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 |
|---|---|---|---|---|
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $494.19 | $969.00 | $279.18 – $4,042.00 | 5 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $494.19 | $969.00 | $279.18 – $4,042.00 | 5 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | not published | not published | $565.65 – $4,042.00 | 5 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $808.35 | $1,585.00 | $565.65 – $4,042.00 | 5 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | not published | not published | $279.18 – $4,042.00 | 5 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | not published | not published | $279.18 – $4,042.00 | 5 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $19,953.65 | $39,124.80 | not published | 0 |
| Sheath laser cavaclear 14f HCPCS C1603 | $9,754.31 | $19,126.10 | not published | 0 |
| Shigella antibody CPT 86771 | not published | not published | $23.99 – $197.47 | 4 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $3,423.00 – $15,575.00 | 5 |
| Shoe post-op mens m HCPCS L3260 | $31.88 | $62.50 | not published | 0 |
| Shortening of hand tendon CPT 26479 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Shortening of thigh bone CPT 27465 | not published | not published | $2,995.00 – $15,575.00 | 5 |
| Shorten/lengthen thighs CPT 27468 | not published | not published | $2,995.00 – $24,668.00 | 4 |
| Shorten radius or ulna CPT 25390 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Shorten radius & ulna CPT 25392 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $4,812.00 – $15,575.00 | 5 |
| Shoulder MRI (with and without contrast) CPT 73223 | $9,694.59 | $19,009.00 | $485.45 – $6,272.09 | 4 |
| Shoulder MRI (with contrast) CPT 73222 | $5,237.70 | $10,270.00 | $1,089.31 – $3,388.28 | 4 |
| Shoulder MRI (without contrast) CPT 73221 | $4,281.45 | $8,395.00 | $332.01 – $2,769.47 | 4 |
| Shoulder prosthesis removal CPT 23334 | not published | not published | $6,682.00 – $10,302.82 | 5 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $691.00 – $10,302.82 | 5 |
| Shoulder X-ray CPT 73030 | $1,143.42 | $2,242.00 | $121.09 – $143.23 | 4 |
| Shunt as-aort to pulm art CPT 33755 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Shunt central w/prostc graft CPT 33764 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Shunt desc aorta to pulm art CPT 33762 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $7,249.14 | $14,214.00 | not published | 0 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $359.55 | $705.00 | $145.47 – $197.17 | 4 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $6,732.00 – $12,568.00 | 2 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $11.98 – $102.40 | 4 |
| Sialography s&i CPT 70390 | not published | not published | $332.01 – $446.28 | 4 |
| Sialolithotomy 42330 CPT 42330 | $6,161.82 | $12,082.00 | $2,995.00 – $4,737.00 | 5 |
| Sickling rbc CPT 85660 | $104.04 | $204.00 | $5.40 – $48.57 | 4 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $1,294.00 – $4,042.00 | 5 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $1,294.00 – $4,737.00 | 5 |
| Sigmoidoscopy for bleeding CPT 45334 | $2,101.71 | $4,121.00 | $1,665.08 – $4,737.00 | 5 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $1,294.00 – $4,042.00 | 5 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $2,238.00 – $8,619.83 | 5 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $1,294.00 – $4,737.00 | 5 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $1,294.00 – $4,042.00 | 5 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $82.09 – $567.89 | 3 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $1,665.08 – $4,737.00 | 5 |
| Sildenafil citrate, 25 mg HCPCS S0090 | not published | not published | $37.27 – $37.27 | 1 |
| Sim ang w/prs cath rad emb HCPCS C8004 | not published | not published | $16,063.33 – $16,391.15 | 2 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $347.66 – $4,042.00 | 5 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | not published | not published | $76.97 – $308.01 | 3 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $145.47 – $716.73 | 4 |
| Single transfer toe-hand CPT 26553 | not published | not published | $6,682.00 – $11,377.00 | 5 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,884.05 | $5,655.00 | $244.06 – $1,762.86 | 4 |
| Sinus CT scan (with contrast) CPT 70487 | $2,612.73 | $5,123.00 | $244.06 – $1,414.13 | 4 |
| Sinus CT scan (without contrast) CPT 70486 | $2,375.58 | $4,658.00 | $145.47 – $1,179.97 | 4 |
| Sinus/juglr venogram s&i CPT 75860 | not published | not published | $1,087.62 – $4,434.05 | 4 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $2,995.00 – $11,377.00 | 5 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $44,354.33 – $122,586.77 | 4 |
| Sirolimus, oral HCPCS J7520 | $25.21 | $49.43 | $2.29 – $25.10 | 3 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $85.37 – $252.90 | 4 |
| Skeletal muscle relaxant 1/2 CPT 80369 | not published | not published | $0.07 – $142.05 | 2 |
| Skel musc relaxant 3 or more CPT 80370 | $5.56 | $10.91 | $0.07 – $156.23 | 2 |
| Skin and muscle repair face CPT 15845 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Skin Biopsy CPT 11102 | $391.68 | $768.00 | $565.65 – $4,042.00 | 5 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $2,870.98 – $6,732.00 | 5 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $1,716.00 – $19,505.00 | 4 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $2,870.98 – $5,318.00 | 5 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $1,716.00 – $19,505.00 | 4 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $29.60 – $84.49 | 4 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $4,233.00 – $12,568.00 | 3 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $5,530.00 – $12,568.00 | 3 |
| Skyla, 13.5 mg HCPCS J7301 | not published | not published | $930.42 – $2,609.37 | 2 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $171.31 – $1,097.95 | 4 |
| Sleep study attended CPT 95807 | not published | not published | $519.24 – $1,600.25 | 3 |
| Sleep Study (Polysomnography) CPT 95810 | $2,083.35 | $4,085.00 | $1,194.91 – $1,622.17 | 3 |
| Sleep study unattended CPT 95806 | $1,663.62 | $3,262.00 | $300.45 – $1,335.54 | 3 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $2,995.00 – $12,568.00 | 3 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $22.95 | $45.00 | not published | 0 |
| Sling pelv split sam med HCPCS L0621 | $153.00 | $300.00 | not published | 0 |
| Sling suprapubic suburetheral HCPCS C1771 | $21,928.08 | $42,996.24 | not published | 0 |
| Slitting of prepuce CPT 54000 | not published | not published | $2,995.00 – $6,732.00 | 5 |
| Slitting of prepuce CPT 54001 | $4,017.78 | $7,878.00 | $2,908.69 – $6,732.00 | 5 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $82.09 – $339.57 | 3 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $3,096.60 – $9,277.06 | 4 |
| Small animal inoculation CPT 87003 | not published | not published | $16.50 – $147.72 | 4 |
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.