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 |
|---|---|---|---|---|
| Plasma volume single CPT 78110 | not published | not published | $236.29 – $2,035.50 | 4 |
| Plastic surgery neck CPT 15819 | not published | not published | $4,042.00 – $15,202.00 | 3 |
| Platelet aggregation each agent teg CPT 85576 | $192.78 | $378.00 | $24.41 – $160.18 | 4 |
| Platelet automated CPT 85049 | $86.19 | $169.00 | $4.39 – $39.29 | 4 |
| Platelet deplete of harvest CPT 38213 | not published | not published | $613.88 – $4,042.00 | 5 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $379.95 | $745.00 | $501.36 – $511.59 | 2 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $500.31 | $981.00 | $667.00 – $680.61 | 2 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $455.94 | $894.00 | not published | 0 |
| Platelet survival CPT 78191 | not published | not published | $556.27 – $1,842.10 | 4 |
| Plcg2 gene common variants CPT 81320 | not published | not published | $285.53 – $1,521.84 | 4 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $4,471.68 | $8,768.00 | $3,423.00 – $11,377.00 | 5 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $2,531.13 | $4,963.00 | $1,716.00 – $12,908.00 | 4 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $4,321.74 | $8,474.00 | $2,238.00 – $11,377.00 | 5 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $4,321.74 | $8,474.00 | $2,238.00 – $11,377.00 | 5 |
| Plcmt dlyd xtn pros 1st vsl CPT 34710 | $11,168.49 | $21,899.00 | $2,238.00 – $25,242.00 | 4 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $1,021.53 | $2,003.00 | $570.67 – $4,042.00 | 5 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | not published | not published | $287.29 – $4,042.00 | 3 |
| Plcmt xtn pros evasc rpr per vsl CPT 34709 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $900.66 | $1,766.00 | $1,716.00 – $12,908.00 | 3 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $818.55 | $1,605.00 | $1,716.00 – $12,908.00 | 3 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $900.66 | $1,766.00 | $1,716.00 – $12,908.00 | 3 |
| Plerixafor injection HCPCS J2562 | not published | not published | $32.09 – $372.61 | 4 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $801.72 | $1,572.00 | $253.54 – $529.83 | 3 |
| Pleurectomy parietal ; separate 32310 CPT 32310 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Plmt access bil tree sm bwl CPT 47541 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Plmt biliary drainage cath CPT 47534 | $4,471.68 | $8,768.00 | $3,423.00 – $11,377.00 | 5 |
| Plmt nephroureteral catheter CPT 50433 | $4,417.62 | $8,662.00 | $2,238.00 – $6,732.00 | 5 |
| Plmt ureteral stent prq CPT 50694 | $4,321.74 | $8,474.00 | $2,238.00 – $11,377.00 | 5 |
| Pm device progr eval dual CPT 93280 | $223.89 | $439.00 | $51.93 – $162.55 | 3 |
| Pm device progr eval multi CPT 93281 | $298.35 | $585.00 | $51.93 – $190.26 | 3 |
| Pml/raralpha 1 breakpoint CPT 81316 | not published | not published | $203.16 – $491.84 | 4 |
| Pmp22 gene dup/delet CPT 81324 | not published | not published | $743.19 – $4,023.82 | 4 |
| Pmp22 gene full sequence CPT 81325 | not published | not published | $754.19 – $4,083.38 | 4 |
| Pmp22 gene known fam variant CPT 81326 | not published | not published | $45.67 – $247.28 | 4 |
| Pm phone r-strip device eval CPT 93293 | not published | not published | $51.93 – $298.63 | 3 |
| Pms2 gene dup/delet variants CPT 81319 | not published | not published | $199.43 – $3,836.81 | 4 |
| Pms2 gene full seq analysis CPT 81317 | not published | not published | $662.97 – $3,811.76 | 4 |
| Pms2 known familial variants CPT 81318 | not published | not published | $324.38 – $662.00 | 4 |
| Pneumothrx tx-intraplrl inj ai CPT 32960 | not published | not published | $872.87 – $4,042.00 | 5 |
| #pnh-flow cytometry interp CPT 88187 | $35.86 | $70.31 | $78.68 – $436.00 | 3 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $581.40 | $1,140.00 | $25.55 – $169.82 | 4 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | not published | not published | $134.48 – $285.37 | 4 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $1,973.70 | $3,870.00 | $1,194.91 – $7,250.15 | 3 |
| Polysom any age 1-3> param CPT 95808 | not published | not published | $1,194.91 – $1,612.66 | 3 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $2,726.46 | $5,346.00 | $1,194.91 – $1,868.69 | 3 |
| Polyvalent mult org ea ag ia CPT 87451 | not published | not published | $10.30 – $65.76 | 4 |
| Porfimer sodium injection HCPCS J9600 | not published | not published | $3,752.65 – $52,091.10 | 2 |
| Positional change of finger CPT 26555 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Post-coital mucous exam HCPCS Q0115 | not published | not published | $24.50 – $87.21 | 4 |
| Post d/c phone follow up HCPCS G0544 | not published | not published | $141.36 – $144.24 | 2 |
| Post non-seg/spine instrumentation 22840 CPT 22840 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Postop app non-wgt bear dsg HCPCS L5450 | $1,382.79 | $2,711.36 | not published | 0 |
| Postop dress & 1 cast chg bk HCPCS L5400 | $3,267.37 | $6,406.60 | not published | 0 |
| Post op service lvrs min 6 HCPCS G0305 | not published | not published | $519.24 – $529.83 | 2 |
| Postpartum Care Only CPT 59430 | not published | not published | $691.00 – $12,908.00 | 2 |
| Post seg spine instrument/3-6 seg 22842 CPT 22842 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Potassium 24 hour urine CPT 84133 | $161.16 | $316.00 | $4.64 – $37.76 | 4 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $176.87 | $346.80 | $0.41 – $0.93 | 3 |
| Potassium hydroxide preps HCPCS Q0112 | not published | not published | $5.71 – $37.58 | 4 |
| Potassium serum/plasma/whole blood CPT 84132 | $143.31 | $281.00 | $4.66 – $40.71 | 4 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $134.26 – $715.60 | 4 |
| Pq biliary strict dil s&i CPT 74363 | not published | not published | $574.34 – $1,523.74 | 2 |
| Pq dr cath chg w cont s&i CPT 75984 | $1,148.01 | $2,251.00 | $490.66 – $556.36 | 2 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $16,614.78 | $32,578.00 | $4,042.00 – $15,575.00 | 5 |
| Pq thr inj ext pse CPT 36002 | $1,123.02 | $2,202.00 | $872.87 – $4,042.00 | 5 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $6,837.06 | $13,406.00 | $1,716.00 – $12,908.00 | 4 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $6,486.18 | $12,718.00 | $4,042.00 – $11,377.00 | 5 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $6,486.18 | $12,718.00 | $4,042.00 – $11,377.00 | 5 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $223.59 – $803.61 | 4 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $297.97 | $584.26 | $129.27 – $223.69 | 2 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $3,981.06 | $7,806.00 | $2,995.00 – $4,737.00 | 5 |
| Pr application of long arm splint CPT 29105 | $1,148.01 | $2,251.00 | $226.11 – $4,042.00 | 5 |
| Pr application splint static short arm CPT 29125 | $831.81 | $1,631.00 | $185.13 – $4,042.00 | 5 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | not published | not published | $48.81 – $53.03 | 3 |
| Pr biopsy skin punch single lesion CPT 11104 | $808.35 | $1,585.00 | $565.65 – $4,042.00 | 5 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Pr correction hammertoe CPT 28285 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $54.57 | $107.00 | not published | 0 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | $5,467.20 | $10,720.00 | $691.00 – $6,732.00 | 3 |
| Prcrd drg 6+yr without anomly CPT 33017 | $1,049.58 | $2,058.00 | $691.00 – $6,732.00 | 3 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $933.81 | $1,831.00 | $279.18 – $1,716.00 | 4 |
| Prealbumin CPT 84134 | $158.10 | $310.00 | $14.30 – $128.40 | 4 |
| Pr ecg 12 lead report only CPT 93010 | not published | not published | $51.44 – $99.27 | 2 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | not published | not published | $160.49 – $371.42 | 2 |
| Prednisolone acetate inj HCPCS J2650 | not published | not published | $1.21 – $1.21 | 1 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $5.61 | $11.00 | $0.65 – $1.03 | 3 |
| Prednisone 1 mg tablet HCPCS J7512 | $230.64 | $452.23 | $0.01 – $3.07 | 3 |
| Pregabalin - sendout CPT 80366 | $5.56 | $10.91 | $0.07 – $0.07 | 1 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $3,379.77 | $6,627.00 | $2,670.09 – $4,737.00 | 5 |
| Pregnancy associated plasma protein-a CPT 84163 | not published | not published | $14.75 – $129.40 | 4 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $2,878.95 | $5,645.00 | $145.47 – $514.77 | 4 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $1,422.90 | $2,790.00 | $145.47 – $275.52 | 4 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $691.00 – $691.00 | 1 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $2,238.00 – $2,238.00 | 1 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $300.45 – $306.58 | 2 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $519.24 – $529.83 | 2 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $519.24 – $529.83 | 2 |
| Preparation for bladder xray CPT 51605 | not published | not published | $298.69 – $4,042.00 | 3 |
| Preparation palate mold CPT 42280 | not published | not published | $691.00 – $4,042.00 | 5 |
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.