Providence Holy Cross Medical Center
15031 Rinaldi St, Mission Hills, CA · Providence · · NPI 1477587632
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 |
|---|---|---|---|---|
| Subtemporal cranial dcmprn CPT 61340 | not published | not published | $1,142.00 – $7,953.00 | 4 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $34.15 | $97.57 | $0.84 – $13.03 | 4 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $1,747.00 – $7,309.00 | 10 |
| Suction socket HCPCS L6686 | not published | not published | $963.67 – $1,782.79 | 6 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $533.75 – $987.44 | 6 |
| Sugars multiple quant CPT 84379 | not published | not published | $11.53 – $30.75 | 10 |
| Sugars single quant CPT 84378 | not published | not published | $11.53 – $30.75 | 10 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $2,803.50 | $8,010.00 | not published | 0 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $34.02 | $97.19 | $0.08 – $0.13 | 4 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $0.02 – $105.62 | 2 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $246.83 | $705.24 | $37.74 – $352.08 | 4 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $4.79 – $4.79 | 1 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $16.74 – $111.42 | 7 |
| Supply of digital device HCPCS G0552 | not published | not published | $171.24 – $316.79 | 6 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $35.73 – $35.73 | 1 |
| Support clav 29.6-40.5in med HCPCS L3650 | $23.75 | $67.87 | $88.92 – $164.50 | 6 |
| Supprelin la implant HCPCS J9226 | not published | not published | $41,173.43 – $97,205.89 | 9 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $3,409.00 – $7,629.00 | 4 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $3,409.00 – $7,629.00 | 4 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $1,528.00 – $7,629.00 | 10 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $1,142.00 – $16,065.00 | 9 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $1,142.00 – $12,132.52 | 9 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $1,142.00 – $16,065.00 | 9 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $1,142.00 – $12,132.52 | 9 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $1,528.00 – $12,111.00 | 9 |
| Surgical opening esophagus CPT 43351 | not published | not published | $1,142.00 – $7,953.00 | 4 |
| Surgical opening esophagus CPT 43352 | not published | not published | $1,142.00 – $5,789.00 | 4 |
| Surgical opening of stomach CPT 43510 | not published | not published | $1,142.00 – $4,768.00 | 9 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Surgical opening of throat CPT 42955 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Surgical pathology level 1 gross examination only CPT 88300 | $39.55 | $113.00 | $14.13 – $68.82 | 9 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $66.15 | $189.00 | $34.84 – $88.87 | 9 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $97.65 | $279.00 | $49.00 – $123.99 | 9 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $134.75 | $385.00 | $60.98 – $123.99 | 9 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $284.90 | $814.00 | $99.95 – $852.89 | 9 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $330.05 | $943.00 | $136.40 – $1,917.04 | 9 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $1,142.00 – $6,749.00 | 4 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $1,142.00 – $6,749.00 | 4 |
| Surgical revision intestine CPT 44680 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $160.06 – $353.00 | 9 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $1,142.00 – $7,309.00 | 10 |
| Susceptibility agar dilution per agent CPT 87181 | $56.00 | $160.00 | $4.25 – $9.50 | 10 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $69.30 | $198.00 | $4.25 – $9.50 | 10 |
| Susceptibility mic per plate CPT 87186 | $56.00 | $160.00 | $8.65 – $23.07 | 10 |
| Suscept studies macrobroth dilution ea CPT 87188 | not published | not published | $6.64 – $17.71 | 10 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $1,142.00 – $4,768.00 | 4 |
| Suspension of testis CPT 54620 | not published | not published | $1,747.00 – $7,332.00 | 10 |
| Suspension of uterus CPT 58410 | not published | not published | $1,142.00 – $4,768.00 | 4 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $1,142.00 – $7,629.00 | 4 |
| Suspension sleeve lower ext HCPCS L2397 | not published | not published | $151.86 – $280.94 | 6 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $1,142.00 – $6,749.00 | 4 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Svc venogram s&i CPT 75827 | $991.55 | $2,833.00 | $346.10 – $5,349.00 | 9 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $5.12 – $134.99 | 9 |
| Symes ankle without (sach) foot HCPCS L5703 | not published | not published | $2,946.99 – $5,451.93 | 6 |
| Symes met fr leath socket ar HCPCS L5060 | not published | not published | $4,508.51 – $8,340.74 | 6 |
| Symes type medial opening so HCPCS L5636 | not published | not published | $311.94 – $577.09 | 6 |
| Symes type poster opening so HCPCS L5634 | not published | not published | $496.53 – $918.58 | 6 |
| Symes type ptb brim design s HCPCS L5632 | not published | not published | $289.31 – $535.22 | 6 |
| Syme typ expandabl wall sckt HCPCS L5630 | not published | not published | $674.53 – $1,247.88 | 6 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $1,528.00 – $6,035.00 | 9 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $1,528.00 – $6,264.00 | 4 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $2,160.00 – $7,629.00 | 9 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $1,528.00 – $6,264.00 | 4 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $16.78 – $99.56 | 5 |
| Synthetic sentence id test CPT 92576 | not published | not published | $40.66 – $88.87 | 7 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $6.96 – $29.10 | 9 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $78.05 | $223.00 | $4.40 – $11.77 | 10 |
| System cardiomems hosp electronics HCPCS C2624 | $33,334.88 | $95,242.50 | not published | 0 |
| System pacing micra av HCPCS C1786 | $20,408.85 | $58,311.00 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $6,593.33 | $18,838.08 | not published | 0 |
| System sealant biosentry tract HCPCS C2613 | $630.26 | $1,800.75 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $206.15 | $589.00 | $16.94 – $45.21 | 10 |
| T3 (triiodothyronine) total CPT 84480 | $211.75 | $605.00 | $14.18 – $37.84 | 10 |
| T4 (thyroxine) free CPT 84439 | $116.90 | $334.00 | $9.02 – $24.07 | 10 |
| T4 (thyroxine) total CPT 84436 | $211.75 | $605.00 | $6.87 – $18.36 | 10 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.59 – $1.66 | 5 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.78 – $4.16 | 5 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $1.73 | $4.95 | $0.38 – $16.36 | 5 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $916.63 | $2,618.95 | $259.96 – $548.38 | 9 |
| Tacrolimus therapeutic drug level CPT 80197 | $16.86 | $48.18 | $13.73 – $36.61 | 10 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $4,944.71 | $14,127.74 | $14.17 – $29.95 | 9 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $1,747.00 – $9,640.00 | 4 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $1,747.00 – $9,640.00 | 4 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $1,142.00 – $9,640.00 | 4 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $71.26 – $151.32 | 9 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $18,025.00 | $51,500.00 | $71.03 – $150.50 | 9 |
| Talymed HCPCS Q4127 | not published | not published | $134.34 – $296.10 | 8 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $0.20 – $12.12 | 4 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $1,142.00 – $4,768.00 | 4 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $1,142.00 – $4,768.00 | 4 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.70 – $0.70 | 1 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $759.53 – $1,519.06 | 9 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $1,567.57 – $5,839.20 | 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.