Top 40 services provided by SANTA ROSA MEMORIAL HOSPITAL
Services CPT Price Est. Cash Price
Epidural steroid injections for lower back pain 64483 $2,794.00 $1,257.30
CT scan of the head or brain without contrast or dye 70450 $4,697.00 $2,113.65
MRI scan of the brain with and without contrast 70553 $8,212.00 $3,695.40
X-ray of the chest, 2 views 71046 $1,142.00 $513.90
X-ray of the chest, 2 views 71046 $187.00 $84.15
X-ray of the lower spine with 4 or more views 72110 $265.00 $119.25
X-ray of the lower spine with 4 or more views 72110 $3,320.00 $1,494.00
CT scan of the pelvis with contrast or dye 72193 $9,657.00 $4,345.65
CT scan of the abdomen with contrast or dye 74160 $9,554.00 $4,299.30
Ultrasound of the abdomen 76700 $2,388.00 $1,074.60
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $4,883.00 $2,197.35
Mammogram of both breasts 77067 $1,084.00 $487.80
Mammogram of both breasts 77067 $916.00 $412.20
Basic Metabolic Panel 80048 $289.20 $130.14
Comprehensive Metabolic Panel 80053 $497.90 $224.06
Lipid Panel 80061 $358.10 $161.14
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $173.50 $78.08
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $20.60 $9.27
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $70.90 $31.90
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $332.90 $149.80
Blood test that measures gases in the blood including the acidity, or pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery. 82805 $821.00 $369.45
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $351.60 $158.22
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $455.30 $204.88
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $204.60 $92.07
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $164.00 $73.80
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $556.00 $250.20
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $111.00 $49.95
Ultrasound of chest to examine the heart 93307 $2,558.00 $1,151.10
Insertion of catheter into left heart for diagnosis 93452 $18,721.00 $8,424.45
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $541.00 $243.45
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $231.00 $103.95
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $307.00 $138.15
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $244.00 $109.80
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $255.00 $114.75
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $615.00 $276.75
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $292.00 $131.40
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $374.00 $168.30
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $360.00 $162.00
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $305.00 $137.25
Training for walking to 1 or more areas for 15 minutes 97116 $278.00 $125.10
Physical therapy evaluation session for 20 minutes 97161 $280.00 $126.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $1,021.00 $459.45
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $983.00 $442.35
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $3,215.00 $1,446.75
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $410.00 $184.50
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $297.00 $133.65
Emergency department visit facility fees for a visit of moderate severity 99283 $2,315.00 $1,041.75
Emergency department visit facility fees for a visit of high to moderate severity 99284 $3,922.00 $1,764.90