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 |
|---|---|---|---|---|
| Mopath procedure level 5 CPT 81404 | not published | not published | $269.33 – $1,510.68 | 4 |
| Mopath procedure level 6 CPT 81405 | not published | not published | $295.32 – $1,980.36 | 4 |
| Mopath procedure level 7 CPT 81406 | not published | not published | $277.22 – $2,020.07 | 4 |
| Mopath procedure level 8 CPT 81407 | not published | not published | $829.34 – $16,284.50 | 4 |
| Mopath procedure level 9 CPT 81408 | not published | not published | $1,960.00 – $19,030.74 | 4 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $150.91 | $295.91 | $0.93 – $9.95 | 3 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $85.68 | $168.00 | $4.36 – $14.28 | 3 |
| Morphine 500 mg HCPCS S0093 | not published | not published | $46.17 – $46.17 | 1 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | not published | not published | $16.69 – $21.11 | 3 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $43.35 | $85.00 | $237.06 – $1,309.72 | 4 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $437.07 | $857.00 | $498.77 – $581.53 | 4 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $374.85 | $735.00 | $237.06 – $326.99 | 4 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $641.45 – $1,378.06 | 3 |
| Motion analysis video/3d CPT 96000 | not published | not published | $125.32 – $529.83 | 3 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $149.31 – $1,219.29 | 3 |
| Motor &/ sens nrve cndj test CPT 95905 | not published | not published | $442.56 – $634.29 | 3 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $94.56 – $321.85 | 3 |
| M/phmtrc alys ishquant/semiq CPT 88377 | not published | not published | $237.06 – $1,218.61 | 4 |
| M/phmtrc alysishquant/semiq CPT 88369 | not published | not published | $165.30 – $398.42 | 3 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $204.03 – $287.00 | 4 |
| Mpl gene analysis common variants CPT 81338 | not published | not published | $147.32 – $447.70 | 4 |
| M.pneumon dna dir probe CPT 87580 | not published | not published | $19.65 – $170.29 | 4 |
| M.pneumon dna quant CPT 87582 | not published | not published | $227.07 – $605.24 | 4 |
| Mpsv4 vaccine subq CPT 90733 | $443.30 | $869.22 | $104.42 – $178.73 | 2 |
| MRA abdomen post contrast CPT 74185 | $4,802.16 | $9,416.00 | $483.89 – $2,784.53 | 3 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $6,062.37 | $11,887.00 | $477.54 – $2,783.88 | 3 |
| MRA chest w IV cont HCPCS C8909 | not published | not published | $485.45 – $4,198.19 | 4 |
| MRA chest wo IV cont HCPCS C8910 | not published | not published | $332.01 – $3,710.01 | 4 |
| MRA chest wwo IV cont HCPCS C8911 | not published | not published | $485.45 – $3,765.02 | 4 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $6,927.33 | $13,583.00 | $481.01 – $2,784.59 | 3 |
| MRA pelvis CPT 72198 | $5,489.64 | $10,764.00 | $481.58 – $2,784.53 | 3 |
| MRA pelvis w IV cont HCPCS C8918 | not published | not published | $485.45 – $3,762.66 | 4 |
| MRA pelvis wo IV cont HCPCS C8919 | not published | not published | $332.01 – $4,081.73 | 4 |
| MRA spinal canal CPT 72159 | not published | not published | $500.06 – $3,088.18 | 3 |
| MRA upper extremity post contrast-bil CPT 73225 | $4,989.84 | $9,784.00 | $500.06 – $2,783.12 | 3 |
| MRA w/cont, abd HCPCS C8900 | not published | not published | $485.45 – $4,198.19 | 4 |
| MRA w/cont, lwr ext HCPCS C8912 | not published | not published | $485.45 – $3,749.07 | 4 |
| Mra, w/dye, spinal canal HCPCS C8931 | not published | not published | $485.45 – $610.96 | 3 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $485.45 – $610.96 | 3 |
| MRA without cont, abd HCPCS C8901 | not published | not published | $332.01 – $3,762.66 | 4 |
| MRA without cont, lwr ext HCPCS C8913 | not published | not published | $332.01 – $3,465.10 | 4 |
| Mra, without dye, spinal canal HCPCS C8932 | not published | not published | $332.01 – $372.86 | 3 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $332.01 – $372.86 | 3 |
| MRA without fol w/cont, abd HCPCS C8902 | not published | not published | $485.45 – $3,762.66 | 4 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | not published | not published | $485.45 – $3,749.07 | 4 |
| MRA without fol w/cont, pelvis HCPCS C8920 | not published | not published | $485.45 – $3,762.66 | 4 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $485.45 – $610.96 | 3 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | not published | not published | $485.45 – $610.96 | 3 |
| Mr elastography CPT 76391 | not published | not published | $332.01 – $1,660.76 | 4 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $2,238.00 – $20,488.00 | 5 |
| MRI brain w/dye CPT 70558 | not published | not published | $244.06 – $3,329.49 | 4 |
| MRI brain without dye CPT 70557 | not published | not published | $760.32 – $2,779.57 | 4 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $244.06 – $5,473.94 | 4 |
| MRI breast c- unilateral CPT 77046 | not published | not published | $332.01 – $1,458.98 | 4 |
| MRI breast c-+ w/cad uni CPT 77048 | $4,296.75 | $8,425.00 | $459.63 – $2,563.69 | 3 |
| MRI breast without cont bi CPT 77047 | $3,031.95 | $5,945.00 | $332.01 – $1,450.17 | 4 |
| MRI breast w IV cont bi CPT 77049 | $5,562.57 | $10,907.00 | $457.90 – $2,563.69 | 3 |
| MRI cardiac morph & func wo IV cont CPT 75557 | not published | not published | $332.01 – $2,516.75 | 4 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $525.30 | $1,030.00 | $485.45 – $3,674.38 | 4 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $1,089.31 – $4,592.42 | 4 |
| MRI chest without contrast CPT 71550 | $3,538.38 | $6,938.00 | $332.01 – $2,780.99 | 4 |
| MRI chest without & w/contrast CPT 71552 | $5,154.57 | $10,107.00 | $485.45 – $6,245.26 | 4 |
| MRI chest w IV cont CPT 71551 | $3,600.60 | $7,060.00 | $1,089.31 – $3,396.03 | 4 |
| MRI compatible system HCPCS L0859 | $3,990.75 | $7,825.00 | not published | 0 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $2,081.16 – $2,563.69 | 2 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $332.01 – $4,857.07 | 4 |
| MRI guid ndl plc s&i CPT 77021 | $2,310.81 | $4,531.00 | $2,563.69 – $2,852.78 | 2 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $2,563.69 – $2,852.54 | 2 |
| MRI hyperpolarized xenon129 HCPCS C9791 | not published | not published | $1,703.14 – $2,000.80 | 3 |
| MRI loex nonjt w IV cont CPT 73719 | $5,237.70 | $10,270.00 | $485.45 – $3,388.28 | 4 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $4,369.17 | $8,567.00 | $332.01 – $2,826.01 | 4 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $6,392.34 | $12,534.00 | $485.45 – $2,779.57 | 4 |
| MRI orbit/face/neck without contrast CPT 70540 | $4,096.32 | $8,032.00 | $332.01 – $2,779.57 | 4 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $8,391.03 | $16,453.00 | $485.45 – $6,272.09 | 4 |
| MRI orbit fac&nck w IV cont CPT 70542 | $4,703.22 | $9,222.00 | $485.45 – $3,388.28 | 4 |
| MRI tmj CPT 70336 | $3,560.31 | $6,981.00 | $332.01 – $2,465.94 | 4 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $4,369.17 | $8,567.00 | $332.01 – $2,826.01 | 4 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $5,959.35 | $11,685.00 | $485.45 – $2,779.57 | 4 |
| MRI upper extremity w/dye CPT 73219 | $4,785.84 | $9,384.00 | $485.45 – $3,406.01 | 4 |
| MRI w/cont, breast, bi HCPCS C8906 | not published | not published | $485.45 – $6,058.37 | 4 |
| MRI w/cont, breast, uni HCPCS C8903 | not published | not published | $244.06 – $6,058.37 | 4 |
| MRI without fol w/cont, breast HCPCS C8908 | not published | not published | $485.45 – $4,198.19 | 4 |
| MRI without fol w/cont, brst, un HCPCS C8905 | not published | not published | $485.45 – $6,058.37 | 4 |
| Mr safety determination physician/other qhp CPT 76016 | not published | not published | $121.09 – $304.71 | 4 |
| Mr safety implant elec prepj CPT 76018 | not published | not published | $132.29 – $540.82 | 4 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | not published | not published | $353.40 – $360.06 | 2 |
| Mr safety implt pos&/immoblj CPT 76019 | not published | not published | $82.09 – $827.99 | 4 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | not published | not published | $39.18 – $73.39 | 4 |
| Mr sfty med physics xm cstmz CPT 76017 | not published | not published | $332.01 – $1,283.49 | 4 |
| Mr spectroscopy CPT 76390 | not published | not published | $121.09 – $2,814.14 | 4 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $209.03 – $2,016.76 | 4 |
| Msh2 gene full seq CPT 81295 | not published | not published | $374.07 – $3,836.22 | 4 |
| Msh2 gene known variants CPT 81296 | not published | not published | $267.74 – $675.46 | 4 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $233.24 – $1,460.99 | 4 |
| Msh6 gene full seq CPT 81298 | not published | not published | $629.01 – $5,402.50 | 4 |
| Msh6 gene known variants CPT 81299 | not published | not published | $267.74 – $616.00 | 4 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $4,812.00 – $15,575.00 | 5 |
| Mthfr gene analy common variants CPT 81291 | $158.10 | $310.00 | $64.03 – $384.18 | 4 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $26.34 – $170.29 | 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.