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 |
|---|---|---|---|---|
| Drainage of pelvis lesion 26990 CPT 26990 | $3,148.95 | $8,997.00 | $1,142.00 – $7,332.00 | 10 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $1,528.00 – $7,332.00 | 10 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $1,142.00 – $7,309.00 | 10 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $1,528.00 – $7,332.00 | 10 |
| Drainage of rectal abscess CPT 45005 | $1,153.25 | $3,295.00 | $1,528.00 – $7,309.00 | 10 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Drainage of salivary gland CPT 42305 | $1,731.10 | $4,946.00 | $1,528.00 – $7,332.00 | 10 |
| Drainage of salivary gland CPT 42320 | $437.50 | $1,250.00 | $693.67 – $7,309.00 | 10 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $1,528.00 – $10,336.00 | 4 |
| Drainage of spinal cyst CPT 63173 | not published | not published | $1,747.00 – $10,336.00 | 4 |
| Drainage of throat abscess CPT 42725 | not published | not published | $1,528.00 – $12,111.00 | 10 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Drainage of urethra abscess 53060 CPT 53060 | $1,731.10 | $4,946.00 | $1,528.00 – $6,035.00 | 9 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $896.84 – $7,309.00 | 10 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $1,142.00 – $6,035.00 | 9 |
| Drain bladder by trocar/cath CPT 51101 | $515.90 | $1,474.00 | $203.00 – $3,094.00 | 9 |
| Drain blood from under nail 11740 CPT 11740 | $189.00 | $540.00 | $171.12 – $1,528.00 | 9 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $3,402.70 | $9,722.00 | $1,142.00 – $3,962.00 | 9 |
| Drain cath image guided visceral pq CPT 49405 | $1,669.15 | $4,769.00 | $1,142.00 – $10,336.00 | 9 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $705.95 | $2,017.00 | $907.88 – $7,309.00 | 10 |
| Drain chest lesion CPT 21502 | not published | not published | $1,528.00 – $7,332.00 | 10 |
| Drain chst dry seal exp thorastat HCPCS A7041 | not published | not published | $147.03 – $147.03 | 1 |
| Drain finger abscess;simple 26010 CPT 26010 | $189.00 | $540.00 | $203.00 – $1,528.00 | 9 |
| Drain lower leg bursa CPT 27604 | $2,614.50 | $7,470.00 | $1,528.00 – $7,332.00 | 10 |
| Drain lower leg lesion 27603 CPT 27603 | $2,292.15 | $6,549.00 | $1,528.00 – $7,309.00 | 10 |
| Drain neck/chest lesion 21501 CPT 21501 | $2,636.55 | $7,533.00 | $1,528.00 – $7,309.00 | 10 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,142.00 – $7,953.00 | 4 |
| Drain ostomy pouch w/flange HCPCS A5063 | not published | not published | $5.36 – $5.36 | 1 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $1,142.00 – $7,332.00 | 9 |
| Drain ovary abscess open CPT 58820 | not published | not published | $1,747.00 – $7,332.00 | 10 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Drain penis lesion CPT 54015 | $1,360.45 | $3,887.00 | $2,124.23 – $7,309.00 | 10 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $1,747.00 – $7,309.00 | 10 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $1,747.00 – $7,309.00 | 10 |
| Drain shoulder lesion CPT 23030 | $2,292.15 | $6,549.00 | $1,142.00 – $7,309.00 | 10 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,636.55 | $7,533.00 | $1,747.00 – $7,309.00 | 10 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $1,142.00 – $7,309.00 | 10 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $1,142.00 – $5,789.00 | 4 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $189.00 | $540.00 | $258.05 – $7,309.00 | 10 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $189.00 | $540.00 | $258.05 – $2,589.00 | 9 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $384.65 | $1,099.00 | $522.85 – $7,309.00 | 10 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $506.45 | $1,447.00 | $203.00 – $1,528.00 | 9 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $11,698.98 | $33,425.66 | $53.52 – $296.10 | 8 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | $810.25 | $2,315.00 | $1,142.00 – $6,749.00 | 4 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $810.25 | $2,315.00 | $1,142.00 – $4,768.00 | 4 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $108,243.35 – $200,250.20 | 6 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $1,142.00 – $7,309.00 | 5 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $1,142.00 – $7,309.00 | 5 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Drng hand tendon sheath 26020 CPT 26020 | $2,738.05 | $7,823.00 | $1,528.00 – $7,332.00 | 10 |
| Drng of eyelid abscess 67700 CPT 67700 | $290.50 | $830.00 | $353.00 – $2,589.00 | 9 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,564.15 | $4,469.00 | $1,142.00 – $7,309.00 | 10 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $203.00 – $2,109.00 | 9 |
| Drng of mouth lesion 40801 CPT 40801 | $691.95 | $1,977.00 | $693.67 – $7,309.00 | 10 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $1,747.00 – $7,332.00 | 10 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,528.00 – $7,332.00 | 10 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $1,142.00 – $7,332.00 | 10 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | $1,002.75 | $2,865.00 | $1,142.00 – $7,309.00 | 10 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $1,747.00 – $7,332.00 | 10 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,564.15 | $4,469.00 | $1,142.00 – $7,309.00 | 10 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,142.00 – $9,640.00 | 4 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,142.00 – $9,640.00 | 4 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $1,142.00 – $7,629.00 | 4 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $1,142.00 – $9,640.00 | 4 |
| Drng salivary gland simple 42300 CPT 42300 | $1,307.95 | $3,737.00 | $1,142.00 – $7,309.00 | 10 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $503.30 | $1,438.00 | $693.67 – $7,309.00 | 10 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $2.00 – $20.80 | 5 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $9.88 – $21.08 | 5 |
| Drop lock knee HCPCS L2182 | not published | not published | $122.83 – $227.24 | 6 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $48.56 – $89.84 | 6 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,444.66 | $4,127.60 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $2,567.36 | $7,335.31 | $11.37 – $296.10 | 8 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $382.24 | $1,092.11 | $12.48 – $296.10 | 8 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $8.60 – $296.10 | 8 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $21.67 – $21.67 | 1 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $160.06 – $301.03 | 8 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | $5,346.89 | $15,276.83 | $48.54 – $296.10 | 8 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $21,905.91 | $62,588.31 | $53.52 – $296.10 | 8 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $160.06 – $409.34 | 8 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $1,528.00 – $1,528.00 | 1 |
| Drug assay caffeine CPT 80155 | $11.20 | $32.00 | $35.77 – $77.14 | 10 |
| Drug assay posaconazole CPT 80187 | not published | not published | $27.11 – $54.22 | 10 |
| Drug assay rufinamide CPT 80210 | not published | not published | $27.11 – $54.22 | 10 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $38.57 – $77.14 | 10 |
| Drug assay voriconazole CPT 80285 | not published | not published | $27.11 – $54.22 | 10 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $18.64 – $37.28 | 10 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $12.60 – $28.57 | 10 |
| Drug screening tapentadol CPT 80372 | not published | not published | $0.02 – $98.84 | 2 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $27.11 – $54.22 | 10 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $0.02 – $96.79 | 2 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $198.74 – $397.48 | 10 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $114.43 – $228.86 | 10 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $246.92 – $493.84 | 10 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $156.59 – $313.18 | 10 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $62.14 – $124.28 | 9 |
| Drug test prsmv instrmnt CPT 80306 | $448.00 | $1,280.00 | $17.14 – $38.10 | 10 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $314.30 | $898.00 | $62.14 – $152.44 | 10 |
| Drvvt confirm - quest CPT 85597 | not published | not published | $17.98 – $47.98 | 10 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $1,142.00 – $7,629.00 | 10 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $3,471.65 | $9,919.00 | $353.00 – $6,035.00 | 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.