCPCS S0139 | not published | not published | $2.77 – $2.77 | 1 |
| Miroderm HCPCS Q4175 | not published | not published | $92.40 – $176.69 | 4 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | not published | not published | $69.71 – $146.35 | 4 |
| Misoprostol, oral, 200 mcg HCPCS S0191 | not published | not published | $2.58 – $2.58 | 1 |
| Mitochondrial gene CPT 81440 | not published | not published | $3,257.52 – $18,093.86 | 4 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $697.00 | $1,366.67 | $27.89 – $170.91 | 4 |
| Mitomycin instillation HCPCS J9281 | not published | not published | $316.71 – $672.95 | 4 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | not published | not published | $37.84 – $334.13 | 4 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Mlh1 gene CPT 81288 | not published | not published | $188.47 – $1,123.83 | 4 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $198.35 – $2,274.20 | 4 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $661.89 – $4,269.92 | 4 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $267.74 – $662.00 | 4 |
| Mlt fam grp bhv train 1st 60 CPT 96202 | not published | not published | $17.81 – $691.00 | 3 |
| Mlt fam grp bhv train ea add CPT 96203 | not published | not published | $5.03 – $691.00 | 3 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $4,233.00 – $18,229.15 | 5 |
| Mnl appl strs jt radiography CPT 77071 | $127.50 | $250.00 | $116.22 – $127.70 | 4 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | not published | not published | $1,716.00 – $12,908.00 | 2 |
| Mnl prep&insj i-artic rx dev CPT 20704 | not published | not published | $1,716.00 – $12,908.00 | 2 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $1,716.00 – $12,908.00 | 2 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $2,237.46 – $4,737.00 | 5 |
| Mnpj elbow under anes CPT 24300 | $3,107.43 | $6,093.00 | $2,237.46 – $4,737.00 | 5 |
| Mnpj of tmj w/anesth CPT 21073 | $3,024.81 | $5,931.00 | $2,158.97 – $4,737.00 | 5 |
| Mnt subs tx for change dx HCPCS G0270 | not published | not published | $22.33 – $22.79 | 2 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Modification of contact lens CPT 92325 | not published | not published | $185.13 – $188.91 | 2 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | not published | not published | $24.10 – $37.73 | 4 |
| Molecular pathology interpr HCPCS G0452 | not published | not published | $5.84 – $114.71 | 3 |
| Mometasone sinus sinuva HCPCS J7402 | not published | not published | $11.12 – $24.40 | 4 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $15,539.45 | $30,469.50 | not published | 0 |
| Monovisc inj per dose HCPCS J7327 | not published | not published | $642.23 – $1,426.83 | 4 |
| Monthly tx for dmht 20mins HCPCS G0553 | not published | not published | $185.25 – $189.04 | 2 |
| Mopath procedure level 1 CPT 81400 | $178.50 | $350.00 | $62.68 – $265.89 | 4 |
| Mopath procedure level 3 CPT 81402 | not published | not published | $147.32 – $625.02 | 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.