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 |
|---|---|---|---|---|
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $120.78 | $671.00 | $18.84 – $413.00 | 86 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $307.80 | $1,710.00 | $20.65 – $784.27 | 86 |
| Wrist X-ray CPT 73110 | $369.90 | $2,055.00 | $15.91 – $2,096.10 | 62 |
| Xe133 xenon 10mci HCPCS A9558 | $9.90 | $55.00 | $49.50 – $1,121.26 | 31 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $385.74 | $2,143.00 | $52.00 – $3,980.58 | 85 |
| Xm archive tissue molec anal CPT 88363 | $68.58 | $381.00 | $23.07 – $582.93 | 64 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | $193.50 | $1,075.00 | $65.00 – $1,020.52 | 77 |
| X-ray abdomen 1 view CPT 74018 | $180.54 | $1,003.00 | $10.31 – $1,534.59 | 62 |
| X-ray abdomen 2 views CPT 74019 | $225.36 | $1,252.00 | $19.69 – $1,582.02 | 62 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $315.72 | $1,754.00 | $29.02 – $2,683.62 | 62 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $208.08 | $1,156.00 | $18.61 – $1,768.68 | 62 |
| X-ray ankle 2 views (both sides) CPT 73600 | $235.26 | $1,307.00 | $12.40 – $999.09 | 62 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $499.68 | $2,776.00 | $33.03 – $4,247.28 | 62 |
| X-ray bone age studies CPT 77072 | $176.22 | $979.00 | $10.22 – $1,497.87 | 62 |
| X-ray bone length studies CPT 77073 | $236.88 | $1,316.00 | $16.23 – $2,013.48 | 62 |
| X-ray bone survey complete CPT 77075 | $674.82 | $3,749.00 | $30.57 – $5,735.97 | 62 |
| X-ray bone survey infant CPT 77076 | $359.28 | $1,996.00 | $28.89 – $3,053.88 | 62 |
| X-ray cervical spine 2-3 views CPT 72040 | $242.10 | $1,345.00 | $15.97 – $1,822.23 | 62 |
| X-ray cervical spine 4-5 views CPT 72050 | $333.00 | $1,850.00 | $26.60 – $1,915.56 | 62 |
| X-ray cervical spine >= 6 views CPT 72052 | $407.88 | $2,266.00 | $33.90 – $2,197.08 | 62 |
| X-ray clavicle complete (both sides) CPT 73000 | $275.40 | $1,530.00 | $12.77 – $1,170.45 | 62 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $598.86 | $3,327.00 | $38.65 – $3,817.35 | 62 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $682.38 | $3,791.00 | $46.81 – $5,800.23 | 62 |
| X-ray elbow 2 views (both sides) CPT 73070 | $300.60 | $1,670.00 | $13.93 – $989.91 | 62 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $376.20 | $2,090.00 | $15.97 – $2,131.29 | 62 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $309.06 | $1,717.00 | $28.36 – $2,627.01 | 62 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $371.16 | $2,062.00 | $19.83 – $1,924.74 | 62 |
| X-ray exam entire spi 6/> vw CPT 72084 | $653.22 | $3,629.00 | $22.78 – $2,448.00 | 62 |
| X-ray exam of arm infant CPT 73092 | $156.78 | $871.00 | $14.32 – $999.09 | 62 |
| X-ray exam of eye sockets CPT 70200 | $301.68 | $1,676.00 | $23.70 – $2,564.28 | 62 |
| X-ray exam of femur 1 CPT 73551 | $237.42 | $1,319.00 | $14.03 – $1,344.87 | 62 |
| X-ray exam of jaw joint CPT 70328 | $92.52 | $514.00 | $15.93 – $786.42 | 62 |
| X-ray exam of sinuses CPT 70210 | $235.80 | $1,310.00 | $14.08 – $2,004.30 | 62 |
| X-ray exam si joints CPT 72200 | $168.48 | $936.00 | $14.08 – $1,061.82 | 62 |
| X-ray exam thorac spine4/>vw CPT 72074 | $558.72 | $3,104.00 | $24.77 – $4,749.12 | 62 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $127.44 | $708.00 | $19.41 – $1,083.24 | 62 |
| X-ray facial bones complete > 3 views CPT 70150 | $338.40 | $1,880.00 | $23.47 – $2,778.48 | 62 |
| X-ray femur >=2 views (both sides) CPT 73552 | $373.50 | $2,075.00 | $13.54 – $2,115.99 | 62 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $227.88 | $1,266.00 | $9.86 – $1,089.36 | 62 |
| X-ray foot 2 views (both sides) CPT 73620 | $268.74 | $1,493.00 | $11.28 – $1,077.12 | 62 |
| X-ray forearm 2 views (both sides) CPT 73090 | $271.44 | $1,508.00 | $14.32 – $1,153.62 | 62 |
| X-ray hand 2 views (both sides) CPT 73120 | $237.60 | $1,320.00 | $11.92 – $1,346.40 | 62 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $251.64 | $1,398.00 | $12.40 – $1,425.96 | 62 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $301.32 | $1,674.00 | $30.72 – $1,741.14 | 62 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $301.32 | $1,674.00 | $19.12 – $2,507.67 | 62 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $452.88 | $2,516.00 | $20.48 – $2,656.08 | 62 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $525.06 | $2,917.00 | $18.43 – $3,906.09 | 62 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $148.32 | $824.00 | $35.28 – $1,135.26 | 62 |
| X-ray humerus >= 2 views left CPT 73060 | $298.80 | $1,660.00 | $13.54 – $1,095.48 | 62 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $260.28 | $1,446.00 | $1.25 – $167.89 | 86 |
| X-ray knee 3 views (both sides) CPT 73562 | $311.58 | $1,731.00 | $15.24 – $1,678.41 | 62 |
| X-ray knee ap standing bilateral CPT 73565 | $188.82 | $1,049.00 | $12.40 – $660.96 | 62 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $187.92 | $1,044.00 | $13.54 – $1,197.99 | 62 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $428.04 | $2,378.00 | $21.26 – $1,406.07 | 62 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $434.16 | $2,412.00 | $30.52 – $2,793.78 | 62 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $456.66 | $2,537.00 | $37.55 – $3,881.61 | 62 |
| X-ray mandible complete > 4 views CPT 70110 | $309.06 | $1,717.00 | $23.47 – $2,627.01 | 62 |
| X-ray mandible ltd <4 views CPT 70100 | $257.40 | $1,430.00 | $15.42 – $2,187.90 | 62 |
| X-ray nasal bones complete > 3 views CPT 70160 | $249.84 | $1,388.00 | $15.23 – $1,592.73 | 62 |
| X-ray neck soft tissue CPT 70360 | $202.86 | $1,127.00 | $12.89 – $1,612.62 | 62 |
| X-ray nose to rectum for foreign body child CPT 76010 | $160.20 | $890.00 | $16.24 – $1,361.70 | 62 |
| X-ray optic foramina CPT 70190 | $158.76 | $882.00 | $15.97 – $899.64 | 62 |
| X-ray pelvis 1-2 views CPT 72170 | $191.34 | $1,063.00 | $14.08 – $1,626.39 | 62 |
| X-ray pelvis complete > 3 views CPT 72190 | $274.14 | $1,523.00 | $20.56 – $2,037.96 | 62 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $559.80 | $3,110.00 | $34.67 – $4,758.30 | 62 |
| X-ray ribs 2 views left CPT 71100 | $206.64 | $1,148.00 | $17.54 – $1,756.44 | 62 |
| X-ray ribs 3 views bilateral CPT 71110 | $293.40 | $1,630.00 | $23.47 – $2,480.13 | 62 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $414.00 | $2,300.00 | $33.32 – $2,977.38 | 62 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $243.90 | $1,355.00 | $19.91 – $1,869.66 | 62 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $275.40 | $1,530.00 | $17.39 – $1,756.44 | 62 |
| X-ray scapula complete (both sides) CPT 73010 | $282.78 | $1,571.00 | $15.23 – $1,104.66 | 62 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $225.72 | $1,254.00 | $10.63 – $924.12 | 62 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $308.88 | $1,716.00 | $24.32 – $1,575.90 | 62 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $333.18 | $1,851.00 | $31.13 – $2,832.03 | 62 |
| X-ray skull < 4 views CPT 70250 | $294.66 | $1,637.00 | $15.97 – $1,820.70 | 62 |
| X-ray skull > 4 views complete CPT 70260 | $403.02 | $2,239.00 | $28.17 – $3,118.14 | 62 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $472.50 | $2,625.00 | $27.02 – $4,016.25 | 62 |
| X-ray small intestine follow-through study CPT 74248 | $236.16 | $1,312.00 | $39.78 – $2,007.36 | 60 |
| X-ray spine single view CPT 72020 | $192.96 | $1,072.00 | $10.63 – $872.10 | 62 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $207.54 | $1,153.00 | $15.97 – $1,764.09 | 62 |
| X-ray sternum > 2 views CPT 71120 | $231.48 | $1,286.00 | $15.97 – $1,872.72 | 62 |
| X-ray surgical specimen CPT 76098 | $387.54 | $2,153.00 | $10.38 – $3,294.09 | 62 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $339.48 | $1,886.00 | $38.65 – $2,885.58 | 62 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $318.06 | $1,767.00 | $24.82 – $2,703.51 | 62 |
| X-ray thoracic spine 2 views CPT 72070 | $238.86 | $1,327.00 | $18.61 – $1,127.61 | 62 |
| X-ray thoracic spine 3 views CPT 72072 | $446.58 | $2,481.00 | $21.14 – $3,795.93 | 62 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $288.00 | $1,600.00 | $20.30 – $2,448.00 | 62 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $210.06 | $1,167.00 | $16.43 – $630.36 | 62 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $292.14 | $1,623.00 | $28.45 – $1,228.59 | 62 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $282.78 | $1,571.00 | $13.54 – $1,201.05 | 62 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $241.92 | $1,344.00 | $9.58 – $1,370.88 | 62 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $470.88 | $2,616.00 | $38.89 – $4,002.48 | 62 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $381.96 | $2,122.00 | $38.41 – $3,246.66 | 62 |
| X-ray wrist 2 views (both sides) CPT 73100 | $296.28 | $1,646.00 | $10.96 – $1,144.44 | 62 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | $138.24 | $768.00 | $80.04 – $1,117.00 | 83 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $35.64 | $198.00 | $59.40 – $1,435.88 | 86 |
| Yersinia antibody CPT 86793 | $2.11 | $11.72 | $4.57 – $146.99 | 61 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $34.05 | $189.18 | $0.01 – $662.13 | 61 |
| Zidovudine, oral, 100 mg HCPCS S0104 | $6.87 | $38.14 | $0.01 – $133.49 | 27 |
| Zika virus dna/rna amp probe CPT 87662 | $8.21 | $45.61 | $43.61 – $538.97 | 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.