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 |
|---|---|---|---|---|
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,280.95 | $6,517.00 | $225.59 – $740.92 | 8 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,931.65 | $5,519.00 | $134.46 – $473.15 | 8 |
| Ctlso a-p-l control molded HCPCS L0700 | not published | not published | $3,097.57 – $5,730.50 | 7 |
| Ctlso a-p-l control with inter HCPCS L0710 | not published | not published | $3,199.93 – $5,919.87 | 7 |
| Ctlso axilla sling HCPCS L1010 | not published | not published | $87.29 – $161.49 | 7 |
| Ctlso milwauke initial model HCPCS L1000 | not published | not published | $3,110.63 – $5,754.67 | 7 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,906.40 | $8,304.00 | $225.59 – $823.77 | 8 |
| CT neck soft tissue w/contrast CPT 70491 | $1,853.95 | $5,297.00 | $225.59 – $740.92 | 8 |
| CT neck soft tissue without contrast CPT 70490 | $1,614.55 | $4,613.00 | $134.46 – $473.15 | 8 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,074.45 | $5,927.00 | $225.59 – $823.77 | 8 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,975.75 | $5,645.00 | $225.59 – $823.77 | 8 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,754.20 | $5,012.00 | $225.59 – $740.92 | 8 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,632.40 | $4,664.00 | $134.46 – $473.15 | 8 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $303.10 | $866.00 | $184.68 – $5,977.00 | 9 |
| CT scan for localization CPT 77011 | $1,264.20 | $3,612.00 | $1,065.14 – $3,183.78 | 3 |
| CT scan for therapy guide CPT 77014 | $785.75 | $2,245.00 | $376.20 – $705.06 | 3 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $2,037.00 | $5,820.00 | $448.71 – $1,431.43 | 8 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,949.15 | $5,569.00 | $448.71 – $1,207.19 | 8 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $1,890.35 | $5,401.00 | $306.88 – $632.83 | 8 |
| CT thoracic spine w/contrast CPT 72129 | $2,493.75 | $7,125.00 | $225.59 – $740.92 | 8 |
| CT thoracic spine without contrast CPT 72128 | $2,365.65 | $6,759.00 | $134.46 – $473.15 | 8 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $1,908.55 | $5,453.00 | $129.44 – $248.76 | 8 |
| CT t-spine w /wo contrast CPT 72130 | $2,605.75 | $7,445.00 | $225.59 – $823.77 | 8 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,014.25 | $5,755.00 | $448.71 – $830.11 | 8 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,807.05 | $5,163.00 | $134.46 – $473.15 | 8 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,596.30 | $7,418.00 | $225.59 – $823.77 | 8 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $1,602.37 – $2,964.38 | 7 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $82.05 – $405.38 | 9 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $85.34 – $405.38 | 9 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $561.69 – $9,834.00 | 9 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $561.69 – $9,297.00 | 9 |
| Culture aerobic additional method definitive id each CPT 87077 | $45.85 | $131.00 | $8.08 – $25.08 | 9 |
| Culture afb any source CPT 87116 | $168.00 | $480.00 | $10.80 – $33.51 | 9 |
| Culture anaerobic additional method definitive id each CPT 87076 | $67.55 | $193.00 | $8.08 – $25.08 | 9 |
| Culture anaerobic except blood CPT 87075 | $265.30 | $758.00 | $9.47 – $29.35 | 9 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $9.66 – $29.26 | 9 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $38.98 – $46.14 | 3 |
| Culture bact stool aero addl path ea CPT 87046 | $65.80 | $188.00 | $9.44 – $29.26 | 9 |
| Culture body fluid CPT 87070 | $169.40 | $484.00 | $8.62 – $26.72 | 9 |
| Culture fungi definitive id mold CPT 87107 | $33.95 | $97.00 | $10.32 – $32.02 | 9 |
| Culture fungi definitive id yeast CPT 87106 | $51.10 | $146.00 | $10.32 – $32.02 | 9 |
| Culture fungi other (except blood) CPT 87102 | $154.35 | $441.00 | $8.41 – $26.06 | 9 |
| Culture fungi skin/hair/nail CPT 87101 | $169.05 | $483.00 | $7.71 – $23.94 | 9 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $14.61 – $36.29 | 9 |
| Culture mycoplasma any source CPT 87109 | $57.75 | $165.00 | $15.39 – $47.72 | 9 |
| Culture of specimen by kit CPT 87084 | not published | not published | $25.02 – $67.23 | 9 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.89 – $29.26 | 9 |
| Culture screening strep group a CPT 87081 | $120.40 | $344.00 | $6.63 – $20.56 | 9 |
| Culture type pulse field gel CPT 87152 | not published | not published | $7.74 – $19.21 | 9 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $19.21 | 9 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $12.52 – $38.87 | 9 |
| Culture typing immunologic CPT 87147 | $12.25 | $35.00 | $5.18 – $16.05 | 9 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $218.06 – $541.45 | 9 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $35.09 – $108.86 | 9 |
| Culture urine each isolate CPT 87088 | not published | not published | $8.09 – $25.12 | 9 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $60.66 | 9 |
| Curette/treat cornea CPT 65435 | $708.75 | $2,025.00 | $1,142.09 – $5,977.00 | 9 |
| Curette/treat cornea CPT 65436 | $1,910.30 | $5,458.00 | $1,142.09 – $5,821.00 | 8 |
| Cus elbo skt in for con/atyp HCPCS L6696 | not published | not published | $1,580.90 – $2,924.67 | 7 |
| Cus elbo skt in not con/atyp HCPCS L6697 | not published | not published | $1,580.90 – $2,924.67 | 7 |
| Custom glove for term device HCPCS L6895 | not published | not published | $683.61 – $1,264.68 | 7 |
| Custom shape cover ak HCPCS L5705 | not published | not published | $1,225.62 – $2,267.40 | 7 |
| Custom shape cover bk HCPCS L5704 | not published | not published | $746.54 – $1,381.10 | 7 |
| Custom shape cvr hip disart HCPCS L5707 | not published | not published | $1,726.83 – $3,194.64 | 7 |
| Custom shape cvr knee disart HCPCS L5706 | not published | not published | $1,214.73 – $2,247.25 | 7 |
| Cutter lead HCPCS C1773 | $13,715.63 | $39,187.50 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $2,343.95 | $6,697.00 | $1,142.09 – $5,977.00 | 9 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $19.32 – $162.52 | 2 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $30.47 – $198.78 | 2 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $14.32 – $44.41 | 9 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $33.05 | $94.44 | $0.95 – $7.57 | 5 |
| Cyclic citrullinated peptide antibody CPT 86200 | $90.30 | $258.00 | $12.95 – $40.16 | 9 |
| Cyclophosphamide 100 mg inj HCPCS J9070 | not published | not published | $16.08 – $32.04 | 2 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $1,907.64 | $5,450.41 | $0.62 – $1.89 | 9 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $527.00 | $1,505.70 | $1.98 – $4.73 | 5 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $218.69 | $624.84 | $71.17 – $153.51 | 5 |
| Cyclosporine 2 hour CPT 80158 | not published | not published | $18.05 – $56.00 | 9 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $0.61 | $1.75 | $0.77 – $3.22 | 5 |
| Cyclosporine oral 100 mg HCPCS J7502 | $4.38 | $12.51 | $2.07 – $13.62 | 5 |
| Cygnus matrix, per sq cm HCPCS Q4199 | not published | not published | $160.06 – $714.70 | 8 |
| Cygnus, per sq cm HCPCS Q4170 | not published | not published | $160.06 – $956.19 | 8 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $22,282.07 | $63,663.07 | not published | 0 |
| Cymetra injectable HCPCS Q4112 | $424.46 | $1,212.75 | $381.63 – $1,735.44 | 2 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $194.88 – $723.43 | 8 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $434.07 | 8 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $298.72 – $1,119.60 | 8 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $434.07 | 9 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $434.07 | 9 |
| Cystatin c CPT 82610 | not published | not published | $18.52 – $45.99 | 9 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $1,239.02 | 8 |
| Cystine urine quantitative CPT 82131 | not published | not published | $22.98 – $57.07 | 9 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $441.35 | $1,261.00 | $114.33 – $1,733.40 | 9 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $1,528.38 – $21,833.00 | 9 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $352.70 – $22,524.58 | 9 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $5,821.00 – $22,524.58 | 8 |
| Cystometrogram w/up 51727 CPT 51727 | $1,681.40 | $4,804.00 | $549.87 – $2,362.00 | 8 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $1,142.09 – $15,828.09 | 9 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $352.70 – $15,861.00 | 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.