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 |
|---|---|---|---|---|
| Cystoscopy and biopsy CPT 52007 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cystoscopy and treatment CPT 52214 | $2,029.65 | $5,799.00 | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52224 | $5,535.95 | $15,817.00 | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52234 | $5,535.95 | $15,817.00 | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52235 | $5,535.95 | $15,817.00 | $1,746.72 – $10,103.00 | 9 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $1,746.72 – $12,111.00 | 9 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $896.84 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $1,528.38 – $10,103.00 | 9 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $1,528.38 – $12,111.00 | 9 |
| Cystoscopy and treatment CPT 52310 | $3,071.60 | $8,776.00 | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $2,455.49 – $13,207.00 | 9 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,374.10 | $3,926.00 | $896.84 – $5,977.00 | 9 |
| Cystoscopy chemodenervation CPT 52287 | $4,092.20 | $11,692.00 | $1,528.38 – $13,207.00 | 9 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $896.84 – $9,297.00 | 9 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $4,533.71 – $15,861.00 | 9 |
| Cystoscopy inject material CPT 52327 | $5,866.70 | $16,762.00 | $1,528.38 – $12,111.00 | 9 |
| Cystoscopy prostatic imp 1-3 HCPCS C9739 | not published | not published | $1,528.38 – $15,861.00 | 9 |
| Cystoscopy removal of clots CPT 52001 | $2,029.65 | $5,799.00 | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cystoscopy & ureter catheter CPT 52005 | $2,918.30 | $8,338.00 | $1,528.38 – $9,297.00 | 9 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $1,628.90 | $4,654.00 | $2,159.89 – $12,557.00 | 9 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Cystouretero & or pyeloscope CPT 52351 | $2,484.30 | $7,098.00 | $1,746.72 – $10,103.00 | 9 |
| Cysto/uretero stricture tx CPT 52344 | $2,029.65 | $5,799.00 | $1,746.72 – $10,103.00 | 9 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $2,159.89 – $15,861.00 | 9 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $1,746.72 – $12,111.00 | 9 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $2,159.89 – $10,103.00 | 9 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $4,306.05 | $12,303.00 | $1,528.38 – $9,297.00 | 9 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $3,795.75 | $10,845.00 | $1,528.38 – $9,297.00 | 9 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $352.70 – $9,891.00 | 4 |
| Cystourethro w/implant CPT 52441 | not published | not published | $352.70 – $9,891.00 | 4 |
| Cysto with bx(s) with blue light HCPCS C7550 | not published | not published | $352.70 – $15,861.00 | 3 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $110.89 | $316.82 | $0.81 – $18.92 | 5 |
| Cytarabine liposome inj HCPCS J9098 | not published | not published | $604.66 – $1,250.46 | 5 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,197.94 – $2,974.48 | 8 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $42.38 – $107.99 | 9 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $40.70 – $101.08 | 9 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,160.00 – $2,880.28 | 9 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $445.96 – $2,234.70 | 8 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,396.25 – $5,597.44 | 9 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $11.98 – $29.76 | 9 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $26.25 | $75.00 | $14.39 – $44.65 | 9 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | not published | not published | $16.85 – $52.25 | 9 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.42 – $33.31 | 9 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,791.99 – $3,895.82 | 9 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $30.03 – $74.57 | 9 |
| Cyto/molecular report CPT 88291 | not published | not published | $30.47 – $119.79 | 5 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $25.37 – $66.27 | 9 |
| Cytopath c/v automated CPT 88147 | not published | not published | $33.08 – $125.53 | 9 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $27.64 – $68.65 | 9 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $18.54 – $47.15 | 9 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $14.65 – $36.37 | 9 |
| Cytopath c/v manual CPT 88150 | not published | not published | $18.54 – $45.15 | 9 |
| Cytopath c/v redo CPT 88153 | not published | not published | $24.03 – $59.67 | 9 |
| Cytopath c/v thin layer redo CPT 88143 | $93.80 | $268.00 | $23.04 – $62.85 | 9 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $35.14 – $126.90 | 9 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $150.85 | $431.00 | $67.02 – $123.99 | 9 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | not published | not published | $26.61 – $82.17 | 9 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $88.20 | $252.00 | $20.26 – $62.85 | 9 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $150.85 | $431.00 | $42.11 – $116.47 | 9 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $225.05 | $643.00 | $40.66 – $127.70 | 9 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $214.20 | $612.00 | $14.44 – $30.17 | 5 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $239.40 | $684.00 | $42.11 – $405.38 | 9 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $362.25 | $1,035.00 | $67.02 – $250.59 | 9 |
| Cytopath smear other source CPT 88160 | not published | not published | $30.86 – $140.54 | 9 |
| Cytopath smear other source CPT 88162 | not published | not published | $58.21 – $226.49 | 9 |
| Cytopath smear oth prep screen & interp CPT 88161 | not published | not published | $33.24 – $142.94 | 9 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $18.54 – $45.15 | 9 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $18.54 – $45.15 | 9 |
| Cytopath tbs c/v redo CPT 88165 | $60.55 | $173.00 | $30.70 – $104.82 | 9 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $18.54 – $45.15 | 9 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $78.65 – $195.28 | 9 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $29.68 – $92.07 | 9 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $142.17 – $863.40 | 9 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $91.38 | $261.08 | $3.82 – $37.47 | 5 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $35.58 – $752.25 | 9 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $3,593.07 | $10,265.92 | $15.00 – $33.48 | 9 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $18.04 – $377.14 | 5 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $1,618.65 | $4,624.70 | $0.03 – $0.95 | 5 |
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.