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 |
|---|---|---|---|---|
| Small bowel endoscopy CPT 44360 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44364 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44366 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44369 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44376 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44378 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44382 | not published | not published | $1,262.04 – $4,737.00 | 5 |
| Small bowel endoscopy CPT 44384 | not published | not published | $2,238.00 – $4,737.00 | 5 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $1,262.04 – $4,737.00 | 5 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $2,670.09 – $4,737.00 | 5 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $4,042.00 – $11,377.00 | 5 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.01 – $0.09 | 4 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $287.64 | $564.00 | $5.28 – $47.15 | 4 |
| Smear gram stain CPT 87205 | $163.20 | $320.00 | $4.18 – $37.46 | 4 |
| Smear nasal eosinophil CPT 89190 | $147.39 | $289.00 | $5.67 – $41.66 | 4 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $57.63 | $113.00 | $5.87 – $52.59 | 4 |
| Smear wet mount CPT 87210 | $185.64 | $364.00 | $5.70 – $37.46 | 4 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $295.32 – $1,574.02 | 4 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $181.50 – $967.37 | 4 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $46.06 – $650.37 | 4 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $50.05 – $338.57 | 4 |
| Sodium 24 hour urine CPT 84300 | $143.31 | $281.00 | $4.96 – $42.66 | 4 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $65.33 | $128.10 | $4.94 – $13.26 | 3 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $65.33 | $128.10 | $2.47 – $15.21 | 3 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $65.33 | $128.10 | $1.24 – $11.87 | 3 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $65.33 | $128.10 | $0.09 – $0.22 | 2 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $157.05 | $307.95 | $3.87 – $10.29 | 3 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | not published | not published | $147.92 – $172.86 | 3 |
| Sodium serum/plasma/whole blood CPT 84295 | $143.31 | $281.00 | $4.71 – $42.07 | 4 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $84.15 | $165.00 | $0.86 – $2.00 | 4 |
| Soft interface below knee se HCPCS L2820 | $339.26 | $665.21 | not published | 0 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $121.09 – $123.56 | 2 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,318.40 – $2,690.62 | 4 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,171.91 – $2,391.66 | 4 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $1,413.12 – $6,577.02 | 4 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,025.42 – $2,092.70 | 4 |
| Somatosensory testing CPT 95927 | not published | not published | $298.21 – $306.58 | 3 |
| Somatropin injection HCPCS J2941 | not published | not published | $58.42 – $105.18 | 2 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $1,413.12 – $5,979.10 | 4 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $878.93 – $1,793.74 | 4 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $23.73 – $48.98 | 2 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Special physics consult CPT 77370 | $1,371.39 | $2,689.00 | $187.03 – $794.78 | 3 |
| Special radiation dosimetry CPT 77331 | $253.47 | $497.00 | $129.58 – $190.84 | 3 |
| Special radiation treatment CPT 77470 | $2,272.56 | $4,456.00 | $768.84 – $2,437.40 | 3 |
| Special teletx port plan CPT 77321 | $1,077.12 | $2,112.00 | $521.01 – $1,154.91 | 3 |
| Specific gravity body fluid CPT 84315 | not published | not published | $3.21 – $22.04 | 4 |
| Specimen fat stain CPT 89125 | not published | not published | $5.76 – $37.87 | 4 |
| Speech audiometry complete CPT 92556 | not published | not published | $82.09 – $83.76 | 2 |
| Speech evaluation complex CPT 70371 | not published | not published | $332.01 – $520.50 | 4 |
| Speech recep thresh CPT 92555 | not published | not published | $82.09 – $83.76 | 2 |
| Sperm antibody test CPT 89325 | not published | not published | $10.46 – $93.65 | 4 |
| Sperm evaluation test CPT 89329 | not published | not published | $19.20 – $184.00 | 4 |
| Sperm identification CPT 89257 | not published | not published | $72.51 – $165.44 | 4 |
| Sperm isolation complex CPT 89261 | not published | not published | $72.51 – $508.15 | 4 |
| Sperm isolation simple CPT 89260 | not published | not published | $72.51 – $283.62 | 4 |
| Sperm washing 58323 CPT 58323 | not published | not published | $73.76 – $1,716.00 | 4 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $4,233.00 – $11,377.00 | 5 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $3,423.00 – $11,377.00 | 5 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $1,716.00 – $12,908.00 | 4 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $2,238.00 – $12,908.00 | 4 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $2,788.68 | $5,468.00 | $982.21 – $4,042.00 | 5 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $691.00 – $18,229.15 | 5 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $300.45 – $1,161.83 | 3 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $1,187.28 | $2,328.00 | $285.39 – $529.83 | 3 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $179.04 – $559.61 | 3 |
| Spleen imaging CPT 78185 | not published | not published | $556.27 – $589.01 | 4 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Splicing of ureters CPT 50770 | not published | not published | $2,238.00 – $9,773.00 | 3 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $99.04 | $194.20 | not published | 0 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $7,088.49 | $13,899.00 | $2,995.00 – $11,377.00 | 5 |
| Split blood or products CPT 86985 | $166.26 | $326.00 | $104.04 – $287.00 | 4 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | not published | not published | $1,716.00 – $19,505.00 | 4 |
| Sprchoroidal spc njx rx agt CPT 67516 | not published | not published | $459.61 – $4,042.00 | 5 |
| Sputum specimen collection CPT 89220 | not published | not published | $94.91 – $287.00 | 4 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $1,209.16 – $8,914.63 | 4 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $12,568.00 – $15,575.00 | 2 |
| Srs cranial lesion simple CPT 61796 | not published | not published | $12,568.00 – $15,575.00 | 2 |
| Srs cran les complex addl CPT 61799 | not published | not published | $4,737.00 – $9,773.00 | 2 |
| Srs cran les simple addl CPT 61797 | not published | not published | $4,737.00 – $9,773.00 | 2 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $171.89 – $522.33 | 4 |
| Srs linear based CPT 77372 | $31,663.86 | $62,086.00 | $5,558.26 – $10,457.69 | 3 |
| Srs multisource CPT 77371 | not published | not published | $7,324.54 – $10,457.69 | 3 |
| Srs spinal lesion CPT 63620 | not published | not published | $12,568.00 – $15,575.00 | 2 |
| Srs spinal lesion addl CPT 63621 | not published | not published | $4,737.00 – $9,773.00 | 2 |
| Staggered spondaic word test CPT 92572 | not published | not published | $179.04 – $182.70 | 2 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $9,773.00 – $9,773.00 | 1 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $348.84 | $684.00 | $130.61 – $133.28 | 2 |
| Staph a dna amp probe CPT 87640 | not published | not published | $34.39 – $301.34 | 4 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $293.76 | $576.00 | $105.37 – $107.52 | 2 |
| Stem cells total count CPT 86367 | not published | not published | $76.22 – $323.86 | 4 |
| Stenger test pure tone CPT 92565 | not published | not published | $82.09 – $83.76 | 2 |
| Stenger test speech CPT 92577 | not published | not published | $519.24 – $529.83 | 2 |
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.