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 |
|---|---|---|---|---|
| Wet mounts/ w preparations HCPCS Q0111 | not published | not published | $13.25 – $45.15 | 9 |
| Whfo electric custom fitted HCPCS L3904 | not published | not published | $4,390.61 – $8,122.63 | 7 |
| Whfo nontorsion joint prefab HCPCS L3931 | not published | not published | $261.73 – $484.20 | 7 |
| Whfo w/joint(s) custom fab HCPCS L3806 | not published | not published | $495.89 – $917.40 | 7 |
| Whole blood for transfusion HCPCS P9010 | not published | not published | $189.84 – $417.35 | 7 |
| Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit HCPCS P9054 | not published | not published | $229.58 – $490.60 | 7 |
| Whole blood/red blood cells leukocytes reduced cmv negative each unit HCPCS P9051 | not published | not published | $151.58 – $412.51 | 7 |
| Whole mitochondrial genome CPT 81460 | not published | not published | $1,287.00 – $3,195.62 | 8 |
| Whole mitochondrial genome CPT 81465 | not published | not published | $936.00 – $2,324.09 | 8 |
| Who nontorsion jnts pre cst HCPCS L3915 | not published | not published | $580.28 – $1,073.52 | 7 |
| Who nontorsion jnts pre ots HCPCS L3916 | not published | not published | $580.28 – $1,073.52 | 7 |
| Wilate injection HCPCS J7183 | not published | not published | $1.27 – $2.75 | 9 |
| Wipe adh remover univ ostomy adh/barrier remover HCPCS A4456 | not published | not published | $0.48 – $0.59 | 2 |
| Wnd prep f/n/hf/g addl cm CPT 15005 | $238.00 | $680.00 | $857.14 – $9,891.00 | 4 |
| Woman's shoe oxford brace HCPCS L3224 | not published | not published | $90.10 – $166.68 | 7 |
| Wound closure by adhesive HCPCS G0168 | $79.80 | $228.00 | $1,142.09 – $1,487.00 | 2 |
| Woundfix biowound plus xplus HCPCS Q4217 | not published | not published | $160.06 – $588.05 | 8 |
| Wound pouch each HCPCS A6154 | not published | not published | $28.47 – $33.77 | 2 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $592.90 | $1,694.00 | $360.34 – $967.27 | 7 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $458.50 | $1,310.00 | $360.34 – $679.70 | 7 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $256.55 | $733.00 | $22.32 – $477.39 | 7 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $576.45 | $1,647.00 | $25.32 – $967.27 | 7 |
| Wrist arthroscopy CPT 29840 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Wrist arthroscopy/surgery CPT 29843 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Wrist/elbow bowden cable mol HCPCS L6580 | not published | not published | $2,187.89 – $4,047.60 | 7 |
| Wrist/elbow bowden cbl dir f HCPCS L6582 | not published | not published | $1,684.94 – $3,117.14 | 7 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $2,068.15 – $15,861.00 | 9 |
| Wrist X-ray CPT 73110 | $341.60 | $976.00 | $69.83 – $427.38 | 9 |
| Wrst mld sck flx hng tri pad HCPCS L6050 | not published | not published | $3,090.96 – $5,718.28 | 7 |
| Xcapsl ctrc rmvl cplx w/ecp CPT 66987 | not published | not published | $2,455.49 – $15,861.00 | 9 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $2,968.25 – $15,201.00 | 9 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $352.70 – $15,201.00 | 9 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $2,455.49 – $15,861.00 | 9 |
| Xcellistem, 1 mg HCPCS A2004 | not published | not published | $26.39 – $33.54 | 2 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $1,142.09 – $15,201.00 | 9 |
| Xe133 xenon 10mci HCPCS A9558 | not published | not published | $77.26 – $585.57 | 3 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $2,131.85 | $6,091.00 | $1,528.38 – $9,297.00 | 9 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $2,486.75 | $7,105.00 | $1,746.72 – $10,103.00 | 9 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $914.00 – $2,269.46 | 8 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $0.02 – $2,269.46 | 8 |
| Xm archive tissue molec anal CPT 88363 | not published | not published | $20.42 – $68.82 | 9 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| X-ray abdomen 1 view CPT 74018 | $281.75 | $805.00 | $44.26 – $427.38 | 9 |
| X-ray abdomen 2 views CPT 74019 | $329.70 | $942.00 | $53.00 – $516.16 | 9 |
| X-ray abdomen >=3 views CPT 74021 | $416.15 | $1,189.00 | $61.75 – $516.16 | 9 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $539.70 | $1,542.00 | $82.66 – $516.16 | 9 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $317.80 | $908.00 | $68.98 – $427.38 | 9 |
| X-ray ankle 2 views (both sides) CPT 73600 | $230.30 | $658.00 | $51.01 – $427.38 | 9 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $508.55 | $1,453.00 | $203.33 – $1,733.40 | 9 |
| X-ray assay calculus CPT 82370 | not published | not published | $12.52 – $38.87 | 9 |
| X-ray bone age studies CPT 77072 | $163.80 | $468.00 | $35.58 – $516.16 | 9 |
| X-ray bone length studies CPT 77073 | $408.80 | $1,168.00 | $61.26 – $516.16 | 9 |
| X-ray bone survey complete CPT 77075 | $1,027.25 | $2,935.00 | $134.46 – $516.16 | 9 |
| X-ray bone survey infant CPT 77076 | not published | not published | $134.46 – $516.16 | 9 |
| X-ray cervical spine 2-3 views CPT 72040 | $437.50 | $1,250.00 | $68.98 – $427.38 | 9 |
| X-ray cervical spine 4-5 views CPT 72050 | $577.50 | $1,650.00 | $93.78 – $516.16 | 9 |
| X-ray cervical spine >= 6 views CPT 72052 | $689.85 | $1,971.00 | $123.73 – $516.16 | 9 |
| X-ray clavicle complete (both sides) CPT 73000 | $329.00 | $940.00 | $51.86 – $427.38 | 9 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $1,001.00 | $2,860.00 | $211.62 – $864.05 | 9 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,032.85 | $2,951.00 | $225.59 – $864.05 | 9 |
| X-ray consultation CPT 76140 | not published | not published | $87.93 – $104.63 | 2 |
| X-ray elbow 2 views (both sides) CPT 73070 | $300.30 | $858.00 | $51.86 – $427.38 | 9 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $383.25 | $1,095.00 | $64.68 – $427.38 | 9 |
| Xray endovasc thor ao repr CPT 75956 | $1,139.60 | $3,256.00 | $800.50 – $2,543.04 | 2 |
| Xray endovasc thor ao repr CPT 75957 | $1,139.60 | $3,256.00 | $685.17 – $2,178.67 | 2 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $487.90 | $1,394.00 | $169.96 – $864.05 | 9 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $510.30 | $1,458.00 | $119.97 – $516.16 | 9 |
| X-ray exam entire spi 6/> vw CPT 72084 | $677.95 | $1,937.00 | $134.46 – $516.16 | 9 |
| X-ray exam of arm infant CPT 73092 | $163.10 | $466.00 | $56.98 – $516.16 | 9 |
| X-ray exam of eye sockets CPT 70200 | $412.30 | $1,178.00 | $76.68 – $516.16 | 9 |
| X-ray exam of femur 1 CPT 73551 | $256.20 | $732.00 | $46.15 – $427.38 | 9 |
| X-ray exam of jaw joint CPT 70328 | $289.80 | $828.00 | $55.28 – $427.38 | 9 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $144.28 – $1,173.24 | 9 |
| X-ray exam of mastoids CPT 70120 | $98.00 | $280.00 | $65.56 – $516.16 | 9 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $74.96 – $2,661.28 | 9 |
| X-ray exam of penis CPT 74445 | not published | not published | $134.46 – $516.16 | 9 |
| X-ray exam of perineum CPT 74775 | not published | not published | $249.17 – $1,173.24 | 9 |
| X-ray exam of salivary gland CPT 70380 | $256.55 | $733.00 | $76.68 – $427.38 | 9 |
| X-ray exam of sinuses CPT 70210 | $312.90 | $894.00 | $56.13 – $427.38 | 9 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $163.22 – $1,173.24 | 9 |
| X-ray exam of teeth CPT 70300 | not published | not published | $21.91 – $427.38 | 9 |
| X-ray exam of teeth CPT 70310 | not published | not published | $69.64 – $1,173.24 | 9 |
| X-ray exam si joints CPT 72200 | not published | not published | $53.56 – $516.16 | 9 |
| X-ray exam thorac spine4/>vw CPT 72074 | $570.85 | $1,631.00 | $85.23 – $516.16 | 9 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $195.65 | $559.00 | $51.01 – $427.38 | 9 |
| X-ray facial bones complete > 3 views CPT 70150 | $603.05 | $1,723.00 | $75.81 – $516.16 | 9 |
| X-ray fallopian tube CPT 74742 | not published | not published | $141.83 – $574.67 | 3 |
| X-ray femur >=2 views (both sides) CPT 73552 | $341.60 | $976.00 | $54.75 – $427.38 | 9 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $192.85 | $551.00 | $62.13 – $427.38 | 9 |
| X-ray foot 2 views (both sides) CPT 73620 | $275.10 | $786.00 | $49.28 – $427.38 | 9 |
| X-ray forearm 2 views (both sides) CPT 73090 | $334.95 | $957.00 | $50.13 – $427.38 | 9 |
| X-ray hand 2 views (both sides) CPT 73120 | $297.85 | $851.00 | $49.28 – $516.16 | 9 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $29.61 – $427.38 | 9 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $297.15 | $849.00 | $50.13 – $427.38 | 9 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $470.75 | $1,345.00 | $89.07 – $516.16 | 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.