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 |
|---|---|---|---|---|
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $284.22 | $1,579.00 | $20.30 – $2,019.60 | 62 |
| L/s ratio fetal lung CPT 83661 | $19.13 | $106.27 | $7.89 – $244.91 | 61 |
| Lumbar diskogram s&i CPT 72295 | $1,326.42 | $7,369.00 | $85.22 – $11,274.57 | 62 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $1,027.62 | $5,709.00 | $232.80 – $3,317.55 | 77 |
| Lung function test (mbc/mvv) CPT 94200 | $48.06 | $267.00 | $12.21 – $408.51 | 63 |
| Lung Function Test (Spirometry) CPT 94010 | $203.94 | $1,133.00 | $18.31 – $1,381.59 | 63 |
| Lung perfusion imaging CPT 78580 | $931.32 | $5,174.00 | $69.12 – $7,916.22 | 62 |
| Lymphatics/lymph node imaging CPT 78195 | $1,418.04 | $7,878.00 | $85.22 – $12,053.34 | 62 |
| Lymphocyte transformation mitogen CPT 86353 | $28.26 | $157.00 | $15.78 – $546.32 | 61 |
| Macro exam dissect molec study ea CPT 88387 | $15.48 | $86.00 | $7.88 – $131.58 | 64 |
| Macroscopic exam arthropod CPT 87168 | $30.42 | $169.00 | $0.99 – $209.76 | 61 |
| Macroscopic exam parasite CPT 87169 | $54.72 | $304.00 | $0.99 – $47.57 | 61 |
| Magnesium CPT 83735 | $71.10 | $395.00 | $2.22 – $74.21 | 61 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $21.62 | $120.10 | $0.87 – $193.66 | 29 |
| Manipulate finger w/anesth CPT 26340 | $259.20 | $1,440.00 | $35.00 – $3,102.23 | 85 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $169.38 | $941.00 | $16.78 – $1,439.73 | 66 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $254.34 | $1,413.00 | $28.54 – $2,161.89 | 66 |
| Manipulat palm cord post inj CPT 26341 | $53.64 | $298.00 | $63.66 – $475.88 | 85 |
| Mapping io sentinel lymph node CPT 38900 | $73.80 | $410.00 | $20.00 – $615.00 | 85 |
| Map tachycard site(s) CPT 93609 | $4,437.90 | $24,655.00 | $85.22 – $86,292.50 | 24 |
| Marker biop eviva buckle ss HCPCS A4648 | $200.34 | $1,113.00 | $116.10 – $451.50 | 20 |
| Mastectomy partial CPT 19301 | $368.28 | $2,046.00 | $300.00 – $1,005.96 | 77 |
| Mast mod rad CPT 19307 | $766.98 | $4,261.00 | $70.00 – $2,351.61 | 77 |
| Mastoids complete CPT 70130 | $188.64 | $1,048.00 | $28.17 – $1,603.44 | 62 |
| Mast simple complete CPT 19303 | $533.52 | $2,964.00 | $70.00 – $1,850.76 | 77 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $12.60 | $70.00 | $18.55 – $346.14 | 60 |
| M.avium-intra dna dir prob CPT 87560 | $61.74 | $343.00 | $7.02 – $299.88 | 61 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $2.31 | $12.86 | $5.02 – $161.10 | 61 |
| Mayo aathr protein s free CPT 85306 | $2.45 | $13.62 | $5.33 – $170.85 | 61 |
| Mayo activated protein c resistance assay CPT 85307 | $2.45 | $13.62 | $3.53 – $170.70 | 61 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $37.89 | $210.50 | $32.78 – $322.07 | 59 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $17.39 | $96.59 | $0.04 – $117.95 | 26 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $108.54 | $603.00 | $0.04 – $117.95 | 26 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $3.20 | $17.80 | $5.14 – $164.85 | 61 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $24.48 | $136.00 | $0.04 – $327.75 | 26 |
| Mayo alpha 1 antitrypsin CPT 82103 | $6.54 | $36.36 | $4.63 – $149.62 | 61 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $115.38 | $641.00 | $3.67 – $168.00 | 61 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $1.55 | $8.59 | $0.04 – $186.61 | 26 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $1.55 | $8.59 | $0.04 – $169.73 | 26 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $19.46 | $108.11 | $103.39 – $1,470.59 | 61 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $17.88 | $99.31 | $77.91 – $550.47 | 61 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $24.66 | $137.00 | $109.60 – $969.36 | 59 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $260.55 | $1,447.50 | $100.65 – $3,928.34 | 60 |
| Mayo androstenedione CPT 82157 | $4.68 | $26.02 | $10.33 – $326.17 | 61 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $2.34 | $12.98 | $5.08 – $162.67 | 61 |
| Mayo antithrombin iii antigen CPT 85301 | $1.73 | $9.61 | $3.71 – $120.50 | 61 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $9.72 | $54.00 | $5.23 – $167.78 | 61 |
| Mayo avwpr vw factor activity CPT 85397 | $17.10 | $95.00 | $26.23 – $260.40 | 61 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $5.43 | $30.15 | $29.83 – $189.14 | 56 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $5.80 | $32.23 | $0.04 – $125.08 | 26 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $1.63 | $9.05 | $2.35 – $113.30 | 61 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $26.07 | $144.84 | $35.00 – $605.56 | 61 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $22.86 | $127.00 | $51.00 – $1,332.03 | 61 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $2.06 | $11.47 | $4.47 – $146.99 | 61 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $26.28 | $146.00 | $0.04 – $201.92 | 26 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $62.46 | $347.00 | $4.57 – $146.99 | 61 |
| Mayo brcmg brucella antibody igm CPT 86622 | $25.56 | $142.00 | $3.00 – $89.89 | 61 |
| Mayo c1 esterase inhibitor CPT 83883 | $11.12 | $61.76 | $4.71 – $151.72 | 61 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $69.66 | $387.00 | $0.04 – $258.57 | 26 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $2.70 | $14.99 | $5.89 – $187.13 | 61 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $7.44 | $41.33 | $6.18 – $298.41 | 61 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $19.56 | $108.64 | $103.89 – $860.79 | 61 |
| Mayo ceruloplasmin CPT 82390 | $1.50 | $8.35 | $3.69 – $119.68 | 61 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $15.21 | $84.50 | $4.91 – $157.50 | 61 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $23.18 | $128.75 | $4.47 – $143.62 | 61 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $41.22 | $229.00 | $4.08 – $143.84 | 61 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $1.67 | $9.30 | $4.39 – $143.84 | 61 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $70.20 | $390.00 | $97.50 – $1,102.32 | 64 |
| Mayo chromium CPT 82495 | $30.42 | $169.00 | $7.11 – $226.00 | 61 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $26.28 | $146.00 | $0.04 – $165.53 | 26 |
| Mayo coccidioides antibody CPT 86635 | $37.08 | $206.00 | $3.95 – $129.66 | 61 |
| Mayo cocou cortisone urine CPT 82542 | $93.60 | $520.00 | $6.32 – $200.42 | 61 |
| Mayo cortisol free CPT 82530 | $2.67 | $14.85 | $5.83 – $189.01 | 61 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $34.56 | $192.00 | $27.50 – $337.20 | 59 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $1.94 | $10.78 | $4.18 – $140.69 | 61 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | $4.62 | $25.68 | $0.04 – $222.10 | 26 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $4.86 | $27.00 | $0.04 – $254.89 | 26 |
| Mayo cyanide CPT 82600 | $9.72 | $54.00 | $6.80 – $216.25 | 61 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $80.46 | $447.00 | $186.26 – $3,375.78 | 64 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $2.12 | $11.77 | $4.59 – $147.67 | 61 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $4.04 | $22.47 | $8.90 – $281.68 | 61 |
| Mayo dihydrotestosterone CPT 82642 | $4.68 | $26.02 | $24.89 – $230.20 | 59 |
| Mayo efpo chloride stool CPT 82438 | $99.90 | $555.00 | $1.38 – $54.47 | 61 |
| Mayo estriol CPT 82677 | $3.87 | $21.49 | $8.51 – $270.65 | 61 |
| Mayo estrone CPT 82679 | $3.99 | $22.18 | $8.79 – $278.15 | 61 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $2.61 | $14.52 | $5.70 – $182.11 | 61 |
| Mayo everolimus therapeutic drug level CPT 80169 | $2.20 | $12.21 | $11.67 – $93.93 | 61 |
| Mayo factor ii CPT 85210 | $2.08 | $11.54 | $4.19 – $144.74 | 61 |
| Mayo factor v CPT 85220 | $108.18 | $601.00 | $6.17 – $196.74 | 61 |
| Mayo factor vii CPT 85230 | $123.12 | $684.00 | $6.26 – $199.59 | 61 |
| Mayo factor viii vw factor antigen CPT 85246 | $3.67 | $20.39 | $8.07 – $255.72 | 61 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $3.67 | $20.39 | $8.07 – $255.72 | 61 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $3.67 | $20.39 | $8.07 – $255.72 | 61 |
| Mayo factor x CPT 85260 | $2.86 | $15.91 | $6.26 – $199.59 | 61 |
| Mayo factor xi CPT 85270 | $2.86 | $15.91 | $6.26 – $199.59 | 61 |
| Mayo fbl culture fungi blood CPT 87103 | $57.06 | $317.00 | $3.08 – $100.47 | 61 |
| Mayo fdp/fsp paracoagulation CPT 85366 | $14.48 | $80.46 | $2.22 – $272.48 | 61 |
| Mayo ffspg allergen clam igg CPT 86001 | $6.30 | $35.00 | $1.48 – $58.23 | 61 |
| Mayo fibrinogen antigen CPT 85385 | $1.67 | $9.25 | $2.87 – $94.09 | 61 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $2.60 | $14.43 | $14.43 – $90.76 | 61 |
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.