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 |
|---|---|---|---|---|
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $192.86 – $493.01 | 4 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $151.28 – $386.78 | 4 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $329.70 | $942.00 | $185.45 – $1,487.00 | 8 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $334.95 | $957.00 | $256.73 – $1,487.00 | 8 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $498.75 | $1,425.00 | $120.80 – $647.88 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $360.50 | $1,030.00 | $97.95 – $506.08 | 9 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $110.46 – $427.38 | 9 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $1,750.70 | $5,002.00 | $1,487.00 – $5,559.00 | 3 |
| Dialysis one evaluation CPT 90945 | $1,022.70 | $2,922.00 | $118.06 – $992.84 | 7 |
| Dialysis repeated eval CPT 90947 | not published | not published | $171.11 – $460.94 | 2 |
| Dialysis training incompl CPT 90993 | not published | not published | $307.32 – $307.32 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $8.24 – $15.24 | 6 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $31.50 | $90.00 | $0.16 – $0.32 | 3 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $55.63 | $158.95 | $6.17 – $12.45 | 5 |
| Dicyclomine injection HCPCS J0500 | $302.03 | $862.93 | $11.68 – $40.87 | 5 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.18 – $0.48 | 5 |
| Diffusing capacity CPT 94729 | $205.80 | $588.00 | $153.58 – $217.56 | 2 |
| Digital analysis of eeg CPT 95957 | not published | not published | $295.44 – $1,274.26 | 2 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $494.87 | $1,413.92 | $4.00 – $10.49 | 5 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $17,877.79 | $51,079.39 | $1,462.39 – $10,682.45 | 9 |
| Digoxin total therapeutic drug level CPT 80162 | $240.45 | $687.00 | $13.28 – $41.17 | 9 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $175.65 | $501.87 | $80.99 – $184.36 | 5 |
| Dilate biliary duct/ampulla CPT 47542 | $1,024.45 | $2,927.00 | $1,487.00 – $9,891.00 | 4 |
| Dilate esophagus CPT 43453 | not published | not published | $1,135.67 – $5,977.00 | 9 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $1,135.67 – $5,977.00 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $21,361.90 | $61,034.00 | $5,559.00 – $9,297.00 | 3 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $21,361.90 | $61,034.00 | $5,559.00 – $9,297.00 | 3 |
| Dilate ic vasospasm init CPT 61640 | $21,361.90 | $61,034.00 | $5,821.00 – $10,103.00 | 3 |
| Dilate tear duct opening CPT 68801 | not published | not published | $182.60 – $1,487.00 | 8 |
| Dilate urethra stricture CPT 53600 | $310.45 | $887.00 | $321.35 – $5,977.00 | 9 |
| Dilate urethra stricture CPT 53601 | $241.85 | $691.00 | $171.12 – $5,977.00 | 9 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Dilate urethra stricture CPT 53621 | not published | not published | $321.35 – $5,977.00 | 9 |
| Dilation/female urethra/initial 53660 CPT 53660 | $345.10 | $986.00 | $165.49 – $1,487.00 | 8 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $1,528.38 – $7,332.00 | 9 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Dilation of salivary duct CPT 42660 | not published | not published | $537.23 – $1,487.00 | 8 |
| Dilation of urethra CPT 53661 | $329.00 | $940.00 | $171.12 – $1,487.00 | 8 |
| Dilation of urethra CPT 53665 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Dilation of vagina CPT 57400 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $592.20 | $1,692.00 | $896.84 – $9,891.00 | 9 |
| Dilator fascial 10fx20cm HCPCS C2627 | $465.75 | $1,330.70 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $4,283.65 | $12,239.00 | $1,142.09 – $15,861.00 | 9 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $4,005.00 – $9,891.00 | 9 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.04 – $0.04 | 1 |
| Dimecaprol injection HCPCS J0470 | $608.80 | $1,739.43 | $54.55 – $108.55 | 4 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.38 – $17.95 | 5 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $2,622.87 | $7,493.92 | $162.36 – $1,536.65 | 9 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $2.80 | 5 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $33.60 | $96.00 | $0.90 – $4.16 | 5 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $36.16 – $147.30 | 4 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.86 – $67.56 | 5 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $35.63 – $88.87 | 7 |
| Disability dlco CPT 94727 | $206.85 | $591.00 | $127.63 – $513.77 | 7 |
| Disaccharidases CPT 82657 | not published | not published | $22.17 – $56.00 | 9 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,528.38 – $30,548.47 | 9 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,746.72 – $9,891.00 | 4 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Discography cerv/thor spine CPT 72285 | $1,544.20 | $4,412.00 | $225.58 – $9,478.15 | 9 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $79.41 – $146.91 | 7 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $224.28 – $414.92 | 7 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $352.70 – $4,235.11 | 8 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Dissolve clot heart vessel CPT 92975 | $2,257.85 | $6,451.00 | $528.54 – $5,821.00 | 3 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $3,409.47 – $13,460.00 | 9 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $5,821.00 – $12,235.00 | 3 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $2,159.89 – $12,111.00 | 9 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.02 – $113.18 | 2 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $1,198.40 | $3,424.00 | $1,142.09 – $9,891.00 | 4 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $279.00 – $692.76 | 8 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $682.40 | 9 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $340.17 | 9 |
| Dna antibody native/double stranded CPT 86225 | not published | not published | $13.74 – $42.60 | 9 |
| Dna gardnerella CPT 87510 | not published | not published | $20.05 – $62.20 | 9 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.75 – $62.20 | 9 |
| Dna probe gc CPT 87590 | not published | not published | $26.88 – $66.74 | 9 |
| Dna trichomonas CPT 87660 | not published | not published | $20.05 – $62.20 | 9 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $107.59 | $307.40 | $6.80 – $32.55 | 5 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $642.60 | $1,836.01 | $0.38 – $56.58 | 5 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $2.27 – $110.98 | 9 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $7.04 – $42.20 | 4 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $60.31 – $309.11 | 5 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $87.41 | $249.75 | $0.60 – $1.53 | 5 |
| Doppler echo complete CPT 93320 | $386.40 | $1,104.00 | $297.07 – $411.80 | 2 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $288.75 | $825.00 | $1,487.00 – $1,487.00 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $452.55 | $1,293.00 | $263.00 – $759.42 | 8 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $365.75 | $1,045.00 | $161.23 – $625.64 | 8 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.81 – $2.46 | 5 |
| Dornase alfa non-comp unit HCPCS J7639 | $77.25 | $220.71 | $37.28 – $115.22 | 5 |
| Dornhoffer fixed part w/window HCPCS L8614 | $20,701.45 | $59,147.00 | $33,581.40 – $33,581.40 | 1 |
| Dorsi & plantar flex ass/res HCPCS L2220 | not published | not published | $125.47 – $232.12 | 7 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $240.61 – $516.30 | 9 |
| Double transfer toe-hand CPT 26554 | not published | not published | $3,409.47 – $17,265.50 | 9 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $613.84 | $1,753.84 | $2.72 – $145.14 | 5 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,669.98 | $4,771.38 | $71.86 – $323.38 | 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.