Providence Saint Joseph Medical Center
501 S Buena Vista, Burbank, CA · Providence · · NPI 1336173269
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 |
|---|---|---|---|---|
| Destruction anal lesion(s) CPT 46924 | not published | not published | $1,142.00 – $6,604.43 | 9 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $523.25 | $1,495.00 | $353.00 – $2,581.00 | 9 |
| Destruction benign lesions < 14 lesions CPT 17110 | $522.55 | $1,493.00 | $202.00 – $1,311.00 | 9 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $1,137.58 – $3,452.00 | 9 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $1,311.00 – $4,751.00 | 3 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $1,747.00 – $5,553.00 | 9 |
| Destruction ciliary body CPT 66700 | not published | not published | $1,528.00 – $4,449.00 | 9 |
| Destruction ciliary body CPT 66720 | not published | not published | $1,528.00 – $5,175.00 | 9 |
| Destruction ciliary body CPT 66740 | not published | not published | $1,528.00 – $5,175.00 | 9 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $202.00 – $1,311.00 | 9 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $1,142.00 – $6,604.43 | 9 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $1,142.00 – $5,175.00 | 9 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $202.00 – $1,311.00 | 9 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $522.85 – $2,581.00 | 9 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $202.00 – $1,311.00 | 9 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $522.85 – $2,581.00 | 9 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $202.00 – $1,311.00 | 9 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,142.00 – $4,449.00 | 9 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $353.00 – $2,581.00 | 9 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $3,569.96 – $10,302.00 | 9 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,142.00 – $7,332.00 | 9 |
| Destruction vag lesions simple 57061 CPT 57061 | $5,107.55 | $14,593.00 | $1,747.00 – $7,332.00 | 9 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $1,528.00 – $4,751.00 | 9 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $117.40 | 10 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $234.77 | 10 |
| Determination venous press CPT 93770 | $64.75 | $185.00 | $6.26 – $7.33 | 2 |
| Determine refractive state CPT 92015 | not published | not published | $244.49 – $244.49 | 1 |
| Developmental screen/score/document 96110 CPT 96110 | $961.10 | $2,746.00 | $55.63 – $317.90 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $165.49 – $306.17 | 7 |
| Device ablt adv novasure HCPCS C1886 | $4,494.00 | $12,840.00 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $3,762.50 | $10,750.00 | $353.00 – $353.00 | 1 |
| Device intraute mirena HCPCS J7298 | $524.62 | $1,498.92 | $1,238.93 – $3,133.75 | 4 |
| Device sut capio slim opn HCPCS C2631 | $1,946.41 | $5,561.16 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $8,085.00 | $23,100.00 | not published | 0 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $326.51 – $326.51 | 1 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,528.00 – $9,005.00 | 4 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $78.11 – $78.11 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $137.20 | $392.00 | $34.27 – $302.08 | 9 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $92.55 – $237.96 | 9 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.17 – $27.22 | 4 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $8.93 | $25.50 | $0.06 – $1.20 | 5 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $84.18 | $240.52 | $0.17 – $4.82 | 5 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $200.06 – $441.27 | 9 |
| Dexamethasone panel CPT 80420 | not published | not published | $151.09 – $421.68 | 10 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.74 – $1.38 | 3 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,573.13 | $4,494.67 | $49.74 – $238.65 | 9 |
| Dextran 40 infusion HCPCS J7100 | $68.93 | $196.95 | $67.89 – $428.09 | 4 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $28.89 – $278.73 | 2 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.71 – $1.41 | 3 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $68.93 | $196.95 | $2.24 – $60.47 | 5 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $68.93 | $196.95 | $3.61 – $16.20 | 4 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $68.93 | $196.95 | $3.25 – $34.45 | 5 |
| Dextrose 5 % IV bolus HCPCS J7070 | $68.93 | $196.95 | $5.36 – $37.10 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | not published | not published | $22.23 – $130.18 | 10 |
| Diabetes (HbA1c) Test CPT 83036 | $122.50 | $350.00 | $9.71 – $56.82 | 10 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $377.96 – $377.96 | 1 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $64.20 – $64.20 | 1 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $64.20 – $64.20 | 1 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $64.20 – $64.20 | 1 |
| Diab manage trn ind/group HCPCS G0109 | $134.40 | $384.00 | $17.48 – $32.34 | 5 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $126.02 – $126.02 | 1 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $64.20 – $64.20 | 1 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,528.00 – $4,235.11 | 9 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,747.00 – $12,111.00 | 9 |
| Diagnostic anoscopy CPT 46601 | $308.35 | $881.00 | $353.00 – $2,581.00 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,142.00 – $4,877.00 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $258.30 | $738.00 | $171.12 – $1,311.00 | 9 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $162.19 – $410.31 | 4 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $151.28 – $311.29 | 4 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $258.30 | $738.00 | $202.00 – $1,311.00 | 9 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $164.85 | $471.00 | $202.00 – $1,311.00 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $416.15 | $1,189.00 | $120.80 – $636.19 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $290.15 | $829.00 | $97.95 – $496.95 | 9 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $81.72 – $302.08 | 8 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $1,754.55 | $5,013.00 | $1,311.00 – $5,149.00 | 3 |
| Dialysis one evaluation CPT 90945 | $1,310.05 | $3,743.00 | $118.06 – $992.84 | 7 |
| Dialysis repeated eval CPT 90947 | not published | not published | $171.11 – $331.93 | 2 |
| Dialysis training incompl CPT 90993 | not published | not published | $221.30 – $221.30 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $8.24 – $15.24 | 6 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.16 – $0.41 | 3 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $55.40 | $158.29 | $10.05 – $12.45 | 5 |
| Dicyclomine injection HCPCS J0500 | $302.03 | $862.93 | $22.94 – $52.04 | 5 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.18 – $0.48 | 4 |
| Diffusing capacity CPT 94729 | $375.55 | $1,073.00 | $213.63 – $216.75 | 2 |
| Digital analysis of eeg CPT 95957 | not published | not published | $295.44 – $1,251.26 | 2 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $1,311.00 – $4,751.00 | 4 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $494.87 | $1,413.92 | $5.98 – $10.49 | 5 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $17,877.79 | $51,079.39 | $2,348.58 – $10,682.45 | 9 |
| Digoxin total therapeutic drug level CPT 80162 | $282.10 | $806.00 | $13.28 – $77.72 | 10 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $472.05 | $1,348.72 | $85.89 – $184.36 | 5 |
| Dilate biliary duct/ampulla CPT 47542 | $1,655.85 | $4,731.00 | $1,311.00 – $4,751.00 | 4 |
| Dilate esophagus CPT 43453 | not published | not published | $1,142.00 – $4,449.00 | 9 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $1,142.00 – $2,654.00 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $10,371.20 | $29,632.00 | $1,807.00 – $5,149.00 | 3 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $9,681.00 | $27,660.00 | $1,807.00 – $5,149.00 | 3 |
| Dilate ic vasospasm init CPT 61640 | $10,371.20 | $29,632.00 | $1,807.00 – $7,764.00 | 3 |
| Dilate tear duct opening CPT 68801 | not published | not published | $202.00 – $1,311.00 | 9 |
| Dilate urethra stricture CPT 53600 | $814.45 | $2,327.00 | $321.35 – $2,581.00 | 9 |
| Dilate urethra stricture CPT 53601 | not published | not published | $171.12 – $2,581.00 | 9 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,528.00 – $5,893.83 | 9 |
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.