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 |
|---|---|---|---|---|
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $4,812.00 – $12,568.00 | 5 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $4,233.00 – $12,568.00 | 5 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | not published | not published | $4,233.00 – $12,568.00 | 5 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $4,233.00 – $6,732.00 | 5 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Realignment of knee CPT 27457 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Realignment of knee CPT 27455 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Realignment of tendons CPT 26437 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Realignment of thigh bone CPT 27454 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Rechanneling of artery CPT 35361 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Rechanneling of artery CPT 35306 | not published | not published | $4,042.00 – $6,732.00 | 2 |
| Rechanneling of artery CPT 35311 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Rechanneling of artery CPT 35363 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | not published | not published | $2,238.00 – $15,575.00 | 5 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Recipient nephrectomy CPT 50340 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Recon, cta for surg plan HCPCS G0288 | not published | not published | $644.52 – $2,591.38 | 2 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconst lwr jaw w/graft CPT 21194 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconst lwr jaw without fixation CPT 21195 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Reconst lwr jaw without graft CPT 21193 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Reconst major injured chest 32820 CPT 32820 | not published | not published | $2,995.00 – $9,773.00 | 3 |
| Reconst pectus excavatum/carinatum opn 21740 CPT 21740 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Reconstr lwr jaw segment CPT 21198 | not published | not published | $6,682.00 – $9,773.00 | 5 |
| Reconstr lwr jaw w/advance CPT 21199 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $2,995.00 – $37,756.02 | 5 |
| Reconstruct bronchus CPT 31775 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Reconstruct cleft foot CPT 28360 | not published | not published | $4,812.00 – $15,575.00 | 5 |
| Reconstruct cleft palate CPT 42200 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct cleft palate CPT 42205 | not published | not published | $4,613.34 – $11,377.00 | 5 |
| Reconstruct cleft palate CPT 42210 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct cleft palate CPT 42215 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Reconstruct cleft palate CPT 42220 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct cleft palate CPT 42225 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Reconstruct cranial bone CPT 21182 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct cranial bone CPT 21183 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct cranial bone CPT 21184 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Reconstruct elbow joint CPT 24360 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct elbow joint CPT 24361 | not published | not published | $4,812.00 – $24,668.00 | 5 |
| Reconstruct elbow joint CPT 24362 | not published | not published | $4,812.00 – $18,229.15 | 5 |
| Reconstruct elbow lat ligmnt CPT 24344 | not published | not published | $5,318.00 – $11,377.00 | 5 |
| Reconstruct elbow med ligmnt CPT 24346 | not published | not published | $5,318.00 – $18,229.15 | 5 |
| Reconstruct extra finger CPT 26587 | not published | not published | $4,552.87 – $9,773.00 | 5 |
| Reconstruct finger joint CPT 26545 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Reconstruct finger joint CPT 26548 | $6,486.18 | $12,718.00 | $4,233.00 – $11,377.00 | 5 |
| Reconstruct head of radius CPT 24365 | not published | not published | $4,812.00 – $18,229.15 | 5 |
| Reconstruct head of radius CPT 24366 | not published | not published | $4,812.00 – $20,488.00 | 5 |
| Reconstruction ankle joint CPT 27703 | not published | not published | $2,995.00 – $24,397.68 | 5 |
| Reconstruction knee CPT 27427 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Reconstruction knee CPT 27428 | not published | not published | $4,233.00 – $18,229.15 | 5 |
| Reconstruction knee CPT 27429 | not published | not published | $4,233.00 – $18,229.15 | 5 |
| Reconstruction of anus CPT 46753 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Reconstruction of bile ducts 47800 CPT 47800 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Reconstruction of eyelid CPT 67971 | not published | not published | $3,308.19 – $6,732.00 | 5 |
| Reconstruction of eyelid CPT 67973 | not published | not published | $3,308.19 – $6,732.00 | 5 |
| Reconstruction of eyelid CPT 67974 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction of eyelid CPT 67975 | not published | not published | $3,308.19 – $6,732.00 | 5 |
| Reconstruction of hip socket CPT 27120 | not published | not published | $2,995.00 – $18,229.15 | 5 |
| Reconstruction of hip socket CPT 27122 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Reconstruction of jaw CPT 21245 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Reconstruction of jaw CPT 21246 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Reconstruction of jaw CPT 21248 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Reconstruction of jaw CPT 21249 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Reconstruction of jaw joint CPT 21240 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Reconstruction of jaw joint CPT 21242 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruction of jaw joint CPT 21243 | not published | not published | $4,812.00 – $37,756.02 | 5 |
| Reconstruction of lower jaw CPT 21244 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Reconstruction of midface CPT 21188 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction of mouth CPT 40840 | not published | not published | $2,995.00 – $8,405.34 | 5 |
| Reconstruction of mouth CPT 40842 | not published | not published | $3,423.00 – $8,405.34 | 5 |
| Reconstruction of mouth CPT 40843 | not published | not published | $3,423.00 – $8,405.34 | 5 |
| Reconstruction of mouth CPT 40844 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruction of mouth CPT 40845 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruction of nail bed CPT 11762 | $3,738.30 | $7,330.00 | $2,238.00 – $4,737.00 | 5 |
| Reconstruction of nose CPT 30410 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruction of nose CPT 30420 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruction of orbit CPT 21256 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruction of throat CPT 42950 | not published | not published | $2,995.00 – $8,405.34 | 5 |
| Reconstruction of urethra CPT 53410 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruction of urethra CPT 53415 | not published | not published | $2,238.00 – $11,377.00 | 3 |
| Reconstruction of urethra CPT 53430 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruction of urethra CPT 54308 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction of urethra CPT 54312 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction of urethra CPT 54316 | not published | not published | $3,423.00 – $13,441.06 | 5 |
| Reconstruction of urethra CPT 54318 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction of urethra CPT 54322 | not published | not published | $3,423.00 – $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.