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 |
|---|---|---|---|---|
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | $1,702.05 | $4,863.00 | $1,528.38 – $9,297.00 | 9 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | $1,084.65 | $3,099.00 | $1,528.38 – $9,297.00 | 9 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | $542.50 | $1,550.00 | $857.14 – $9,891.00 | 4 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $1,910.30 | $5,458.00 | $1,746.72 – $10,103.00 | 9 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $110.81 – $316.58 | 7 |
| Furnsh initial orthosis only HCPCS L1200 | not published | not published | $2,400.62 – $4,441.15 | 7 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $96.74 | $276.41 | $0.02 – $0.05 | 4 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $0.92 – $3.03 | 2 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $1,528.38 – $9,891.00 | 4 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $1,142.09 – $11,276.00 | 4 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $1,142.09 – $11,276.00 | 4 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fuse/graft added joint CPT 26863 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $8,837.00 – $9,891.00 | 2 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $1,528.38 – $9,891.00 | 4 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fuse upper gi structures CPT 47721 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $2,159.89 – $30,073.00 | 9 |
| Fusion of big toe joint CPT 28750 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Fusion of big toe joint CPT 28755 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Fusion of finger joint CPT 26860 | $2,457.00 | $7,020.00 | $1,746.72 – $10,103.00 | 9 |
| Fusion of finger tendons CPT 26471 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Fusion of finger tendons CPT 26474 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Fusion of foot bones CPT 28730 | not published | not published | $2,159.89 – $30,073.00 | 9 |
| Fusion of foot bones CPT 28735 | not published | not published | $2,159.89 – $30,073.00 | 9 |
| Fusion of foot bones CPT 28740 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Fusion of hand joint CPT 26843 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Fusion of knee CPT 27580 | not published | not published | $1,746.72 – $30,548.47 | 9 |
| Fusion of knuckle CPT 26850 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $1,142.09 – $9,834.00 | 9 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $1,746.72 – $12,132.52 | 9 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Fusion of skull arteries CPT 61711 | not published | not published | $2,159.89 – $11,276.00 | 4 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Fusion of thumb CPT 26841 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $2,159.89 – $30,073.00 | 9 |
| Fusion of toes CPT 28280 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $274.83 – $682.40 | 9 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $137.00 – $340.17 | 9 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $274.83 – $682.40 | 9 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $185.20 – $459.85 | 9 |
| G6pc gene CPT 81250 | not published | not published | $58.49 – $145.24 | 8 |
| G6pd full gene sequence CPT 81249 | not published | not published | $600.00 – $1,489.80 | 9 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $434.07 | 9 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $931.74 | 9 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | not published | not published | $47.30 – $274.06 | 3 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $49.63 – $112.77 | 8 |
| Gabapentin non-blood CPT 80355 | not published | not published | $0.02 – $83.05 | 2 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $51.45 | $147.00 | $0.52 – $2.43 | 3 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $2.97 – $10.46 | 3 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.24 – $1.38 | 3 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $29.27 – $37.95 | 3 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $21.07 – $65.35 | 9 |
| Galactokinase - sendout CPT 82759 | not published | not published | $21.48 – $66.64 | 9 |
| Galactose transferase test CPT 82776 | $13.30 | $38.00 | $11.74 – $29.15 | 9 |
| Galectin-3 CPT 82777 | not published | not published | $36.75 – $109.86 | 9 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $3,409.47 – $16,213.00 | 9 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $1.59 – $15.38 | 9 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $363.50 – $1,545.91 | 8 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $550.13 – $1,578.91 | 8 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $478.52 – $2,216.65 | 8 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $362.50 – $1,873.21 | 8 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $2.40 – $4.14 | 4 |
| Galsulfase injection HCPCS J1458 | not published | not published | $500.00 – $1,042.49 | 9 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $108.05 – $1,051.03 | 9 |
| Gamma globulin 1 cc inj HCPCS J1460 | $1,598.22 | $4,566.35 | $29.33 – $105.11 | 9 |
| Gammaglobulin iga CPT 82784 | $66.15 | $189.00 | $9.30 – $28.84 | 9 |
| Gammaglobulin ige CPT 82785 | $66.15 | $189.00 | $16.46 – $51.07 | 9 |
| Gamma glutamyltransferase CPT 82977 | $105.70 | $302.00 | $7.20 – $22.34 | 9 |
| Gammagraft HCPCS Q4111 | not published | not published | $15.12 – $296.10 | 9 |
| Gammaplex injection HCPCS J1557 | not published | not published | $62.47 – $123.58 | 9 |
| Gamunex-c/gammaked HCPCS J1561 | $5,103.06 | $14,580.16 | $48.03 – $103.95 | 9 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $435.44 | $1,244.10 | $39.62 – $94.24 | 5 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $8,825.26 – $36,441.60 | 5 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $35.09 – $108.86 | 9 |
| Gardner vag dna quant CPT 87512 | not published | not published | $41.76 – $129.49 | 9 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $6.71 – $16.93 | 9 |
| Gastric emptying imag study CPT 78265 | $1,340.15 | $3,829.00 | $514.17 – $1,950.38 | 9 |
| Gastric emptying imag study CPT 78266 | $1,474.55 | $4,213.00 | $698.35 – $2,612.61 | 9 |
| Gastric motility studies CPT 91020 | not published | not published | $155.10 – $1,487.00 | 8 |
| Gastric mucosa imaging CPT 78261 | $676.55 | $1,933.00 | $514.17 – $1,950.38 | 9 |
| Gastrin test CPT 82938 | not published | not published | $17.69 – $54.88 | 9 |
| Gastroduodenostomy CPT 43810 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Gastroesophageal reflux study CPT 78262 | $923.65 | $2,639.00 | $514.17 – $1,950.38 | 9 |
| Gastroesophageal reflux test CPT 91034 | $1,759.45 | $5,027.00 | $479.94 – $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.