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 |
|---|---|---|---|---|
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | not published | not published | $15.68 – $16.00 | 2 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $144.33 | $283.00 | $31.83 – $32.48 | 2 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $161.67 | $317.00 | $33.28 – $33.96 | 2 |
| Pt wheelchair management each 15 minutes CPT 97542 | $113.73 | $223.00 | $32.06 – $32.71 | 2 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $6,682.00 – $16,391.15 | 5 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $4,042.00 – $15,575.00 | 3 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,301.41 – $16,378.92 | 4 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Pulmonary vent imaging CPT 78579 | $1,688.61 | $3,311.00 | $556.27 – $1,044.95 | 4 |
| Pulse ox continuous overnight monitoring CPT 94762 | $655.35 | $1,285.00 | $179.04 – $304.83 | 3 |
| Pulse ox multiple CPT 94761 | $370.26 | $726.00 | $206.39 – $206.39 | 1 |
| Pulse ox single CPT 94760 | not published | not published | $79.83 – $79.83 | 1 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $1,387.20 | $2,720.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | $1,335.18 | $2,618.00 | $982.21 – $4,042.00 | 5 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $297.33 | $583.00 | $185.13 – $4,042.00 | 4 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $592.11 | $1,161.00 | $565.65 – $4,042.00 | 5 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,364.76 | $2,676.00 | $982.21 – $4,042.00 | 5 |
| Puraply 1 sq cm HCPCS Q4195 | $17,246.65 | $33,816.96 | $173.16 – $691.00 | 4 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $158.11 – $691.00 | 4 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $982.21 – $4,042.00 | 5 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $982.21 – $4,042.00 | 5 |
| Pyelotomy complicated CPT 50135 | not published | not published | $9,773.00 – $9,773.00 | 1 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $2,238.00 – $6,732.00 | 3 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $85.69 | $168.02 | $3.99 – $27.03 | 3 |
| Pyruvate CPT 84210 | $51.74 | $101.45 | $14.19 – $95.31 | 4 |
| Pyruvate kinase CPT 84220 | not published | not published | $9.25 – $82.78 | 4 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $33.92 – $691.00 | 4 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | not published | not published | $755.17 – $1,816.33 | 4 |
| Quant diff pulm perf w/imaging CPT 78597 | not published | not published | $556.27 – $1,120.76 | 4 |
| Quest t3 uptake CPT 84479 | $228.48 | $448.00 | $6.34 – $56.78 | 4 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $9.16 – $142.35 | 2 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $1,507.94 | $2,956.75 | $101.36 – $746.74 | 4 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $237.33 – $518.47 | 4 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $5,444.19 | $10,674.88 | $102.75 – $623.31 | 4 |
| Rabies vaccine id CPT 90676 | not published | not published | $120.09 – $568.61 | 4 |
| Radial keratotomy CPT 65771 | not published | not published | $4,042.00 – $25,815.00 | 4 |
| Radiation handling CPT 77790 | not published | not published | $129.58 – $129.58 | 1 |
| Radiation physics consult CPT 77336 | $1,735.02 | $3,402.00 | $187.03 – $660.18 | 3 |
| Radiation therapy dose plan CPT 77300 | $1,083.75 | $2,125.00 | $187.03 – $338.69 | 3 |
| Radiation therapy management CPT 77431 | not published | not published | $529.83 – $529.83 | 1 |
| Radiation treatment aid(s) CPT 77332 | $911.88 | $1,788.00 | $187.03 – $337.27 | 3 |
| Radiation treatment aid(s) CPT 77333 | $911.88 | $1,788.00 | $187.03 – $479.73 | 3 |
| Radiation treatment aid(s) CPT 77334 | $2,356.20 | $4,620.00 | $521.01 – $815.52 | 3 |
| Radiation treatment delivery CPT 77401 | not published | not published | $393.11 – $393.11 | 1 |
| Radiation treatment delivery CPT 77402 | $997.05 | $1,955.00 | $141.97 – $393.81 | 3 |
| Radiation treatment delivery CPT 77412 | $1,683.51 | $3,301.00 | $526.29 – $784.53 | 3 |
| Radiation tx management x5 CPT 77427 | not published | not published | $1,096.00 – $1,096.00 | 1 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $2,995.00 – $25,815.00 | 4 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Radical resection of elbow CPT 24149 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $3,423.00 – $4,737.00 | 5 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Radiesse injection HCPCS Q2026 | not published | not published | $342.21 – $716.85 | 3 |
| Radiology port images(s) CPT 77417 | $3,115.59 | $6,109.00 | $145.35 – $145.35 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | $7,475.07 | $14,657.00 | $1,925.97 – $6,685.04 | 3 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $184.72 | $362.20 | $162.86 – $363.48 | 4 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | not published | not published | $755.52 – $2,035.50 | 4 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $3,151.29 | $6,179.00 | $755.52 – $2,035.50 | 4 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $1,801.46 – $5,064.46 | 4 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $3,450.15 | $6,765.00 | $755.52 – $2,035.50 | 4 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $556.27 – $844.89 | 4 |
| Radphm quant measure sgl area add-on CPT 78835 | $809.37 | $1,587.00 | $586.59 – $655.69 | 2 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $5,318.00 – $11,377.00 | 5 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $5,318.00 – $11,377.00 | 5 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $2,238.00 – $9,773.00 | 5 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $72.98 – $157.75 | 4 |
| Range of motion measurements CPT 95852 | not published | not published | $4.95 – $105.06 | 3 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $66.50 – $581.27 | 4 |
| Rapid desensitization CPT 95180 | not published | not published | $621.60 – $634.29 | 2 |
| Rapid Strep Test CPT 87880 | $239.70 | $470.00 | $16.20 – $78.88 | 4 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $12,715.73 | $24,932.80 | $148.10 – $796.49 | 4 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $219.20 – $473.69 | 4 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $662.40 – $1,036.92 | 2 |
| Rbc count only automated CPT 85041 | $84.15 | $165.00 | $2.96 – $26.41 | 4 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $613.88 – $4,042.00 | 5 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.43 – $75.45 | 4 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $7.32 – $58.67 | 4 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $126.39 – $621.60 | 4 |
| Rcm img acquisj&i&r 1st les CPT 96931 | not published | not published | $691.00 – $691.00 | 1 |
| Rcm img acquisj only 1st les CPT 96932 | not published | not published | $4,233.00 – $4,233.00 | 1 |
| Rcm i&r only 1st lesion CPT 96933 | not published | not published | $691.00 – $691.00 | 1 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $4,233.00 – $11,377.00 | 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.