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 |
|---|---|---|---|---|
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $4,588.50 – $15,861.00 | 9 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $2,455.49 – $12,111.00 | 9 |
| Rpr hypopl a-arch w/byp CPT 33853 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr hypopl a-arch wo byp CPT 33852 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $1,746.72 – $12,111.00 | 9 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $4,588.50 – $15,861.00 | 9 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $2,455.49 – $9,891.00 | 9 |
| Rpr intst excl anrect fist HCPCS C9796 | not published | not published | $3,569.96 – $9,891.00 | 8 |
| Rpr nsl vlv collapse w/implt CPT 30468 | not published | not published | $352.70 – $15,861.00 | 9 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | $352.70 – $15,861.00 | 9 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | not published | not published | $1,142.09 – $13,460.00 | 4 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | not published | not published | $1,142.09 – $15,861.00 | 4 |
| Rpr pul art unifocal without cpb CPT 33925 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Rpr&refitg spect xcp aphakia CPT 92370 | not published | not published | $92.48 – $92.48 | 1 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $75.87 – $140.37 | 7 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $2,455.49 – $13,207.00 | 9 |
| Rpr tga aortic pulm art rcns CPT 33778 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga atr bfl clsr vsd CPT 33776 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga atr bfl rmvl plm bnd CPT 33775 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga atrial baffle px CPT 33774 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga bfl rpr sbpulm obstr CPT 33777 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga rcnstj clsr vsd CPT 33780 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga rcnstj rmvl plm bnd CPT 33779 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga rcnstj rpr sbpl obst CPT 33781 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga without surg enlgmnt vsd CPT 33770 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr tga w/surg enlgmnt vsd CPT 33771 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Rpr umbil hern block < 5 yr CPT 49582 | not published | not published | $5,679.85 – $9,891.00 | 4 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | $5,779.90 | $16,514.00 | $1,528.38 – $16,065.00 | 9 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $300.11 – $1,087.86 | 9 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $1,746.72 – $15,828.09 | 9 |
| Rsect hip tum incl femur CPT 27078 | not published | not published | $1,746.72 – $17,265.50 | 9 |
| Rsv assay w/optic CPT 87807 | not published | not published | $13.10 – $32.55 | 9 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $295.80 – $907.09 | 4 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | $53.20 | $152.00 | $171.24 – $316.79 | 7 |
| Rtm dev sply cbt 16-30 d CPT 98978 | not published | not published | $48.00 – $352.70 | 7 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $48.00 – $93.78 | 7 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $48.00 – $93.78 | 7 |
| Rubella antibody igg CPT 86762 | $149.45 | $427.00 | $14.39 – $44.65 | 9 |
| Rubeola ag if CPT 87283 | not published | not published | $26.99 – $150.97 | 9 |
| Rubeola antibody igg CPT 86765 | not published | not published | $12.88 – $39.97 | 9 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $329.51 – $818.17 | 9 |
| Russell viper venom diluted CPT 85613 | not published | not published | $9.58 – $29.70 | 9 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $917.08 – $2,277.10 | 8 |
| Sach foot, replacement HCPCS L5971 | not published | not published | $312.80 – $578.68 | 7 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $9,050.84 | $25,859.55 | $35.61 – $76.97 | 9 |
| Salivary gland function exam CPT 78232 | not published | not published | $239.43 – $1,950.38 | 9 |
| Salivary gland imaging CPT 78230 | $511.35 | $1,461.00 | $360.97 – $1,950.38 | 9 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $259.98 – $1,950.38 | 9 |
| Salmonella antibody CPT 86768 | not published | not published | $13.19 – $40.91 | 9 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $171.24 – $316.79 | 6 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $1.46 – $3.13 | 3 |
| Sargramostim injection HCPCS J2820 | not published | not published | $53.22 – $128.74 | 9 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $8.86 – $127.70 | 9 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $0.22 – $347.31 | 4 |
| Sarscov coronavirus ag ia CPT 87426 | $77.70 | $222.00 | $35.33 – $90.74 | 8 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $70.29 – $174.54 | 9 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $4,588.50 – $15,861.00 | 9 |
| Sbrt management CPT 77435 | not published | not published | $847.13 – $3,918.16 | 3 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $822.85 | $2,351.00 | $306.88 – $1,173.24 | 8 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $271.60 | $776.00 | $134.46 – $516.16 | 8 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $618.10 | $1,766.00 | $306.88 – $1,173.24 | 8 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $522.20 | $1,492.00 | $134.46 – $516.16 | 8 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $462.70 | $1,322.00 | $134.46 – $516.16 | 8 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $610.05 | $1,743.00 | $134.46 – $516.16 | 8 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $883.75 | $2,525.00 | $306.88 – $1,173.24 | 8 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $588.35 | $1,681.00 | $134.46 – $516.16 | 8 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $522.20 | $1,492.00 | $134.46 – $516.16 | 8 |
| Scan proc cranial extra CPT 61782 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Scan proc spinal CPT 61783 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Scap thorac prosth tiss shap HCPCS L6570 | not published | not published | $7,144.50 – $13,217.32 | 7 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,926.05 | $5,503.00 | $1,142.09 – $14,539.00 | 9 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $3,812.64 – $15,861.00 | 9 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $5,235.51 | $14,958.60 | not published | 0 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $18.54 – $45.15 | 9 |
| Scr c/v cyto,autosys and md HCPCS G0141 | not published | not published | $41.78 – $52.70 | 2 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $31.94 – $79.30 | 9 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $43.97 – $109.18 | 9 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $26.49 – $82.17 | 9 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $27.05 – $67.16 | 9 |
| Screen cerv/vag thin layer HCPCS G0123 | $137.20 | $392.00 | $20.26 – $62.85 | 9 |
| Screen c/v thin layer by md HCPCS G0124 | not published | not published | $52.70 – $90.65 | 2 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $352.70 – $9,297.00 | 9 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $352.70 – $9,297.00 | 9 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | not published | not published | $18.05 – $49.34 | 9 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $28.27 – $70.21 | 8 |
| Screening hepatitis c antibody high risk HCPCS G0472 | not published | not published | $46.35 – $115.10 | 8 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | not published | not published | $24.08 – $59.78 | 8 |
| Screening Mammogram CPT 77067 | $281.40 | $804.00 | $108.84 – $535.04 | 9 |
| Screening pap smear by phys HCPCS P3001 | not published | not published | $41.78 – $66.36 | 3 |
| Screening prostate cancer PSA HCPCS G0103 | not published | not published | $19.31 – $57.07 | 9 |
| Screen pap by tech w md supv HCPCS P3000 | $73.15 | $209.00 | $18.54 – $45.15 | 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.