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 |
|---|---|---|---|---|
| Perq transcath cls mitral CPT 93590 | not published | not published | $9,358.73 – $25,507.82 | 4 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $6,732.00 – $24,401.00 | 3 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $6,447.42 | $12,642.00 | $2,995.00 – $6,732.00 | 5 |
| Perq tx malar fracture CPT 21355 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $2,995.00 – $8,405.34 | 5 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Pertussis ag if CPT 87265 | not published | not published | $11.74 – $78.88 | 4 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $13.91 – $34.89 | 4 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $59.02 – $135.43 | 4 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $245.77 | $481.90 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $7,678.56 | $15,056.00 | $1,989.72 – $6,280.95 | 4 |
| Pet CT whole body initial CPT 78816 | $7,678.56 | $15,056.00 | $1,989.72 – $7,474.51 | 4 |
| Pet fdg brain metoblic eval sb CPT 78608 | $4,218.72 | $8,272.00 | $1,989.72 – $5,370.12 | 4 |
| Pet image full body CPT 78813 | not published | not published | $1,989.72 – $6,883.64 | 4 |
| Pet image ltd area CPT 78811 | not published | not published | $1,801.46 – $5,170.11 | 4 |
| Pet image skull-thigh CPT 78812 | not published | not published | $1,989.72 – $5,690.08 | 4 |
| Pet image w/ct lmtd CPT 78814 | $7,678.56 | $15,056.00 | $1,989.72 – $5,760.98 | 4 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $556.27 – $7,966.52 | 4 |
| Pet scan brain perf study CPT 78609 | not published | not published | $6,157.75 – $16,147.41 | 2 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $81,583.93 | $159,968.49 | not published | 0 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | not published | not published | $19.86 – $20.27 | 2 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | not published | not published | $28.91 – $29.50 | 2 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | not published | not published | $11.57 – $11.81 | 2 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Ph body fluid CPT 83986 | $168.30 | $330.00 | $3.51 – $31.38 | 4 |
| Phencyclidine (pcp) CPT 83992 | $51.00 | $100.00 | $0.07 – $113.27 | 3 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $129.01 | $252.96 | $4.45 – $63.30 | 3 |
| Phenobarbital therapeutic drug level CPT 80184 | $415.14 | $814.00 | $14.99 – $100.33 | 4 |
| Phentolaine mesylate inj HCPCS J2760 | $1,402.21 | $2,749.43 | $41.73 – $966.00 | 4 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $198.42 | $389.05 | $0.02 – $0.09 | 2 |
| Phenylep ketorolac opth soln HCPCS J1097 | not published | not published | $94.68 – $210.85 | 4 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $84.15 | $165.00 | $1.04 – $2.23 | 3 |
| Phenytoin total therapeutic drug level CPT 80185 | $468.69 | $919.00 | $12.98 – $116.34 | 4 |
| Phlebotomy therapeutic CPT 99195 | $609.96 | $1,196.00 | $185.13 – $4,042.00 | 3 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $4,393.52 – $11,377.00 | 5 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $4,393.52 – $11,377.00 | 5 |
| Phosphorus CPT 84100 | $143.31 | $281.00 | $4.65 – $41.54 | 4 |
| Phosphorus 24 hour urine CPT 84105 | $17.85 | $35.00 | $5.66 – $45.38 | 4 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $82.09 – $83.76 | 2 |
| Photochemotherapy puva CPT 96912 | not published | not published | $82.09 – $83.76 | 2 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $565.65 – $577.20 | 2 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $1,716.00 – $4,042.00 | 2 |
| Photo patch test CPT 95052 | not published | not published | $65.35 – $83.76 | 3 |
| Photopheresis CPT 36522 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Photosensitivity tests CPT 95056 | not published | not published | $53.36 – $188.91 | 3 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $72.51 – $261.05 | 4 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $237.06 – $287.00 | 4 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $40.25 – $164.08 | 4 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $128.32 | $251.61 | $4.89 – $6.21 | 3 |
| Pierce earlobes 69090 CPT 69090 | not published | not published | $691.00 – $6,732.00 | 2 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | not published | not published | $339.56 – $731.29 | 4 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $269.33 – $818.41 | 4 |
| Pild/placebo control clin tr HCPCS G0276 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Pin caspar distraction 12mm HCPCS C1821 | $16,124.16 | $31,616.00 | not published | 0 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | $1,258.68 | $2,468.00 | $1,028.39 – $4,042.00 | 5 |
| Pin finger dislocation CPT 26776 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Pin finger fracture each CPT 26756 | $6,447.42 | $12,642.00 | $2,995.00 – $6,732.00 | 5 |
| Pin hand dislocation CPT 26676 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $2,995.00 – $4,737.00 | 5 |
| Pin service 60m per month HCPCS G0023 | not published | not published | $141.36 – $144.24 | 2 |
| Pinworm exam CPT 87172 | not published | not published | $4.18 – $37.46 | 4 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $4.18 – $47.68 | 4 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $145.35 | $285.00 | $2.24 – $7.23 | 3 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $567.89 – $4,318.14 | 4 |
| Place breast cath for rad CPT 19297 | not published | not published | $4,042.00 – $33,905.00 | 4 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $4,042.00 – $19,567.04 | 5 |
| Place cath intracranial art CPT 36228 | not published | not published | $1,539.59 – $5,318.00 | 4 |
| Place cath xtrnl carotid CPT 36227 | $671.16 | $1,316.00 | $755.56 – $5,318.00 | 4 |
| Place cecostomy tube perc CPT 49442 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Place device/marker, non pro HCPCS C9728 | $2,366.91 | $4,641.00 | $1,925.97 – $1,965.27 | 2 |
| Place duod/jej tube perc CPT 49441 | $4,340.10 | $8,510.00 | $2,670.09 – $4,737.00 | 5 |
| Place endorectal app HCPCS C9725 | not published | not published | $1,294.00 – $2,741.00 | 3 |
| Place gastrostomy tube open 43832 CPT 43832 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Place gastrostomy tube perc CPT 49440 | $4,340.10 | $8,510.00 | $2,670.09 – $4,737.00 | 5 |
| Placement bile duct support CPT 47801 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,676.37 | $3,287.00 | $2,298.14 – $4,737.00 | 4 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $900.66 | $1,766.00 | $1,716.00 – $12,908.00 | 3 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,676.37 | $3,287.00 | $985.34 – $4,042.00 | 4 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $3,618.96 | $7,096.00 | $2,238.00 – $6,732.00 | 5 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $431.46 | $846.00 | $1,716.00 – $4,042.00 | 2 |
| Placement of drain pancreas CPT 48001 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Placement of seton CPT 46020 | $5,565.63 | $10,913.00 | $3,423.00 – $6,732.00 | 5 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $14,819.58 | $29,058.00 | $4,233.00 – $20,488.00 | 5 |
| Place ndl musc/tis for right CPT 20555 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Place needles h&n for right CPT 41019 | not published | not published | $2,238.00 – $8,405.34 | 5 |
| Place needles pelvic for right CPT 55920 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Place non-slctv cath thoracic arta CPT 36221 | $4,678.74 | $9,174.00 | $1,476.68 – $11,377.00 | 5 |
| Placental lactogen CPT 83632 | not published | not published | $19.82 – $177.38 | 4 |
| Place po breast cath for rad CPT 19296 | not published | not published | $4,042.00 – $15,575.00 | 5 |
| Place right device/marker pros CPT 55876 | not published | not published | $1,925.97 – $8,992.00 | 5 |
| Place slctv cath carotd art uni CPT 36224 | $12,016.62 | $23,562.00 | $2,238.00 – $15,575.00 | 5 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $5,710.47 | $11,197.00 | $2,016.28 – $11,377.00 | 5 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $10,400.94 | $20,394.00 | $2,179.29 – $15,575.00 | 5 |
| Place slctv cath subclavian art CPT 36225 | $7,137.96 | $13,996.00 | $2,170.26 – $11,377.00 | 5 |
| Place slctv cath vertebral art uni CPT 36226 | $7,728.54 | $15,154.00 | $2,238.00 – $15,575.00 | 5 |
| Plasmaprotein fract,5%,250ml HCPCS P9048 | not published | not published | $34.61 – $75.67 | 3 |
| Plasma protein fract,5%,50ml HCPCS P9043 | not published | not published | $7.95 – $32.22 | 3 |
| Plasma volume multiple CPT 78111 | not published | not published | $537.30 – $2,035.50 | 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.