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 |
|---|---|---|---|---|
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $160.06 – $3,536.73 | 8 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | $7,948.85 | $22,711.00 | $5,821.00 – $12,235.00 | 3 |
| Description not available HCPCS S0013 | not published | not published | $15.20 – $155.52 | 4 |
| Design custom breast implant CPT 19396 | not published | not published | $2,821.63 – $9,891.00 | 9 |
| Design mlc device for imrt CPT 77338 | $1,168.65 | $3,339.00 | $481.58 – $890.92 | 7 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $47.31 | $135.16 | $3.57 – $9.65 | 5 |
| Desoxycorticosterone CPT 82633 | not published | not published | $30.98 – $96.08 | 9 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | $642.95 | $1,837.00 | $5,821.00 – $9,891.00 | 3 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | $7,948.85 | $22,711.00 | $5,821.00 – $12,235.00 | 3 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | $642.95 | $1,837.00 | $5,821.00 – $9,891.00 | 3 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | $363.65 | $1,039.00 | $258.05 – $1,487.00 | 8 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $258.05 – $1,487.00 | 8 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $258.05 – $1,487.00 | 8 |
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $1,289.23 – $5,977.00 | 9 |
| Destroy cth facet jnt addl 64634 CPT 64634 | not published | not published | $450.55 – $9,891.00 | 4 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $959.20 – $13,207.00 | 9 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $256.55 | $733.00 | $151.53 – $1,487.00 | 8 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $1,528.38 – $9,891.00 | 9 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $258.05 – $1,487.00 | 8 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $352.70 – $5,977.00 | 9 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $576.45 | $1,647.00 | $352.70 – $5,977.00 | 9 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $352.70 – $5,977.00 | 9 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $66.86 – $9,891.00 | 4 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $1,528.38 – $9,891.00 | 9 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $1,142.09 – $6,604.43 | 9 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $423.50 | $1,210.00 | $352.70 – $5,977.00 | 9 |
| Destruction benign lesions < 14 lesions CPT 17110 | $363.65 | $1,039.00 | $151.53 – $1,487.00 | 8 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $1,137.58 – $9,297.00 | 9 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $1,289.23 – $9,891.00 | 4 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $1,746.72 – $13,207.00 | 9 |
| Destruction ciliary body CPT 66700 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Destruction ciliary body CPT 66720 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Destruction ciliary body CPT 66740 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $258.05 – $1,487.00 | 8 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $1,142.09 – $6,604.43 | 9 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $475.93 – $1,487.00 | 8 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $475.93 – $5,977.00 | 9 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $258.55 – $1,487.00 | 8 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $475.93 – $5,977.00 | 9 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $258.55 – $1,487.00 | 8 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $352.70 – $5,977.00 | 9 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $3,569.96 – $15,861.00 | 9 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,142.09 – $7,332.00 | 9 |
| Destruction vag lesions simple 57061 CPT 57061 | $3,648.40 | $10,424.00 | $1,746.72 – $9,891.00 | 9 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $1,528.38 – $9,891.00 | 9 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $74.57 | 9 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $124.41 | 9 |
| Determination venous press CPT 93770 | $57.40 | $164.00 | $6.26 – $7.47 | 2 |
| Determine refractive state CPT 92015 | not published | not published | $244.49 – $244.49 | 1 |
| Developmental screen/score/document 96110 CPT 96110 | $256.55 | $733.00 | $55.63 – $323.75 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | $3.10 | $8.86 | $165.49 – $306.17 | 7 |
| Device ablt adv novasure HCPCS C1886 | $4,494.00 | $12,840.00 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $3,762.50 | $10,750.00 | $352.70 – $352.70 | 1 |
| Device intraute mirena HCPCS J7298 | $524.62 | $1,498.92 | $1,238.93 – $3,133.75 | 5 |
| Device sut capio slim opn HCPCS C2631 | $2,845.55 | $8,130.15 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $8,085.00 | $23,100.00 | not published | 0 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $332.51 – $332.51 | 1 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,528.38 – $9,891.00 | 4 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $87.93 – $241.72 | 7 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $78.11 – $78.11 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $47.58 – $427.38 | 9 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $92.55 – $237.96 | 9 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.17 – $21.38 | 5 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $8.93 | $25.50 | $0.02 – $0.95 | 5 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $33.10 | $94.56 | $0.12 – $3.78 | 5 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $200.06 – $441.27 | 9 |
| Dexamethasone panel CPT 80420 | not published | not published | $161.88 – $401.94 | 9 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.74 – $1.38 | 3 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,024.88 | $2,928.24 | $32.09 – $238.65 | 9 |
| Dextran 40 infusion HCPCS J7100 | $68.93 | $196.95 | $67.89 – $336.26 | 5 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $14.52 – $218.94 | 3 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.59 – $1.41 | 4 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $68.93 | $196.95 | $1.36 – $47.50 | 5 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $68.93 | $196.95 | $2.84 – $16.20 | 5 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $68.93 | $196.95 | $2.03 – $27.06 | 5 |
| Dextrose 5 % IV bolus HCPCS J7070 | $68.93 | $196.95 | $3.04 – $29.14 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | not published | not published | $22.23 – $68.96 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $78.40 | $224.00 | $9.71 – $30.11 | 9 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $377.96 – $448.62 | 2 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $64.20 – $73.43 | 2 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $64.20 – $73.43 | 2 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $64.20 – $73.43 | 2 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $17.48 – $42.66 | 6 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $126.02 – $149.56 | 2 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $64.20 – $73.43 | 2 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,746.72 – $12,111.00 | 9 |
| Diagnostic anoscopy CPT 46601 | $443.45 | $1,267.00 | $324.84 – $5,977.00 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,142.09 – $12,557.00 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $201.25 | $575.00 | $112.54 – $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.