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 |
|---|---|---|---|---|
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $106.74 | $593.00 | $3.15 – $107.82 | 61 |
| Ghs protoporphyrins fract CPT 84202 | $2.30 | $12.75 | $4.98 – $159.97 | 61 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $1.96 | $10.89 | $4.23 – $136.49 | 61 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $239.04 | $1,328.00 | $80.00 – $3,486.00 | 35 |
| Ghs refill of implantable pump CPT 95990 | $199.08 | $1,106.00 | $64.28 – $1,494.81 | 59 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $70.56 | $392.00 | $3.00 – $322.83 | 61 |
| Ghs sedimentation rate CPT 85651 | $54.54 | $303.00 | $1.12 – $39.54 | 61 |
| Ghs semen analysis fert CPT 89320 | $83.16 | $462.00 | $10.46 – $1,617.00 | 64 |
| Ghs sensitivity (per antimicro) CPT 87184 | $67.68 | $376.00 | $2.31 – $76.76 | 61 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $212.58 | $1,181.00 | $35.00 – $784.27 | 85 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $222.84 | $1,238.00 | $41.00 – $784.27 | 85 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $225.00 | $1,250.00 | $40.00 – $784.27 | 85 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $252.00 | $1,400.00 | $131.18 – $793.50 | 85 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $159.66 | $887.00 | $61.07 – $387.07 | 85 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $151.20 | $840.00 | $62.04 – $387.07 | 85 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $212.04 | $1,178.00 | $18.00 – $484.50 | 85 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $247.50 | $1,375.00 | $20.00 – $753.00 | 85 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $297.00 | $1,650.00 | $41.00 – $897.00 | 85 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $20.88 | $116.00 | $34.80 – $1,656.72 | 86 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $210.42 | $1,169.00 | $67.43 – $1,788.57 | 67 |
| Ghs st - eval for alt comm CPT 92567 | $88.02 | $489.00 | $40.83 – $1,711.50 | 59 |
| Ghs st - re-eval for alt comm CPT 92597 | $265.68 | $1,476.00 | $66.28 – $2,258.28 | 67 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $41.94 | $233.00 | $17.56 – $948.00 | 62 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $145.98 | $811.00 | $150.00 – $1,240.83 | 62 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $496.26 | $2,757.00 | $50.00 – $1,425.86 | 85 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $195.84 | $1,088.00 | $37.00 – $1,632.00 | 85 |
| Ghs urine, porphyrins quant CPT 84120 | $2.35 | $13.08 | $4.74 – $163.95 | 61 |
| Ghs windowing of cast CPT 29730 | $28.98 | $161.00 | $28.29 – $313.50 | 85 |
| Giardia ag if CPT 87269 | $35.10 | $195.00 | $2.62 – $298.35 | 61 |
| Giardia lamblia antibody CPT 86674 | $11.34 | $63.00 | $5.05 – $162.07 | 61 |
| Gi inhouse confirmation CPT 87045 | $122.58 | $681.00 | $3.22 – $105.12 | 61 |
| Gjb6 gene com variants CPT 81254 | $6.30 | $35.00 | $29.75 – $122.50 | 60 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $98.70 | $548.33 | $89.92 – $1,277.06 | 61 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $327.16 | $1,817.54 | $114.75 – $4,233.04 | 58 |
| Glucagon plasma - sendout CPT 82943 | $2.29 | $12.70 | $4.96 – $135.21 | 61 |
| Glucose 1 hr post dose CPT 82950 | $57.96 | $322.00 | $1.31 – $52.90 | 61 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $35.64 | $198.00 | $2.25 – $172.89 | 58 |
| Glucose blood quantitative CPT 82947 | $59.04 | $328.00 | $1.25 – $43.82 | 61 |
| Glucose body fluid CPT 82945 | $106.92 | $594.00 | $0.86 – $43.67 | 61 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $141.12 | $784.00 | $4.00 – $143.47 | 61 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $18.00 | $100.00 | $1.08 – $43.74 | 61 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $38.01 | $211.15 | $1.04 – $196.60 | 26 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $590.54 | $3,280.80 | $9.59 – $7,640.98 | 61 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $80.28 | $446.00 | $6.50 – $207.09 | 61 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $80.28 | $446.00 | $6.48 – $206.42 | 61 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $343.68 | $1,909.33 | $856.07 – $6,682.66 | 29 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $20.52 | $114.00 | $39.41 – $346.14 | 60 |
| Graft axiofill 1000mg HCPCS J3590 | $1,268.70 | $7,048.33 | $173.97 – $676.55 | 23 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $9,090.00 | $50,500.00 | $33.46 – $346.14 | 57 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $20,868.84 | $115,938.00 | $1,600.00 – $8,151.50 | 19 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $17,463.96 | $97,022.00 | $684.00 – $2,660.00 | 20 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $2,916.00 | $16,200.00 | $127.97 – $953.19 | 60 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $112.14 | $623.00 | $127.97 – $953.19 | 60 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $8,977.50 | $49,875.00 | $641.70 – $2,495.50 | 20 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $6,985.62 | $38,809.00 | $698.40 – $2,716.00 | 20 |
| Granisetron 1 mg tab HCPCS Q0166 | $52.77 | $293.15 | $1.38 – $1,026.03 | 29 |
| Granisetron hcl injection HCPCS J1626 | $12.96 | $72.00 | $0.39 – $238.74 | 29 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $51.30 | $285.00 | $11.27 – $997.50 | 58 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,152.18 | $6,401.00 | $81.16 – $10,307.03 | 62 |
| Guided cath fluid drainage 10030 CPT 10030 | $973.44 | $5,408.00 | $85.22 – $10,233.00 | 60 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $18,545.76 | $103,032.00 | $567.91 – $3,076.50 | 51 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $1,316.34 | $7,313.00 | $50.76 – $197.40 | 22 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $830.16 | $4,612.00 | $405.90 – $1,578.50 | 22 |
| Guid loc target vol rad tx CPT 77387 | $694.08 | $3,856.00 | $11.40 – $409.97 | 64 |
| Gw stiffened micro access kit HCPCS C1894 | $905.58 | $5,031.00 | $259.20 – $1,008.00 | 22 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $29.22 | $162.33 | $0.01 – $568.16 | 29 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $10.44 | $58.00 | $0.01 – $193.66 | 29 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $3,834.00 | $21,300.00 | $1,600.00 – $74,550.00 | 20 |
| Hand X-ray CPT 73130 | $305.64 | $1,698.00 | $15.91 – $1,681.47 | 62 |
| Haptoglobin quantitative CPT 83010 | $87.66 | $487.00 | $4.35 – $140.16 | 61 |
| Harvest femoropopliteal vein 35572 CPT 35572 | $176.58 | $981.00 | $70.00 – $722.02 | 77 |
| Hba1/hba2 full gene sequence CPT 81259 | $84.15 | $467.50 | $467.50 – $5,104.71 | 61 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $29.15 | $161.92 | $161.92 – $1,722.03 | 61 |
| Hbb gene dup/del variants CPT 81363 | $29.15 | $161.92 | $161.92 – $1,722.03 | 61 |
| Hbot, full body chamber, 30m HCPCS G0277 | $111.60 | $620.00 | $48.19 – $2,674.00 | 63 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $229.14 | $1,273.00 | $37.80 – $1,947.69 | 62 |
| Hcg free betachain test CPT 84704 | $2.41 | $13.38 | $3.48 – $167.70 | 61 |
| Hcg qualitative CPT 84703 | $85.68 | $476.00 | $2.43 – $83.74 | 61 |
| Hcg quantitative CPT 84702 | $113.94 | $633.00 | $3.65 – $160.57 | 61 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $103.86 | $577.00 | $39.54 – $2,019.50 | 31 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $814.68 | $4,526.00 | $85.22 – $212.13 | 82 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $1,081.98 | $6,011.00 | $85.22 – $1,897.12 | 86 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $2,049.66 | $11,387.00 | $85.22 – $3,454.95 | 86 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $722.88 | $4,016.00 | $85.22 – $5,451.51 | 86 |
| Head CT scan (with and without contrast) CPT 70470 | $2,044.80 | $11,360.00 | $85.22 – $17,380.80 | 66 |
| Head CT scan (with contrast) CPT 70460 | $1,858.86 | $10,327.00 | $85.22 – $15,800.31 | 66 |
| Head CT scan (without contrast) CPT 70450 | $1,487.16 | $8,262.00 | $85.22 – $12,640.86 | 66 |
| Heart infarct image CPT 78466 | $447.48 | $2,486.00 | $57.03 – $3,803.58 | 62 |
| Heinz bodies direct CPT 85441 | $10.22 | $56.75 | $1.18 – $86.83 | 61 |
| Heinz bodies induced CPT 85445 | $10.22 | $56.75 | $2.28 – $86.83 | 61 |
| Helicobacter pylori antibody igm CPT 86677 | $55.80 | $310.00 | $5.04 – $365.67 | 61 |
| Hematocrit CPT 85014 | $23.76 | $132.00 | $0.69 – $26.34 | 61 |
| Hemodialysis one evaluation CPT 90935 | $1,335.06 | $7,417.00 | $81.19 – $6,230.16 | 64 |
| Hemoglobin CPT 85018 | $32.76 | $182.00 | $0.69 – $26.34 | 61 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $29.70 | $165.00 | $2.47 – $211.14 | 61 |
| Hemoglobin plasma CPT 83051 | $23.22 | $129.00 | $2.45 – $81.41 | 61 |
| Hemoglobin urine CPT 83069 | $0.63 | $3.51 | $1.41 – $43.97 | 61 |
| Hemolysins/agglutinins auto CPT 86940 | $1.40 | $7.75 | $2.78 – $91.24 | 61 |
| Hemolysins and agglutinins incubated CPT 86941 | $1.82 | $10.12 | $4.18 – $134.99 | 61 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $208.80 | $1,160.00 | $40.00 – $1,794.12 | 85 |
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.