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 |
|---|---|---|---|---|
| Immunofixation electrophoresis serum CPT 86334 | $163.98 | $911.00 | $5.39 – $248.96 | 61 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $17.97 | $99.84 | $31.89 – $646.27 | 64 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $97.20 | $540.00 | $63.09 – $493.03 | 64 |
| Immunoglobulin assay CPT 86023 | $23.58 | $131.00 | $3.78 – $119.68 | 61 |
| Immunology procedure CPT 86849 | $18.00 | $100.00 | $60.08 – $233.63 | 24 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $12,600.00 | $70,000.00 | $123.30 – $479.50 | 22 |
| Implant neuroelectrodes CPT 63655 | $555.12 | $3,084.00 | $30.00 – $2,068.28 | 77 |
| Implant ureth bulk agent HCPCS L8606 | $1,242.00 | $6,900.00 | $209.55 – $733.43 | 53 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | $137.88 | $766.00 | $159.15 – $1,149.00 | 85 |
| In-111 autol wbc diag per dose HCPCS A9570 | $1,191.96 | $6,622.00 | $85.22 – $18,504.24 | 41 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $673.74 | $3,743.00 | $85.22 – $9,252.12 | 63 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $2,330.46 | $12,947.00 | $85.22 – $19,808.91 | 59 |
| In-111 pentetreotide HCPCS A9572 | $1,546.38 | $8,591.00 | $85.22 – $26,872.10 | 41 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | $353.34 | $1,963.00 | $60.00 – $1,037.36 | 77 |
| Incis 1 vertebral seg cerv CPT 22210 | $1,167.12 | $6,484.00 | $209.60 – $3,650.80 | 77 |
| Incis 1 vertebral seg lumbar CPT 22214 | $997.02 | $5,539.00 | $40.00 – $3,041.92 | 77 |
| Incis 1 vertebral seg thorac CPT 22212 | $998.28 | $5,546.00 | $65.00 – $3,004.33 | 77 |
| Incis addl spine segment CPT 22216 | $228.24 | $1,268.00 | $70.00 – $816.86 | 77 |
| Incise thigh tendon & fascia CPT 27305 | $331.38 | $1,841.00 | $30.00 – $967.20 | 77 |
| Incise wrist/forearm tendon CPT 25290 | $302.58 | $1,681.00 | $75.00 – $1,566.06 | 77 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $1,751.76 | $9,732.00 | $21.60 – $3,186.35 | 85 |
| Incision & drainage open of deep abscess (subfascial) pos CPT 22010 | $646.02 | $3,589.00 | $35.00 – $1,826.66 | 77 |
| Incision of anal sphincter CPT 46080 | $89.10 | $495.00 | $50.00 – $340.30 | 77 |
| Incision of breast lesion CPT 19020 | $181.26 | $1,007.00 | $42.00 – $3,186.35 | 85 |
| Incision of foot fascia CPT 28008 | $749.88 | $4,166.00 | $183.92 – $6,312.51 | 84 |
| Incision of hip tendon CPT 27000 | $266.22 | $1,479.00 | $213.33 – $3,102.23 | 85 |
| Incision of hip tendon CPT 27003 | $408.60 | $2,270.00 | $35.00 – $1,205.24 | 77 |
| Incision of hip tendons CPT 27006 | $484.56 | $2,692.00 | $40.00 – $6,312.51 | 85 |
| Incision of knee joint CPT 27435 | $546.12 | $3,034.00 | $118.02 – $1,646.24 | 77 |
| Incision of tendon sheath CPT 25000 | $244.80 | $1,360.00 | $60.00 – $3,102.23 | 85 |
| Incision of thigh tendon CPT 27306 | $237.60 | $1,320.00 | $60.00 – $6,312.51 | 85 |
| Incision of tibia CPT 27705 | $498.78 | $2,771.00 | $35.00 – $1,626.20 | 77 |
| Incision tendon sheath CPT 26055 | $886.68 | $4,926.00 | $40.00 – $3,102.23 | 85 |
| Incisn of toe tndn CPT 28010 | $514.98 | $2,861.00 | $50.00 – $3,102.23 | 85 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $125.46 | $697.00 | $59.67 – $1,009.80 | 56 |
| Infect ag drug suscept pheno predict CPT 87900 | $72.93 | $405.19 | $30.07 – $1,421.07 | 61 |
| Infect ag eia influenza a or b ea CPT 87400 | $65.70 | $365.00 | $1.51 – $306.00 | 61 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $46.34 | $257.45 | $6.07 – $2,319.68 | 61 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $63.54 | $353.00 | $6.07 – $2,319.68 | 61 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $28.06 | $155.90 | $29.70 – $1,161.74 | 61 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $76.18 | $423.21 | $59.41 – $2,867.42 | 61 |
| Infect ag ia optc obs influenza CPT 87804 | $54.72 | $304.00 | $2.30 – $322.83 | 61 |
| Infect ag if hep delta agent CPT 87380 | $22.50 | $125.00 | $5.72 – $191.25 | 61 |
| Infect ag if influenza a CPT 87276 | $2.89 | $16.07 | $3.00 – $100.17 | 61 |
| Infect ag if influenza b CPT 87275 | $35.10 | $195.00 | $1.54 – $103.47 | 61 |
| Infect ag if legionella pneumophila CPT 87278 | $1.82 | $10.10 | $3.00 – $100.17 | 61 |
| Infect ag if nos ea CPT 87299 | $1.82 | $10.10 | $3.00 – $100.17 | 61 |
| Infect ag if pneumocystis carinii CPT 87281 | $66.60 | $370.00 | $2.62 – $103.47 | 61 |
| Infect ag if varicella zoster CPT 87290 | $1.82 | $10.10 | $3.00 – $100.17 | 61 |
| Infect ag na hpv high-risk types CPT 87624 | $125.46 | $697.00 | $29.83 – $299.69 | 61 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $135.00 | $750.00 | $19.90 – $768.01 | 61 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $15.30 | $85.00 | $35.09 – $226.43 | 55 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $373.14 | $2,073.00 | $96.17 – $3,755.38 | 61 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $105.74 | $587.47 | $112.76 – $5,442.59 | 61 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $7.74 | $43.02 | $6.01 – $290.31 | 61 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | $23.04 | $128.00 | $35.17 – $191.25 | 59 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $192.96 | $1,072.00 | $3.00 – $100.17 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $39.96 | $222.00 | $2.62 – $103.47 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $59.22 | $329.00 | $3.00 – $100.17 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $38.34 | $213.00 | $2.15 – $103.92 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $2.60 | $14.45 | $3.32 – $177.68 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $76.50 | $425.00 | $3.54 – $111.35 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $56.52 | $314.00 | $2.39 – $115.03 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $118.26 | $657.00 | $5.26 – $223.73 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $192.96 | $1,072.00 | $3.00 – $100.17 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $71.46 | $397.00 | $3.00 – $100.17 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $1.59 | $8.82 | $2.28 – $103.47 | 61 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $128.70 | $715.00 | $11.60 – $378.47 | 61 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $139.86 | $777.00 | $10.00 – $378.47 | 61 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $132.12 | $734.00 | $7.44 – $489.97 | 61 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $281.88 | $1,566.00 | $354.26 – $3,971.77 | 61 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $30.06 | $167.00 | $11.60 – $378.47 | 61 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $142.02 | $789.00 | $8.02 – $382.67 | 61 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $128.70 | $715.00 | $11.60 – $378.47 | 61 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $139.86 | $777.00 | $10.00 – $378.47 | 61 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $72.18 | $401.00 | $43.61 – $410.66 | 59 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $115.56 | $642.00 | $121.24 – $982.26 | 59 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $123.30 | $685.00 | $11.60 – $378.47 | 61 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $6.32 | $35.09 | $29.83 – $240.16 | 61 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $139.86 | $777.00 | $59.65 – $1,078.65 | 34 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $128.70 | $715.00 | $65.25 – $287.95 | 56 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $495.18 | $2,751.00 | $354.26 – $4,209.03 | 61 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $20.53 | $114.04 | $109.05 – $1,095.50 | 61 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $150.48 | $836.00 | $210.39 – $1,822.50 | 61 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $97.02 | $539.00 | $15.20 – $288.36 | 61 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $6.85 | $38.08 | $15.20 – $288.36 | 61 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $109.62 | $609.00 | $15.20 – $288.36 | 61 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $16.83 | $93.50 | $26.83 – $449.20 | 61 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $91.62 | $509.00 | $15.85 – $1,155.90 | 61 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,123.16 | $6,239.75 | $26.38 – $4,525.06 | 61 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $930.01 | $5,166.71 | $13.84 – $12,033.27 | 56 |
| Infuse radioactive materials CPT 77750 | $279.72 | $1,554.00 | $85.22 – $2,377.62 | 60 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $156.06 | $867.00 | $105.00 – $1,326.51 | 66 |
| Initial nursing facility care/day 35 minutes CPT 99305 | $62.28 | $346.00 | $46.90 – $194.11 | 85 |
| Initial nursing facility care/day 45 minutes CPT 99306 | $84.78 | $471.00 | $72.10 – $264.12 | 85 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | $37.44 | $208.00 | $37.80 – $116.16 | 85 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,255.32 | $6,974.00 | $58.52 – $10,670.22 | 66 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $45.90 | $255.00 | $108.09 – $357.00 | 39 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $2,854.49 | $15,858.25 | $0.01 – $9,950.35 | 58 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $502.79 | $2,793.30 | $3.24 – $6,505.60 | 58 |
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.