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 |
|---|---|---|---|---|
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $3,409.00 – $30,073.00 | 9 |
| Lumizyme injection HCPCS J0221 | not published | not published | $202.65 – $433.38 | 9 |
| Lung function test (mbc/mvv) CPT 94200 | $140.35 | $401.00 | $36.00 – $140.37 | 7 |
| Lung Function Test (Spirometry) CPT 94010 | $441.00 | $1,260.00 | $53.72 – $513.77 | 7 |
| Lung perfusion imaging CPT 78580 | $434.35 | $1,241.00 | $302.95 – $1,439.81 | 9 |
| Lung transplant double CPT 32853 | not published | not published | $2,109.00 – $12,050.00 | 4 |
| Lung transplant single CPT 32851 | not published | not published | $2,109.00 – $12,050.00 | 4 |
| Lung transplant with bypass CPT 32852 | not published | not published | $2,109.00 – $12,050.00 | 4 |
| Lung transplant with bypass CPT 32854 | not published | not published | $2,109.00 – $12,050.00 | 4 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,528.00 – $12,050.00 | 4 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $206.81 – $440.84 | 9 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $15,728.33 | $44,938.09 | $41.13 – $88.67 | 9 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $319.94 – $636.94 | 8 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $259.60 – $516.43 | 8 |
| Lvad shower bag heartmate HCPCS Q0501 | $833.49 | $2,381.40 | $613.75 – $1,135.44 | 6 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $37.20 – $1,528.00 | 9 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $339.39 – $627.87 | 6 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $53.52 | 10 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $1,142.00 – $19,447.84 | 9 |
| Lymphatics/lymph node imaging CPT 78195 | $877.80 | $2,508.00 | $360.62 – $1,928.68 | 9 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $150.66 | 10 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $49.03 – $130.82 | 10 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $112.88 – $379.02 | 10 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $122.34 | 10 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $479.46 – $2,128.87 | 9 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,721.95 | $7,777.00 | $479.46 – $5,349.00 | 9 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $539.66 – $10,837.86 | 9 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $539.66 – $10,837.86 | 9 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $693.67 – $7,309.00 | 10 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $1,142.00 – $7,332.00 | 10 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $14.01 – $58.79 | 5 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $12.55 – $31.68 | 5 |
| Macroscopic exam arthropod CPT 87168 | $103.60 | $296.00 | $4.27 – $11.38 | 10 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $4.31 – $11.38 | 10 |
| Magnesium CPT 83735 | $237.65 | $679.00 | $6.70 – $17.88 | 10 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $86.10 | $246.00 | $0.51 – $1.66 | 5 |
| Magnetic image bone marrow CPT 77084 | $1,189.30 | $3,398.00 | $306.88 – $1,166.33 | 8 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $19.60 – $29.71 | 3 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $35.20 | 10 |
| Male sling procedure CPT 53440 | not published | not published | $1,528.00 – $22,059.69 | 10 |
| Mammosite ced HCPCS C1728 | $3,762.50 | $10,750.00 | not published | 0 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,109.00 – $6,749.00 | 4 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $353.00 – $3,826.07 | 9 |
| Manipulate wrist w/anesthes CPT 25259 | $1,346.45 | $3,847.00 | $1,142.00 – $3,962.00 | 9 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $125.30 | $358.00 | $40.22 – $316.58 | 7 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $136.50 | $390.00 | $49.09 – $316.58 | 7 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Manipulation of spine CPT 22505 | not published | not published | $1,528.00 – $7,309.00 | 10 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $317.26 – $2,589.00 | 9 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $4.50 – $18.03 | 5 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $2.54 – $19.97 | 4 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $103.64 – $191.73 | 6 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $10.14 | 10 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $115.47 – $210.94 | 2 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $1,528.00 – $4,768.00 | 3 |
| Map tachycard site(s) CPT 93609 | $592.20 | $1,692.00 | $241.50 – $6,264.00 | 3 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $52.96 – $104.34 | 9 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,969.37 | $11,341.07 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,542.63 | $4,407.52 | $1,254.00 – $2,446.61 | 7 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,142.00 – $6,264.00 | 4 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $151.26 – $151.26 | 1 |
| Mastectomy form HCPCS L8020 | not published | not published | $255.91 – $473.43 | 6 |
| Mastectomy partial CPT 19301 | not published | not published | $1,747.00 – $7,332.00 | 9 |
| Mast mod rad CPT 19307 | not published | not published | $6,264.00 – $15,799.68 | 8 |
| Mastoidectomy CPT 69501 | not published | not published | $3,409.00 – $12,111.00 | 10 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $3,409.00 – $12,111.00 | 10 |
| Mastoids complete CPT 70130 | $583.80 | $1,668.00 | $70.19 – $366.18 | 9 |
| Mastoid surgery revision CPT 69603 | not published | not published | $3,409.00 – $12,111.00 | 10 |
| Mastopexy CPT 19316 | not published | not published | $2,160.00 – $15,799.68 | 10 |
| Mast radical CPT 19305 | not published | not published | $2,109.00 – $6,264.00 | 3 |
| Mast rad urban type CPT 19306 | not published | not published | $2,109.00 – $6,264.00 | 3 |
| Mast simple complete CPT 19303 | not published | not published | $2,160.00 – $15,799.68 | 9 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $160.06 – $353.00 | 9 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $3,721.30 – $5,518.34 | 2 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $6,785.68 | $19,387.65 | $42.79 – $296.10 | 8 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $35.09 – $93.67 | 10 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $54.58 | 10 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $42.84 – $114.31 | 10 |
| Maxillofacial fixation CPT 21100 | not published | not published | $1,528.00 – $12,111.00 | 10 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | not published | not published | $14.46 – $38.58 | 10 |
| Mayo aathr protein s free CPT 85306 | not published | not published | $15.32 – $40.89 | 10 |
| Mayo activated protein c resistance assay CPT 85307 | not published | not published | $15.32 – $40.89 | 10 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | not published | not published | $38.57 – $77.14 | 10 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | not published | not published | $0.02 – $52.76 | 2 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $314.30 | $898.00 | $0.02 – $52.76 | 2 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | not published | not published | $14.78 – $39.46 | 10 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | not published | not published | $0.02 – $146.60 | 2 |
| Mayo alpha 1 antitrypsin CPT 82103 | not published | not published | $13.44 – $35.85 | 10 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $10.76 | $30.75 | $15.08 – $40.22 | 10 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $0.02 – $83.47 | 2 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $0.02 – $75.92 | 2 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | not published | not published | $121.63 – $316.45 | 10 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $64.75 | $185.00 | $75.28 – $183.32 | 9 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | not published | not published | $137.00 – $274.00 | 9 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | not published | not published | $60.02 – $2,320.00 | 9 |
| Mayo androstenedione CPT 82157 | not published | not published | $29.28 – $78.12 | 10 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | not published | not published | $14.60 – $38.94 | 10 |
| Mayo antithrombin iii antigen CPT 85301 | not published | not published | $10.81 – $28.86 | 10 |
| Mayo aspergillus fumigatus antibody CPT 86606 | not published | not published | $15.05 – $40.17 | 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.