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 |
|---|---|---|---|---|
| Rsv assay w/optic CPT 87807 | $67.68 | $376.00 | $2.22 – $416.16 | 61 |
| Rubella antibody igg CPT 86762 | $59.76 | $332.00 | $3.98 – $159.90 | 61 |
| Rubeola antibody igg CPT 86765 | $53.28 | $296.00 | $4.47 – $143.62 | 61 |
| Russell viper venom diluted CPT 85613 | $6.30 | $35.00 | $3.13 – $106.62 | 61 |
| Salmonella antibody CPT 86768 | $2.11 | $11.72 | $4.57 – $146.99 | 61 |
| Saquinavir, 200 mg HCPCS S0140 | $8.62 | $47.87 | $0.01 – $167.55 | 24 |
| Sargramostim injection HCPCS J2820 | $30.30 | $168.36 | $52.60 – $392.11 | 61 |
| Sbrt management CPT 77435 | $488.34 | $2,713.00 | $300.00 – $1,173.51 | 77 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $72.18 | $401.00 | $52.00 – $228.03 | 85 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $35.10 | $195.00 | $27.50 – $111.17 | 85 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $50.76 | $282.00 | $40.00 – $160.70 | 85 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $18.90 | $105.00 | $13.70 – $60.70 | 85 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $673.74 | $3,743.00 | $85.22 – $5,726.79 | 65 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $266.76 | $1,482.00 | $60.50 – $2,267.46 | 65 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $562.86 | $3,127.00 | $32.85 – $1,243.87 | 86 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $340.38 | $1,891.00 | $22.16 – $2,893.23 | 65 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $462.06 | $2,567.00 | $19.87 – $3,927.51 | 65 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $593.82 | $3,299.00 | $18.28 – $890.57 | 86 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $761.04 | $4,228.00 | $45.09 – $2,705.04 | 65 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $445.68 | $2,476.00 | $22.13 – $2,357.73 | 65 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $437.58 | $2,431.00 | $32.40 – $3,719.43 | 65 |
| Scan proc spinal CPT 61783 | $144.18 | $801.00 | $20.00 – $654.86 | 77 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,430.00 | $13,500.00 | $1,600.00 – $47,250.00 | 20 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $58.50 | $325.00 | $15.34 – $693.00 | 58 |
| Screening Mammogram CPT 77067 | $282.78 | $1,571.00 | $40.32 – $1,802.34 | 66 |
| Screening prostate cancer PSA HCPCS G0103 | $79.92 | $444.00 | $12.70 – $204.99 | 58 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $63.72 | $354.00 | $290.00 – $541.62 | 23 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $32,047.20 | $178,040.00 | $12.60 – $840.00 | 22 |
| Sc ther infusion reset pump CPT 96371 | $41.76 | $232.00 | $78.71 – $948.00 | 62 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $3,875.76 | $21,532.00 | $30.00 – $3,663.67 | 85 |
| Sedimentation rate erythrocyte automated CPT 85652 | $44.82 | $249.00 | $0.80 – $209.61 | 61 |
| Semen analysis presence/motility CPT 89321 | $66.96 | $372.00 | $10.24 – $134.24 | 64 |
| Serial casting application 97139app CPT 97139 | $71.28 | $396.00 | $14.24 – $1,386.00 | 35 |
| Serpina1 gene CPT 81332 | $7.86 | $43.65 | $37.10 – $627.91 | 60 |
| Sertraline (zoloft) - sendout CPT 80332 | $36.00 | $200.00 | $0.04 – $195.39 | 26 |
| Set radiation therapy field CPT 77280 | $204.66 | $1,137.00 | $34.09 – $723.48 | 86 |
| Set radiation therapy field CPT 77285 | $114.66 | $637.00 | $51.39 – $1,162.04 | 86 |
| Set radiation therapy field CPT 77290 | $384.66 | $2,137.00 | $72.71 – $1,352.31 | 86 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $17.69 | $98.30 | $0.15 – $344.05 | 26 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $91.62 | $509.00 | $13.00 – $387.07 | 85 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $106.74 | $593.00 | $39.46 – $387.07 | 85 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $117.00 | $650.00 | $13.00 – $784.27 | 85 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $135.00 | $750.00 | $8.00 – $784.27 | 85 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $51.48 | $286.00 | $13.00 – $387.07 | 85 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $63.18 | $351.00 | $35.37 – $387.07 | 85 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $70.92 | $394.00 | $39.84 – $387.07 | 85 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | $95.94 | $533.00 | $8.00 – $784.27 | 85 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $95.94 | $533.00 | $24.62 – $784.27 | 85 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $64.26 | $357.00 | $13.00 – $387.07 | 85 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $96.84 | $538.00 | $13.00 – $387.07 | 85 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $32.58 | $181.00 | $114.30 – $444.50 | 22 |
| Sho arthrs dx +- synovial bx CPT 29805 | $321.84 | $1,788.00 | $11.00 – $987.25 | 77 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $611.82 | $3,399.00 | $65.00 – $1,869.25 | 77 |
| Sho arthrs srg capsulorraphy CPT 29806 | $706.32 | $3,924.00 | $169.40 – $2,242.60 | 77 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $369.36 | $2,052.00 | $80.00 – $1,210.25 | 77 |
| Sho arthrs srg lss&rescj ads CPT 29825 | $398.34 | $2,213.00 | $90.30 – $1,232.80 | 77 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | $397.98 | $2,211.00 | $50.00 – $1,235.31 | 77 |
| Sho arthrs srg rpr slap les CPT 29807 | $690.66 | $3,837.00 | $11.00 – $2,187.48 | 77 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $401.40 | $2,230.00 | $55.00 – $1,320.50 | 77 |
| Shoe post-op mens m HCPCS L3260 | $109.80 | $610.00 | $98.10 – $381.50 | 21 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $710.64 | $3,948.00 | $161.10 – $2,317.77 | 77 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,020.32 | $11,224.00 | $85.22 – $17,172.72 | 65 |
| Shoulder MRI (with contrast) CPT 73222 | $1,448.46 | $8,047.00 | $81.09 – $12,311.91 | 65 |
| Shoulder MRI (without contrast) CPT 73221 | $1,871.64 | $10,398.00 | $85.22 – $7,954.47 | 65 |
| Shoulder prosthesis removal CPT 23334 | $708.30 | $3,935.00 | $35.00 – $2,620.96 | 77 |
| Shoulder X-ray CPT 73030 | $335.34 | $1,863.00 | $15.97 – $1,900.26 | 62 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $2,324.16 | $12,912.00 | $1,600.00 – $22,575.00 | 16 |
| Sialography s&i CPT 70390 | $435.96 | $2,422.00 | $25.39 – $3,705.66 | 62 |
| Sickling rbc CPT 85660 | $43.92 | $244.00 | $1.51 – $61.68 | 61 |
| Sigmoidoscopy and biopsy CPT 45331 | $40.86 | $227.00 | $20.00 – $1,794.12 | 85 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $56.52 | $314.00 | $50.00 – $369.77 | 77 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $37.98 | $211.00 | $56.67 – $479.08 | 77 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $660.24 | $3,668.00 | $97.74 – $550.45 | 77 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $180.00 | $1,000.00 | $13.62 – $1,530.00 | 63 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,633.68 | $9,076.00 | $85.22 – $13,886.28 | 66 |
| Sinus CT scan (with contrast) CPT 70487 | $1,485.00 | $8,250.00 | $85.22 – $12,622.50 | 66 |
| Sinus CT scan (without contrast) CPT 70486 | $1,188.18 | $6,601.00 | $85.22 – $7,575.03 | 66 |
| Sinus/juglr venogram s&i CPT 75860 | $1,753.02 | $9,739.00 | $8.34 – $6,091.58 | 63 |
| Sirolimus, oral HCPCS J7520 | $17.89 | $99.39 | $2.64 – $285.88 | 28 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $32.04 | $178.00 | $0.04 – $192.39 | 26 |
| Skel musc relaxant 3 or more CPT 80370 | $1.08 | $6.00 | $0.04 – $211.60 | 26 |
| Skin Biopsy CPT 11102 | $107.28 | $596.00 | $26.77 – $784.27 | 85 |
| Skin full graft add-on 15241 CPT 15241 | $58.68 | $326.00 | $78.44 – $498.78 | 53 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $61.02 | $339.00 | $55.00 – $344.53 | 77 |
| Sleep study attended CPT 95807 | $770.94 | $4,283.00 | $85.22 – $6,552.99 | 63 |
| Sleep Study (Polysomnography) CPT 95810 | $1,597.32 | $8,874.00 | $85.22 – $1,656.72 | 86 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $9.90 | $55.00 | $9.15 – $192.50 | 54 |
| Sling suprapubic suburetheral HCPCS C1771 | $1,784.34 | $9,913.00 | $1,600.00 – $21,241.50 | 16 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $70.20 | $390.00 | $1.77 – $59.88 | 61 |
| Smear gram stain CPT 87205 | $47.88 | $266.00 | $1.36 – $47.57 | 61 |
| Smear nasal eosinophil CPT 89190 | $65.52 | $364.00 | $4.63 – $52.90 | 65 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $71.82 | $399.00 | $1.99 – $66.78 | 61 |
| Smear wet mount CPT 87210 | $58.86 | $327.00 | $1.36 – $47.57 | 61 |
| Smpd1 gene common variants CPT 81330 | $8.46 | $47.00 | $39.95 – $880.96 | 60 |
| Snrpn/ube3a gene CPT 81331 | $60.30 | $335.00 | $43.41 – $512.55 | 61 |
| Sodium 24 hour urine CPT 84300 | $76.86 | $427.00 | $1.38 – $54.17 | 61 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $14.83 | $82.40 | $3.49 – $260.75 | 29 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $14.83 | $82.40 | $1.75 – $288.40 | 30 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $14.83 | $82.40 | $0.87 – $260.75 | 30 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $13.84 | $76.88 | $0.15 – $223.30 | 28 |
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.