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 |
|---|---|---|---|---|
| Crystal identification light microscopy CPT 89060 | $53.46 | $297.00 | $6.23 – $379.44 | 65 |
| Csf leakage imaging CPT 78650 | $26.64 | $148.00 | $21.32 – $359.42 | 77 |
| CT 3d report other modality w/workstation CPT 76377 | $444.24 | $2,468.00 | $75.13 – $8,638.00 | 63 |
| Cta abdomen without & /or w/contrast CPT 74175 | $784.44 | $4,358.00 | $85.22 – $6,667.74 | 66 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,058.76 | $5,882.00 | $85.22 – $8,999.46 | 66 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,050.28 | $16,946.00 | $85.22 – $17,284.41 | 66 |
| Cta neck without &/or w/contrast CPT 70498 | $1,463.40 | $8,130.00 | $85.22 – $12,438.90 | 66 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,641.68 | $14,676.00 | $85.22 – $22,454.28 | 66 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,591.92 | $8,844.00 | $85.22 – $13,531.32 | 66 |
| CT Angiogram of the Head CPT 70496 | $1,344.42 | $7,469.00 | $85.22 – $11,427.57 | 66 |
| CT angio hrt w/3d image CPT 75574 | $1,147.68 | $6,376.00 | $17.39 – $1,286.28 | 87 |
| CT angio pelvis CPT 72191 | $1,188.54 | $6,603.00 | $85.22 – $10,102.59 | 66 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,200.32 | $12,224.00 | $85.22 – $12,467.97 | 66 |
| CT cerebral perf w cont & prcssng CPT 70473 | $352.98 | $1,961.00 | $85.22 – $3,000.33 | 39 |
| CT guidance for needle placement CPT 77012 | $1,305.18 | $7,251.00 | $63.42 – $11,094.03 | 64 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,278.54 | $7,103.00 | $85.22 – $10,867.59 | 60 |
| CT guid parench tis ablat CPT 77013 | $968.76 | $5,382.00 | $66.80 – $18,837.00 | 32 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $1,046.70 | $5,815.00 | $4.19 – $363.00 | 87 |
| CT hrt w/3d image CPT 75572 | $60.84 | $338.00 | $12.77 – $338.00 | 77 |
| CT limited or localized follow-up study CPT 76380 | $352.98 | $1,961.00 | $85.22 – $3,000.33 | 66 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,441.34 | $13,563.00 | $85.22 – $13,832.73 | 66 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,952.28 | $10,846.00 | $85.22 – $8,297.19 | 66 |
| CT lwr extremity w/o&w/dye CPT 73702 | $3,050.28 | $16,946.00 | $85.22 – $17,284.41 | 66 |
| CT neck soft tissue w/contrast CPT 70491 | $1,616.40 | $8,980.00 | $85.22 – $13,739.40 | 66 |
| CT neck soft tissue without contrast CPT 70490 | $1,293.12 | $7,184.00 | $85.22 – $10,991.52 | 66 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,778.58 | $9,881.00 | $85.22 – $15,117.93 | 66 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,728.18 | $9,601.00 | $85.22 – $14,689.53 | 66 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,346.94 | $7,483.00 | $85.22 – $11,448.99 | 66 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,100.70 | $6,115.00 | $85.22 – $9,355.95 | 66 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $2,781.36 | $15,452.00 | $85.22 – $23,641.56 | 66 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,555.64 | $14,198.00 | $85.22 – $21,722.94 | 66 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,113.56 | $11,742.00 | $85.22 – $17,965.26 | 66 |
| CT thoracic spine w/contrast CPT 72129 | $1,934.10 | $10,745.00 | $85.22 – $16,439.85 | 66 |
| CT thoracic spine without contrast CPT 72128 | $1,547.46 | $8,597.00 | $85.22 – $13,153.41 | 66 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $94.32 | $524.00 | $58.16 – $1,904.00 | 64 |
| CT t-spine w /wo contrast CPT 72130 | $2,127.24 | $11,818.00 | $85.22 – $18,081.54 | 66 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,199.24 | $12,218.00 | $85.22 – $12,461.85 | 66 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,812.06 | $10,067.00 | $85.22 – $7,700.49 | 66 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,748.78 | $15,271.00 | $85.22 – $15,576.93 | 66 |
| Culture aerobic additional method definitive id each CPT 87077 | $61.74 | $343.00 | $1.73 – $89.97 | 61 |
| Culture afb any source CPT 87116 | $98.46 | $547.00 | $2.36 – $120.20 | 61 |
| Culture anaerobic additional method definitive id each CPT 87076 | $85.32 | $474.00 | $4.45 – $140.39 | 61 |
| Culture anaerobic except blood CPT 87075 | $124.20 | $690.00 | $3.23 – $105.42 | 61 |
| Culture bact stool aero addl path ea CPT 87046 | $38.16 | $212.00 | $0.68 – $49.82 | 61 |
| Culture body fluid CPT 87070 | $111.24 | $618.00 | $2.92 – $95.89 | 61 |
| Culture fungi definitive id mold CPT 87107 | $50.22 | $279.00 | $2.39 – $115.03 | 61 |
| Culture fungi definitive id yeast CPT 87106 | $55.62 | $309.00 | $3.54 – $115.03 | 61 |
| Culture fungi other (except blood) CPT 87102 | $103.86 | $577.00 | $2.36 – $93.64 | 61 |
| Culture fungi skin/hair/nail CPT 87101 | $103.86 | $577.00 | $1.97 – $396.27 | 61 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $44.28 | $246.00 | $3.76 – $296.82 | 61 |
| Culture mycoplasma any source CPT 87109 | $7.90 | $43.88 | $5.36 – $171.45 | 61 |
| Culture screening strep group a CPT 87081 | $90.00 | $500.00 | $1.97 – $73.31 | 61 |
| Culture typing added method CPT 87158 | $3.70 | $20.56 | $1.71 – $58.30 | 61 |
| Culture typing immunologic CPT 87147 | $66.60 | $370.00 | $1.18 – $52.15 | 61 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $4.15 | $23.05 | $5.98 – $490.42 | 61 |
| Culture urine each isolate CPT 87088 | $67.86 | $377.00 | $1.58 – $448.29 | 61 |
| Cutter lead HCPCS C1773 | $451.26 | $2,507.00 | $1,600.00 – $7,311.50 | 22 |
| Cv line/pic reposition CPT 36597 | $1,090.80 | $6,060.00 | $44.68 – $10,233.00 | 58 |
| Cv stress test i&r only 93018 CPT 93018 | $13.14 | $73.00 | $12.45 – $211.88 | 86 |
| Cv stress test/supervision only 93016 CPT 93016 | $19.98 | $111.00 | $18.90 – $259.15 | 86 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $2.29 | $12.73 | $4.97 – $159.67 | 61 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $12.42 | $69.00 | $1.75 – $197.82 | 29 |
| Cyclic citrullinated peptide antibody CPT 86200 | $3.60 | $20.00 | $1.84 – $141.14 | 64 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $246.83 | $1,371.30 | $0.66 – $1,653.12 | 58 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $12.02 | $66.80 | $3.63 – $52.50 | 28 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $50.40 | $280.00 | $60.48 – $980.00 | 28 |
| Cyclosporine 2 hour CPT 80158 | $67.86 | $377.00 | $4.96 – $201.24 | 61 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $7.36 | $40.87 | $1.44 – $113.16 | 28 |
| Cyclosporine oral 100 mg HCPCS J7502 | $10.86 | $60.33 | $4.93 – $138.95 | 28 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $11,425.32 | $63,474.00 | $1,600.00 – $19,190.50 | 17 |
| Cyp2c19 gene com variants CPT 81225 | $23.40 | $130.00 | $90.00 – $1,231.47 | 61 |
| Cyp2c9 gene com variants CPT 81227 | $18.00 | $100.00 | $70.00 – $618.83 | 61 |
| Cyp2d6 gene com variants CPT 81226 | $32.40 | $180.00 | $150.00 – $1,708.69 | 60 |
| Cyp3a4 gene common variants CPT 81230 | $12.60 | $70.00 | $70.00 – $1,487.25 | 60 |
| Cyp3a5 gene common variants CPT 81231 | $12.60 | $70.00 | $70.00 – $1,487.25 | 60 |
| Cystatin c CPT 82610 | $43.38 | $241.00 | $3.84 – $151.57 | 61 |
| Cystic fibrosis cftr CPT 81223 | $223.84 | $1,243.57 | $424.15 – $8,729.92 | 61 |
| Cystine urine quantitative CPT 82131 | $3.30 | $18.36 | $5.85 – $186.98 | 61 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $389.34 | $2,163.00 | $21.27 – $3,309.39 | 62 |
| Cystoscopy (Bladder Scope) CPT 52000 | $489.24 | $2,718.00 | $13.80 – $4,077.00 | 85 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $51.30 | $285.00 | $2.29 – $302.75 | 29 |
| Cytogenomic neo microra alys CPT 81277 | $276.30 | $1,535.00 | $986.00 – $4,679.27 | 59 |
| Cytogenom microarray copy nmbr var CPT 81228 | $183.60 | $1,020.00 | $516.91 – $3,090.92 | 60 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $14.76 | $82.00 | $3.98 – $159.90 | 61 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $2.58 | $14.36 | $5.88 – $179.78 | 61 |
| Cyto/molecular report CPT 88291 | $26.28 | $146.00 | $13.62 – $55.62 | 77 |
| Cytopath c/v manual CPT 88150 | $36.72 | $204.00 | $11.94 – $312.12 | 64 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $122.58 | $681.00 | $30.05 – $492.75 | 64 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $7.92 | $44.00 | $22.62 – $225.63 | 64 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $75.96 | $422.00 | $17.22 – $157.57 | 64 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $127.26 | $707.00 | $31.66 – $1,081.71 | 64 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $98.46 | $547.00 | $37.04 – $836.91 | 64 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $24.48 | $136.00 | $6.20 – $208.08 | 64 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $83.34 | $463.00 | $40.58 – $708.39 | 64 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $145.08 | $806.00 | $56.97 – $1,233.18 | 64 |
| Cytopath smear other source CPT 88160 | $98.46 | $547.00 | $31.62 – $836.91 | 64 |
| Cytopath smear other source CPT 88162 | $90.90 | $505.00 | $56.97 – $772.65 | 64 |
| Cytopath smear oth prep screen & interp CPT 88161 | $42.30 | $235.00 | $29.63 – $359.55 | 64 |
| Cytopath tbs c/v manual CPT 88164 | $5.40 | $30.00 | $11.36 – $57.63 | 64 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $80.46 | $447.00 | $186.26 – $2,833.21 | 64 |
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.