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 |
|---|---|---|---|---|
| Prophylactic tx ulna CPT 25491 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $143.79 | $281.95 | $0.19 – $0.19 | 3 |
| _propoxygc/msur CPT 80367 | $5.56 | $10.91 | $0.07 – $156.82 | 2 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $84.15 | $165.00 | $12.70 – $21.72 | 2 |
| Prostate biopsy, any mthd HCPCS G0416 | not published | not published | $498.77 – $1,985.32 | 4 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Prostate laser enucleation CPT 52649 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $4,737.00 – $8,992.00 | 5 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $4,904.88 – $11,377.00 | 5 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $1,474.94 | $2,892.03 | not published | 0 |
| Prosthetic sock multi ply bk HCPCS L8420 | $88.23 | $173.00 | not published | 0 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $84.15 | $165.00 | $2.80 – $6.21 | 3 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $8,221.57 | $16,120.72 | $1,119.15 – $1,119.15 | 1 |
| Protein analysis w/probe CPT 88372 | not published | not published | $52.44 – $193.21 | 3 |
| Protein c activity CPT 85303 | $88.05 | $172.65 | $13.56 – $121.48 | 4 |
| Protein c concentrate HCPCS J2724 | not published | not published | $14.75 – $32.29 | 4 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $17.15 | $33.63 | $10.53 – $94.36 | 4 |
| Protein s total CPT 85305 | $100.22 | $196.50 | $11.38 – $102.04 | 4 |
| Protein total 24 hour urine CPT 84156 | $198.90 | $390.00 | $3.60 – $32.26 | 4 |
| Protein total body fluid CPT 84157 | $218.79 | $429.00 | $3.92 – $32.26 | 4 |
| Protein total serum plasma whole blood CPT 84155 | $55.59 | $109.00 | $3.60 – $32.14 | 4 |
| Protein western blot tissue CPT 88371 | not published | not published | $44.46 – $188.72 | 3 |
| Prothrombin complex kcentra HCPCS J7168 | $5,076.52 | $9,953.97 | $2.01 – $4.69 | 4 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $5.65 | $11.08 | $3.86 – $34.57 | 4 |
| Proton treatment complex CPT 77525 | not published | not published | $1,100.79 – $1,774.46 | 3 |
| Proton trmt intermediate CPT 77523 | not published | not published | $1,145.64 – $1,774.46 | 3 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $781.72 – $1,774.46 | 3 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $768.84 – $916.50 | 3 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $9.55 – $75.51 | 4 |
| Provide inr test mater/equip HCPCS G0249 | not published | not published | $185.25 – $189.04 | 2 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $691.00 – $6,732.00 | 3 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $4,982.00 – $11,377.00 | 5 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $141.36 – $144.24 | 2 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | not published | not published | $2,238.00 – $25,815.00 | 5 |
| Prq av fstl crt uxtr sep acs CPT 36837 | not published | not published | $2,995.00 – $25,815.00 | 5 |
| Prq card angio/athrect addl CPT 92925 | not published | not published | $4,812.00 – $20,488.00 | 3 |
| Prq cardiac angio addl art CPT 92921 | $12,617.40 | $24,740.00 | $4,812.00 – $15,575.00 | 3 |
| Prq card revasc chronic addl CPT 92944 | not published | not published | $4,812.00 – $15,575.00 | 3 |
| Prq card revasc mi 1 vsl CPT 92941 | $22,529.25 | $44,175.00 | $4,812.00 – $15,575.00 | 3 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $22,111.05 | $43,355.00 | $4,812.00 – $12,568.00 | 3 |
| Prq card stent/ath/angio CPT 92934 | not published | not published | $4,812.00 – $15,575.00 | 3 |
| Prq card stent w/angio addl CPT 92929 | $22,529.25 | $44,175.00 | $4,812.00 – $15,575.00 | 3 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $22,529.25 | $44,175.00 | $4,812.00 – $16,391.15 | 5 |
| Prq revasc byp graft addl CPT 92938 | $22,529.25 | $44,175.00 | $4,812.00 – $15,575.00 | 3 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $2,995.00 – $10,302.82 | 5 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Prq skel fix sprcndlr hum fx CPT 24538 | $8,803.62 | $17,262.00 | $2,995.00 – $10,302.82 | 5 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $2,995.00 – $10,302.82 | 5 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $2,995.00 – $10,302.82 | 5 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $22,529.25 | $44,175.00 | $4,812.00 – $16,391.15 | 5 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | $22,529.25 | $44,175.00 | $25,507.82 – $26,028.38 | 2 |
| Prq trlml c athrc st angiop1 CPT 92933 | $22,529.25 | $44,175.00 | $4,812.00 – $26,028.38 | 5 |
| Prq trl rvs ch occ ant&rtrgr CPT 92945 | not published | not published | $16,063.33 – $16,391.15 | 2 |
| Prq trluml c angiop 1art&/br CPT 92920 | $12,617.40 | $24,740.00 | $4,812.00 – $15,575.00 | 5 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $19,325.94 | $37,894.00 | $4,812.00 – $20,488.00 | 5 |
| Prq trluml revsc ch occ ant CPT 92943 | $22,529.25 | $44,175.00 | $4,812.00 – $16,391.15 | 5 |
| Pr removal drug delivery implant CPT 11982 | $818.04 | $1,604.00 | $621.60 – $1,716.00 | 4 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $246.33 | $483.00 | $185.13 – $4,042.00 | 5 |
| Pr removal intrauterine device CPT 58301 | $761.43 | $1,493.00 | $424.02 – $4,042.00 | 5 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $2,147.10 | $4,210.00 | $565.65 – $4,042.00 | 5 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $1,358.64 | $2,664.00 | $279.18 – $4,042.00 | 5 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $1,358.64 | $2,664.00 | $279.18 – $4,042.00 | 5 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $1,358.64 | $2,664.00 | $279.18 – $4,042.00 | 5 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $1,358.64 | $2,664.00 | $279.18 – $4,042.00 | 5 |
| Pr robotic surgical system HCPCS S2900 | $0.51 | $1.00 | not published | 0 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $2,870.98 – $4,737.00 | 5 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $613.88 – $4,042.00 | 5 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $4,263.60 | $8,360.00 | $2,190.38 – $4,042.00 | 5 |
| PSA (Prostate) Test CPT 84153 | $190.74 | $374.00 | $18.02 – $161.43 | 4 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | not published | not published | $40.25 – $691.00 | 3 |
| Psychoanalysis CPT 90845 | not published | not published | $246.98 – $252.02 | 2 |
| Psychoeducation 45 min + HCPCS G0177 | $181.56 | $356.00 | not published | 0 |
| Psychotherapy group therapy CPT 90853 | $371.79 | $729.00 | $141.36 – $144.24 | 2 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $322.83 | $633.00 | $246.98 – $252.02 | 2 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $512.55 | $1,005.00 | $246.98 – $252.02 | 2 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $704.31 | $1,381.00 | $246.98 – $252.02 | 2 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | not published | not published | $300.45 – $2,238.00 | 3 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | not published | not published | $691.00 – $691.00 | 1 |
| Psycl/nrpsyc tech 1st CPT 96138 | not published | not published | $621.60 – $2,238.00 | 3 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | not published | not published | $185.13 – $2,238.00 | 3 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | not published | not published | $691.00 – $691.00 | 1 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | not published | not published | $2,238.00 – $2,238.00 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $107.10 | $210.00 | $15.44 – $15.76 | 2 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $145.86 | $286.00 | $19.63 – $20.03 | 2 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $139.74 | $274.00 | $14.70 – $15.00 | 2 |
| Pt application of modality traction mechanical CPT 97012 | $444.21 | $871.00 | $14.62 – $14.92 | 2 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $92.94 – $600.00 | 4 |
| Pten gene full sequence CPT 81321 | not published | not published | $114.39 – $1,200.00 | 4 |
| Pten gene known fam variant CPT 81322 | not published | not published | $45.67 – $93.20 | 4 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $4,233.00 – $9,773.00 | 5 |
| Pt evaluation high complexity patient/family CPT 97163 | $360.57 | $707.00 | $119.04 – $121.47 | 2 |
| Pt evaluation low complexity patient/family CPT 97161 | $150.45 | $295.00 | $119.03 – $121.46 | 2 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $240.21 | $471.00 | $100.95 – $103.01 | 2 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $28.79 – $180.75 | 3 |
| Pt re-evaluation patient/family CPT 97164 | $135.15 | $265.00 | $72.41 – $73.89 | 2 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $100.47 | $197.00 | $29.67 – $30.28 | 2 |
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.