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 |
|---|---|---|---|---|
| Intraventricular pacing CPT 93612 | $3,659.60 | $10,456.00 | $279.38 – $16,065.00 | 8 |
| Intrinsic factor antibody CPT 86340 | not published | not published | $15.08 – $46.76 | 9 |
| Intrm oph exam est patient CPT 92012 | not published | not published | $170.80 – $316.79 | 7 |
| Intro cath dialysis circuit CPT 36901 | $846.65 | $2,419.00 | $1,686.85 – $4,099.00 | 8 |
| Intro cath dialysis circuit w/pta CPT 36902 | $2,289.35 | $6,541.00 | $3,409.47 – $13,460.00 | 8 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $4,578.70 | $13,082.00 | $3,409.47 – $27,468.35 | 8 |
| Intro catheter aorta CPT 36200 | $730.80 | $2,088.00 | $1,487.00 – $9,891.00 | 3 |
| Intro cath svc/ivc CPT 36010 | $626.15 | $1,789.00 | $1,487.00 – $9,891.00 | 3 |
| Intro long gi tube CPT 44500 | $1,348.90 | $3,854.00 | $1,071.68 – $5,977.00 | 9 |
| Intro long gi tube w/mult fluo CPT 74340 | $232.40 | $664.00 | $203.77 – $480.70 | 3 |
| Intro windpipe wire/tube CPT 31730 | $1,107.75 | $3,165.00 | $762.10 – $5,977.00 | 9 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $1,056.65 | $3,019.00 | $1,487.00 – $9,891.00 | 3 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $674.45 | $1,927.00 | $1,487.00 – $9,891.00 | 3 |
| Intubation endotracheal emergency procedure CPT 31500 | $483.70 | $1,382.00 | $304.63 – $5,977.00 | 9 |
| Io anal gast n-stim init CPT 95980 | not published | not published | $50.37 – $182.29 | 2 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $22.32 – $140.37 | 7 |
| Iodine i-123 sod iodide mil HCPCS A9509 | not published | not published | $285.64 – $4,086.50 | 3 |
| Iodine i-125 sodium iodide HCPCS A9527 | not published | not published | $36.79 – $733.19 | 9 |
| Iodine i-131 iobenguane 1mci HCPCS A9590 | not published | not published | $384.47 – $881.71 | 4 |
| Io ga n-stim subsq w/reprog CPT 95982 | not published | not published | $36.21 – $88.80 | 7 |
| Ionm in operatng room 15 min CPT 95940 | $61.95 | $177.00 | $164.81 – $164.81 | 1 |
| Ionm remote/>1 pt or per hr CPT 95941 | not published | not published | $220.49 – $220.49 | 1 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $34.25 | $97.86 | $0.82 – $1.14 | 3 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $52.50 | $150.00 | $0.28 – $1.14 | 3 |
| Io radiation tx management CPT 77469 | not published | not published | $475.49 – $2,000.90 | 3 |
| Io rad tx deliver by elctrns CPT 77425 | not published | not published | $505.26 – $17,525.04 | 6 |
| Io rad tx delivery by x-ray CPT 77424 | $10,035.20 | $28,672.00 | $716.00 – $17,525.04 | 6 |
| Ioxaglate 39.3%-19.6% inj 200 ml HCPCS Q9964 | not published | not published | $0.58 – $0.58 | 1 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $63,066.15 | $180,189.00 | $181.09 – $387.47 | 9 |
| Ipratropium bromide comp HCPCS J7645 | not published | not published | $0.06 – $0.19 | 3 |
| Ipratropium bromide non-comp HCPCS J7644 | $0.61 | $1.75 | $0.39 – $9.65 | 5 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $161.08 | $460.22 | $1.40 – $388.87 | 5 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | not published | not published | $65.26 – $140.35 | 9 |
| Iron CPT 83540 | $110.25 | $315.00 | $6.47 – $20.10 | 9 |
| Iron binding capacity CPT 83550 | $127.05 | $363.00 | $8.74 – $22.91 | 9 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | not published | not published | $18.03 – $37.04 | 9 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $6.88 – $20.08 | 9 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $41.34 | $118.10 | $0.22 – $1.70 | 5 |
| Irradiation of blood product each unit reference CPT 86945 | $66.15 | $189.00 | $2.10 – $88.87 | 9 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $187.60 | $536.00 | $75.87 – $140.37 | 7 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Irrigation syringe HCPCS A4322 | not published | not published | $6.04 – $7.16 | 2 |
| Irrigation tray HCPCS A4320 | not published | not published | $8.99 – $10.64 | 2 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $75.87 – $1,487.00 | 8 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $82.86 – $169.55 | 9 |
| Island pedicle flap graft CPT 15740 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Ivc venogram s&i CPT 75825 | $1,806.35 | $5,161.00 | $377.93 – $15,276.98 | 9 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $151.98 – $302.44 | 3 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $113.40 | $324.00 | $85.83 – $171.32 | 7 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $113.40 | $324.00 | $60.95 – $60.95 | 1 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $113.40 | $324.00 | $60.23 – $111.42 | 7 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $318.15 | $909.00 | $267.38 – $506.11 | 7 |
| IV inj ra drug dx study CPT 78808 | not published | not published | $105.35 – $1,950.38 | 9 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $112.54 – $1,487.00 | 8 |
| Ivp w/nephrotomography CPT 74415 | $850.50 | $2,430.00 | $225.59 – $864.05 | 9 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $736.05 | $2,103.00 | $221.31 – $864.05 | 9 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $136.99 – $292.85 | 9 |
| Jak2 targeted sequence analysis CPT 81279 | not published | not published | $185.20 – $459.85 | 9 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| John cunningham antibody CPT 86711 | not published | not published | $16.89 – $87.67 | 9 |
| J-tube placement CPT 44015 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,789.03 – $3,309.71 | 7 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,552.14 – $2,871.46 | 7 |
| Kafo fem fx cast molded to p HCPCS L2128 | not published | not published | $2,472.79 – $4,574.66 | 7 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $1,481.88 – $2,741.48 | 7 |
| Kafo fem fx cast thermoplas HCPCS L2126 | not published | not published | $1,574.26 – $2,912.38 | 7 |
| Kafo femoral fx cast rigid HCPCS L2136 | $1,286.91 | $3,676.89 | $1,811.94 – $3,352.09 | 7 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $955.33 – $1,767.36 | 7 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $2,403.16 – $4,445.85 | 7 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $2,551.96 – $4,721.13 | 7 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $207.77 – $384.37 | 7 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,554.06 – $2,875.01 | 7 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $4,915.21 – $9,093.14 | 7 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $1,416.67 – $2,620.84 | 7 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $1,875.31 – $3,469.32 | 7 |
| Keratomileusis CPT 65760 | not published | not published | $3,409.47 – $5,821.00 | 3 |
| Keratophakia CPT 65765 | not published | not published | $3,409.47 – $8,365.00 | 3 |
| Keratoprosthesis CPT 65770 | not published | not published | $3,409.47 – $30,073.00 | 9 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $160.06 – $1,517.15 | 8 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $0.02 – $87.45 | 2 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $15.47 – $43.98 | 9 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $53.20 | $152.00 | $8.17 – $25.34 | 9 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $33.60 | $96.00 | $0.34 – $1.30 | 9 |
| Kidney endoscopy CPT 50551 | not published | not published | $1,142.09 – $12,111.00 | 9 |
| Kidney endoscopy CPT 50553 | not published | not published | $1,142.09 – $12,111.00 | 9 |
| Kidney endoscopy CPT 50570 | not published | not published | $1,142.09 – $7,332.00 | 9 |
| Kidney endoscopy CPT 50575 | not published | not published | $1,142.09 – $12,111.00 | 9 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $1,142.09 – $15,828.09 | 9 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $1,142.09 – $5,977.00 | 9 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $1,142.09 – $21,833.00 | 9 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $1,142.09 – $12,111.00 | 9 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $1,142.09 – $15,828.09 | 9 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $1,142.09 – $12,111.00 | 9 |
| Kidney function study CPT 78725 | $302.75 | $865.00 | $211.20 – $1,950.38 | 9 |
| Kidney imaging (3d) CPT 78710 | not published | not published | $1,084.59 – $1,084.59 | 1 |
| Kidney imaging morphology CPT 78700 | $392.70 | $1,122.00 | $385.77 – $1,950.38 | 9 |
| Kidney imag w/bld flow multi CPT 78709 | not published | not published | $698.35 – $2,612.61 | 9 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,341.20 | $3,832.00 | $479.92 – $2,612.61 | 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.