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 |
|---|---|---|---|---|
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $90.47 | $258.48 | $0.12 – $0.26 | 4 |
| Dpyd gene common variants CPT 81232 | not published | not published | $174.81 – $434.07 | 9 |
| Drainable plastic pch w fcpl HCPCS A4375 | not published | not published | $34.03 – $40.41 | 2 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,036.70 | $2,962.00 | $245.04 – $2,362.00 | 8 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $1,036.70 | $2,962.00 | $245.04 – $2,362.00 | 8 |
| Drainage external ear complex 69005 CPT 69005 | $1,262.45 | $3,607.00 | $1,142.09 – $9,891.00 | 9 |
| Drainage external ear simple 69000 CPT 69000 | $1,036.70 | $2,962.00 | $245.04 – $2,362.00 | 8 |
| Drainage lymph node lesion 38300 CPT 38300 | $2,115.40 | $6,044.00 | $1,142.09 – $5,977.00 | 9 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage mouth roof lesion CPT 42000 | $473.20 | $1,352.00 | $304.63 – $9,297.00 | 9 |
| Drainage of abdomen CPT 48000 | not published | not published | $1,528.38 – $9,891.00 | 4 |
| Drainage of arm bursa 23931 CPT 23931 | $1,185.80 | $3,388.00 | $1,528.38 – $9,297.00 | 9 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $1,142.09 – $6,911.51 | 9 |
| Drainage of bone lesion CPT 26992 | not published | not published | $2,159.89 – $9,891.00 | 9 |
| Drainage of bone lesion CPT 27303 | not published | not published | $1,528.38 – $9,891.00 | 9 |
| Drainage of eye CPT 65800 | $1,754.55 | $5,013.00 | $1,142.09 – $5,977.00 | 9 |
| Drainage of eye CPT 65810 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Drainage of eye CPT 65815 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage of kidney lesion CPT 50390 | $1,712.20 | $4,892.00 | $910.78 – $5,977.00 | 9 |
| Drainage of mouth lesion CPT 41005 | $347.90 | $994.00 | $304.63 – $5,977.00 | 9 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Drainage of mouth lesion CPT 41007 | $1,657.95 | $4,737.00 | $1,142.09 – $5,977.00 | 9 |
| Drainage of mouth lesion CPT 41008 | $2,858.45 | $8,167.00 | $1,142.09 – $7,332.00 | 9 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $537.23 – $5,977.00 | 9 |
| Drainage of mouth lesion CPT 41015 | $761.60 | $2,176.00 | $537.23 – $5,977.00 | 9 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $1,142.09 – $12,111.00 | 9 |
| Drainage of mouth lesion CPT 41017 | $2,858.45 | $8,167.00 | $1,142.09 – $7,332.00 | 9 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Drainage of nose lesion int 30000 CPT 30000 | $473.20 | $1,352.00 | $304.63 – $1,487.00 | 8 |
| Drainage of nose lesion sept 30020 CPT 30020 | $682.50 | $1,950.00 | $537.23 – $1,487.00 | 8 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Drainage of pelvis lesion 26990 CPT 26990 | $4,719.40 | $13,484.00 | $1,142.09 – $7,332.00 | 9 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage of rectal abscess CPT 45005 | $2,015.30 | $5,758.00 | $1,528.38 – $9,297.00 | 9 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage of salivary gland CPT 42305 | $2,858.45 | $8,167.00 | $1,528.38 – $9,297.00 | 9 |
| Drainage of salivary gland CPT 42320 | $761.60 | $2,176.00 | $537.23 – $5,977.00 | 9 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $1,528.38 – $18,416.00 | 4 |
| Drainage of spinal cyst CPT 63173 | not published | not published | $1,746.72 – $18,416.00 | 4 |
| Drainage of throat abscess CPT 42725 | not published | not published | $1,528.38 – $12,111.00 | 9 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drainage of urethra abscess 53060 CPT 53060 | $2,193.80 | $6,268.00 | $1,528.38 – $9,891.00 | 9 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $896.84 – $10,103.00 | 9 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Drain bladder by trocar/cath CPT 51101 | $752.15 | $2,149.00 | $191.34 – $4,099.00 | 8 |
| Drain blood from under nail 11740 CPT 11740 | $114.10 | $326.00 | $66.86 – $1,487.00 | 8 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $2,197.65 | $6,279.00 | $1,142.09 – $10,103.00 | 9 |
| Drain cath image guided visceral pq CPT 49405 | $2,101.05 | $6,003.00 | $1,142.09 – $15,861.00 | 9 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $985.95 | $2,817.00 | $672.48 – $5,977.00 | 9 |
| Drain chest lesion CPT 21502 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drain chst dry seal exp thorastat HCPCS A7041 | not published | not published | $147.03 – $174.52 | 2 |
| Drain finger abscess;simple 26010 CPT 26010 | $473.20 | $1,352.00 | $245.04 – $1,487.00 | 8 |
| Drain lower leg bursa CPT 27604 | $1,824.55 | $5,213.00 | $1,528.38 – $9,297.00 | 9 |
| Drain lower leg lesion 27603 CPT 27603 | $2,115.40 | $6,044.00 | $1,528.38 – $9,297.00 | 9 |
| Drain neck/chest lesion 21501 CPT 21501 | $2,266.60 | $6,476.00 | $1,528.38 – $9,297.00 | 9 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,142.09 – $11,276.00 | 4 |
| Drain ostomy pouch w/flange HCPCS A5063 | not published | not published | $5.36 – $6.37 | 2 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Drain ovary abscess open CPT 58820 | $3,988.25 | $11,395.00 | $1,746.72 – $10,103.00 | 9 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Drain penis lesion CPT 54015 | $1,724.10 | $4,926.00 | $2,124.23 – $12,557.00 | 9 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Drain shoulder lesion CPT 23030 | $2,115.40 | $6,044.00 | $1,142.09 – $6,911.51 | 9 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,266.60 | $6,476.00 | $1,746.72 – $10,103.00 | 9 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $578.90 | $1,654.00 | $258.05 – $9,297.00 | 9 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $578.90 | $1,654.00 | $258.05 – $5,977.00 | 9 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $578.90 | $1,654.00 | $258.55 – $9,297.00 | 9 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $432.60 | $1,236.00 | $112.54 – $1,487.00 | 8 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $11,698.98 | $33,425.66 | $36.52 – $296.10 | 9 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | $1,987.30 | $5,678.00 | $1,142.09 – $9,891.00 | 4 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $2,018.10 | $5,766.00 | $1,142.09 – $9,891.00 | 4 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $108,243.35 – $200,250.20 | 7 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Drng hand tendon sheath 26020 CPT 26020 | $2,457.00 | $7,020.00 | $1,528.38 – $9,297.00 | 9 |
| Drng of eyelid abscess 67700 CPT 67700 | $473.20 | $1,352.00 | $352.70 – $5,977.00 | 9 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,344.30 | $6,698.00 | $1,142.09 – $5,977.00 | 9 |
| Drng of hydrocele 55000 CPT 55000 | $1,898.75 | $5,425.00 | $352.70 – $2,362.00 | 8 |
| Drng of mouth lesion 40801 CPT 40801 | $566.30 | $1,618.00 | $693.67 – $9,297.00 | 9 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $1,142.09 – $7,332.00 | 9 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | $1,486.10 | $4,246.00 | $1,142.09 – $5,977.00 | 9 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Drng of scrotum abscess 55100 CPT 55100 | $2,344.30 | $6,698.00 | $1,142.09 – $5,977.00 | 9 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,142.09 – $12,235.00 | 4 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,142.09 – $12,235.00 | 4 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $1,142.09 – $12,235.00 | 4 |
| Drng salivary gland simple 42300 CPT 42300 | $1,657.95 | $4,737.00 | $1,142.09 – $5,977.00 | 9 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $761.60 | $2,176.00 | $537.23 – $5,977.00 | 9 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.68 – $14.19 | 5 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $5.36 – $19.66 | 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.