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 |
|---|---|---|---|---|
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $670.60 | $1,916.00 | $72.25 – $366.18 | 9 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $737.80 | $2,108.00 | $86.87 – $366.18 | 9 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $158.20 | $452.00 | $42.97 – $303.19 | 9 |
| X-ray humerus >= 2 views left CPT 73060 | $386.40 | $1,104.00 | $46.54 – $303.19 | 9 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $48.96 – $366.18 | 9 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $247.10 | $706.00 | $45.28 – $303.19 | 9 |
| X-ray knee 3 views (both sides) CPT 73562 | $475.30 | $1,358.00 | $50.92 – $303.19 | 9 |
| X-ray knee ap standing bilateral CPT 73565 | $176.05 | $503.00 | $42.75 – $303.19 | 9 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $302.05 | $863.00 | $42.75 – $303.19 | 9 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | not published | not published | $79.33 – $366.18 | 9 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $812.35 | $2,321.00 | $81.02 – $366.18 | 9 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $812.35 | $2,321.00 | $104.64 – $366.18 | 9 |
| X-ray male genital tract CPT 74440 | not published | not published | $99.58 – $832.32 | 9 |
| X-ray mandible complete > 4 views CPT 70110 | $572.60 | $1,636.00 | $55.14 – $366.18 | 9 |
| X-ray mandible ltd <4 views CPT 70100 | $358.40 | $1,024.00 | $45.28 – $303.19 | 9 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $150.06 – $150.06 | 1 |
| X-ray nasal bones complete > 3 views CPT 70160 | $572.60 | $1,636.00 | $45.28 – $303.19 | 9 |
| X-ray neck soft tissue CPT 70360 | $302.40 | $864.00 | $36.00 – $303.19 | 9 |
| X-ray nose to rectum for foreign body child CPT 76010 | $222.60 | $636.00 | $41.92 – $303.19 | 9 |
| X-ray of mammary ducts CPT 77054 | $705.25 | $2,015.00 | $134.08 – $832.32 | 9 |
| X-ray optic foramina CPT 70190 | not published | not published | $55.14 – $303.19 | 9 |
| X-ray pelvis 1-2 views CPT 72170 | $341.95 | $977.00 | $40.40 – $366.18 | 9 |
| X-ray pelvis complete > 3 views CPT 72190 | $499.45 | $1,427.00 | $59.35 – $366.18 | 9 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $358.09 – $988.80 | 2 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $407.99 – $1,129.39 | 2 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $891.80 | $2,548.00 | $230.94 – $1,229.72 | 9 |
| X-ray ribs 2 views left CPT 71100 | $391.30 | $1,118.00 | $48.85 – $303.19 | 9 |
| X-ray ribs 3 views bilateral CPT 71110 | $609.70 | $1,742.00 | $62.68 – $366.18 | 9 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $411.25 | $1,175.00 | $59.35 – $366.18 | 9 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $637.70 | $1,822.00 | $79.33 – $366.18 | 9 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $356.30 | $1,018.00 | $55.14 – $366.18 | 9 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $374.50 | $1,070.00 | $47.31 – $303.19 | 9 |
| X-ray scapula complete (both sides) CPT 73010 | $720.65 | $2,059.00 | $45.28 – $366.18 | 9 |
| X-ray sella turcica CPT 70240 | not published | not published | $36.00 – $303.19 | 9 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $320.95 | $917.00 | $36.56 – $303.19 | 9 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $620.90 | $1,774.00 | $60.36 – $303.19 | 9 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $782.95 | $2,237.00 | $80.33 – $1,887.98 | 9 |
| X-ray skull < 4 views CPT 70250 | $441.00 | $1,260.00 | $55.14 – $366.18 | 9 |
| X-ray skull > 4 views complete CPT 70260 | $774.55 | $2,213.00 | $69.59 – $366.18 | 9 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $110.41 – $366.18 | 9 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $1,002.05 | $2,863.00 | $115.47 – $612.97 | 9 |
| X-ray small intestine follow-through study CPT 74248 | $189.35 | $541.00 | $104.60 – $186.71 | 3 |
| X-ray spine single view CPT 72020 | $336.70 | $962.00 | $36.00 – $303.19 | 9 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $310.80 | $888.00 | $60.36 – $303.19 | 9 |
| X-ray sternum > 2 views CPT 71120 | $386.40 | $1,104.00 | $50.38 – $303.19 | 9 |
| X-ray surgical specimen CPT 76098 | $844.20 | $2,412.00 | $25.03 – $1,887.98 | 9 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $695.45 | $1,987.00 | $115.47 – $612.97 | 9 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $503.30 | $1,438.00 | $75.25 – $303.19 | 9 |
| X-ray thoracic spine 2 views CPT 72070 | $331.10 | $946.00 | $51.91 – $366.18 | 9 |
| X-ray thoracic spine 3 views CPT 72072 | $609.70 | $1,742.00 | $61.13 – $366.18 | 9 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $441.00 | $1,260.00 | $56.53 – $303.19 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $229.25 | $655.00 | $54.52 – $303.19 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $296.45 | $847.00 | $99.19 – $366.18 | 9 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $596.40 | $1,704.00 | $43.47 – $303.19 | 9 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $336.70 | $962.00 | $36.00 – $303.19 | 9 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $882.00 | $2,520.00 | $146.28 – $612.97 | 9 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $840.70 | $2,402.00 | $128.83 – $612.97 | 9 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $213.12 – $213.12 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $317.23 – $317.23 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $300.30 | $858.00 | $42.75 – $303.19 | 9 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $104.64 – $612.97 | 9 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $322.38 – $856.33 | 2 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $160.06 – $6,297.39 | 9 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.91 – $31.61 | 10 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.49 – $3.20 | 9 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $35.20 | 10 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $135,600.07 | 8 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $142.29 – $296.10 | 8 |
| Ziconotide injection HCPCS J2278 | not published | not published | $10.46 – $20.86 | 9 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $104.90 | $299.71 | $1.49 – $4.16 | 9 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $0.98 – $4.67 | 3 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $51.31 – $121.00 | 10 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.85 – $39.73 | 10 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | $8.15 | $23.28 | $2.48 – $2.48 | 1 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $58.46 | $167.03 | $10.31 – $78.20 | 5 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.61 – $17.85 | 9 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $32.64 – $62.25 | 6 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $241.98 | $691.36 | $18.94 – $731.84 | 5 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $216.92 – $771.34 | 4 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $386.50 | 10 |
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.