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 |
|---|---|---|---|---|
| Adapter b 8 channel 10cm HCPCS C1883 | $6,875.44 | $19,644.10 | not published | 0 |
| Adding walker to prev cast CPT 29440 | $163.10 | $466.00 | $194.49 – $1,487.00 | 8 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $1,198.46 | $3,424.17 | $0.46 – $5.87 | 5 |
| Adenovirus ag ia CPT 87301 | not published | not published | $11.98 – $29.76 | 9 |
| Adenovirus antibody,serum - quest CPT 86603 | not published | not published | $12.87 – $39.92 | 9 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $21.76 – $54.01 | 9 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Adh-sendout CPT 84588 | not published | not published | $33.94 – $105.30 | 9 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Adjmt/revj ext fixj sys anes CPT 20693 | $4,291.70 | $12,262.00 | $1,746.72 – $16,065.00 | 9 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $2,131.85 | $6,091.00 | $1,746.72 – $10,103.00 | 9 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $201.78 | $576.50 | $0.23 – $1.20 | 5 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $275.10 | $786.00 | $85.83 – $171.32 | 7 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $275.10 | $786.00 | $92.60 – $179.25 | 7 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $984.90 | $2,814.00 | $424.83 – $785.93 | 7 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $564.55 | $1,613.00 | $312.25 – $785.93 | 7 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $275.10 | $786.00 | $85.83 – $171.32 | 7 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $349.30 | $998.00 | $85.83 – $171.32 | 7 |
| Administration immunization 1 vaccine CPT 90471 | $22.75 | $65.00 | $85.83 – $171.32 | 7 |
| Administration immunization each additional vaccine CPT 90472 | $22.75 | $65.00 | $61.17 – $61.17 | 1 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $61.17 – $171.32 | 7 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $61.17 – $61.17 | 1 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $72.18 – $72.18 | 1 |
| Administration vaccine hepatitis b HCPCS G0010 | not published | not published | $60.23 – $111.42 | 7 |
| Administration vaccine influenza virus HCPCS G0008 | not published | not published | $60.23 – $111.42 | 7 |
| Administration vaccine pneumococcal HCPCS G0009 | not published | not published | $60.23 – $111.42 | 7 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $63.07 – $63.07 | 1 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $14,346.62 | $40,990.35 | $40.70 – $88.39 | 9 |
| Adrenal cortex & medulla img CPT 78075 | $2,182.95 | $6,237.00 | $928.95 – $6,336.39 | 9 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $277.71 – $513.77 | 7 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $277.71 – $652.05 | 7 |
| Aep thrshld est mlt freq i&r CPT 92652 | $635.60 | $1,816.00 | $277.71 – $652.05 | 7 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,943.42 – $6,395.04 | 9 |
| _afb id by dna probe rflx ast CPT 87149 | $84.35 | $241.00 | $20.05 – $62.20 | 9 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $18.15 | 9 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $115.36 – $357.82 | 9 |
| Aflibercept injection HCPCS J0178 | not published | not published | $731.88 – $1,711.10 | 9 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $889.32 – $1,645.24 | 7 |
| After cataract laser surgery CPT 66821 | not published | not published | $707.39 – $9,297.00 | 9 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $227.58 – $479.11 | 9 |
| Air conduction bilat CPT 92552 | $87.85 | $251.00 | $77.27 – $316.58 | 7 |
| Air injection into abdomen 49400 CPT 49400 | $366.10 | $1,046.00 | $1,487.00 – $9,891.00 | 3 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $127.63 – $306.17 | 7 |
| Albumin body fluid quantitative each specimen CPT 82042 | $81.90 | $234.00 | $7.78 – $19.33 | 9 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $156.21 | $446.32 | $53.08 – $236.54 | 9 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $58.85 | 9 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $179.34 | $512.40 | $53.08 – $135.80 | 9 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $95.18 | 9 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $105.30 | 9 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $77.70 | $222.00 | $5.78 – $17.94 | 9 |
| Albumin serum plasma or whole blood CPT 82040 | $96.60 | $276.00 | $4.95 – $15.35 | 9 |
| Albuterol ipratrop non-comp HCPCS J7620 | $0.61 | $1.75 | $0.20 – $10.60 | 5 |
| Albuterol non-comp con HCPCS J7611 | $0.61 | $1.75 | $0.16 – $0.39 | 5 |
| Albuterol non-comp unit HCPCS J7613 | $0.61 | $1.75 | $0.08 – $1.14 | 5 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $127.05 | $363.00 | $0.02 – $42.90 | 9 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $37.20 – $68.82 | 7 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $196.51 – $422.33 | 7 |
| Aldesleukin injection HCPCS J9015 | $15,640.46 | $44,687.02 | $1,903.85 – $12,300.59 | 9 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,440.42 – $5,249.20 | 9 |
| Alkaline phosphatase CPT 84075 | $75.25 | $215.00 | $5.18 – $16.05 | 9 |
| Allergen alpha lactalbumin ige CPT 86008 | not published | not published | $17.93 – $48.49 | 9 |
| Allergen egg white ige CPT 86003 | not published | not published | $5.22 – $16.18 | 9 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $7.97 – $19.79 | 9 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $60.23 – $111.42 | 7 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $60.23 – $111.42 | 7 |
| Allergy Skin Testing CPT 95004 | not published | not published | $17.68 – $2,043.29 | 7 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $35.63 – $2,043.29 | 7 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $4,588.50 – $30,073.00 | 9 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $27.96 | $79.88 | $33.93 – $33.93 | 1 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $3,985.24 | $11,386.40 | $160.06 – $296.10 | 8 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $160.06 – $296.10 | 8 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $21,510.09 | $61,457.41 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $8,403.84 | $24,010.98 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $22,984.85 | $65,671.01 | $48.70 – $296.10 | 8 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $17,109.79 | $48,885.10 | $160.06 – $352.70 | 9 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $4,232.06 | $12,091.60 | $160.06 – $296.10 | 9 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $5,783.40 | $16,524.00 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $4,191.43 | $11,975.50 | $160.06 – $296.10 | 8 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $4,814.57 | $13,755.92 | $160.06 – $531.09 | 9 |
| Alloskin HCPCS Q4115 | not published | not published | $21.05 – $296.10 | 9 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $48.04 – $129.12 | 7 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $37.20 – $72.09 | 7 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $0.52 – $11.09 | 9 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $199.79 | 9 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $17.00 – $52.03 | 9 |
| Alpha-fetoprotein tumor marker CPT 82105 | $54.95 | $157.00 | $16.77 – $52.03 | 9 |
| Alprostadil for injection HCPCS J0270 | $465.63 | $1,330.38 | $0.39 – $36.90 | 5 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $31,630.68 | $90,373.36 | $91.40 – $196.64 | 9 |
| Alt/sgpt CPT 84460 | $81.90 | $234.00 | $5.30 – $16.43 | 9 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.49 – $9.89 | 9 |
| Aluminum - quest CPT 82108 | not published | not published | $25.48 – $79.02 | 9 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $2,159.89 – $9,891.00 | 9 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $147.00 | $420.00 | $122.28 – $226.21 | 7 |
| Amantadine (symmetrel)-sendout CPT 80375 | not published | not published | $0.02 – $113.18 | 2 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $84.58 – $316.58 | 7 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $88.09 | $251.68 | $0.62 – $17.41 | 5 |
| Amino acid screen, urine CPT 82128 | not published | not published | $13.87 – $42.99 | 9 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $42.99 | 9 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $19.61 – $52.32 | 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.