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 |
|---|---|---|---|---|
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $707.24 – $1,582.77 | 8 |
| Fluoroestradiol f 18 HCPCS A9591 | not published | not published | $1.69 – $1,561.25 | 9 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $219.45 | $627.00 | $82.66 – $235.77 | 3 |
| Fluoroguide needle placement CPT 77002 | $346.50 | $990.00 | $121.18 – $308.64 | 3 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $18.91 – $58.69 | 9 |
| Fluoroscopy up to 1 hour CPT 76000 | $369.60 | $1,056.00 | $174.23 – $1,173.24 | 9 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $92.69 | $264.83 | $1.72 – $5.49 | 5 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | not published | not published | $7.53 – $145.90 | 5 |
| Flurpiridaz f18, diag, 1 mci HCPCS A9611 | not published | not published | $106.84 – $1,107.25 | 8 |
| Flutamide 125 mg HCPCS S0175 | not published | not published | $9.16 – $90.41 | 4 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | not published | not published | $1,944.01 – $6,495.36 | 9 |
| Fluvirin vacc, 3 yrs & >, im HCPCS Q2037 | not published | not published | $15.83 – $34.86 | 4 |
| Fluzone vacc, 3 yrs & >, im HCPCS Q2038 | not published | not published | $23.82 – $106.68 | 4 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $306.88 – $834.41 | 8 |
| Fmri brain by tech CPT 70554 | $460.60 | $1,316.00 | $306.88 – $834.41 | 8 |
| Fna bx w/ct gdn 1st les CPT 10009 | $3,208.80 | $9,168.00 | $352.70 – $5,977.00 | 9 |
| Fna bx w/ct gdn ea addl CPT 10010 | $1,604.05 | $4,583.00 | $1,487.00 – $9,891.00 | 3 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $352.70 – $5,977.00 | 9 |
| Fna bx w/mr gdn ea addl CPT 10012 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | $21.14 | $60.39 | $39.49 – $46.87 | 2 |
| Foam drg <=16 sq in w/border HCPCS A6212 | $8.80 | $25.14 | $19.25 – $22.82 | 2 |
| Foam drg > 48 sq in w/border HCPCS A6214 | not published | not published | $20.41 – $24.20 | 2 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | not published | not published | $58.21 – $69.09 | 2 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | not published | not published | $14.81 – $17.59 | 2 |
| Foam/fabric leg strap HCPCS A5114 | not published | not published | $17.73 – $21.05 | 2 |
| Foam stability fetal lung CPT 83662 | not published | not published | $18.91 – $58.69 | 9 |
| Folic acid CPT 82746 | $152.60 | $436.00 | $14.70 – $45.60 | 9 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $32.83 | $93.80 | $0.06 – $0.13 | 4 |
| Follow-up angiography CPT 75898 | $651.00 | $1,860.00 | $165.28 – $15,276.98 | 9 |
| Followup eval of foot pt lop HCPCS G0246 | not published | not published | $171.24 – $316.79 | 7 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $3,542.74 | $10,122.11 | $3.22 – $25.65 | 9 |
| Fondaparinux sodium HCPCS J1652 | $116.35 | $332.42 | $0.72 – $21.19 | 5 |
| Fo nontorsion joint cf HCPCS L3935 | not published | not published | $241.15 – $446.13 | 7 |
| Foot arch support remov prem HCPCS L3030 | not published | not published | $91.55 – $169.37 | 7 |
| Foot arch supp premold metat HCPCS L3050 | not published | not published | $56.45 – $104.43 | 7 |
| Foot drp splt w/exp heel lg HCPCS L4398 | not published | not published | $91.13 – $168.59 | 7 |
| Foot external keel sach foot HCPCS L5970 | not published | not published | $312.80 – $578.68 | 7 |
| Foot insert plastazote or eq HCPCS L3002 | not published | not published | $193.73 – $358.40 | 7 |
| Foot insert remov molded spe HCPCS L3001 | not published | not published | $158.66 – $293.52 | 7 |
| Foot insert silicone gel eac HCPCS L3003 | not published | not published | $209.04 – $386.72 | 7 |
| Foot lamin/prepreg composite HCPCS L3031 | not published | not published | $146.92 – $271.80 | 6 |
| Foot longitudinal arch suppo HCPCS L3010 | not published | not published | $209.04 – $386.72 | 7 |
| Foot longitud/metatarsal sup HCPCS L3020 | not published | not published | $237.97 – $440.24 | 7 |
| Foot plas heel stabi pre ots HCPCS L3170 | not published | not published | $61.04 – $112.92 | 7 |
| Foot plate molded stirrup at HCPCS L2250 | not published | not published | $544.42 – $1,007.18 | 7 |
| Foot single axis ankle/foot HCPCS L5974 | not published | not published | $380.38 – $703.70 | 7 |
| Foot X-ray CPT 73630 | $364.00 | $1,040.00 | $58.71 – $427.38 | 9 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | not published | not published | $1,351.54 – $2,500.35 | 7 |
| Forearm/arm cuffs free motio HCPCS L3720 | not published | not published | $980.65 – $1,814.20 | 7 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | $3,684.10 | $10,526.00 | $1,746.72 – $10,103.00 | 9 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $43.70 – $1,360.75 | 3 |
| Forensic cytopathology CPT 88125 | not published | not published | $7.47 – $123.99 | 9 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $310.45 | $887.00 | $321.35 – $5,977.00 | 9 |
| Formoterol comp unit HCPCS J7640 | not published | not published | $2.88 – $3.44 | 3 |
| Formoterol fumarate, inh HCPCS J7606 | not published | not published | $1.97 – $15.14 | 5 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $82.67 | $236.20 | $0.11 – $4.73 | 5 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $15.58 – $54.30 | 5 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $87.16 | $249.02 | $1.33 – $16.51 | 9 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $28.50 – $81.58 | 9 |
| Fracture assessment via dxa CPT 77086 | $95.55 | $273.00 | $64.10 – $427.38 | 9 |
| _fragile x methylation-sendout CPT 81244 | not published | not published | $40.98 – $111.47 | 8 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $4,533.71 – $15,861.00 | 9 |
| Frame typ sock above elb/dis HCPCS L6688 | not published | not published | $773.73 – $1,431.40 | 7 |
| Frame typ socket bel elbow/w HCPCS L6687 | not published | not published | $714.22 – $1,321.31 | 7 |
| Frame typ socket shoulder di HCPCS L6689 | not published | not published | $882.33 – $1,632.31 | 7 |
| Frame typ sock interscap-tho HCPCS L6690 | not published | not published | $1,022.10 – $1,890.89 | 7 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $2,455.49 – $9,891.00 | 4 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $2,455.49 – $9,891.00 | 4 |
| Free omental flap microvasc CPT 49906 | not published | not published | $1,142.09 – $9,891.00 | 3 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $1,528.38 – $11,276.00 | 4 |
| Free skin flap microvasc CPT 15757 | not published | not published | $2,455.49 – $9,891.00 | 4 |
| Frenectomy 41115 CPT 41115 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Frenotomy 40806 CPT 40806 | not published | not published | $537.23 – $1,487.00 | 8 |
| Frenulotomy of penis CPT 54164 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $28.70 | $82.00 | $73.77 – $159.32 | 7 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $18.55 | $53.00 | $85.98 – $174.74 | 7 |
| Fresh frozen plasma thawing ea un CPT 86927 | $157.15 | $449.00 | $1.41 – $405.38 | 9 |
| Fr frz plasma donor retested HCPCS P9060 | not published | not published | $53.25 – $177.11 | 7 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $7.11 – $116.07 | 9 |
| Frozen blood prep CPT 86930 | not published | not published | $8.37 – $566.82 | 9 |
| Frozen blood thaw CPT 86931 | $306.60 | $876.00 | $6.26 – $566.82 | 9 |
| Frozen cell preparation CPT 88241 | not published | not published | $12.09 – $30.03 | 9 |
| Frozen plasma, pooled, sd HCPCS P9023 | not published | not published | $2.49 – $146.23 | 7 |
| Fructosamine glycated protein CPT 82985 | not published | not published | $16.76 – $46.76 | 9 |
| Ft arch suprt premold longit HCPCS L3040 | not published | not published | $56.45 – $104.43 | 7 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Fth/gft fr trnk each addl CPT 15201 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Ft insert ucb berkeley shell HCPCS L3000 | not published | not published | $376.80 – $697.08 | 7 |
| Ftl cgen abnor 3 proteins CPT 81509 | not published | not published | $140.88 – $3,693.14 | 8 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $69.52 – $172.63 | 8 |
| Ftl cgen abnor four anal CPT 81511 | not published | not published | $153.50 – $381.16 | 8 |
| Ftl cgen abnor three anal CPT 81510 | not published | not published | $55.54 – $137.90 | 8 |
| Ftl cgen abnor two proteins CPT 81508 | not published | not published | $54.30 – $134.85 | 8 |
| Ft prosth multiaxial ankl/ft HCPCS L5978 | not published | not published | $476.36 – $881.27 | 7 |
| Full field erg w/i&r CPT 92273 | not published | not published | $277.71 – $513.77 | 7 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $76.68 – $1,173.24 | 9 |
| Full sole/heel wedge btween HCPCS L3420 | not published | not published | $65.62 – $121.40 | 7 |
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.