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 |
|---|---|---|---|---|
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.05 – $0.53 | 5 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $18,316.22 | $52,332.07 | $54.67 – $113.93 | 9 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | not published | not published | $3.00 – $6.90 | 9 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $3.00 – $7.03 | 9 |
| Dark field exam spec collj CPT 87164 | not published | not published | $10.74 – $33.31 | 9 |
| Dark field exam without collj CPT 87166 | not published | not published | $11.30 – $35.04 | 9 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $249.61 – $535.39 | 9 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $250.29 | $715.12 | $19.76 – $56.76 | 5 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $111.26 – $276.00 | 5 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $258.05 – $1,487.00 | 7 |
| D&c after delivery 59160 CPT 59160 | $2,732.10 | $7,806.00 | $1,746.72 – $10,103.00 | 9 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $3,679.90 | $10,514.00 | $1,528.38 – $9,297.00 | 9 |
| Dch glucoscan CPT 82948 | $36.75 | $105.00 | $5.04 – $12.53 | 9 |
| Dch pulmonary stress test CPT 94621 | not published | not published | $279.65 – $887.89 | 7 |
| Dch validity tests CPT 81002 | $55.65 | $159.00 | $3.48 – $8.63 | 9 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $2,511.53 – $15,861.00 | 9 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $3,409.47 – $9,891.00 | 9 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| D&c of cervical stump CPT 57558 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Deamidated gliadin antibody iga CPT 86258 | not published | not published | $12.05 – $29.91 | 9 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $872.55 | $2,493.00 | $352.70 – $1,487.00 | 8 |
| Debridement (>20 cm) charge pt CPT 97598 | $70.00 | $200.00 | $258.55 – $1,487.00 | 2 |
| Debridement bone <= 20 sq cm CPT 11044 | $2,344.30 | $6,698.00 | $1,427.22 – $9,297.00 | 9 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $222.25 | $635.00 | $475.93 – $9,891.00 | 4 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $215.60 | $616.00 | $1,427.22 – $9,891.00 | 4 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $578.90 | $1,654.00 | $475.93 – $9,297.00 | 9 |
| Debride nail1-5 11720 CPT 11720 | $92.40 | $264.00 | $75.87 – $1,487.00 | 8 |
| Debride nail6 or more 11721 CPT 11721 | $184.10 | $526.00 | $75.87 – $1,487.00 | 8 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $782.25 | $2,235.00 | $763.02 – $9,297.00 | 9 |
| Debride skin bone at fx site CPT 11012 | $3,951.85 | $11,291.00 | $763.02 – $9,297.00 | 9 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $292.60 | $836.00 | $475.93 – $9,891.00 | 4 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $151.53 – $1,487.00 | 8 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $912.80 | $2,608.00 | $763.02 – $9,297.00 | 9 |
| Debr inf skin add-on 11001 CPT 11001 | $163.10 | $466.00 | $151.53 – $9,891.00 | 4 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $578.90 | $1,654.00 | $475.93 – $9,297.00 | 9 |
| Decalcification CPT 88311 | $123.90 | $354.00 | $16.05 – $20.09 | 5 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $6,204.08 | $17,725.95 | $1.59 – $73.04 | 5 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $1,065.40 | $3,044.00 | $352.70 – $1,487.00 | 8 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompress fasciotomyhand 26037 CPT 26037 | $1,824.55 | $5,213.00 | $1,528.38 – $12,557.00 | 9 |
| Decompress fingers/hand CPT 26035 | not published | not published | $1,528.38 – $12,557.00 | 9 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompression fasct forearm CPT 24495 | not published | not published | $1,528.38 – $16,065.00 | 9 |
| Decompression of leg CPT 27892 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompression of leg CPT 27893 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Decompression of leg CPT 27894 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompression of lower leg CPT 27600 | $2,457.00 | $7,020.00 | $1,746.72 – $10,103.00 | 9 |
| Decompression of lower leg CPT 27601 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompression of thigh/knee CPT 27496 | $2,457.00 | $7,020.00 | $2,455.49 – $13,207.00 | 9 |
| Decompression of thigh/knee CPT 27497 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompression of thigh/knee CPT 27498 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Decompression of thigh/knee CPT 27499 | not published | not published | $1,746.72 – $12,132.52 | 9 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Decompression unspecified nerve 64722 CPT 64722 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Decompressive craniotomy CPT 61322 | not published | not published | $1,528.38 – $11,276.00 | 4 |
| Decompress optic nerve CPT 67570 | not published | not published | $2,821.63 – $12,557.00 | 9 |
| Decompres spinal cord;thoracic 63055 CPT 63055 | not published | not published | $3,409.47 – $16,065.00 | 9 |
| Decompress small bowel CPT 44021 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $3,409.47 – $16,065.00 | 9 |
| Decompress spinal cord thrc CPT 63064 | not published | not published | $3,409.47 – $16,065.00 | 9 |
| Decompress spine cord add-on CPT 63066 | not published | not published | $1,487.00 – $11,276.00 | 4 |
| Decomp spinal cord/transped/ad seg 63057 CPT 63057 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Deep muscle biopsy 20205 CPT 20205 | $7,548.80 | $21,568.00 | $1,746.72 – $10,103.00 | 9 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $148.04 | $422.96 | $9.02 – $39.55 | 5 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $2,554.13 | $7,297.50 | $1.14 – $9.37 | 9 |
| Delayed breast prosthesis 19342 CPT 19342 | not published | not published | $1,746.72 – $19,447.84 | 9 |
| Delay flap arms/legs CPT 15610 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Delay flap eye/nos/ear/lip CPT 15630 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Delay flap fccnaxghf 15620 CPT 15620 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Delay flap trunk 15600 CPT 15600 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Delivery of placenta 59414 CPT 59414 | $3,535.00 | $10,100.00 | $1,528.38 – $9,891.00 | 9 |
| Delivery only failed vbac 59620 CPT 59620 | not published | not published | $1,746.72 – $9,891.00 | 3 |
| Delivery only/pp care/failed vbac 59622 CPT 59622 | not published | not published | $1,746.72 – $9,891.00 | 3 |
| Delivery transcath fxtn dvc to endogrft w/s&i CPT 34712 | $3,222.10 | $9,206.00 | $1,142.09 – $9,891.00 | 4 |
| Demonstrate use home inr mon HCPCS G0248 | not published | not published | $171.24 – $321.56 | 7 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $329.35 | $941.00 | $57.69 – $521.04 | 7 |
| Denervation of hip joint CPT 27035 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Dengue vacc quad 3 dose subq CPT 90587 | not published | not published | $67.32 – $309.61 | 4 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $12,397.98 | $35,422.79 | $29.24 – $59.79 | 9 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $473.20 | $1,352.00 | $171.12 – $5,977.00 | 9 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | not published | not published | $5.13 – $6.09 | 2 |
| Depo-estradiol cypionate inj HCPCS J1000 | $176.41 | $504.04 | $12.49 – $90.99 | 5 |
| Dermabrasion other than face CPT 15782 | not published | not published | $763.02 – $5,977.00 | 9 |
| Dermabrasion segmental face 15781 CPT 15781 | not published | not published | $763.02 – $5,977.00 | 9 |
| Dermabrasion suprfl any site CPT 15783 | not published | not published | $352.70 – $5,977.00 | 9 |
| Dermabrasion total face CPT 15780 | not published | not published | $1,746.72 – $9,891.00 | 9 |
| Derma-fat-fascia graft 15770 CPT 15770 | $3,684.10 | $10,526.00 | $1,746.72 – $10,103.00 | 9 |
| Derma-gide, 1 sq cm HCPCS Q4203 | not published | not published | $160.06 – $645.39 | 9 |
| Dermagraft HCPCS Q4106 | $1,912.31 | $5,463.75 | $88.70 – $109.52 | 4 |
| Dermal filler injection(s) HCPCS G0429 | not published | not published | $2,653.72 – $9,891.00 | 7 |
| Dermapure 1 square cm HCPCS Q4152 | not published | not published | $108.69 – $296.10 | 8 |
| Derm autograft face/nck/hf/g CPT 15135 | not published | not published | $1,528.38 – $9,834.00 | 9 |
| Derm autograft trnk/arm/leg CPT 15130 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Dermavest, plurivest sq cm HCPCS Q4153 | not published | not published | $160.06 – $296.10 | 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.