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 |
|---|---|---|---|---|
| Optx ulnar styloid fracture CPT 25652 | $428.40 | $2,380.00 | $97.20 – $1,267.88 | 77 |
| Organic acids total quant ea spec CPT 83918 | $17.68 | $98.20 | $5.74 – $177.53 | 61 |
| Orthovisc inj per dose HCPCS J7324 | $101.32 | $562.90 | $92.73 – $1,071.53 | 61 |
| Osmolality blood CPT 83930 | $65.88 | $366.00 | $1.97 – $100.32 | 61 |
| Osmolality urine CPT 83935 | $66.06 | $367.00 | $1.97 – $76.01 | 61 |
| Osteochondral knee allograft CPT 27415 | $911.88 | $5,066.00 | $75.00 – $2,909.12 | 77 |
| Osteot humerus w/wo int fixj CPT 24400 | $558.18 | $3,101.00 | $30.00 – $1,723.92 | 77 |
| Ot evaluation high complexity patient/family CPT 97167 | $205.02 | $1,139.00 | $80.00 – $1,742.67 | 68 |
| Ot evaluation low complexity patient/family CPT 97165 | $185.40 | $1,030.00 | $80.00 – $3,605.00 | 67 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $190.80 | $1,060.00 | $80.00 – $3,710.00 | 67 |
| Oth resp proc, group HCPCS G0239 | $31.32 | $174.00 | $40.83 – $609.00 | 65 |
| Oth resp proc, indiv HCPCS G0238 | $31.32 | $174.00 | $31.62 – $609.00 | 65 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $61.20 | $340.00 | $48.30 – $1,190.00 | 67 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $67.50 | $375.00 | $28.16 – $413.00 | 86 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $70.20 | $390.00 | $25.99 – $596.70 | 68 |
| Ot re-evaluation patient/family CPT 97168 | $104.22 | $579.00 | $64.84 – $885.87 | 68 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $72.18 | $401.00 | $15.98 – $613.53 | 68 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $74.88 | $416.00 | $16.54 – $636.48 | 68 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $74.88 | $416.00 | $17.65 – $636.48 | 68 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $64.62 | $359.00 | $15.72 – $549.00 | 68 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $67.86 | $377.00 | $17.53 – $576.81 | 68 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $58.14 | $323.00 | $6.89 – $549.00 | 68 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $13.32 | $74.00 | $1.22 – $259.00 | 29 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $58.46 | $324.80 | $0.10 – $1,136.80 | 29 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $9.96 | $55.33 | $2.03 – $193.66 | 29 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $18,495.00 | $102,750.00 | $1,600.00 – $359,625.00 | 16 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $56.39 | $313.30 | $0.12 – $157.61 | 29 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $2,338.56 | $12,992.02 | $0.01 – $30,258.41 | 53 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $806.16 | $4,478.64 | $371.24 – $3,766.34 | 60 |
| Palonosetron hcl HCPCS J2469 | $124.74 | $693.00 | $0.96 – $2,425.50 | 29 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $34.21 | $190.03 | $15.15 – $736.32 | 29 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $13.29 | $73.81 | $10.15 – $258.34 | 26 |
| Papaverin hcl injection HCPCS J2440 | $16.20 | $90.00 | $3.05 – $262.50 | 28 |
| Parathormone (pth) intact CPT 83970 | $167.94 | $933.00 | $14.64 – $460.03 | 61 |
| Parathyrd planar w/spect&ct CPT 78072 | $638.64 | $3,548.00 | $80.53 – $5,428.44 | 62 |
| Parathyroid planar imaging CPT 78070 | $1,030.86 | $5,727.00 | $59.05 – $8,762.31 | 62 |
| Parathyroid planar img w/tomo spect CPT 78071 | $594.54 | $3,303.00 | $60.72 – $5,053.59 | 62 |
| Paricalcitol HCPCS J2501 | $21.73 | $120.73 | $1.27 – $422.56 | 29 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $102.06 | $567.00 | $11.96 – $387.07 | 85 |
| Partial exc bone humerus CPT 24140 | $476.46 | $2,647.00 | $25.00 – $1,558.55 | 77 |
| Partial hip replacement CPT 27125 | $750.96 | $4,172.00 | $75.00 – $2,340.32 | 77 |
| Partial removal leg bone(s) CPT 27360 | $608.94 | $3,383.00 | $58.00 – $6,312.51 | 85 |
| Part removal hip bone deep CPT 27071 | $651.42 | $3,619.00 | $101.27 – $1,904.33 | 77 |
| Passy muir valve metal trach HCPCS L8501 | $338.76 | $1,882.00 | $123.24 – $326.23 | 33 |
| Path clin consltj sf 5-20 CPT 80503 | $25.02 | $139.00 | $23.04 – $212.67 | 59 |
| Pegaspargase injection HCPCS J9266 | $7,342.72 | $40,792.89 | $1,600.00 – $95,006.64 | 50 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $1,469.62 | $8,164.53 | $67.57 – $19,015.19 | 55 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $6,698.66 | $37,214.80 | $643.34 – $86,673.27 | 50 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,669.14 | $9,273.00 | $8.66 – $1,447.77 | 87 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,517.22 | $8,429.00 | $85.22 – $9,672.66 | 66 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,213.74 | $6,743.00 | $85.22 – $7,737.21 | 66 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,985.58 | $11,031.00 | $85.22 – $16,877.43 | 65 |
| Pelvic MRI (with contrast) CPT 72196 | $1,805.40 | $10,030.00 | $85.22 – $15,345.90 | 65 |
| Pelvic MRI (without contrast) CPT 72195 | $1,510.92 | $8,394.00 | $52.88 – $9,632.88 | 65 |
| Pelvic Ultrasound (complete) CPT 76856 | $538.56 | $2,992.00 | $50.38 – $4,574.70 | 62 |
| Pelvic Ultrasound (limited) CPT 76857 | $280.44 | $1,558.00 | $31.44 – $1,620.27 | 62 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $1,952.64 | $10,848.00 | $52.06 – $23,833.91 | 53 |
| Peng benzathine/procaine inj HCPCS J0558 | $44.26 | $245.88 | $7.11 – $572.65 | 61 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,249.57 | $6,942.06 | $8.99 – $87.04 | 61 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $32.40 | $180.00 | $2.13 – $305.90 | 29 |
| Penicillin g procaine inj HCPCS J2510 | $25.20 | $140.00 | $17.84 – $304.50 | 29 |
| Penile injection CPT 54235 | $164.70 | $915.00 | $25.96 – $482.02 | 85 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $8,866.80 | $49,260.00 | $1,600.00 – $172,410.00 | 16 |
| Penile vascular study CPT 93980 | $357.12 | $1,984.00 | $85.22 – $3,035.52 | 65 |
| Penile vascular study CPT 93981 | $304.92 | $1,694.00 | $32.40 – $2,591.82 | 65 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $32.34 | $179.68 | $161.71 – $628.88 | 22 |
| Pentazocine injection HCPCS J3070 | $13.14 | $73.00 | $56.85 – $255.50 | 29 |
| Perc d-e cor revasc chro add HCPCS C9608 | $5,225.04 | $29,028.00 | $85.22 – $87,584.00 | 25 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $9,790.20 | $54,390.00 | $85.22 – $190,365.00 | 57 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $5,475.60 | $30,420.00 | $85.22 – $91,784.00 | 25 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $11,216.88 | $62,316.00 | $85.22 – $218,106.00 | 57 |
| Perc d-e cor stent ather br HCPCS C9603 | $5,225.04 | $29,028.00 | $85.22 – $87,584.00 | 25 |
| Perc d-e cor stent ather s HCPCS C9602 | $7,935.12 | $44,084.00 | $85.22 – $154,294.00 | 57 |
| Perc drug-el cor stent bran HCPCS C9601 | $5,225.04 | $29,028.00 | $85.22 – $87,584.00 | 25 |
| Perc drug-el cor stent sing HCPCS C9600 | $8,723.16 | $48,462.00 | $85.22 – $169,617.00 | 57 |
| Perc rf ablate renal tumor CPT 50592 | $2,126.88 | $11,816.00 | $61.78 – $18,078.48 | 36 |
| Percut ablate liver rf CPT 47382 | $2,968.74 | $16,493.00 | $719.07 – $25,234.29 | 53 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $151.20 | $840.00 | $65.21 – $2,940.00 | 29 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $1,000.08 | $5,556.00 | $85.22 – $10,233.00 | 58 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,799.82 | $9,999.00 | $20.00 – $3,036.95 | 85 |
| Peri-proc device eval pm CPT 93286 | $74.88 | $416.00 | $16.41 – $3,389.00 | 63 |
| Perphenazine injeciton HCPCS J3310 | $8.82 | $49.00 | $0.01 – $171.50 | 26 |
| Perq art m-thrombect &/nfs CPT 61645 | $657.72 | $3,654.00 | $637.57 – $5,590.62 | 53 |
| Perq clsr tcat l atr apndge CPT 33340 | $20,284.74 | $112,693.00 | $85.22 – $2,257.90 | 85 |
| Perq plmt bile duct stent CPT 47538 | $8,312.58 | $46,181.00 | $1,600.00 – $70,656.93 | 53 |
| Perq plmt bile duct stent CPT 47539 | $5,325.66 | $29,587.00 | $1,600.00 – $45,268.11 | 53 |
| Perq plmt bile duct stent CPT 47540 | $5,043.78 | $28,021.00 | $1,600.00 – $42,872.13 | 53 |
| Perq skel fix rad/uln dislc CPT 25671 | $370.98 | $2,061.00 | $32.00 – $1,059.91 | 77 |
| Pertussis ag if CPT 87265 | $12.24 | $68.00 | $3.00 – $104.04 | 61 |
| Pet CT skull-mid thgh initial CPT 78815 | $3,517.38 | $19,541.00 | $85.22 – $29,897.73 | 70 |
| Pet CT whole body initial CPT 78816 | $3,031.38 | $16,841.00 | $85.22 – $25,766.73 | 70 |
| Pet fdg brain metoblic eval sb CPT 78608 | $3,154.32 | $17,524.00 | $85.22 – $26,811.72 | 50 |
| Pet image full body CPT 78813 | $2,638.08 | $14,656.00 | $85.22 – $22,423.68 | 70 |
| Pet image ltd area CPT 78811 | $2,327.58 | $12,931.00 | $85.22 – $19,784.43 | 70 |
| Pet image skull-thigh CPT 78812 | $2,483.28 | $13,796.00 | $85.22 – $21,107.88 | 70 |
| Pet image w/ct lmtd CPT 78814 | $3,721.68 | $20,676.00 | $85.22 – $31,634.28 | 70 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $27,942.30 | $155,235.00 | $270.00 – $1,050.00 | 20 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $10.62 | $59.00 | $17.70 – $82.60 | 85 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $14.76 | $82.00 | $24.60 – $114.80 | 85 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $5.40 | $30.00 | $9.00 – $42.00 | 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.