▸ Hospital · CA · CCN 050150

Sierra Nevada Memorial Hospital

155 GLASSON WAY, GRASS VALLEY, CA, 95945

104 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
182
of 209 target codes
Payers
13
with negotiated rates
Rates published
5,103
last crawl 2026-05-22

Procedures & rates

ProcedureTypeCodePayersGrossCashNeg minNeg medianNeg max
behavioral
PsychosesMS-DRG8857$12,306$12,306$12,306
emergency
ED visit level 1CPT9928113$557$389.9$21.77$409.96$3,104
ED visit level 2CPT9928213$1,114$779.8$34.97$819.91$5,298
ED visit level 3CPT9928313$1,838$1,286.6$63.97$1,352.77$7,062
ED visit level 4CPT9928413$3,622$2,535.4$98.04$2,665.8$11,349
ED visit level 5CPT9928513$5,571$3,899.7$155.03$4,100.26$15,755
Critical care, first hourCPT9929113$8,021$5,614.7$265$6,007.74$18,322
imaging
CT head without contrastCPT7045012$4,152$2,906.4$149.03$381.17$4,089.72
CT head with contrastCPT7046012$6,228$4,359.6$209.04$451.53$6,134.58
CT head with and without contrastCPT7047012$6,228$4,359.6$247.23$534.02$6,134.58
CT neck with contrastCPT7049112$6,228$4,359.6$250.76$567.86$6,134.58
MRI brain without contrastCPT7055112$4,736$3,315.2$283.78$1,116.18$4,664.96
MRI brain with contrastCPT7055212$7,254$5,077.8$396.44$1,237.85$7,145.19
MRI brain with and without contrastCPT7055312$7,254$5,077.8$467.23$1,314.31$7,145.19
Chest X-ray single viewCPT7104512$980$686$17.67$114.22$965.3
Chest X-ray 2 viewsCPT7104612$980$686$27.48$114.22$965.3
Chest X-ray 3 viewsCPT7104712$980$686$35.27$114.22$965.3
CT chest without contrastCPT7125012$4,152$2,906.4$152.84$450.63$4,089.72
CT chest with contrastCPT7126012$6,228$4,359.6$238.02$514.12$6,134.58
CT chest with and without contrastCPT7127012$6,228$4,359.6$250.76$610.96$6,134.58
MRI chest without contrastCPT7155012$4,736$3,315.2$323.03$1,366.09$4,664.96
MRI chest with contrastCPT7155112$7,440$5,208$395.33$1,314.82$7,328.4
MRI chest with and without contrastCPT7155212$7,254$5,077.8$501.11$1,350.9$7,145.19
Lumbosacral spine X-rayCPT7210012$1,093$765.1$43.45$153.73$1,076.61
CT cervical spine without contrastCPT7212512$4,152$2,906.4$152.84$450.63$4,089.72
CT thoracic spine without contrastCPT7212812$4,152$2,906.4$152.84$450.63$4,089.72
CT lumbar spine without contrastCPT7213112$4,152$2,906.4$152.84$450.63$4,089.72
MRI cervical spine without contrastCPT7214112$4,736$3,315.2$277.53$1,109.43$4,664.96
MRI thoracic spine without contrastCPT7214612$4,736$3,315.2$277.53$1,109.43$4,664.96
MRI lumbar spine without contrastCPT7214812$4,736$3,315.2$277.97$1,109.91$4,664.96
MRI lumbar spine with and without contrastCPT7214912$7,254$5,077.8$399.67$1,241.34$7,145.19
MRI cervical spine with and without contrastCPT7215612$7,254$5,077.8$471.83$1,319.27$7,145.19
MRI lumbar spine with contrastCPT7215812$7,254$5,077.8$470.9$1,318.27$7,145.19
CT pelvis without contrastCPT7219212$4,152$2,906.4$152.84$450.63$4,089.72
CT pelvis with contrastCPT7219312$6,228$4,359.6$250.76$633.44$6,134.58
Shoulder X-rayCPT7303012$980$686$37.09$114.22$965.3
Humerus X-rayCPT7306012$980$686$29.81$114.22$965.3
Hand X-ray 3 viewsCPT7313012$980$686$36.06$114.22$965.3
MRI upper extremity joint without contrastCPT7322112$4,736$3,315.2$295.44$1,128.77$4,664.96
MRI upper extremity joint with and without contrastCPT7322312$7,254$5,077.8$408.36$1,250.73$7,145.19
Knee X-ray 1-2 viewsCPT7356012$980$686$27.28$114.22$965.3
Ankle X-ray 3 viewsCPT7361012$980$686$36.06$114.22$965.3
MRI lower extremity joint without contrastCPT7372112$6,594$4,615.8$294.53$2,550.5$6,495.09
MRI lower extremity joint with and without contrastCPT7372312$7,254$5,077.8$407.06$1,249.32$7,145.19
CT abdomen without contrastCPT7415012$4,152$2,906.4$152.84$450.63$4,089.72
CT abdomen with contrastCPT7416012$6,228$4,359.6$250.76$646.81$6,134.58
CT abdomen with and without contrastCPT7417012$6,228$4,359.6$250.76$736.28$6,134.58
CT abdomen and pelvis without contrastCPT7417612$5,507$3,854.9$178.43$385.41$5,424.4
CT abdomen and pelvis with contrastCPT7417712$8,218$5,752.6$281.8$608.69$8,094.73
CT abdomen and pelvis with and without contrastCPT7417812$8,218$5,752.6$319.24$689.56$8,094.73
MRI abdomen without contrastCPT7418112$4,736$3,315.2$287.28$1,119.96$4,664.96
MRI abdomen with and without contrastCPT7418312$7,254$5,077.8$351.25$1,189.05$7,145.19
Abdominal ultrasound completeCPT7670012$1,743$1,220.1$119.34$257.77$1,716.86
Abdominal ultrasound limitedCPT7670512$1,743$1,220.1$87.13$188.2$1,716.86
Retroperitoneal ultrasound completeCPT7677012$1,743$1,220.1$115.78$250.08$1,716.86
Obstetric ultrasound first trimesterCPT7680112$1,743$1,220.1$78.42$169.39$1,716.86
Obstetric ultrasound after first trimesterCPT7680512$1,163$814.1$135.29$292.23$1,145.56
Obstetric ultrasound with fetal anatomyCPT7681112$2,597$1,817.9$159.03$343.5$2,558.05
Transvaginal ultrasoundCPT7683012$1,743$1,220.1$97.04$209.61$1,716.86
Pelvic ultrasound completeCPT7685612$1,743$1,220.1$97.04$209.61$1,716.86
Scrotal ultrasoundCPT7687012$1,743$1,220.1$85.75$185.22$1,716.86
Diagnostic mammography unilateralCPT770658$518$362.6$117.89$479.45$518
Diagnostic mammography bilateralCPT770668$666$466.2$149.36$617.13$666
Screening mammography bilateralCPT770678$541$378.7$120.94$462.93$541
EKG tracing onlyCPT9300512$441$308.7$29.84$159.39$434.39
Transthoracic echocardiogram completeCPT9330612$3,640$2,548$239.76$682.3$3,585.4
Transthoracic echocardiogramCPT9330712$2,172$1,520.4$215.3$394.99$2,139.42
Stress echocardiogramCPT9335012$2,796$1,957.2$137.87$682.3$2,754.06
inpatient
Respiratory infections & inflammations w MCCMS-DRG1777$18,168$18,168$18,168
COPD w MCCMS-DRG1907$11,207$11,207$11,207
COPD w CCMS-DRG1917$8,891.69$8,891.69$8,891.69
COPD w/o CC/MCCMS-DRG1927$7,077.43$7,077.43$7,077.43
Simple pneumonia & pleurisy w CCMS-DRG1947$8,695.55$8,695.55$8,695.55
Simple pneumonia & pleurisy w/o CC/MCCMS-DRG1957$6,790.91$6,790.91$6,790.91
AMI discharged alive w MCCMS-DRG2807$15,839$15,839$15,839
AMI discharged alive w CCMS-DRG2817$9,336.84$9,336.84$9,336.84
AMI discharged alive w/o CC/MCCMS-DRG2827$7,370.67$7,370.67$7,370.67
Heart failure & shock w MCCMS-DRG2917$12,584$12,584$12,584
Heart failure & shock w CCMS-DRG2927$8,691.71$8,691.71$8,691.71
Heart failure & shock w/o CC/MCCMS-DRG2937$6,061.17$6,061.17$6,061.17
Cardiac arrhythmia w MCCMS-DRG3087$11,936$11,936$11,936
Cardiac arrhythmia w CCMS-DRG3097$7,605.26$7,605.26$7,605.26
Cardiac arrhythmia w/o CC/MCCMS-DRG3107$5,766.01$5,766.01$5,766.01
GI hemorrhage w CCMS-DRG3787$9,941.59$9,941.59$9,941.59
GI hemorrhage w/o CC/MCCMS-DRG3797$6,515.94$6,515.94$6,515.94
Esophagitis/gastroenteritis w/o MCCMS-DRG3927$7,752.37$7,752.37$7,752.37
Fractures of femur w/o MCCMS-DRG5337$14,006$14,006$14,006
Kidney/UTI w MCCMS-DRG6897$11,102$11,102$11,102
Kidney/UTI w/o MCCMS-DRG6907$8,023.5$8,023.5$8,023.5
Septicemia or severe sepsis w MV 96+ hrsMS-DRG8717$18,390$18,390$18,390
Septicemia or severe sepsis w/o MV 96+ hrsMS-DRG8727$10,257$10,257$10,257
lab
Basic metabolic panel (BMP)CPT8004811$1,106$774.2$8.46$47.81$1,083.88
General health panelCPT800507$2,774$1,941.8$174.89$2,135.98$2,718.52
Electrolyte panelCPT8005111$764$534.8$7.01$39.59$748.72
Comprehensive metabolic panelCPT8005311$1,622$1,135.4$10.56$59.65$1,589.56
Lipid panelCPT8006111$616$431.2$5.73$13.38$603.68
Renal function panelCPT8006911$1,323$926.1$8.68$49.02$1,296.54
Hepatic function panelCPT8007611$876$613.2$8.17$46.12$858.48
Urinalysis non-automatedCPT8100211$127$88.9$3.08$14.45$124.46
Urinalysis automatedCPT8100311$267$186.9$2.25$54.91$261.66
Glucose quantitativeCPT8294711$263$184.1$3.93$23.71$257.74
Hemoglobin A1cCPT8303611$503$352.1$9.71$244.35$492.94
Thyroid stimulating hormone (TSH)CPT8444311$745$521.5$16.8$378.96$730.1
Complete blood count with automated differentialCPT8502511$709$496.3$7.77$43.89$694.82
Complete blood count without differentialCPT8502711$523$366.1$6.47$36.55$512.54
Urine culture bacterialCPT8708611$338$236.6$8.07$45.58$331.24
Urine culture identificationCPT8708811$338$236.6$8.09$20$331.24
Tissue exam by pathologist level IVCPT8830512$855$598.5$22.16$64.91$842.18
maternity
Fetal non-stress testCPT5902513$404$282.8$32.7$328.39$7,899
Routine obstetric care including vaginal deliveryCPT594003$1,994.02$4,340.9$9,605
Vaginal delivery onlyCPT594099$780.72$3,704.81$15,008
Vaginal delivery with postpartumCPT594103$3,286.37$5,021$9,605
Routine obstetric care with C-sectionCPT595103$1,995.21$4,961.03$9,605
C-section delivery onlyCPT595143$781.35$4,961.03$9,605
C-section with postpartumCPT595153$3,755.85$6,447$11,048
office
Office visit, new patient, 15-29 minCPT992027$600$420$49.2$256.1$591
Office visit, new patient, 30-44 minutesCPT992037$397$277.9$82.05$305.69$391.05
Office visit, new patient, 45-59 minCPT992047$3,410$2,387$98.83$391.05$3,358.85
Office visit, new patient, 60-74 minCPT992057$564$394.8$118.62$476.9$555.54
Office visit, established patient, 5 minCPT992117$294$205.8$17.21$220.5$289.59
Office visit, established patient, 10-19 minCPT992127$312$218.4$16.37$240.24$307.32
Office visit, established patient, 20-29 minutesCPT992137$397$277.9$34.43$266.42$391.05
Office visit, established patient, 30-39 minutesCPT992147$486$340.2$53.79$379.23$478.71
Office visit, established patient, 40-54 minCPT992157$600$420$82.05$482.6$591
preventive
Upper GI endoscopy diagnosticCPT432359$405.42$1,142.58$11,058
Upper GI endoscopy with biopsyCPT432399$423.61$1,142.58$11,058
Sigmoidoscopy diagnosticCPT453309$99$1,120.59$9,875
Sigmoidoscopy with biopsyCPT453319$130.65$1,120.59$9,875
Colonoscopy diagnosticCPT453789$534.04$1,137.06$11,058
Colonoscopy with biopsyCPT453809$597.36$1,464.28$11,058
Colonoscopy with polyp removalCPT453859$723.96$1,514.02$11,058
surgery
Total shoulder arthroplastyCPT234728$1,676.4$17,361$31,598
PCI w drug-eluting stent w MCCMS-DRG2467$30,428$30,428$30,428
PCI w drug-eluting stent w/o MCCMS-DRG2477$19,361$19,361$19,361
Hip hemiarthroplastyCPT271255$1,885.66$5,655.32$27,648
Total hip replacementCPT271309$2,693.8$15,684$31,598
Total knee replacementCPT274479$2,693.8$16,840$31,598
Knee revision arthroplasty single componentCPT274864$1,853.2$6,811$31,598
Knee revision arthroplasty all componentsCPT274875$2,584.03$6,544.12$31,598
Shoulder arthroscopy with decompressionCPT298265$605.06$5,307.22$9,259
Shoulder arthroscopy with rotator cuff repairCPT298279$623.03$8,844.69$27,648
Knee arthroscopy with meniscectomyCPT298819$790.35$3,998.92$18,959
ACL reconstructionCPT298889$1,220.29$8,844.69$27,648
Major small/large bowel procedures w MCCMS-DRG3297$47,368$47,368$47,368
Major small/large bowel procedures w CCMS-DRG3307$24,900$24,900$24,900
Major small/large bowel procedures w/o CC/MCCMS-DRG3317$16,835$16,835$16,835
CABG single arterial graftCPT335334$3,386.12$9,414$22,909
CABG 2 arterial graftsCPT335344$3,807.69$13,095$22,909
CABG 3 arterial graftsCPT335354$4,228.6$13,095$22,909
CABG 4+ arterial graftsCPT335364$4,650.86$13,095$22,909
Laparoscopic cholecystectomy w/o CDE w MCCMS-DRG4187$16,628$16,628$16,628
Laparoscopic cholecystectomy w/o CDE w CCMS-DRG4197$13,036$13,036$13,036
Laparoscopic cholecystectomy w/o CDE w/o CC/MCCMS-DRG4207$34,199$34,199$34,199
Open appendectomyCPT449509$724.63$4,492.62$18,959
Laparoscopic appendectomyCPT449709$494.31$7,144.95$27,648
Spinal fusion (non-cervical) w MCCMS-DRG4597$65,129$65,129$65,129
Spinal fusion (non-cervical) w/o MCCMS-DRG4607$38,181$38,181$38,181
Major joint replacement w MCCMS-DRG4697$30,059$30,059$30,059
Major joint replacement w/o MCCMS-DRG4707$18,660$18,660$18,660
Laparoscopic cholecystectomyCPT475629$843.15$7,144.95$27,648
Lap cholecystectomy with cholangiographyCPT475639$970.44$7,144.95$27,648
Hip & femur procedures except major joint w MCCMS-DRG4807$29,481$29,481$29,481
Hip & femur procedures except major joint w CCMS-DRG4817$20,543$20,543$20,543
Hip & femur procedures except major joint w/o CC/MCCMS-DRG4827$16,213$16,213$16,213
Open umbilical hernia repairCPT495609$839.12$4,492.62$18,959
Umbilical hernia repair age 5+CPT495859$534.04$4,492.62$18,959
Lap inguinal hernia repairCPT496509$379.7$7,144.95$27,648
Lap incisional hernia repairCPT496529$524.57$7,144.95$27,648
Total abdominal hysterectomyCPT581505$1,162.9$5,767.19$18,959
Vaginal hysterectomyCPT582609$1,162.9$6,226.62$18,959
Lap-assisted vaginal hysterectomyCPT585509$838.74$7,144.95$27,648
Lap-assisted vaginal hysterectomy >250gCPT585529$616.65$12,577$27,648
Lap salpingo-oophorectomyCPT586619$701.38$7,144.95$27,648
OR procedure for obesity w MCCMS-DRG6197$29,826$29,826$29,826
OR procedure for obesity w CCMS-DRG6207$17,337$17,337$17,337
OR procedure for obesity w/o CC/MCCMS-DRG6217$15,745$15,745$15,745
Complex cataract surgeryCPT669829$1,272.35$2,932.34$18,073
Cataract surgery with lens implantCPT669849$1,818.32$3,429.96$18,073
Intravitreal injectionCPT670289$447.62$1,063.86$7,899
Vitrectomy mechanicalCPT670429$1,186.9$5,529.91$22,909
Uterine & adnexa procedures w CC/MCCMS-DRG7437$11,281$11,281$11,281
Uterine & adnexa procedures w/o CC/MCCMS-DRG7447$17,651$17,651$17,651

Payer mix (top 13)

PayerCodes coveredMedian rate
Anthem BCBS182$1,167
Aetna170$1,101.62
Kaiser Permanente168$519.99
Blue Cross Blue Shield166$2,463.69
Humana155$519.99
commercial | hill physicians | all plans155$519.99
Medicare155$519.99
Medicaid133$292.75
UnitedHealthcare117$1,160.84
First Health94$632.7
Multiplan94$652.68
commercial | healthsmart | all plans94$652.68
Health Net7$1,838