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 |
|---|---|---|---|---|
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $27,279.40 | $77,941.15 | $61.91 – $296.10 | 8 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $381.63 – $4,294.63 | 4 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $46,027.63 | $131,507.50 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $31,998.58 | $91,424.50 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $27,688.86 | $79,111.03 | $66.20 – $296.10 | 9 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $7,541.10 | $21,546.00 | $160.06 – $296.10 | 9 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $13,167.00 | $37,620.00 | $160.06 – $296.10 | 8 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $45.95 – $296.10 | 9 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $2,610.56 | $7,458.75 | $160.06 – $322.54 | 7 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $34,036.43 | $97,246.95 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $4,063.50 | $11,610.00 | $74.63 – $296.10 | 8 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $46,981.90 | $134,234.00 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $2,677.50 | $7,650.00 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | $4.92 | $14.05 | $3.06 – $142.95 | 5 |
| Granisetron hcl injection HCPCS J1626 | $78.32 | $223.77 | $0.23 – $50.34 | 5 |
| Granulocyte pheresis ea unit HCPCS P9050 | not published | not published | $2,932.91 – $2,932.91 | 1 |
| Great toe-hand transfer CPT 26551 | not published | not published | $3,409.47 – $17,265.50 | 9 |
| Great toe with reduction 28495 CPT 28495 | $675.85 | $1,931.00 | $259.12 – $1,487.00 | 8 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,142.09 – $15,861.00 | 9 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $4,557.82 – $15,861.00 | 9 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $4,557.82 – $15,861.00 | 9 |
| Ground mileage HCPCS A0425 | not published | not published | $9.33 – $17.26 | 6 |
| Group behave couns 2-10 HCPCS G0473 | not published | not published | $48.19 – $123.87 | 7 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $12.70 – $38.61 | 6 |
| Group train without patient HCPCS G0543 | not published | not published | $37.20 – $68.82 | 6 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $48.82 | 9 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $206.91 | 9 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $321.11 | 9 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $61.79 – $187.71 | 9 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $48.19 – $89.15 | 7 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $48.19 – $89.15 | 7 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,528.38 – $9,891.00 | 4 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,746.72 – $9,891.00 | 4 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| G-tube reposition CPT 43761 | $746.20 | $2,132.00 | $321.35 – $5,977.00 | 9 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,807.05 | $5,163.00 | $211.03 – $9,942.85 | 9 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,230.55 | $6,373.00 | $910.78 – $2,362.00 | 8 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $6,494.37 | $18,555.34 | $947.68 – $947.68 | 1 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,836.25 | $10,960.70 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $11,338.25 | $32,395.00 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $292.95 | $837.00 | $91.33 – $445.71 | 2 |
| Gum graft CPT 41870 | not published | not published | $1,995.60 – $9,891.00 | 9 |
| Gw stiffened micro access kit HCPCS C1894 | $13,093.85 | $37,411.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Hair analysis HCPCS P2031 | not published | not published | $7.02 – $201.07 | 3 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $258.55 – $1,487.00 | 8 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $206.01 – $10,103.00 | 9 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $206.01 – $10,103.00 | 9 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $51.86 – $95.94 | 7 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $3,115.46 – $5,763.60 | 7 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $3,952.09 – $7,311.37 | 7 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $4,804.53 – $8,888.38 | 7 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $34.88 | $99.67 | $4.68 – $87.80 | 5 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $33.44 | $95.55 | $0.84 – $20.44 | 5 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $258.53 – $478.28 | 7 |
| Hand-held pefr meter a4614 HCPCS A4614 | not published | not published | $47.13 – $55.95 | 2 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $11.54 – $11.54 | 1 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $115.37 – $213.43 | 7 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $4,868.50 | $13,910.00 | $8,365.00 – $8,365.00 | 1 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $2,396.60 – $4,433.71 | 7 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $2,334.78 – $4,319.34 | 7 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $988.45 – $1,828.63 | 7 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $2,455.98 – $4,543.56 | 7 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $2,159.89 – $16,065.00 | 9 |
| Hand tendon reconstruction CPT 26502 | $2,457.00 | $7,020.00 | $2,159.89 – $12,557.00 | 9 |
| Hand X-ray CPT 73130 | $406.35 | $1,161.00 | $59.56 – $427.38 | 9 |
| Haptoglobin quantitative CPT 83010 | $148.75 | $425.00 | $12.58 – $39.03 | 9 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $275.23 – $509.18 | 7 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $197.96 – $366.23 | 7 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $186.86 – $345.69 | 7 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $561.69 – $9,297.00 | 9 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,142.09 – $9,297.00 | 9 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $567.42 – $5,977.00 | 9 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $1,487.00 – $9,891.00 | 4 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $153.58 – $316.58 | 7 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $127.63 – $316.58 | 7 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $1,489.80 | 9 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $502.56 | 9 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $931.74 | 9 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $805.94 | 9 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $434.07 | 9 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $502.56 | 9 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $931.74 | 9 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $30.11 | 9 |
| Hbot, full body chamber, 30m HCPCS G0277 | not published | not published | $176.99 – $327.43 | 7 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $961.10 | $2,746.00 | $223.33 – $864.05 | 9 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $46.71 | 9 |
| Hcg qualitative CPT 84703 | $128.45 | $367.00 | $7.52 – $23.30 | 9 |
| Hcg quantitative CPT 84702 | $169.40 | $484.00 | $15.05 – $46.71 | 9 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | not published | not published | $70.37 – $203.07 | 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.