Providence Saint John's Health Center

2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273

Source: hospital's published price file ↗ · Published Apr 1, 2026 · Ingested Sep 11, 2026

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
Sup/ext non-ins inf pump syr HCPCS K0552 not published not published $4.79 – $6.15 2
Sup of prep of antigen # of vials 95144 CPT 95144 not published not published $32.37 – $111.42 7
Supply of digital device HCPCS G0552 not published not published $171.24 – $316.79 6
Supp non-insulin inf cath/wk HCPCS A4221 not published not published $35.73 – $52.36 2
Support clav 29.6-40.5in med HCPCS L3650 $23.75 $67.87 $88.92 – $164.50 7
Supprelin la implant HCPCS J9226 not published not published $33,730.64 – $97,205.89 9
Surg dx exam anorectal CPT 45990 not published not published $1,528.38 – $9,297.00 9
Surg ect salp-oophorectomy 59120 CPT 59120 not published not published $3,409.47 – $9,891.00 4
Surg ect without salp-oophorectomy 59121 CPT 59121 not published not published $3,409.47 – $9,891.00 4
Surgery for urethra pouch CPT 53240 not published not published $1,528.38 – $9,834.00 9
Surgery of pancreatic cyst CPT 48500 not published not published $1,142.09 – $9,891.00 4
Surgery to stop leg growth CPT 27475 not published not published $1,142.09 – $16,065.00 9
Surgery to stop leg growth CPT 27477 not published not published $1,142.09 – $12,132.52 9
Surgery to stop leg growth CPT 27479 not published not published $1,142.09 – $16,065.00 9
Surgery to stop leg growth CPT 27485 not published not published $1,142.09 – $12,132.52 9
Surgical exposure prostate 55860 CPT 55860 not published not published $1,528.38 – $12,111.00 9
Surgical opening esophagus CPT 43351 not published not published $1,142.09 – $11,276.00 4
Surgical opening esophagus CPT 43352 not published not published $1,142.09 – $9,891.00 4
Surgical opening of stomach CPT 43510 not published not published $1,142.09 – $9,891.00 9
Surgical opening of stomach 43500 CPT 43500 not published not published $1,142.09 – $9,891.00 4
Surgical opening of throat CPT 42955 not published not published $1,528.38 – $9,297.00 9
Surgical pathology level 1 gross examination only CPT 88300 $100.80 $288.00 $18.17 – $68.82 9
Surgical pathology level 2 gross & microscopic examination CPT 88302 $151.20 $432.00 $42.11 – $88.87 9
Surgical pathology level 3 gross & microscopic examination CPT 88304 $217.70 $622.00 $63.02 – $123.99 9
Surgical pathology level 4 gross & microscopic examination CPT 88305 $283.15 $809.00 $67.02 – $123.99 9
Surgical pathology level 5 gross & microscopic examination CPT 88307 $395.50 $1,130.00 $128.55 – $852.89 9
Surgical pathology level 6 gross & microscopic examination CPT 88309 $494.55 $1,413.00 $142.17 – $1,917.04 9
Surgical repair stomach bleedin ulcer 43501 CPT 43501 not published not published $1,142.09 – $9,891.00 4
Surgical repair stomach gastric lac 43502 CPT 43502 not published not published $1,142.09 – $9,891.00 4
Surgical revision intestine CPT 44680 not published not published $1,142.09 – $9,891.00 4
Surgigraft, 1 sq cm HCPCS Q4183 not published not published $160.06 – $352.70 9
Surg tx anal fistula 2nd stage 46285 CPT 46285 not published not published $1,142.09 – $6,604.43 9
Susceptibility agar dilution per agent CPT 87181 $71.05 $203.00 $4.74 – $11.80 9
Susceptibility enzyme detection per enzyme CPT 87185 $5.60 $16.00 $4.74 – $11.80 9
Susceptibility mic per plate CPT 87186 $80.85 $231.00 $8.65 – $26.83 9
Suscept studies macrobroth dilution ea CPT 87188 not published not published $6.64 – $20.59 9
Suspend bowel w/prosthesis CPT 44700 not published not published $1,142.09 – $9,891.00 4
Suspension of testis CPT 54620 not published not published $1,746.72 – $10,103.00 9
Suspension of uterus CPT 58410 not published not published $1,142.09 – $9,891.00 4
Suspension of uterus 58400 CPT 58400 not published not published $1,142.09 – $9,891.00 4
Suspension sleeve lower ext HCPCS L2397 not published not published $151.86 – $280.94 7
Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 not published not published $1,142.09 – $9,891.00 4
Suture bile duct injury 47900 CPT 47900 not published not published $1,142.09 – $9,891.00 4
Svc venogram s&i CPT 75827 $1,424.15 $4,069.00 $385.63 – $7,539.92 9
Sweat collection by iontophoresis CPT 89230 not published not published $7.22 – $123.99 9
Symes ankle without (sach) foot HCPCS L5703 not published not published $2,946.99 – $5,451.93 7
Symes met fr leath socket ar HCPCS L5060 not published not published $4,508.51 – $8,340.74 7
Symes type medial opening so HCPCS L5636 not published not published $311.94 – $577.09 7
Symes type poster opening so HCPCS L5634 not published not published $496.53 – $918.58 7
Symes type ptb brim design s HCPCS L5632 not published not published $289.31 – $535.22 7
Syme typ expandabl wall sckt HCPCS L5630 not published not published $674.53 – $1,247.88 7
Sympathectomy cervical CPT 64802 not published not published $1,528.38 – $9,297.00 9
Sympathectomy digital artery CPT 64820 not published not published $1,528.38 – $9,891.00 9
Sympathectomy lumbar CPT 64818 not published not published $1,528.38 – $9,891.00 4
Sympathectomy supfc palmar CPT 64823 not published not published $2,159.89 – $9,834.00 9
Sympathectomy thoracolumbar CPT 64809 not published not published $1,528.38 – $9,891.00 4
Synch audio-only est high 40 CPT 98015 $7.71 $22.04 not published 0
Synch audio-only est low 20 CPT 98013 $7.71 $22.04 not published 0
Synch audio-only est mod 30 CPT 98014 $7.71 $22.04 not published 0
Synch audio-only est sf 10 CPT 98012 $7.71 $22.04 not published 0
Synch audio-only new high 60 CPT 98011 $7.71 $22.04 not published 0
Synch audio-only new low 30 CPT 98009 $7.71 $22.04 not published 0
Synch audio-only new mod 45 CPT 98010 $7.71 $22.04 not published 0
Synch audio-only new sf 15 CPT 98008 $7.71 $22.04 not published 0
Synojoynt, inj., 1 mg HCPCS J7331 not published not published $5.61 – $67.93 5
Synthetic sentence id test CPT 92576 not published not published $48.04 – $88.87 7
Synvisc or synvisc-one HCPCS J7325 $413.36 $1,181.04 $6.96 – $26.13 9
Syphilis test non-treponemal antibody quantitative rpr CPT 86593 $276.50 $790.00 $4.40 – $13.64 9
System cardiomems hosp electronics HCPCS C2624 $33,334.88 $95,242.50 not published 0
System pacing micra av HCPCS C1786 $20,408.85 $58,311.00 not published 0
System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 $6,593.33 $18,838.08 not published 0
System sealant biosentry tract HCPCS C2613 $630.26 $1,800.75 not published 0
T3 (triiodothyronine) free CPT 84481 $81.20 $232.00 $16.94 – $52.56 9
T3 (triiodothyronine) total CPT 84480 $141.40 $404.00 $14.18 – $43.98 9
T4 (thyroxine) free CPT 84439 $140.35 $401.00 $9.02 – $27.97 9
T4 (thyroxine) total CPT 84436 $99.40 $284.00 $6.87 – $21.31 9
Tacrol astagraf ex rel oral HCPCS J7508 not published not published $0.59 – $1.23 5
Tacrol envarsus ex rel oral HCPCS J7503 not published not published $1.78 – $3.89 5
Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 $0.83 $2.38 $0.15 – $11.16 5
Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 not published not published $259.96 – $548.38 9
Tacrolimus therapeutic drug level CPT 80197 not published not published $13.73 – $42.60 9
Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 not published not published $14.08 – $29.95 9
Tah rad debulk/lymph remove 58954 CPT 58954 not published not published $1,746.72 – $12,235.00 4
Tah rad dissect for debulk 58953 CPT 58953 not published not published $1,746.72 – $12,235.00 4
Tah w/mmk 58152 CPT 58152 not published not published $1,142.09 – $12,235.00 4
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 $2,003.52 $5,724.34 $71.26 – $151.32 9
Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 not published not published $71.03 – $150.50 9
Talymed HCPCS Q4127 not published not published $91.67 – $296.10 8
Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 not published not published $0.20 – $8.27 4
Tap block bilat cont infusion 64489 CPT 64489 not published not published $1,142.09 – $9,891.00 4
Tap block uni by cont infusion 64487 CPT 64487 not published not published $1,142.09 – $9,891.00 4
Tape plstc 1inx5yd hosp tb pk HCPCS A4452 not published not published $0.70 – $0.85 2
Target gsa panel hmtlmph neop CPT 81450 not published not published $759.53 – $1,885.90 8
Target gsa panel organ/hmtlmph neop CPT 81455 not published not published $1,746.62 – $7,249.37 8
Target gsa panel organ neop CPT 81445 not published not published $597.91 – $1,484.60 8
Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 not published not published $1,530.00 – $3,377.16 9
Tas congenital car anomal CPT 33741 not published not published $1,142.09 – $12,235.00 3
Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 not published not published $352.70 – $1,487.00 8
Tavr perq femoral CPT 33361 $9,750.30 $27,858.00 $2,821.63 – $11,276.00 4
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 $790.27 $2,257.92 $0.25 – $0.85 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.