Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
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 |
|---|---|---|---|---|
| Revision of nose CPT 30430 | not published | not published | $1,746.72 – $12,111.00 | 9 |
| Revision of nose CPT 30435 | not published | not published | $2,455.49 – $13,207.00 | 9 |
| Revision of nose CPT 30450 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Revision of nose CPT 30460 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Revision of nose CPT 30462 | not published | not published | $4,588.50 – $15,861.00 | 9 |
| Revision of pelvis CPT 27158 | not published | not published | $1,746.72 – $17,265.50 | 9 |
| Revision of penis CPT 54300 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Revision of penis CPT 54304 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Revision of penis CPT 54420 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Revision of penis CPT 54430 | $3,070.55 | $8,773.00 | $1,142.09 – $9,891.00 | 4 |
| Revision of penis CPT 54435 | $1,914.50 | $5,470.00 | $2,159.89 – $12,557.00 | 9 |
| Revision of pharyngeal walls CPT 42892 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Revision of pharyngeal walls CPT 42894 | not published | not published | $1,746.72 – $9,891.00 | 4 |
| Revision of pulmonary artery CPT 33788 | not published | not published | $5,821.00 – $12,235.00 | 3 |
| Revision of pulmonary valve CPT 33474 | not published | not published | $1,528.38 – $15,227.00 | 4 |
| Revision of radius CPT 25350 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Revision of radius CPT 25355 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Revision of sciatic nerve CPT 64712 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Revision of scrotum CPT 55175 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Revision of scrotum CPT 55180 | not published | not published | $1,528.38 – $12,111.00 | 9 |
| Revision of spinal shunt CPT 63744 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Revision of testis CPT 54660 | not published | not published | $1,528.38 – $12,111.00 | 9 |
| Revision of thigh muscles CPT 27430 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Revision of toe CPT 28312 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Revision of tricuspid valve CPT 33468 | not published | not published | $2,159.89 – $15,227.00 | 4 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | not published | not published | $1,528.38 – $15,227.00 | 4 |
| Revision of ulna CPT 25360 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $3,409.47 – $16,065.00 | 9 |
| Revision of upper arm CPT 24940 | not published | not published | $3,409.47 – $30,548.47 | 9 |
| Revision of ureter CPT 50700 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Revision of urethra CPT 53450 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Revision of urethra CPT 53460 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Revision of urethra CPT 57220 | not published | not published | $1,746.72 – $11,902.87 | 9 |
| Revision of urinary tract CPT 51820 | not published | not published | $1,142.09 – $11,276.00 | 4 |
| Revision open av fistula without thromb CPT 36832 | not published | not published | $2,159.89 – $13,460.00 | 9 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Revision tips CPT 37183 | $13,257.65 | $37,879.00 | $1,142.09 – $17,698.00 | 9 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $3,409.47 – $30,073.00 | 9 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $3,409.47 – $30,548.47 | 9 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $160.06 – $436.24 | 8 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $160.06 – $2,214.80 | 8 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $7,080.03 – $15,861.00 | 9 |
| Revj fem anast nonautog grf CPT 35883 | not published | not published | $7,080.03 – $15,861.00 | 9 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Revj open gstr rstcv px CPT 43848 | not published | not published | $1,746.72 – $9,891.00 | 4 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,746.72 – $12,111.00 | 9 |
| Revj/rmvl nea pn w/int nstim CPT 64598 | not published | not published | $352.70 – $15,861.00 | 9 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Rev/rmvl gstr nstim eltrd CPT 43882 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Rev rplcm arthrp 1ntrspc crv CPT 22861 | not published | not published | $9,624.00 – $41,720.12 | 8 |
| Rev rplcm rthrp 1ntrspc lmbr CPT 22862 | not published | not published | $9,624.00 – $41,720.12 | 8 |
| Rev/rplcmt sk-mnt crnl nstm CPT 61891 | not published | not published | $352.70 – $73,423.09 | 9 |
| Rev rplc/rmv thrc vrt tethrg CPT 22838 | not published | not published | $352.70 – $41,720.12 | 9 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | not published | not published | $1,142.09 – $26,513.03 | 9 |
| Revsc opn/prq tib/pero stent CPT 37234 | $1,935.85 | $5,531.00 | $2,159.89 – $13,460.00 | 4 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | not published | not published | $10.45 – $22.40 | 9 |
| Rf abltj nrv nrvtg si jt CPT 64625 | not published | not published | $1,746.72 – $14,539.00 | 9 |
| Rheumatoid factor qualitative CPT 86430 | not published | not published | $6.14 – $17.61 | 9 |
| Rheumatoid factor quantitative CPT 86431 | $187.60 | $536.00 | $5.67 – $17.61 | 9 |
| Rh ig IV CPT 90386 | not published | not published | $10.51 – $1,424.87 | 4 |
| Rh ig minidose im CPT 90385 | not published | not published | $30.44 – $148.00 | 9 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | not published | not published | $4.97 – $29.52 | 5 |
| Rho d immune globulin 50 mcg HCPCS J2788 | not published | not published | $27.86 – $105.97 | 5 |
| Rho(d) immune globulin h, sd HCPCS J2792 | not published | not published | $30.77 – $69.90 | 9 |
| Rho d immune globulin inj HCPCS J2790 | $92.93 | $265.50 | $82.42 – $291.98 | 5 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $84.49 – $321.56 | 4 |
| R hrt cath chd abnl nt cnj CPT 93594 | not published | not published | $4,169.67 – $9,891.00 | 9 |
| R hrt cath chd nml nt cnj CPT 93593 | not published | not published | $4,169.67 – $9,891.00 | 9 |
| Rhythm ecg with report CPT 93040 | not published | not published | $35.37 – $101.01 | 2 |
| Rib cartilage graft CPT 21230 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $132.18 – $244.53 | 7 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $2,325.60 – $5,882.40 | 5 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $641.78 | $1,833.66 | $0.16 – $0.30 | 4 |
| Right heart cath congenital CPT 93530 | not published | not published | $7,332.00 – $9,891.00 | 3 |
| Right ventric recording CPT 93603 | not published | not published | $290.80 – $4,099.00 | 8 |
| Rilonacept injection HCPCS J2793 | not published | not published | $27.64 – $66.42 | 5 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $10.10 – $12.00 | 2 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $391.31 – $723.92 | 7 |
| Ring flange plastic/leather HCPCS L1100 | not published | not published | $243.66 – $450.77 | 7 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $2,359.39 | $6,741.11 | $996.45 – $996.45 | 1 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | not published | not published | $10.10 – $12.00 | 2 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | not published | not published | $14.60 – $31.95 | 9 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | not published | not published | $10.80 – $22.58 | 9 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $16,886.06 | $48,245.88 | $74.16 – $164.32 | 9 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $36.28 – $80.69 | 9 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $9,116.38 | $26,046.80 | $31.18 – $86.25 | 9 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $20.26 – $73.12 | 9 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $7,059.73 | $20,170.65 | $13.69 – $73.12 | 9 |
| R & l heart cath congenital CPT 93531 | not published | not published | $3,409.47 – $15,227.00 | 4 |
| R & l heart cath congenital CPT 93532 | not published | not published | $7,332.00 – $15,227.00 | 3 |
| R & l heart cath congenital CPT 93533 | not published | not published | $7,332.00 – $15,227.00 | 3 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | $2,193.80 | $6,268.00 | $4,169.67 – $9,891.00 | 9 |
| R&l hrt cath chd nml nt cnj CPT 93596 | $2,193.80 | $6,268.00 | $4,169.67 – $9,891.00 | 9 |
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.