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 |
|---|---|---|---|---|
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $340.17 | 9 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $66.45 – $199.77 | 4 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $16.05 – $47.27 | 4 |
| Tbs techl calculation only CPT 77091 | not published | not published | $69.37 – $427.38 | 9 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $5.59 – $427.38 | 9 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $100.00 – $248.30 | 9 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | not published | not published | $61.98 – $192.26 | 9 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $818.61 – $1,216.49 | 3 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $1,148.21 – $1,966.64 | 3 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $775.52 – $7,441.90 | 8 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $1,311.65 – $2,054.51 | 3 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $128.66 – $145.98 | 3 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $934.13 – $3,479.02 | 8 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $1,725.03 – $3,479.02 | 3 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $328.60 – $706.49 | 7 |
| Tc-99m labeled rbc HCPCS A9560 | not published | not published | $189.59 – $308.18 | 3 |
| Tc-99m maa HCPCS A9540 | not published | not published | $58.20 – $63.30 | 3 |
| Tc-99m mebrofenin HCPCS A9537 | not published | not published | $112.28 – $243.94 | 3 |
| Tc-99m medronate HCPCS A9503 | not published | not published | $26.39 – $395.03 | 3 |
| Tc-99m mertiatide HCPCS A9562 | not published | not published | $1,204.35 – $1,651.69 | 2 |
| Tc-99m non-heu per study dose HCPCS Q9969 | not published | not published | $12.90 – $21.90 | 3 |
| Tc-99m oxidronate HCPCS A9561 | not published | not published | $88.75 – $108.49 | 3 |
| Tc-99m pentetate dtpa HCPCS A9539 | not published | not published | $43.93 – $63.60 | 3 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | not published | not published | $34.47 – $43.82 | 2 |
| Tc-99m pertechnetate per mci HCPCS A9512 | not published | not published | $3.44 – $22.94 | 3 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | not published | not published | $66.77 – $130.01 | 3 |
| Tc-99m sestamibi p study dose HCPCS A9500 | not published | not published | $197.55 – $968.75 | 3 |
| Tc-99m succimer (dmsa) HCPCS A9551 | not published | not published | $342.32 – $1,431.23 | 8 |
| Tc-99m sulfur colloid HCPCS A9541 | not published | not published | $143.82 – $1,615.51 | 3 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | not published | not published | $173.09 – $339.38 | 3 |
| Tc-99m tilmanocept diag HCPCS A9520 | not published | not published | $525.60 – $1,342.87 | 3 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $258.55 – $1,487.00 | 8 |
| Tcd emboli detect w/inj CPT 93893 | $190.40 | $544.00 | $134.46 – $248.76 | 7 |
| Tcd emboli detect without inj CPT 93892 | $178.50 | $510.00 | $134.46 – $248.76 | 7 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $237.46 – $1,210.50 | 2 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $567.42 – $5,977.00 | 9 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $251.65 | $719.00 | $46.98 – $145.74 | 9 |
| T cells absolute cd 4 count CPT 86361 | not published | not published | $26.78 – $83.04 | 9 |
| T cells total count CPT 86359 | $156.45 | $447.00 | $37.73 – $117.01 | 9 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $207.39 – $513.77 | 7 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $207.39 – $513.77 | 7 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $207.39 – $513.77 | 7 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | $3,222.10 | $9,206.00 | $1,142.09 – $9,891.00 | 4 |
| Team conf w/pat by hc prof CPT 99366 | $7.88 | $22.50 | not published | 0 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $208.90 – $461.73 | 9 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $1,008.25 – $1,865.27 | 7 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $1,008.25 – $1,865.27 | 7 |
| Teflon or equal cable lining HCPCS L6665 | not published | not published | $60.70 – $112.30 | 7 |
| Telavancin injection HCPCS J3095 | $1,784.62 | $5,098.91 | $4.47 – $15.24 | 9 |
| Telethx isodose plan cplx CPT 77307 | $937.65 | $2,679.00 | $279.05 – $890.92 | 7 |
| Telethx isodose plan simple CPT 77306 | $420.70 | $1,202.00 | $175.52 – $890.92 | 7 |
| Temozolomide HCPCS J8700 | $39.02 | $111.48 | $0.36 – $8.70 | 5 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $3,351.62 | $9,576.07 | $10.23 – $22.38 | 9 |
| Temperature gradient studies CPT 93740 | not published | not published | $27.48 – $306.17 | 7 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $9,624.00 – $42,841.00 | 3 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $6,196.26 | $17,703.59 | $30.08 – $65.19 | 9 |
| Tendon lengthening CPT 26476 | not published | not published | $1,142.09 – $7,332.00 | 9 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Tendon shortening CPT 26477 | not published | not published | $1,142.09 – $7,332.00 | 9 |
| Tendon transfer with graft CPT 26492 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $29,822.42 | $85,206.91 | $137.90 – $365.27 | 9 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $616.33 – $6,439.55 | 5 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Tenolysis triceps CPT 24332 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $1,142.09 – $13,460.00 | 9 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | $2,457.00 | $7,020.00 | $1,528.38 – $9,297.00 | 9 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $1,746.72 – $9,891.00 | 9 |
| Tension based scoliosis orth HCPCS L1005 | $1,953.00 | $5,580.00 | $3,839.20 – $7,102.52 | 7 |
| Tens suppl 2 lead per month HCPCS A4595 | not published | not published | $15.74 – $66.69 | 2 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $33.14 | $94.69 | $2.74 – $14.38 | 5 |
| Teriparatide injection HCPCS J3110 | not published | not published | $21.38 – $159.72 | 5 |
| Term dev auto grasp feature HCPCS L6881 | not published | not published | $4,913.43 – $9,089.85 | 7 |
| Term device, multi art digit HCPCS L6715 | not published | not published | $3,794.37 – $7,019.58 | 6 |
| Term dev mech hand vol close HCPCS L6709 | not published | not published | $1,977.62 – $3,658.60 | 7 |
| Term dev mech hand vol open HCPCS L6708 | not published | not published | $1,365.39 – $2,525.97 | 7 |
| Term dev mech hook vol close HCPCS L6707 | not published | not published | $2,017.45 – $3,732.28 | 7 |
| Term dev mech hook vol open HCPCS L6706 | not published | not published | $528.35 – $977.45 | 7 |
| Term dev modifier wrist unit HCPCS L6805 | not published | not published | $518.39 – $959.02 | 7 |
| Term dev, passive hand mitt HCPCS L6703 | not published | not published | $440.00 – $814.00 | 7 |
| Term dev precision pinch dev HCPCS L6810 | not published | not published | $266.48 – $492.99 | 7 |
| Term dev, sport/rec/work att HCPCS L6704 | not published | not published | $955.95 – $1,768.51 | 7 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $185.20 – $459.85 | 9 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $6.01 – $18.62 | 9 |
| Test for porphobilinogen CPT 84106 | not published | not published | $5.82 – $14.44 | 9 |
| Test for urine cystines CPT 82615 | not published | not published | $9.55 – $25.32 | 9 |
| Testicular imaging w/vasc flow CPT 78761 | $541.10 | $1,546.00 | $444.85 – $1,950.38 | 9 |
| Testosterone pellet 75 mg HCPCS S0189 | not published | not published | $5.22 – $213.41 | 4 |
| Testosterone response panel CPT 80414 | not published | not published | $51.64 – $160.18 | 9 |
| Testosterone undecanoate 1mg HCPCS J3145 | $5,760.38 | $16,458.23 | $1.99 – $4.34 | 9 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $78.40 | $224.00 | $62.87 – $140.37 | 8 |
| Test sock elbw disart/above HCPCS L6682 | not published | not published | $377.08 – $697.60 | 7 |
| Test socket above knee HCPCS L5624 | not published | not published | $509.03 – $941.71 | 7 |
| Test socket below knee HCPCS L5620 | not published | not published | $358.07 – $662.43 | 7 |
| Test socket hemipelvectomy HCPCS L5628 | not published | not published | $591.79 – $1,094.81 | 7 |
| Test socket hip disarticulat HCPCS L5626 | not published | not published | $668.75 – $1,237.19 | 7 |
| Test socket knee disarticula HCPCS L5622 | not published | not published | $464.09 – $858.57 | 7 |
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.