Providence St Joseph Hospital Orange
1100 W Stewart Dr, Orange, CA · Providence · · NPI 1912982216
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) CT scan (with contrast) CPT 72132 | $1,456.32 | $3,034.00 | $381.40 – $830.11 | 5 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,400.64 | $2,918.00 | $114.29 – $248.76 | 5 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $5,662.08 | $11,796.00 | $381.40 – $830.11 | 5 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $4,735.20 | $9,865.00 | $381.40 – $830.11 | 5 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $4,173.60 | $8,695.00 | $260.85 – $567.73 | 5 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $580.80 | $1,210.00 | $114.29 – $248.76 | 5 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,471.81 – $14,839.00 | 6 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $219.34 – $477.39 | 4 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $26.05 – $38.70 | 2 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $9,400.00 – $16,652.00 | 6 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $9,400.00 – $25,292.72 | 6 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $9,400.00 – $25,292.72 | 6 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $9,400.00 – $25,292.72 | 6 |
| Lso corset front HCPCS L0972 | not published | not published | $134.03 – $291.71 | 3 |
| Lso flex no ri stays pre ots HCPCS L0628 | $551.23 | $1,148.40 | $24.40 – $53.10 | 3 |
| Lso full corset HCPCS L0976 | not published | not published | $159.10 – $346.28 | 3 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $165.12 – $359.38 | 3 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,344.72 – $2,926.74 | 3 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $345.48 – $751.93 | 3 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $47.11 – $102.53 | 3 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $1,246.59 – $2,713.17 | 3 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,845.42 – $4,016.50 | 3 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $292.37 – $636.34 | 3 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $83.40 – $181.52 | 3 |
| Lso s/c shell/panel custom HCPCS L0640 | $3,178.02 | $6,620.88 | $1,066.91 – $2,322.10 | 3 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,233.54 – $2,684.76 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $5.05 – $43.98 | 5 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $65.08 – $141.65 | 3 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $101.12 – $220.09 | 3 |
| Lumbar diskogram s&i CPT 72295 | $2,397.60 | $4,995.00 | $494.39 – $4,646.33 | 5 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $101.60 – $221.13 | 3 |
| Lumbar sling HCPCS L1090 | not published | not published | $119.37 – $259.81 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $12,633.00 – $39,963.00 | 6 |
| Lumizyme injection HCPCS J0221 | not published | not published | $176.39 – $433.38 | 6 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $64.49 – $140.37 | 4 |
| Lung Function Test (Spirometry) CPT 94010 | $467.04 | $973.00 | $186.59 – $513.77 | 4 |
| Lung perfusion imaging CPT 78580 | $845.28 | $1,761.00 | $437.05 – $951.22 | 5 |
| Lung transplant double CPT 32853 | not published | not published | $5,463.00 – $17,143.00 | 3 |
| Lung transplant single CPT 32851 | not published | not published | $5,463.00 – $17,143.00 | 3 |
| Lung transplant with bypass CPT 32852 | not published | not published | $5,463.00 – $17,143.00 | 3 |
| Lung transplant with bypass CPT 32854 | not published | not published | $5,463.00 – $17,143.00 | 3 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $5,463.00 – $17,143.00 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $180.28 – $440.84 | 6 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $36.34 – $88.67 | 6 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $271.95 – $636.94 | 5 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $220.66 – $516.43 | 5 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,737.94 | $3,620.70 | $521.69 – $1,135.44 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $31.62 – $1,535.00 | 6 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $288.48 – $627.87 | 3 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $17.04 – $40.10 | 5 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $4,971.00 – $19,447.84 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $2,460.96 | $5,127.00 | $593.60 – $1,291.95 | 5 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $18.48 – $73.12 | 5 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $21.07 – $98.06 | 5 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $27.82 – $379.02 | 5 |
| Lymphocytotoxicity assay CPT 86806 | $96.00 | $200.00 | $26.94 – $95.18 | 5 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $685.79 – $1,492.61 | 5 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $1,720.93 – $3,745.56 | 5 |
| Lymph vessel x-ray trunk CPT 75805 | $2,003.04 | $4,173.00 | $2,112.42 – $7,512.94 | 5 |
| Lymph vessel x-ray trunk CPT 75807 | $3,337.92 | $6,954.00 | $2,101.26 – $7,512.94 | 5 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $589.62 – $6,652.00 | 6 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,363.00 – $7,702.45 | 6 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,285.30 – $6,652.00 | 6 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $21.83 – $32.96 | 4 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $14.44 – $73.58 | 3 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $3.63 – $8.54 | 5 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $3.66 – $8.62 | 5 |
| Magnesium CPT 83735 | $62.40 | $130.00 | $5.70 – $13.40 | 5 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $118.18 | $246.20 | $0.68 – $1.05 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $260.85 – $567.73 | 5 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $19.60 – $29.71 | 2 |
| Malaria antibody CPT 86750 | not published | not published | $11.21 – $26.38 | 5 |
| Male sling procedure CPT 53440 | not published | not published | $4,035.00 – $29,305.00 | 6 |
| Mammosite ced HCPCS C1728 | $5,880.00 | $12,250.00 | not published | 0 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $5,463.00 – $14,032.00 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,394.00 – $3,826.07 | 6 |
| Manipulate wrist w/anesthes CPT 25259 | $2,469.60 | $5,145.00 | $1,757.92 – $4,971.00 | 6 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $258.72 | $539.00 | $145.45 – $316.58 | 4 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $476.16 | $992.00 | $145.45 – $316.58 | 4 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,757.92 – $6,652.00 | 6 |
| Manipulation of spine CPT 22505 | not published | not published | $1,757.92 – $6,652.00 | 6 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $269.67 – $1,535.00 | 6 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $3.22 – $7.33 | 4 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $2.54 – $8.12 | 2 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $88.09 – $191.73 | 3 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $3.72 – $10.14 | 5 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $501.20 – $501.20 | 1 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $1,394.00 – $11,456.00 | 3 |
| Map tachycard site(s) CPT 93609 | $3,992.64 | $8,318.00 | $1,394.00 – $14,032.00 | 3 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $45.28 – $104.34 | 6 |
| Marker biop eviva buckle ss HCPCS A4648 | $6,203.30 | $12,923.55 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $3,028.67 | $6,309.72 | $1,065.90 – $2,446.61 | 5 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $4,971.00 – $14,032.00 | 3 |
| Mastectomy form HCPCS L8020 | $201.12 | $419.00 | $217.52 – $473.43 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $4,280.52 – $9,316.42 | 6 |
| Mast mod rad CPT 19307 | not published | not published | $7,259.31 – $15,799.68 | 5 |
| Mastoidectomy CPT 69501 | not published | not published | $6,471.81 – $14,839.00 | 6 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $5,463.00 – $14,839.00 | 6 |
| Mastoids complete CPT 70130 | $625.44 | $1,303.00 | $114.29 – $248.76 | 5 |
| Mastoid surgery revision CPT 69603 | not published | not published | $6,471.81 – $14,839.00 | 6 |
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.