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 |
|---|---|---|---|---|
| Optx post ankle fx CPT 27769 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Optx prox humrl fx w/int fix CPT 23615 | $28,431.48 | $55,748.00 | $4,233.00 – $18,229.15 | 5 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $4,233.00 – $24,895.59 | 5 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $2,995.00 – $10,302.82 | 5 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $3,423.00 – $10,302.82 | 5 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $4,812.00 – $15,575.00 | 5 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Optx sho dislc fx CPT 23670 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $4,233.00 – $10,302.82 | 5 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Optx thigh fx CPT 27269 | not published | not published | $4,737.00 – $10,302.82 | 5 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $3,423.00 – $10,302.82 | 5 |
| Optx ulnar shft fx int fixj CPT 25545 | $14,326.92 | $28,092.00 | $3,423.00 – $15,575.00 | 5 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $5,530.00 – $15,575.00 | 5 |
| Oral aprepitant HCPCS J8501 | $791.32 | $1,551.61 | $6.08 – $7.60 | 3 |
| Oral busulfan HCPCS J8510 | not published | not published | $9.92 – $181.05 | 4 |
| Oral everolimus HCPCS J7527 | not published | not published | $4.04 – $8.53 | 3 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | not published | not published | $11.74 – $62.04 | 4 |
| Oral methotrexate (jylamvo) HCPCS J8611 | not published | not published | $18.34 – $40.79 | 4 |
| Oral methotrexate (xatmep) HCPCS J8612 | not published | not published | $21.85 – $44.53 | 4 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $389.84 – $879.37 | 4 |
| Orbitocranial approach/skull CPT 61584 | not published | not published | $4,812.00 – $12,568.00 | 3 |
| Orbitocranial approach/skull CPT 61585 | not published | not published | $4,812.00 – $12,568.00 | 3 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $5,530.00 – $12,568.00 | 3 |
| Orchiectomy partial CPT 54522 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Orchiopexy ingun/scrot appr CPT 54640 | $7,717.83 | $15,133.00 | $4,233.00 – $11,377.00 | 5 |
| Organic acids total quant ea spec CPT 83918 | not published | not published | $23.13 – $139.80 | 4 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $42.84 – $91.96 | 4 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | not published | not published | $28.00 – $61.34 | 4 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $2,158.97 – $4,042.00 | 5 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | not published | not published | $23.46 – $26.51 | 3 |
| Orthopantogram CPT 70355 | not published | not published | $77.45 – $143.17 | 4 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $82.09 – $691.00 | 3 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $1,419.84 | $2,784.00 | not published | 0 |
| Orthovisc inj per dose HCPCS J7324 | not published | not published | $106.91 – $311.59 | 4 |
| Oscillation chest wall mechanical per session CPT 94669 | $351.90 | $690.00 | $246.92 – $310.92 | 3 |
| Osmolality blood CPT 83930 | $181.56 | $356.00 | $6.48 – $79.00 | 4 |
| Osmolality urine CPT 83935 | $181.56 | $356.00 | $6.68 – $59.86 | 4 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Osteoart algrft w/surf & b1 CPT 20932 | not published | not published | $1,716.00 – $12,908.00 | 3 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $8,992.00 – $18,229.15 | 5 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $4,233.00 – $12,568.00 | 5 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $4,233.00 – $15,575.00 | 5 |
| Osteoplasty humerus CPT 24420 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Ot evaluation high complexity patient/family CPT 97167 | $480.93 | $943.00 | $103.82 – $105.94 | 2 |
| Ot evaluation low complexity patient/family CPT 97165 | $240.21 | $471.00 | $103.82 – $105.94 | 2 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $360.57 | $707.00 | $125.00 – $127.55 | 2 |
| Other bone graft microvasc CPT 20962 | not published | not published | $5,530.00 – $11,377.00 | 5 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $22.67 – $196.23 | 4 |
| Oth resp proc, indiv HCPCS G0238 | not published | not published | $40.25 – $41.07 | 2 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $73.44 | $144.00 | $63.97 – $65.28 | 2 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $78.03 | $153.00 | $48.03 – $49.01 | 2 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $238.68 | $468.00 | $31.96 – $32.61 | 2 |
| Otoplasty 69300 CPT 69300 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Ot re-evaluation patient/family CPT 97168 | $215.22 | $422.00 | $70.87 – $72.32 | 2 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $187.68 | $368.00 | $36.40 – $37.14 | 2 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $289.68 | $568.00 | $18.49 – $18.87 | 2 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $289.68 | $568.00 | $21.00 – $21.43 | 2 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $182.07 | $357.00 | $29.86 – $30.47 | 2 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $121.89 | $239.00 | $40.48 – $41.31 | 2 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $274.38 | $538.00 | $33.45 – $34.13 | 2 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Ovine, 1000 usp units HCPCS J3472 | not published | not published | $193.73 – $228.80 | 2 |
| Ovulation tests CPT 84830 | not published | not published | $12.45 – $88.04 | 4 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $1.27 – $4.08 | 3 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $179.33 | $351.63 | $0.10 – $11.87 | 3 |
| Oxymorphone hcl injection HCPCS J2410 | not published | not published | $4.64 – $4.86 | 2 |
| Oxytetracycline injection HCPCS J2460 | not published | not published | $1.85 – $1.85 | 1 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $84.15 | $165.00 | $1.30 – $4.32 | 2 |
| P-32 chromic phos ther per mci HCPCS A9564 | not published | not published | $325.47 – $1,030.61 | 2 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $101.80 – $385.11 | 4 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $134.26 – $715.60 | 4 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $73,929.60 | $144,960.00 | not published | 0 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $278.56 | $546.20 | $0.25 – $0.65 | 3 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | not published | not published | $5.90 – $28.08 | 4 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $565.76 – $842.40 | 4 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $295.32 – $897.41 | 4 |
| Palifermin injection HCPCS J2425 | not published | not published | $16.41 – $73.08 | 4 |
| Palingen or palingen xplus HCPCS Q4173 | not published | not published | $173.16 – $965.75 | 4 |
| Palingen or promatrx HCPCS Q4174 | not published | not published | $1,781.33 – $3,099.23 | 2 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | not published | not published | $9.09 – $31.69 | 4 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $4,430.32 | $8,686.91 | $428.02 – $1,547.72 | 4 |
| Palonosetron hcl HCPCS J2469 | $84.15 | $165.00 | $1.00 – $40.62 | 3 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $93.95 | $184.22 | $27.75 – $353.14 | 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.