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 |
|---|---|---|---|---|
| Rtm dev sply mscskl 16-30 d CPT 98977 | $214.20 | $420.00 | not published | 0 |
| Rtm dev sply resp sys 16-30d CPT 98976 | $214.20 | $420.00 | not published | 0 |
| Rtm tx mgmt 1st 20 min CPT 98980 | $349.86 | $686.00 | $27.20 – $27.76 | 2 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | $342.21 | $671.00 | $25.78 – $26.31 | 2 |
| Rubella antibody igg CPT 86762 | $231.54 | $454.00 | $14.10 – $125.91 | 4 |
| Rubeola ag if CPT 87283 | not published | not published | $59.58 – $121.60 | 4 |
| Rubeola antibody igg CPT 86765 | $231.54 | $454.00 | $12.62 – $113.09 | 4 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $322.92 – $2,069.64 | 4 |
| Russell viper venom diluted CPT 85613 | $22.95 | $45.00 | $9.39 – $83.96 | 4 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $898.74 – $4,131.36 | 4 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | not published | not published | $36.06 – $76.97 | 4 |
| Safety plan interven HCPCS G0560 | not published | not published | $42.90 – $43.78 | 2 |
| Salivary gland function exam CPT 78232 | not published | not published | $556.27 – $887.72 | 4 |
| Salivary gland imaging CPT 78230 | not published | not published | $547.15 – $589.01 | 4 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $556.27 – $795.90 | 4 |
| Salmonella antibody CPT 86768 | $5.10 | $10.00 | $12.93 – $115.75 | 4 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $2,238.00 – $9,773.00 | 5 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $185.25 – $189.04 | 2 |
| Sargramostim injection HCPCS J2820 | not published | not published | $60.65 – $182.41 | 4 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $50.40 – $117.64 | 4 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | $151.16 | $296.40 | $0.09 – $347.31 | 2 |
| Sarscov coronavirus ag ia CPT 87426 | not published | not published | $34.62 – $149.49 | 4 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $68.88 – $188.78 | 4 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Sbrt management CPT 77435 | not published | not published | $3,783.99 – $3,783.99 | 1 |
| Sbsq psyc collab care mgmt CPT 99493 | not published | not published | $141.36 – $144.24 | 2 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $2,055.30 | $4,030.00 | $332.01 – $1,257.78 | 3 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $1,528.47 | $2,997.00 | $145.47 – $1,003.83 | 3 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,855.89 | $3,639.00 | $332.01 – $1,218.91 | 3 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,535.10 | $3,010.00 | $145.47 – $810.67 | 3 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,783.98 | $3,498.00 | $145.47 – $780.89 | 3 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,736.55 | $3,405.00 | $145.47 – $872.71 | 3 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $2,531.13 | $4,963.00 | $332.01 – $1,182.09 | 3 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,434.63 | $2,813.00 | $145.47 – $789.17 | 3 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $1,434.63 | $2,813.00 | $145.47 – $831.77 | 3 |
| Scan proc cranial extra CPT 61782 | not published | not published | $1,306.64 – $4,042.00 | 3 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $1,570.97 – $4,042.00 | 3 |
| Scan proc spinal CPT 61783 | not published | not published | $1,570.97 – $4,042.00 | 3 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $4,056.54 | $7,954.00 | $2,238.00 – $4,042.00 | 5 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $4,552.87 – $8,992.00 | 5 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $10,944.24 | $21,459.30 | not published | 0 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $18.17 – $57.20 | 4 |
| Scr c/v cyto,autosys and md HCPCS G0141 | not published | not published | $52.70 – $179.48 | 3 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $31.30 – $63.88 | 4 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $43.09 – $124.08 | 4 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $25.96 – $124.08 | 4 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $26.51 – $124.08 | 4 |
| Screen cerv/vag thin layer HCPCS G0123 | not published | not published | $19.85 – $124.08 | 4 |
| Screen c/v thin layer by md HCPCS G0124 | not published | not published | $52.70 – $179.48 | 3 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $691.00 – $4,042.00 | 5 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $691.00 – $4,042.00 | 5 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | not published | not published | $17.69 – $36.10 | 4 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $27.70 – $351.98 | 4 |
| Screening hepatitis c antibody high risk HCPCS G0472 | not published | not published | $45.42 – $114.57 | 4 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | not published | not published | $23.60 – $127.81 | 4 |
| Screening Mammogram CPT 77067 | $684.42 | $1,342.00 | $97.76 – $677.26 | 4 |
| Screening pap smear by phys HCPCS P3001 | not published | not published | $52.70 – $165.52 | 3 |
| Screening prostate cancer PSA HCPCS G0103 | not published | not published | $18.92 – $161.43 | 4 |
| Screen pap by tech w md supv HCPCS P3000 | not published | not published | $18.17 – $57.20 | 4 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $119,168.64 | $233,664.00 | not published | 0 |
| Sc ther infusion reset pump CPT 96371 | $142.80 | $280.00 | $100.19 – $102.23 | 2 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | $6,114.39 | $11,989.00 | $2,238.00 – $6,732.00 | 3 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $4,367.13 | $8,563.00 | $1,716.00 – $12,908.00 | 4 |
| Sedimentation rate erythrocyte automated CPT 85652 | $140.25 | $275.00 | $2.65 – $22.93 | 4 |
| Seg acet and eth estr yearly HCPCS J7294 | not published | not published | $2,990.37 – $6,245.02 | 2 |
| Segmentectomy 32484 CPT 32484 | not published | not published | $2,238.00 – $12,568.00 | 3 |
| Select picture audiometry CPT 92583 | not published | not published | $82.09 – $83.76 | 2 |
| Self-meas bp pt educaj/train CPT 99473 | not published | not published | $40.25 – $41.07 | 2 |
| Semen analysis HCPCS G0027 | not published | not published | $6.37 – $34.33 | 4 |
| Semen analysis presence/motility CPT 89321 | $332.01 | $651.00 | $11.81 – $105.71 | 4 |
| Semen analysis w/count CPT 89310 | not published | not published | $8.44 – $75.45 | 4 |
| Sensorimotor examination CPT 92060 | not published | not published | $82.09 – $83.76 | 2 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $3,308.19 – $9,773.00 | 5 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $188.16 – $429.15 | 4 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Serial tonometry CPT 92100 | $118.32 | $232.00 | $262.23 – $262.23 | 1 |
| Sermorelin acetate injection HCPCS Q0515 | not published | not published | $2.77 – $44.14 | 2 |
| Serpina1 gene CPT 81332 | $45.90 | $90.00 | $42.78 – $463.54 | 4 |
| Sertraline (zoloft) - sendout CPT 80332 | not published | not published | $0.07 – $144.29 | 2 |
| Set radiation therapy field CPT 77280 | $1,751.34 | $3,434.00 | $187.03 – $759.62 | 3 |
| Set radiation therapy field CPT 77285 | $2,258.28 | $4,428.00 | $521.01 – $1,220.09 | 3 |
| Set radiation therapy field CPT 77290 | $5,005.14 | $9,814.00 | $521.01 – $1,419.86 | 3 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | $427.37 – $1,716.00 | 3 |
| Set up port xray equipment HCPCS Q0092 | not published | not published | $178.46 – $178.46 | 1 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | not published | not published | $0.09 – $0.24 | 2 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | not published | not published | $0.09 – $0.67 | 2 |
| Sever cranial nerve CPT 64771 | not published | not published | $2,717.15 – $6,732.00 | 5 |
| Sex chromatin identification CPT 88130 | not published | not published | $17.62 – $132.06 | 4 |
| Sex chromatin identification CPT 88140 | not published | not published | $7.83 – $70.14 | 4 |
| Sex transformation f to m CPT 55980 | not published | not published | $2,238.00 – $9,773.00 | 4 |
| Sex transformation m to f CPT 55970 | not published | not published | $2,238.00 – $9,773.00 | 4 |
| Sf3b1 gene common variants CPT 81347 | not published | not published | $189.38 – $575.51 | 4 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | $279.18 – $4,042.00 | 5 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | $279.18 – $4,042.00 | 5 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | $565.65 – $4,042.00 | 5 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $565.65 – $4,042.00 | 5 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $494.19 | $969.00 | $279.18 – $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.