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 |
|---|---|---|---|---|
| Drop lock knee HCPCS L2182 | not published | not published | $122.83 – $227.24 | 7 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $48.56 – $89.84 | 7 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,444.66 | $4,127.60 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $2,567.36 | $7,335.31 | $7.76 – $296.10 | 9 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $382.24 | $1,092.11 | $8.52 – $296.10 | 9 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $5.87 – $296.10 | 9 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $21.67 – $25.75 | 2 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $160.06 – $301.03 | 8 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | $5,346.89 | $15,276.83 | $48.54 – $296.10 | 8 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $21,905.91 | $62,588.31 | $36.35 – $296.10 | 9 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $160.06 – $409.34 | 8 |
| Drug admin & hemodynmic meas CPT 93463 | $138.25 | $395.00 | $1,487.00 – $1,487.00 | 1 |
| Drug assay caffeine CPT 80155 | not published | not published | $38.57 – $95.77 | 9 |
| Drug assay posaconazole CPT 80187 | not published | not published | $27.11 – $67.31 | 9 |
| Drug assay rufinamide CPT 80210 | not published | not published | $27.11 – $67.31 | 9 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $38.57 – $95.77 | 9 |
| Drug assay voriconazole CPT 80285 | not published | not published | $27.11 – $67.31 | 9 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $18.64 – $46.30 | 9 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $12.60 – $32.76 | 9 |
| Drug screening tapentadol CPT 80372 | not published | not published | $0.02 – $127.12 | 2 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $27.11 – $67.31 | 9 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $0.02 – $124.49 | 2 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $198.74 – $493.47 | 9 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $114.43 – $284.13 | 9 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $246.92 – $613.11 | 9 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $156.59 – $388.80 | 9 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $62.14 – $154.29 | 8 |
| Drug test prsmv instrmnt CPT 80306 | $97.65 | $279.00 | $17.14 – $43.69 | 9 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $186.55 | $533.00 | $62.14 – $174.78 | 9 |
| Drvvt confirm - quest CPT 85597 | not published | not published | $17.98 – $55.76 | 9 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | not published | not published | $352.70 – $5,977.00 | 9 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $475.93 – $5,977.00 | 9 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $475.93 – $1,487.00 | 8 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $475.93 – $5,977.00 | 9 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $475.93 – $1,487.00 | 8 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $601.00 – $5,977.00 | 9 |
| Ductogram sgl duct CPT 77053 | $359.45 | $1,027.00 | $99.11 – $1,173.24 | 9 |
| Duodenal exclusion CPT 48547 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Duodenal motility study CPT 91022 | not published | not published | $131.14 – $1,487.00 | 8 |
| Duplex scan bilateral study 93985 CPT 93985 | $997.85 | $2,851.00 | $306.88 – $1,173.24 | 8 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $134.46 – $516.16 | 8 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $596.40 | $1,704.00 | $134.46 – $516.16 | 8 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | not published | not published | $263.00 – $759.42 | 8 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $819.70 | $2,342.00 | $306.88 – $1,173.24 | 8 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $11,009.65 | $31,456.15 | $38.57 – $55.47 | 2 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $85.25 – $180.32 | 9 |
| Dxa bone density axl vrt fx CPT 77085 | $315.35 | $901.00 | $98.37 – $516.16 | 9 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $165.49 – $352.70 | 7 |
| Dx aly aud oi snd prcsr each CPT 92623 | not published | not published | $352.70 – $352.70 | 1 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $1,917.30 | $5,478.00 | $1,528.38 – $9,297.00 | 9 |
| Dx bronchoscope/wash 31622 CPT 31622 | $1,917.30 | $5,478.00 | $1,142.09 – $5,977.00 | 9 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $37.25 – $1,062.94 | 7 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $217.34 – $5,977.00 | 9 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $217.34 – $5,977.00 | 9 |
| Dx gastr intub w/asp spec CPT 43754 | $727.65 | $2,079.00 | $112.54 – $5,977.00 | 9 |
| Dx gastr intub w/asp specs CPT 43755 | $310.45 | $887.00 | $161.23 – $5,977.00 | 9 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | not published | not published | $75.03 – $156.91 | 2 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | not published | not published | $201.73 – $421.60 | 2 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | not published | not published | $65.41 – $136.15 | 2 |
| Dx laryngoscopy newborn CPT 31520 | $341.25 | $975.00 | $321.51 – $1,487.00 | 8 |
| Dx laryngoscopy w/oper scope CPT 31526 | $1,174.25 | $3,355.00 | $1,528.38 – $9,297.00 | 9 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | not published | not published | $128.11 – $267.85 | 2 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $321.35 – $9,891.00 | 9 |
| Dynamic fine wire emg CPT 96003 | not published | not published | $104.25 – $207.39 | 2 |
| Dynamic surface emg CPT 96002 | not published | not published | $27.21 – $513.77 | 7 |
| Ear and throat examination CPT 92502 | not published | not published | $187.96 – $1,487.00 | 8 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $1,528.38 – $9,891.00 | 9 |
| Ear cartilage graft CPT 21235 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Ear irrigation 69209 CPT 69209 | $249.90 | $714.00 | $75.87 – $1,487.00 | 8 |
| Ear protector evaluation CPT 92596 | not published | not published | $48.04 – $88.87 | 7 |
| Ecallantide injection HCPCS J1290 | not published | not published | $578.75 – $1,213.98 | 9 |
| Ecg 12 lead tracing only CPT 93005 | $191.80 | $548.00 | $65.96 – $140.37 | 7 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $9.53 – $102.00 | 2 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $46.20 | $132.00 | $25.84 – $140.37 | 7 |
| Ecg < 30 days transmission & analysis CPT 93271 | not published | not published | $122.28 – $276.33 | 7 |
| Ecg external < 48 hours recording CPT 93225 | not published | not published | $161.23 – $316.58 | 7 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | not published | not published | $75.87 – $161.23 | 7 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | not published | not published | $48.04 – $88.87 | 7 |
| Ecg external >7 days up to 15 days recording CPT 93246 | not published | not published | $48.04 – $137.25 | 7 |
| Ecg record/review CPT 93268 | not published | not published | $1,255.55 – $1,716.50 | 2 |
| Ecg/review interpret only CPT 93272 | not published | not published | $33.74 – $194.25 | 2 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,374.45 | $3,927.00 | $702.78 – $1,300.14 | 7 |
| Echocardiography doppler color flow mapping CPT 93325 | $300.30 | $858.00 | $503.55 – $605.75 | 2 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $705.25 | $2,015.00 | $1,008.25 – $1,865.27 | 7 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $546.00 | $1,560.00 | $306.88 – $567.73 | 7 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $458.15 | $1,309.00 | $448.71 – $1,372.63 | 7 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $281.40 | $804.00 | $193.69 – $231.15 | 2 |
| Echo exam of eye CPT 76516 | not published | not published | $87.90 – $516.16 | 9 |
| Echo exam of eye CPT 76519 | not published | not published | $100.95 – $516.16 | 9 |
| Echo exam of eye CPT 76529 | not published | not published | $95.79 – $427.38 | 9 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $10.78 – $118.88 | 9 |
| Echo exam of fetal heart CPT 76825 | not published | not published | $338.12 – $2,661.28 | 9 |
| Echo exam of fetal heart CPT 76826 | not published | not published | $111.93 – $1,173.24 | 9 |
| Echo exam of fetal heart CPT 76827 | not published | not published | $96.36 – $516.16 | 9 |
| Echo exam of fetal heart CPT 76828 | not published | not published | $53.56 – $516.16 | 9 |
| Echo exam uterus 76831- CPT 76831 | $368.90 | $1,054.00 | $227.31 – $1,173.24 | 9 |
| Echograp trans r pros study CPT 76873 | $366.10 | $1,046.00 | $134.46 – $516.16 | 9 |
| Echo guidance radiotherapy CPT 76965 | $564.20 | $1,612.00 | $126.31 – $1,021.78 | 3 |
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.