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 |
|---|---|---|---|---|
| Ghs febrile agglutinns(mayo) CPT 86000 | not published | not published | $6.98 – $21.66 | 9 |
| Ghs fish cytogen CPT 88271 | not published | not published | $21.42 – $66.42 | 9 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | not published | not published | $51.19 – $127.09 | 9 |
| Ghs flow volume loop CPT 94375 | $147.35 | $421.00 | $85.95 – $513.77 | 7 |
| Ghs gastric intub aspiration lavage CPT 43753 | $441.35 | $1,261.00 | $112.54 – $5,977.00 | 9 |
| Ghs hcv amplificaiton CPT 87521 | not published | not published | $35.09 – $108.86 | 9 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $22.97 – $57.03 | 9 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $15.49 – $48.05 | 9 |
| Ghs hgb stability-thal CPT 83068 | not published | not published | $9.47 – $26.26 | 9 |
| Ghs histoplasma antigen CPT 87385 | not published | not published | $13.25 – $32.89 | 9 |
| Ghs HIV antibody CPT 86703 | not published | not published | $13.71 – $42.55 | 9 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $106.14 – $263.54 | 9 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $2,015.30 | $5,758.00 | $1,528.38 – $9,297.00 | 9 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,728.30 | $4,938.00 | $1,539.08 – $10,103.00 | 9 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $1,351.35 | $3,861.00 | $910.78 – $2,362.00 | 8 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $1,036.70 | $2,962.00 | $245.04 – $2,362.00 | 8 |
| Ghs immun0electrophoresis CPT 86320 | not published | not published | $29.92 – $74.30 | 9 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $473.20 | $1,352.00 | $321.35 – $5,977.00 | 9 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $412.30 | $1,178.00 | $256.73 – $9,297.00 | 9 |
| Ghs inf midline insertion CPT 36140 | $679.70 | $1,942.00 | $1,487.00 – $9,891.00 | 3 |
| Ghs inhibitor screen CPT 85335 | $108.50 | $310.00 | $12.87 – $39.92 | 9 |
| Ghs init tx 1st degree burn CPT 16000 | $231.00 | $660.00 | $151.53 – $1,487.00 | 8 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | not published | not published | $1,137.58 – $5,977.00 | 9 |
| Ghs inj neurolytic other perph nerve CPT 64640 | not published | not published | $1,137.58 – $5,977.00 | 9 |
| Ghs inj tendon origin/insertion CPT 20551 | $813.05 | $2,323.00 | $352.70 – $5,977.00 | 9 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $725.90 | $2,074.00 | $672.48 – $9,891.00 | 4 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,199.10 | $3,426.00 | $1,137.58 – $5,977.00 | 9 |
| Ghs insertion of needle - bone CPT 36680 | $356.65 | $1,019.00 | $277.95 – $1,487.00 | 8 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $593.25 | $1,695.00 | $522.85 – $9,297.00 | 9 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $593.25 | $1,695.00 | $561.69 – $9,297.00 | 9 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $2,854.60 | $8,156.00 | $561.69 – $9,297.00 | 9 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $77.00 | $220.00 | $1,487.00 – $9,891.00 | 3 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $310.45 | $887.00 | $321.35 – $5,977.00 | 9 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | not published | not published | $60.23 – $111.42 | 6 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $148.75 | $425.00 | $397.75 – $5,977.00 | 9 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $506.45 | $1,447.00 | $184.68 – $9,297.00 | 9 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $576.45 | $1,647.00 | $522.85 – $1,487.00 | 8 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $576.45 | $1,647.00 | $206.01 – $1,487.00 | 8 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $576.45 | $1,647.00 | $522.85 – $1,487.00 | 8 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $576.45 | $1,647.00 | $522.85 – $1,487.00 | 8 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $576.45 | $1,647.00 | $522.85 – $1,487.00 | 8 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $576.45 | $1,647.00 | $522.85 – $1,487.00 | 8 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $593.25 | $1,695.00 | $522.85 – $9,297.00 | 9 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $872.55 | $2,493.00 | $561.69 – $9,297.00 | 9 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $576.45 | $1,647.00 | $206.01 – $9,297.00 | 9 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $872.55 | $2,493.00 | $561.69 – $9,297.00 | 9 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $576.45 | $1,647.00 | $522.85 – $9,297.00 | 9 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $680.40 | $1,944.00 | $561.69 – $9,297.00 | 9 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $675.85 | $1,931.00 | $522.85 – $9,297.00 | 9 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $2,292.50 | $6,550.00 | $561.69 – $9,297.00 | 9 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $675.85 | $1,931.00 | $522.85 – $9,297.00 | 9 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | not published | not published | $8.60 – $26.70 | 9 |
| Ghs low level laser therapy CPT 97039 | $35.70 | $102.00 | not published | 0 |
| Ghs mbp CPT 83873 | not published | not published | $17.20 – $53.37 | 9 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $161.70 | $462.00 | not published | 0 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $161.70 | $462.00 | not published | 0 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $161.70 | $462.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $161.70 | $462.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $129.50 | $370.00 | not published | 0 |
| Ghs musc test done w/n test comp CPT 95886 | not published | not published | $192.28 – $194.59 | 2 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | not published | not published | $182.49 – $184.53 | 2 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $108.91 – $197.83 | 2 |
| Ghs myocardial strain img spckl track CPT 93356 | $301.35 | $861.00 | $261.59 – $261.59 | 1 |
| Ghs nailbed repair/nail removal CPT 11760 | $872.55 | $2,493.00 | $206.01 – $1,487.00 | 8 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,160.60 | $3,316.00 | $1,137.58 – $5,977.00 | 9 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,057.70 | $3,022.00 | $672.48 – $5,977.00 | 9 |
| Ghs nerve block axillary nerve CPT 64417 | $1,160.60 | $3,316.00 | $672.48 – $5,977.00 | 9 |
| Ghs nerve block brachial plexus CPT 64415 | $1,371.30 | $3,918.00 | $672.48 – $5,977.00 | 9 |
| Ghs nerve block celiac plexus CPT 64530 | $1,160.60 | $3,316.00 | $1,137.58 – $5,977.00 | 9 |
| Ghs nerve block interscaline CPT 64510 | $1,160.60 | $3,316.00 | $1,137.58 – $5,977.00 | 9 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | not published | not published | $1,137.58 – $5,977.00 | 9 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,057.70 | $3,022.00 | $352.70 – $5,977.00 | 9 |
| Ghs nerve block suprascapular CPT 64418 | not published | not published | $672.48 – $5,977.00 | 9 |
| Ghs ng placement w fluoro guidance CPT 43752 | $488.25 | $1,395.00 | $217.34 – $1,487.00 | 8 |
| Ghs o2 saturation CPT 82810 | $294.35 | $841.00 | $9.77 – $27.07 | 9 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $131.44 – $306.17 | 7 |
| Ghs o2 uptake rest & indirect CPT 94690 | not published | not published | $75.87 – $140.37 | 7 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $60.23 – $111.42 | 7 |
| Ghs opcc repair cvp without subq port CPT 36575 | $994.35 | $2,841.00 | $806.82 – $9,297.00 | 9 |
| Ghs opcc repair cvp w subq port CPT 36576 | $1,317.40 | $3,764.00 | $1,142.09 – $9,297.00 | 9 |
| Ghs optokenetic CPT 92544 | not published | not published | $120.22 – $306.17 | 7 |
| Ghs oscillating trac CPT 92545 | not published | not published | $113.69 – $513.77 | 7 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | not published | not published | $27.77 – $61.87 | 7 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | not published | not published | $27.77 – $61.87 | 7 |
| Ghs ot dds rom CPT 95851 | not published | not published | $6.88 – $123.37 | 7 |
| Ghs ot group caregiver training CPT 97552 | not published | not published | $9.80 – $352.70 | 6 |
| Ghs ot prosthetic training/15 min CPT 97761 | $74.20 | $212.00 | $44.61 – $82.53 | 6 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $65.10 | $186.00 | $45.42 – $126.65 | 6 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $134.55 – $134.55 | 1 |
| Ghs pacing - transcutaneous CPT 92953 | $1,878.80 | $5,368.00 | $14.16 – $2,362.00 | 8 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | not published | not published | $450.55 – $9,891.00 | 4 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | not published | not published | $450.55 – $9,891.00 | 4 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $52.70 – $118.75 | 4 |
| Ghs peritonsillar abscess i andd CPT 42700 | $473.20 | $1,352.00 | $304.63 – $5,977.00 | 9 |
| Ghs phenylketonurid CPT 84030 | $5.25 | $15.00 | $5.50 – $17.06 | 9 |
| Ghs picc line insert < 5 CPT 36568 | $2,041.20 | $5,832.00 | $1,142.09 – $5,977.00 | 9 |
| Ghs plngl fx pm cl CPT 26725 | $675.85 | $1,931.00 | $259.12 – $1,487.00 | 8 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $4.31 – $13.34 | 9 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $1,104.48 – $2,106.41 | 7 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $149.59 – $316.58 | 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.