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 |
|---|---|---|---|---|
| Revision of urethra CPT 57220 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Revision of urinary tract CPT 51820 | not published | not published | $2,238.00 – $25,815.00 | 4 |
| Revision open av fistula without thromb CPT 36832 | $7,978.95 | $15,645.00 | $4,233.00 – $15,575.00 | 5 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Revision tips CPT 37183 | $20,368.89 | $39,939.00 | $2,238.00 – $20,488.00 | 5 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $6,682.00 – $18,229.15 | 5 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $6,682.00 – $18,229.15 | 5 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $173.16 – $436.24 | 3 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $173.16 – $2,214.80 | 4 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $7,742.78 – $15,575.00 | 4 |
| Revj fem anast nonautog grf CPT 35883 | not published | not published | $7,742.78 – $15,575.00 | 4 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Revj open gstr rstcv px CPT 43848 | not published | not published | $3,423.00 – $9,773.00 | 3 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Revj/rmvl nea pn w/int nstim CPT 64598 | not published | not published | $691.00 – $11,377.00 | 5 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $6,682.00 – $12,568.00 | 5 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $6,868.68 | $13,468.00 | $2,238.00 – $11,377.00 | 5 |
| Rev/rmvl gstr nstim eltrd CPT 43882 | not published | not published | $6,732.00 – $9,773.00 | 2 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $2,238.00 – $11,377.00 | 5 |
| Rev rplcm arthrp 1ntrspc crv CPT 22861 | not published | not published | $9,773.00 – $24,397.68 | 4 |
| Rev rplcm rthrp 1ntrspc lmbr CPT 22862 | not published | not published | $9,773.00 – $24,397.68 | 4 |
| Rev/rplcmt sk-mnt crnl nstm CPT 61891 | not published | not published | $691.00 – $42,937.38 | 5 |
| Rev rplc/rmv thrc vrt tethrg CPT 22838 | not published | not published | $691.00 – $24,397.68 | 5 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | not published | not published | $2,238.00 – $20,488.00 | 5 |
| Revsc opn/prq tib/pero stent CPT 37234 | $12,830.07 | $25,157.00 | $4,042.00 – $15,575.00 | 4 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | not published | not published | $10.57 – $22.40 | 4 |
| Rf abltj nrv nrvtg si jt CPT 64625 | not published | not published | $2,717.15 – $6,732.00 | 5 |
| Rheumatoid factor qualitative CPT 86430 | $14.26 | $27.96 | $6.02 – $49.04 | 4 |
| Rheumatoid factor quantitative CPT 86431 | $66.30 | $130.00 | $5.56 – $49.04 | 4 |
| Rh ig IV CPT 90386 | not published | not published | $188.16 – $1,424.87 | 2 |
| Rh ig minidose im CPT 90385 | not published | not published | $51.93 – $129.56 | 4 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $4,233.00 – $9,773.00 | 5 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $243.11 | $476.68 | $9.77 – $14.47 | 3 |
| Rho d immune globulin 50 mcg HCPCS J2788 | $132.55 | $259.91 | $47.24 – $51.93 | 3 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $1,398.61 | $2,742.37 | $31.44 – $69.90 | 4 |
| Rho d immune globulin inj HCPCS J2790 | $298.84 | $585.96 | $143.09 – $165.89 | 3 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $147.08 – $280.64 | 2 |
| R hrt cath chd abnl nt cnj CPT 93594 | not published | not published | $4,511.03 – $11,377.00 | 4 |
| R hrt cath chd nml nt cnj CPT 93593 | not published | not published | $4,511.03 – $11,377.00 | 4 |
| Rhythm ecg with report CPT 93040 | not published | not published | $77.91 – $129.05 | 2 |
| Rib cartilage graft CPT 21230 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $2,038.89 – $5,882.40 | 2 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $420.68 | $824.87 | $0.28 – $0.30 | 2 |
| Right heart cath congenital CPT 93530 | not published | not published | $9,773.00 – $16,652.00 | 2 |
| Right ventric recording CPT 93603 | $3,782.67 | $7,417.00 | $1,694.16 – $4,737.00 | 4 |
| Rilonacept injection HCPCS J2793 | not published | not published | $32.55 – $58.05 | 2 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $2,880.20 | $5,647.45 | not published | 0 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $18,265.61 | $35,814.93 | $14.31 – $31.95 | 4 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | not published | not published | $10.58 – $22.58 | 4 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $14,021.67 | $27,493.48 | $72.67 – $164.32 | 4 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $35.56 – $80.69 | 4 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | not published | not published | $30.65 – $120.98 | 4 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $19.85 – $102.57 | 4 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | not published | not published | $13.41 – $102.57 | 4 |
| R & l heart cath congenital CPT 93531 | not published | not published | $6,682.00 – $16,652.00 | 3 |
| R & l heart cath congenital CPT 93532 | not published | not published | $12,568.00 – $16,652.00 | 2 |
| R & l heart cath congenital CPT 93533 | not published | not published | $12,568.00 – $16,652.00 | 2 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | not published | not published | $4,511.03 – $11,377.00 | 4 |
| R&l hrt cath chd nml nt cnj CPT 93596 | not published | not published | $4,511.03 – $11,377.00 | 4 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | not published | not published | $2,238.00 – $15,575.00 | 5 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $1,406.07 | $2,757.00 | $985.34 – $4,042.00 | 5 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | $2,238.00 – $15,575.00 | 5 |
| Rmvl ext fixj sys under anes CPT 20694 | $3,107.43 | $6,093.00 | $2,237.46 – $4,737.00 | 5 |
| Rmvl fb upr arm/elbow deep CPT 24201 | $5,595.21 | $10,971.00 | $2,995.00 – $4,737.00 | 5 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $2,429.64 | $4,764.00 | $1,665.08 – $4,737.00 | 5 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $3,247.68 | $6,368.00 | $2,238.00 – $4,042.00 | 5 |
| Rmvl hpglsl nstim ary pg CPT 64584 | not published | not published | $691.00 – $15,575.00 | 5 |
| Rmvl i-artic rx delivery dev 20705 CPT 20705 | not published | not published | $1,716.00 – $12,908.00 | 2 |
| Rmvl icd by tv extr CPT 33244 | $5,202.00 | $10,200.00 | $3,423.00 – $11,377.00 | 5 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $34,278.12 | $67,212.00 | $2,995.00 – $30,951.14 | 5 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $59,653.17 | $116,967.00 | $2,995.00 – $43,676.48 | 5 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $34,027.71 | $66,721.00 | $2,995.00 – $30,951.14 | 5 |
| Rmvl icd pulse gen only CPT 33241 | $5,118.87 | $10,037.00 | $3,423.00 – $11,377.00 | 5 |
| Rmvl imed rx delivery device CPT 20703 | not published | not published | $1,716.00 – $12,908.00 | 2 |
| Rmvl left heart vent thor inscn ecmo CPT 33989 | not published | not published | $691.00 – $9,773.00 | 3 |
| Rmvl lung xcp tot pneumonectomy sleeve lob 32486 CPT 32486 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $2,443.41 | $4,791.00 | $691.00 – $4,042.00 | 5 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | not published | not published | $691.00 – $12,908.00 | 3 |
| Rmvl perm pm pulse gen CPT 33233 | $12,127.80 | $23,780.00 | $3,423.00 – $11,749.91 | 5 |
| Rmvl perq right heart vad CPT 33997 | not published | not published | $691.00 – $9,773.00 | 3 |
| Rmvl phrnc nrv stim pg only CPT 33280 | not published | not published | $691.00 – $11,377.00 | 5 |
| Rmvl phrnc nrv stim sys CPT 33278 | not published | not published | $691.00 – $11,377.00 | 5 |
| Rmvl phrnc nrv stim transvns CPT 33279 | not published | not published | $691.00 – $11,377.00 | 5 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $27,641.49 | $54,199.00 | $2,995.00 – $26,801.96 | 5 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $14,809.38 | $29,038.00 | $2,995.00 – $20,488.00 | 5 |
| Rmvl pq iabp CPT 33968 | $2,188.41 | $4,291.00 | $5,318.00 – $20,488.00 | 3 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $3,174.24 | $6,224.00 | $6,511.00 – $9,773.00 | 3 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Rmvl rplcmt hrt sys f/trnspl CPT 33929 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Rmvl & rplcmt tot hrt sys CPT 33928 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Rmvl sq defib electrode CPT 33272 | not published | not published | $691.00 – $11,377.00 | 5 |
| Rmvl subq card rhythm mntr CPT 33286 | $2,424.54 | $4,754.00 | $985.34 – $4,233.00 | 5 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | $5,628.87 | $11,037.00 | $2,238.00 – $6,732.00 | 5 |
| Rmvl tongs/halo anthr indiv CPT 20665 | $818.04 | $1,604.00 | $621.60 – $4,042.00 | 5 |
| Rmvl tot arthrp 1ntrspc crv CPT 22864 | not published | not published | $9,773.00 – $15,575.00 | 4 |
| Rmvl tot arthrp 1ntrspc lmbr CPT 22865 | not published | not published | $9,773.00 – $15,575.00 | 4 |
| Rmvl transplanted rnl algrft CPT 50370 | not published | not published | $2,238.00 – $9,773.00 | 3 |
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.