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 |
|---|---|---|---|---|
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | $1,339.10 | $3,826.00 | $907.88 – $2,362.00 | 8 |
| Chemo extend IV infus w/pump HCPCS G0498 | $958.65 | $2,739.00 | $424.83 – $785.93 | 6 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $60.23 – $179.25 | 7 |
| Chemo ia infusion up to 1 hr CPT 96422 | $368.55 | $1,053.00 | $424.83 – $785.93 | 7 |
| Chemo ia push tecnique CPT 96420 | $264.60 | $756.00 | $179.25 – $601.00 | 7 |
| Chemo intralesional over 7 CPT 96406 | $600.25 | $1,715.00 | $49.79 – $506.11 | 7 |
| Chemo intralesional up to 7 96405 CPT 96405 | $178.50 | $510.00 | $41.63 – $171.32 | 7 |
| Chemotaxis assay CPT 86155 | not published | not published | $15.99 – $49.58 | 9 |
| Chemotherapy injection 96542 CPT 96542 | $564.55 | $1,613.00 | $63.42 – $785.93 | 7 |
| Chemotx admn pertl cav impl CPT 96446 | $584.15 | $1,669.00 | $40.58 – $785.93 | 7 |
| Chest 2 vws w oblique CPT 71048 | $480.20 | $1,372.00 | $62.62 – $516.16 | 9 |
| Chest apical lordotic proj CPT 71047 | $439.25 | $1,255.00 | $60.87 – $427.38 | 9 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,579.85 | $7,371.00 | $225.59 – $823.77 | 8 |
| Chest CT scan (with contrast) CPT 71260 | $2,531.20 | $7,232.00 | $225.59 – $740.92 | 8 |
| Chest CT scan (without contrast) CPT 71250 | $2,067.10 | $5,906.00 | $134.46 – $473.15 | 8 |
| Chest X-ray CPT 71046 | $397.95 | $1,137.00 | $47.75 – $427.38 | 9 |
| Chest X-ray (single view) CPT 71045 | $331.80 | $948.00 | $25.89 – $427.38 | 9 |
| Chg pr pul rehab for copd patients CPT 94626 | not published | not published | $75.87 – $140.37 | 7 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $487.90 | $1,394.00 | $181.03 – $864.05 | 9 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $207.46 – $515.13 | 8 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $260.79 – $647.53 | 8 |
| Chlamydia culture CPT 87110 | not published | not published | $19.60 – $60.77 | 9 |
| Chlamydia trachomatis ag if CPT 87270 | not published | not published | $11.98 – $29.76 | 9 |
| Chlamydia type CPT 87140 | not published | not published | $5.57 – $17.30 | 9 |
| Chlnggrphy intraop addl s&i CPT 74301 | $245.70 | $702.00 | $51.15 – $125.53 | 3 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $15.52 – $125.52 | 5 |
| Chloride CPT 82435 | $100.10 | $286.00 | $4.60 – $14.26 | 9 |
| Chloride 24 hour urine CPT 82436 | $105.00 | $300.00 | $5.75 – $15.59 | 9 |
| Chloroprocaine hcl injection HCPCS J2401 | $34.26 | $97.89 | $0.04 – $0.19 | 5 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $0.60 – $1.29 | 5 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $235.08 | $671.66 | $26.87 – $83.62 | 5 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $35.06 | $100.16 | $24.98 – $62.44 | 5 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | not published | not published | $0.39 – $1.32 | 3 |
| Chmotx admn plrl cav thrcnts CPT 96440 | $584.15 | $1,669.00 | $186.43 – $785.93 | 7 |
| Cholangiogram percutaneous compl CPT 47532 | $2,421.30 | $6,918.00 | $1,746.72 – $15,861.00 | 9 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $423.15 | $1,209.00 | $83.82 – $150.43 | 2 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $1,142.09 – $11,276.00 | 4 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $1,142.09 – $11,276.00 | 4 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $3,963.05 | $11,323.00 | $1,142.09 – $9,891.00 | 9 |
| Cholesterol CPT 82465 | $91.00 | $260.00 | $4.35 – $13.49 | 9 |
| Cholesterol body fluid CPT 84999 | $184.45 | $527.00 | $87.82 – $87.82 | 1 |
| Cholesterol (Lipid) Test CPT 80061 | $129.85 | $371.00 | $13.39 – $41.54 | 9 |
| Choline c-11 HCPCS A9515 | not published | not published | $2,516.43 – $10,149.00 | 8 |
| Cholinesterase CPT 82480 | not published | not published | $7.87 – $24.44 | 9 |
| Cholinesterase challenge CPT 95857 | not published | not published | $100.64 – $513.77 | 7 |
| Chorion biopsy CPT 59015 | not published | not published | $601.13 – $2,362.00 | 8 |
| Chorionic gonadotropin/1000u HCPCS J0725 | not published | not published | $17.51 – $47.31 | 5 |
| Chrom analysis CPT 88273 | not published | not published | $34.81 – $99.67 | 9 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $39.00 – $96.84 | 9 |
| Chromatography CPT 83021 | $13.30 | $38.00 | $18.06 – $56.00 | 9 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $11.89 – $36.90 | 9 |
| Chromo high res and frag x - sendout CPT 81243 | not published | not published | $57.04 – $141.65 | 8 |
| Chromosome analys amniotic CPT 88269 | not published | not published | $173.66 – $515.92 | 9 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $173.17 – $537.16 | 9 |
| Chromosome analysis 15-20 cell count CPT 88262 | not published | not published | $125.49 – $386.62 | 9 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $173.17 – $461.76 | 9 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $150.29 – $466.16 | 9 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $264.34 – $656.35 | 9 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $173.17 – $537.16 | 9 |
| Chromosome analys placenta CPT 88267 | not published | not published | $188.57 – $557.62 | 9 |
| Chromosome banding study CPT 88283 | not published | not published | $25.12 – $170.33 | 9 |
| Chromosome count additional CPT 88285 | not published | not published | $26.91 – $66.81 | 9 |
| Chromosome karyotype study CPT 88280 | $32.81 | $93.75 | $33.47 – $83.12 | 9 |
| Chromosome study additional CPT 88289 | not published | not published | $28.47 – $85.49 | 9 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $12.46 – $38.65 | 9 |
| Chylomicron screen, bf - sendout CPT 82664 | not published | not published | $61.50 – $152.72 | 9 |
| Cidofovir injection HCPCS J0740 | $2,243.49 | $6,409.98 | $427.08 – $1,121.93 | 9 |
| Cilastatin sodium injection HCPCS J0743 | not published | not published | $6.97 – $41.44 | 5 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $0.01 – $1,189,314.00 | 8 |
| Cinacalcet 30 mg tablet HCPCS J0604 | not published | not published | $0.02 – $2.65 | 5 |
| Cine/video x-rays CPT 76120 | not published | not published | $134.46 – $516.16 | 9 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $80.42 – $144.35 | 3 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $85.30 | $243.70 | $2.32 – $38.98 | 5 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $28.88 – $82.69 | 5 |
| Circum 28 days or older CPT 54161 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $843.15 | $2,409.00 | $896.84 – $9,297.00 | 9 |
| Circumcision (newborn) CPT 54150 | $2,652.30 | $7,578.00 | $1,142.09 – $5,977.00 | 9 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $99.89 | $285.41 | $1.95 – $116.94 | 5 |
| C-kit mutation liquid tumor - sendout CPT 81272 | not published | not published | $329.51 – $818.17 | 9 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $549.68 | $1,570.50 | $8.73 – $35.70 | 9 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $19,019.00 | $54,340.00 | not published | 0 |
| Claviculectomy partial CPT 23120 | not published | not published | $2,455.49 – $13,207.00 | 9 |
| Claviculectomy total CPT 23125 | not published | not published | $2,455.49 – $13,207.00 | 9 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $693.67 – $9,891.00 | 9 |
| Clearance of airways CPT 31720 | $329.35 | $941.00 | $73.26 – $5,977.00 | 9 |
| Clearance of tear duct CPT 68530 | not published | not published | $408.24 – $1,487.00 | 8 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $171.12 – $316.58 | 7 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $140.06 – $316.58 | 7 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $151.22 – $316.58 | 7 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $48.04 – $110.81 | 7 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $86.91 | $248.30 | $1.07 – $3.46 | 5 |
| Clip ligating vesolock lg HCPCS C1760 | $18,945.85 | $54,131.00 | not published | 0 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $1,746.72 – $9,891.00 | 9 |
| Cllr miami j sm HCPCS L0174 | $450.76 | $1,287.89 | $420.89 – $778.65 | 7 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | not published | not published | $10.94 – $88.00 | 9 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $42.73 | $122.08 | $17.67 – $141.36 | 5 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $1,528.38 – $11,276.00 | 4 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $675.85 | $1,931.00 | $259.12 – $1,487.00 | 8 |
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.