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 |
|---|---|---|---|---|
| Ligation of inf vena cava CPT 37619 | not published | not published | $2,822.00 – $12,477.00 | 9 |
| Ligation of neck artery CPT 37606 | not published | not published | $2,822.00 – $7,629.00 | 9 |
| Ligation of salivary duct CPT 42665 | not published | not published | $2,160.00 – $7,728.00 | 10 |
| Ligation of shunt CPT 49428 | not published | not published | $1,142.00 – $4,768.00 | 4 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Liletta, 52 mg HCPCS J7297 | $443.68 | $1,267.65 | $950.37 – $2,674.19 | 4 |
| Limb exercise test CPT 95875 | not published | not published | $76.79 – $306.17 | 7 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $1,528.00 – $7,309.00 | 5 |
| Limited ankle motion ea jnt HCPCS L2200 | not published | not published | $72.84 – $134.75 | 6 |
| Limited autopsy CPT 88036 | not published | not published | $5.58 – $219.68 | 3 |
| Limited autopsy CPT 88037 | not published | not published | $4.96 – $195.09 | 3 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $142.35 – $263.35 | 6 |
| Limited visual field xm CPT 92081 | not published | not published | $59.76 – $140.37 | 7 |
| Lincomycin injection HCPCS J2010 | not published | not published | $9.69 – $20.24 | 5 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $259.43 | $741.24 | $2.86 – $151.14 | 5 |
| Lipase CPT 83690 | $148.40 | $424.00 | $6.89 – $18.37 | 10 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $1,528.00 – $7,332.00 | 10 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.86 – $67.72 | 10 |
| Lipoprotein blood quant CPT 83704 | not published | not published | $34.19 – $84.19 | 10 |
| Lipoprotein direct measurement hdl CPT 83718 | $134.40 | $384.00 | $8.19 – $21.85 | 10 |
| Lipoprotein direct measurement ldl CPT 83721 | $131.60 | $376.00 | $10.50 – $25.46 | 10 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $68.38 | 10 |
| Lip surgery procedure CPT 40799 | not published | not published | $304.63 – $4,768.00 | 9 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $0.01 – $1,110,350.92 | 8 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $35.20 | 10 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $193.82 – $358.57 | 6 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $77.75 – $143.84 | 6 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $606.56 – $1,122.14 | 6 |
| Lithium therapeutic drug level CPT 80178 | $141.75 | $405.00 | $6.61 – $17.65 | 10 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $3,404.80 | $9,728.00 | $353.00 – $353.00 | 1 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,142.00 – $6,749.00 | 4 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $961.49 | 10 |
| Liver elastography 91200 CPT 91200 | not published | not published | $50.48 – $306.17 | 8 |
| Liver Function Test CPT 80076 | $207.55 | $593.00 | $8.17 – $21.81 | 10 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,142.00 – $5,789.00 | 4 |
| Liver image (3d) with flow CPT 78206 | not published | not published | $831.00 – $831.00 | 1 |
| Liver imaging CPT 78201 | $463.05 | $1,323.00 | $209.14 – $2,035.50 | 9 |
| Liver imaging (3d) CPT 78205 | not published | not published | $832.14 – $832.14 | 1 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $253.72 – $2,035.50 | 9 |
| Liver/spleen imag static only CPT 78215 | $518.70 | $1,482.00 | $258.78 – $1,439.81 | 9 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $231.80 – $1,439.81 | 9 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $49.37 – $6,035.00 | 8 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $1,747.00 – $7,629.00 | 10 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $3,412.03 – $6,312.26 | 6 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $31.50 | $90.00 | $1.39 – $2.00 | 3 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $70.84 – $285.22 | 4 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $212.42 – $455.80 | 9 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $180.44 – $333.81 | 6 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $43.75 | $125.00 | $1.44 – $47.70 | 5 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $26.67 – $49.34 | 6 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $218.75 | $625.00 | $93.48 – $172.94 | 6 |
| Loudness balance test CPT 92562 | not published | not published | $36.58 – $513.77 | 7 |
| Low back disk surgery CPT 63030 | not published | not published | $3,409.00 – $16,065.00 | 9 |
| Low cost skin substitute app HCPCS C5271 | $506.45 | $1,447.00 | $353.00 – $2,589.00 | 4 |
| Low cost skin substitute app HCPCS C5273 | $1,655.85 | $4,731.00 | $353.00 – $10,336.00 | 4 |
| Low cost skin substitute app HCPCS C5275 | $506.45 | $1,447.00 | $353.00 – $2,589.00 | 4 |
| Low cost skin substitute app HCPCS C5277 | $506.45 | $1,447.00 | $353.00 – $2,589.00 | 4 |
| Low cost skin substitute app HCPCS C5272 | $253.05 | $723.00 | $1,528.00 – $1,528.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | $659.75 | $1,885.00 | $1,528.00 – $1,528.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | $253.05 | $723.00 | $1,528.00 – $1,528.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | $253.05 | $723.00 | $1,528.00 – $1,528.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,800.05 | $5,143.00 | $225.59 – $781.71 | 8 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,704.50 | $4,870.00 | $448.71 – $830.11 | 8 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,556.10 | $4,446.00 | $134.46 – $522.22 | 8 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,739.70 | $13,542.00 | $448.71 – $2,200.12 | 8 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,769.85 | $10,771.00 | $448.71 – $1,187.61 | 8 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,473.05 | $9,923.00 | $306.88 – $1,098.16 | 8 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $281.75 | $805.00 | $59.35 – $366.18 | 9 |
| Lower jaw bone graft CPT 21215 | not published | not published | $3,409.00 – $12,111.00 | 10 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $258.05 – $477.39 | 6 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $15.30 – $64.06 | 4 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $2,160.00 – $17,773.26 | 9 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $2,160.00 – $21,832.00 | 9 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $2,160.00 – $21,832.00 | 9 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $2,160.00 – $21,832.00 | 9 |
| Lso corset front HCPCS L0972 | not published | not published | $157.68 – $291.71 | 6 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $28.70 – $53.10 | 6 |
| Lso full corset HCPCS L0976 | not published | not published | $187.18 – $346.28 | 6 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $194.26 – $359.38 | 6 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,582.02 – $2,926.74 | 6 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $406.45 – $751.93 | 6 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $55.42 – $102.53 | 6 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $1,466.58 – $2,713.17 | 6 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $2,171.08 – $4,016.50 | 6 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $343.97 – $636.34 | 6 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $98.12 – $181.52 | 6 |
| Lso s/c shell/panel custom HCPCS L0640 | $1,618.71 | $4,624.88 | $1,255.19 – $2,322.10 | 6 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,451.22 – $2,684.76 | 6 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $58.66 | 10 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $3.16 – $3.16 | 1 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $76.57 – $141.65 | 6 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $118.97 – $220.09 | 6 |
| Lumbar diskogram s&i CPT 72295 | $1,777.30 | $5,078.00 | $199.38 – $6,724.02 | 9 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $119.53 – $221.13 | 6 |
| Lumbar sling HCPCS L1090 | not published | not published | $140.44 – $259.81 | 6 |
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.