WHITE MEMORIAL MEDICAL CENTER
1720 E Cesar E Chavez Ave Los Angeles CA 90033|309 W Beverly Blvd, MONTEBELLO, CA · Adventisthealth · · NPI 1215927470
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 |
|---|---|---|---|---|
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $87.12 | $484.00 | $4.67 – $1,043.00 | 29 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $401.20 | $2,228.90 | $27.26 – $5,191.11 | 61 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $167.29 | $929.37 | $0.03 – $1,161.83 | 29 |
| Dark field exam without collj CPT 87166 | $1.88 | $10.42 | $3.89 – $125.83 | 61 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $93.99 | $522.14 | $34.60 – $1,361.05 | 29 |
| Dch glucoscan CPT 82948 | $35.10 | $195.00 | $0.97 – $224.91 | 61 |
| Dch validity tests CPT 81002 | $26.10 | $145.00 | $0.92 – $26.49 | 61 |
| Deamidated gliadin antibody iga CPT 86258 | $96.12 | $534.00 | $10.24 – $43.25 | 56 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $218.16 | $1,212.00 | $19.73 – $784.27 | 85 |
| Debridement (>20 cm) charge pt CPT 97598 | $146.52 | $814.00 | $11.58 – $413.00 | 86 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,016.64 | $5,648.00 | $176.63 – $3,186.35 | 85 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $68.04 | $378.00 | $6.00 – $97.71 | 85 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $98.10 | $545.00 | $6.00 – $159.23 | 85 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $319.14 | $1,773.00 | $46.52 – $784.27 | 85 |
| Debride nail1-5 11720 CPT 11720 | $64.08 | $356.00 | $4.00 – $113.81 | 85 |
| Debride nail6 or more 11721 CPT 11721 | $64.08 | $356.00 | $13.00 – $113.81 | 85 |
| Debride skin bone at fx site CPT 11012 | $268.74 | $1,493.00 | $76.69 – $5,603.93 | 85 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | $914.40 | $5,080.00 | $300.00 – $7,620.00 | 85 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $54.00 | $300.00 | $17.11 – $56.60 | 85 |
| Debr inf skin add-on 11001 CPT 11001 | $9.54 | $53.00 | $6.00 – $61.50 | 85 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $472.50 | $2,625.00 | $25.00 – $1,425.86 | 85 |
| Decalcification CPT 88311 | $42.48 | $236.00 | $11.33 – $361.08 | 64 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $110.10 | $611.67 | $1.77 – $2,140.85 | 29 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $359.82 | $1,999.00 | $33.51 – $10,233.00 | 58 |
| Decompression of lower leg CPT 27600 | $265.14 | $1,473.00 | $25.00 – $887.02 | 77 |
| Decompression of lower leg CPT 27601 | $295.02 | $1,639.00 | $86.75 – $909.57 | 77 |
| Decompres spinal cord;thoracic 63055 CPT 63055 | $1,045.80 | $5,810.00 | $45.00 – $4,103.81 | 77 |
| Decompress spinal cord lmbr CPT 63056 | $962.28 | $5,346.00 | $227.10 – $3,817.31 | 77 |
| Deep muscle biopsy 20205 CPT 20205 | $100.08 | $556.00 | $21.00 – $5,603.93 | 85 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $15.87 | $88.16 | $14.75 – $308.56 | 29 |
| Delivery of placenta 59414 CPT 59414 | $1,229.40 | $6,830.00 | $88.91 – $10,449.90 | 58 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $115.74 | $643.00 | $12.34 – $983.79 | 66 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $458.70 | $2,548.33 | $25.08 – $5,935.06 | 61 |
| Design mlc device for imrt CPT 77338 | $676.62 | $3,759.00 | $85.22 – $2,192.12 | 86 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $31.78 | $176.58 | $9.29 – $120.61 | 28 |
| Desoxycorticosterone CPT 82633 | $5.72 | $31.75 | $9.38 – $334.05 | 61 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $154.80 | $860.00 | $8.00 – $387.07 | 85 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $113.22 | $629.00 | $3.00 – $483.00 | 85 |
| Destruction 2-14 lesions 17003 CPT 17003 | $2.52 | $14.00 | $1.52 – $13.73 | 85 |
| Destruction anal lesion(s) CPT 46924 | $121.68 | $676.00 | $155.58 – $5,354.94 | 85 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $142.56 | $792.00 | $15.00 – $784.27 | 85 |
| Destruction benign lesions < 14 lesions CPT 17110 | $146.70 | $815.00 | $8.00 – $387.07 | 85 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $37.98 | $211.00 | $20.00 – $537.94 | 85 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $127.08 | $706.00 | $156.64 – $3,767.30 | 85 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $256.86 | $1,427.00 | $75.97 – $784.27 | 85 |
| Devel tst phys/qhp 1st hr CPT 96112 | $93.78 | $521.00 | $80.00 – $797.13 | 67 |
| Device ablt adv novasure HCPCS C1886 | $405.00 | $2,250.00 | $1,600.00 – $7,640.50 | 21 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $2,700.00 | $15,000.00 | $1,600.00 – $52,500.00 | 20 |
| Device intraute mirena HCPCS J7298 | $1,967.71 | $10,931.70 | $1,501.51 – $38,260.95 | 25 |
| Dev interrog remote 1/2/mlt CPT 93295 | $16.74 | $93.00 | $27.90 – $433.49 | 86 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $46.80 | $260.00 | $40.22 – $549.00 | 67 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $19.74 | $109.68 | $0.03 – $99.58 | 29 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $27.35 | $151.93 | $0.30 – $9.70 | 29 |
| Dextran 40 infusion HCPCS J7100 | $309.55 | $1,719.73 | $157.10 – $1,037.24 | 28 |
| Dextran 75 infusion HCPCS J7110 | $41.22 | $229.00 | $167.80 – $801.50 | 25 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $13.41 | $74.50 | $1.51 – $260.75 | 29 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $13.41 | $74.50 | $0.71 – $260.75 | 29 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $28.44 | $158.00 | $2.18 – $199.50 | 29 |
| Dextrose 5 % IV bolus HCPCS J7070 | $13.41 | $74.50 | $4.36 – $260.75 | 29 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $3.53 | $19.62 | $7.81 – $247.76 | 61 |
| Diabetes (HbA1c) Test CPT 83036 | $87.30 | $485.00 | $3.32 – $108.20 | 61 |
| Diag laparo separate proc 49320 CPT 49320 | $215.46 | $1,197.00 | $234.18 – $773.18 | 77 |
| Diagnostic anoscopy & biopsy CPT 46607 | $80.46 | $447.00 | $10.00 – $79,364.17 | 77 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $121.86 | $677.00 | $21.97 – $256.68 | 85 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $33.84 | $188.00 | $5.00 – $385.09 | 85 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $218.52 | $1,214.00 | $30.00 – $387.00 | 85 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $364.86 | $2,027.00 | $51.88 – $3,101.31 | 66 |
| Diagnostic Mammogram (one breast) CPT 77065 | $263.52 | $1,464.00 | $42.55 – $2,239.92 | 66 |
| Diagnostic radio unlisted proc CPT 76499 | $217.26 | $1,207.00 | $62.03 – $1,846.71 | 39 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $4,630.50 | $25,725.00 | $85.22 – $39,359.25 | 58 |
| Dialysis one evaluation CPT 90945 | $1,151.82 | $6,399.00 | $103.51 – $9,790.47 | 62 |
| Dialysis repeated eval CPT 90947 | $673.56 | $3,742.00 | $94.38 – $5,725.26 | 58 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.58 | $3.20 | $0.10 – $11.20 | 29 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $17.86 | $99.22 | $7.40 – $347.27 | 29 |
| Dicyclomine injection HCPCS J0500 | $39.22 | $217.90 | $30.84 – $762.65 | 29 |
| Diffusing capacity CPT 94729 | $167.40 | $930.00 | $8.76 – $714.51 | 63 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $15.92 | $88.44 | $3.92 – $195.13 | 29 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $433.94 | $2,410.76 | $1,117.80 – $14,067.12 | 61 |
| Digoxin total therapeutic drug level CPT 80162 | $140.40 | $780.00 | $4.59 – $147.97 | 61 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $33.48 | $186.00 | $61.15 – $651.00 | 29 |
| Dilate biliary duct/ampulla CPT 47542 | $367.56 | $2,042.00 | $101.82 – $3,124.26 | 53 |
| Dilator fascial 10fx20cm HCPCS C2627 | $181.80 | $1,010.00 | $490.50 – $1,907.50 | 22 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $14.03 | $77.94 | $0.08 – $198.07 | 25 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $50.40 | $280.00 | $124.43 – $2,039.78 | 60 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $11.70 | $65.00 | $1.93 – $193.66 | 29 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $21.96 | $122.00 | $30.31 – $297.50 | 28 |
| Disability dlco CPT 94727 | $207.00 | $1,150.00 | $13.19 – $1,326.51 | 63 |
| Disaccharidases CPT 82657 | $60.62 | $336.80 | $6.32 – $200.42 | 61 |
| Disarticulation shoulder CPT 23920 | $748.44 | $4,158.00 | $30.00 – $2,255.13 | 77 |
| Dmd dup/delet analysis CPT 81161 | $50.22 | $279.00 | $146.54 – $2,548.51 | 61 |
| Dmpk gene detc abnor allele CPT 81234 | $19.73 | $109.60 | $109.60 – $969.36 | 59 |
| Dna antibody native/double stranded CPT 86225 | $9.54 | $53.00 | $4.74 – $153.14 | 61 |
| Dna gardnerella CPT 87510 | $3.21 | $17.83 | $7.02 – $216.25 | 61 |
| Dna probe chlamydia CPT 87490 | $93.24 | $518.00 | $7.02 – $524.79 | 61 |
| Dna trichomonas CPT 87660 | $3.21 | $17.83 | $4.63 – $224.28 | 61 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $86.94 | $483.00 | $9.84 – $241.19 | 29 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $164.41 | $913.40 | $1.12 – $1,557.15 | 29 |
| Dolasetron mesylate HCPCS J1260 | $42.30 | $235.00 | $10.00 – $822.50 | 29 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $22.75 | $126.37 | $0.73 – $193.66 | 29 |
| Doppler echo complete CPT 93320 | $547.20 | $3,040.00 | $15.83 – $536.87 | 86 |
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.