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 |
|---|---|---|---|---|
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $128.73 – $399.28 | 9 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | not published | not published | $257.45 – $798.56 | 9 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $32.77 – $145.17 | 9 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $26.99 – $87.63 | 9 |
| Infect ag ia optc obs influenza CPT 87804 | not published | not published | $16.55 – $41.10 | 9 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $11.98 – $29.76 | 9 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $18.36 – $50.92 | 9 |
| Infect ag if influenza a CPT 87276 | not published | not published | $16.07 – $39.92 | 9 |
| Infect ag if influenza b CPT 87275 | not published | not published | $12.25 – $30.41 | 9 |
| Infect ag if legionella pneumophila CPT 87278 | not published | not published | $15.60 – $38.73 | 9 |
| Infect ag if nos ea CPT 87299 | not published | not published | $16.10 – $40.00 | 9 |
| Infect ag if pneumocystis carinii CPT 87281 | not published | not published | $11.98 – $29.76 | 9 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $13.42 – $33.31 | 9 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $53.47 – $132.78 | 9 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $35.09 – $108.86 | 9 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $42.84 – $132.87 | 9 |
| Infect ag na hpv high-risk types CPT 87624 | not published | not published | $35.09 – $211.58 | 9 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $194.60 | $556.00 | $95.80 – $263.94 | 9 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $51.31 – $159.17 | 9 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | $51.31 – $127.40 | 8 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $710.50 | $2,030.00 | $416.78 – $2,537.99 | 9 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $488.66 – $1,515.70 | 9 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $26.07 – $80.85 | 9 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $27.28 – $102.76 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $47.95 | $137.00 | $11.98 – $29.76 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $13.42 – $33.31 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | not published | not published | $13.82 – $34.30 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | not published | not published | $11.98 – $29.76 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $81.55 | $233.00 | $14.38 – $44.61 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $63.70 | $182.00 | $10.33 – $32.04 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | not published | not published | $10.33 – $32.04 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $68.60 | $196.00 | $24.08 – $74.72 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $111.30 | $318.00 | $11.98 – $29.76 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | not published | not published | $11.98 – $29.76 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $11.98 – $29.76 | 9 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $83.30 | $238.00 | $35.09 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $52.50 | $150.00 | $35.09 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | not published | not published | $37.27 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $564.90 | $1,614.00 | $416.78 – $1,252.07 | 9 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | not published | not published | $35.09 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $72.80 | $208.00 | $35.09 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $60.90 | $174.00 | $41.68 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $52.50 | $150.00 | $35.09 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $112.00 | $320.00 | $51.31 – $127.40 | 8 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $497.00 | $1,420.00 | $142.63 – $354.15 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $631.75 | $1,805.00 | $142.63 – $354.15 | 9 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $104.65 | $299.00 | $35.09 – $108.86 | 9 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | not published | not published | $35.09 – $104.59 | 9 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | not published | not published | $70.18 – $129.83 | 5 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $76.77 – $340.09 | 9 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $679.77 – $1,257.57 | 5 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $385.00 | $1,100.00 | $416.78 – $2,512.61 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $175.00 | $500.00 | $128.29 – $773.39 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $292.25 | $835.00 | $262.99 – $1,286.69 | 9 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | not published | not published | $42.84 – $132.87 | 9 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | not published | not published | $42.84 – $132.87 | 9 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | not published | not published | $42.84 – $132.87 | 9 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | not published | not published | $85.10 – $263.94 | 9 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $306.95 | $877.00 | $142.63 – $781.19 | 9 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $4,195.34 | $11,986.68 | $31.04 – $65.62 | 9 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,383.33 | $3,952.36 | $28.04 – $51.87 | 9 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $1,617.43 | $4,621.23 | $16.38 – $96.52 | 9 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $29.22 – $72.54 | 9 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $74.71 – $179.50 | 4 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $25.83 – $62.07 | 4 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $352.70 – $1,487.00 | 2 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,821.63 – $12,235.00 | 4 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,821.63 – $12,235.00 | 4 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $352.70 – $9,891.00 | 3 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $352.70 – $9,891.00 | 3 |
| Infuse radioactive materials CPT 77750 | not published | not published | $228.22 – $917.73 | 7 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $432.52 – $432.52 | 1 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $479.94 – $887.89 | 7 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $547.05 | $1,563.00 | $243.62 – $521.04 | 7 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $2,839.14 – $5,252.41 | 7 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $2,087.82 – $3,862.47 | 7 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,580.90 – $2,924.67 | 7 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $132.63 – $316.79 | 7 |
| Initiation & management bipap/cpap initial day CPT 94660 | $619.50 | $1,770.00 | $111.53 – $521.04 | 7 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $130.66 – $241.72 | 7 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $6.02 – $12.62 | 9 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $7.24 – $15.11 | 9 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.09 – $0.76 | 9 |
| Inj, acetaminophen (b braun) HCPCS J0136 | $35.16 | $100.46 | $0.05 – $0.38 | 5 |
| Inj acetaminophen -fresenius HCPCS J0134 | $34.32 | $98.06 | $0.06 – $0.38 | 5 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.05 – $0.38 | 5 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $4,094.26 – $12,467.48 | 9 |
| Inj, adalimumab, 1 mg HCPCS J0139 | $0.00 | $0.01 | $130.10 – $197.22 | 3 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $13.23 – $26.33 | 4 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | $22,750.00 | $65,000.00 | $61,200.00 – $135,956.56 | 9 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.75 – $12.86 | 5 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $34.51 – $74.22 | 9 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $821.40 – $1,711.10 | 8 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $301.18 – $690.54 | 9 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.57 – $3.25 | 9 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $2.57 – $5.11 | 2 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $8,989.54 | $25,684.40 | $3.81 – $9.57 | 9 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $123.12 – $296.94 | 9 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $51.59 – $99.01 | 9 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.56 – $19.59 | 9 |
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.