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 |
|---|---|---|---|---|
| Reconstruction of urethra CPT 54324 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction of urethra CPT 54326 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruction tongue fold CPT 41520 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruct larynx & pharynx CPT 31395 | not published | not published | $6,682.00 – $12,568.00 | 3 |
| Reconstruct lip with flap CPT 40527 | not published | not published | $2,995.00 – $8,405.34 | 5 |
| Reconstruct lip w/local flap 40525 CPT 40525 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Reconstruct lower jaw bone CPT 21255 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruct lower jaw bone CPT 21247 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Reconstruct orbit/forehead CPT 21172 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $8,992.00 – $20,488.00 | 5 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $3,423.00 – $24,668.00 | 5 |
| Reconstruct ulna/radioulnar CPT 25337 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct upper jaw bone CPT 21206 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reconstruct urethra/bladder CPT 53431 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruct urethra stage 1 CPT 53420 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Reconstruct urethra stage 2 CPT 53425 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reconstruct vena cava 34502 CPT 34502 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Reconstruct windpipe CPT 31780 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Reconstruct windpipe CPT 31781 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Rectal sensation test CPT 91120 | not published | not published | $1,333.00 – $3,589.71 | 3 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $190.23 | $373.00 | $181.21 – $184.91 | 2 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $229.50 | $450.00 | not published | 0 |
| Red blood cells washed each unit HCPCS P9022 | $296.82 | $582.00 | not published | 0 |
| Red cell mass multiple CPT 78121 | not published | not published | $594.47 – $755.52 | 4 |
| Red cell mass single CPT 78120 | not published | not published | $430.33 – $589.01 | 4 |
| Red cell sequestration CPT 78140 | not published | not published | $556.27 – $988.94 | 4 |
| Red cell survival kinetics CPT 78135 | not published | not published | $1,224.11 – $1,224.11 | 1 |
| Red cell survival study CPT 78130 | not published | not published | $556.27 – $716.61 | 4 |
| Redo compl cardiac anomaly CPT 33622 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Redo endovas vena cava filtr CPT 37192 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Reduce bowel obstruction 44050 CPT 44050 | not published | not published | $2,238.00 – $20,652.00 | 4 |
| Reduce testis torsion CPT 54600 | $6,983.94 | $13,694.00 | $4,233.00 – $9,773.00 | 5 |
| Reduction of facial bones CPT 21209 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reduction of procidentia 45900 CPT 45900 | $1,799.79 | $3,529.00 | $1,294.00 – $4,042.00 | 5 |
| Reduction of skull defect CPT 62115 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Reduction of skull defect CPT 62117 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Re-exploration of chest 32120 CPT 32120 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Reexploration pelvic wound 49014 CPT 49014 | not published | not published | $691.00 – $6,732.00 | 3 |
| Re-explore parathyroids CPT 60502 | not published | not published | $2,238.00 – $12,568.00 | 5 |
| Refill maint impl spine pump CPT 95991 | $573.75 | $1,125.00 | $427.11 – $4,042.00 | 4 |
| Refill/maint pump/resvr syst CPT 96522 | $400.86 | $786.00 | $295.97 – $302.01 | 2 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $795.15 | $1,559.12 | $8.82 – $75.49 | 3 |
| Reimplant artery each 35697 CPT 35697 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Reimplant ureter in bladder CPT 50782 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Reimplant ureter in bladder CPT 50783 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Reimplant ureter in bladder CPT 50785 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Reinforce clavicle CPT 23490 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Reinforce eye wall CPT 67250 | not published | not published | $3,308.19 – $6,732.00 | 5 |
| Reinforce/graft eye wall CPT 67255 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Reinforce hip bones CPT 27187 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Reinforce shoulder bones CPT 23491 | not published | not published | $3,423.00 – $18,229.15 | 5 |
| Reinforce thigh CPT 27495 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Reinforce tibia CPT 27745 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Reinnervate larynx CPT 31590 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Reinsertion of spinal fixation device 22849 CPT 22849 | not published | not published | $2,995.00 – $20,488.00 | 5 |
| Reinsert ocular implant CPT 65155 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Release encircling material CPT 67115 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Release eye tissue CPT 67343 | not published | not published | $3,308.19 – $6,732.00 | 5 |
| Release facial nerve CPT 69720 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Release facial nerve CPT 69725 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Release facial nerve CPT 69955 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Release finger contracture CPT 26525 | not published | not published | $2,237.46 – $5,318.00 | 5 |
| Release forearm/hand tendon CPT 26449 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Release inner ear canal CPT 69960 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Release knuckle contracture CPT 26520 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Release middle ear bone CPT 69650 | not published | not published | $4,613.34 – $9,773.00 | 5 |
| Release muscles of hand CPT 26593 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Release of eye fluid CPT 67015 | $6,547.89 | $12,839.00 | $2,238.00 – $6,732.00 | 5 |
| Release of foot tendon CPT 28220 | not published | not published | $2,237.46 – $6,732.00 | 5 |
| Release of foot tendon 28225 CPT 28225 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Release of foot tendons CPT 28222 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Release of foot tendons CPT 28226 | not published | not published | $2,238.00 – $6,732.00 | 5 |
| Release of lower leg tendon CPT 27680 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Release of lower leg tendons CPT 27681 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Release of lung 32220 CPT 32220 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Release of midfoot joint CPT 28260 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Release of midfoot joint CPT 28264 | not published | not published | $2,237.46 – $11,377.00 | 5 |
| Release of shoulder ligament CPT 23415 | not published | not published | $4,812.00 – $11,377.00 | 5 |
| Release of skull seams CPT 61550 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Release of skull seams CPT 61552 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Release of ureter CPT 50715 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Release of ureter CPT 50722 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Release of ureter CPT 50940 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Release palm contracture CPT 26040 | not published | not published | $2,237.46 – $4,737.00 | 5 |
| Release palm contracture CPT 26121 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Release palm contracture CPT 26123 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Release palm contracture CPT 26125 | not published | not published | $1,716.00 – $25,242.00 | 4 |
| Release palm contracture 26045 CPT 26045 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Release palm & finger tendon CPT 26442 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Release palm/finger tendon CPT 26440 | not published | not published | $2,237.46 – $5,318.00 | 5 |
| Release/revise ureter CPT 50725 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Release spinal cord lumbar CPT 63200 | not published | not published | $2,995.00 – $20,488.00 | 3 |
| Release thumb contracture CPT 26508 | not published | not published | $3,423.00 – $5,318.00 | 5 |
| Release wrist/forearm tendon CPT 25295 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Relieve bladder contracture CPT 52640 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Relieve cranial pressure 61345 CPT 61345 | not published | not published | $3,423.00 – $12,568.00 | 3 |
| Relocation of testis(es) CPT 54680 | not published | not published | $3,423.00 – $6,732.00 | 5 |
| Relocation skin pocket aicd CPT 33223 | $2,545.92 | $4,992.00 | $2,870.98 – $5,318.00 | 5 |
| Relocation skin pocket pm CPT 33222 | $2,545.92 | $4,992.00 | $2,870.98 – $5,318.00 | 5 |
| Rem/biv cast full arm/leg CPT 29705 | $334.56 | $656.00 | $389.18 – $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.