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 |
|---|---|---|---|---|
| Mayo factor v CPT 85220 | $155.75 | $445.00 | $17.65 – $54.75 | 9 |
| Mayo factor vii CPT 85230 | $155.75 | $445.00 | $17.90 – $55.54 | 9 |
| Mayo factor viii vw factor antigen CPT 85246 | $105.70 | $302.00 | $22.94 – $71.18 | 9 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | not published | not published | $22.94 – $71.18 | 9 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | not published | not published | $22.94 – $71.18 | 9 |
| Mayo factor x CPT 85260 | $137.55 | $393.00 | $17.90 – $55.54 | 9 |
| Mayo factor xi CPT 85270 | $137.55 | $393.00 | $17.90 – $55.54 | 9 |
| Mayo fat/lipids feces quantitative CPT 82710 | not published | not published | $16.80 – $52.12 | 9 |
| Mayo fbl culture fungi blood CPT 87103 | $234.15 | $669.00 | $20.46 – $50.81 | 9 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $23.76 – $199.79 | 9 |
| Mayo ffspg allergen clam igg CPT 86001 | not published | not published | $7.82 – $19.41 | 9 |
| Mayo fibrinogen antigen CPT 85385 | not published | not published | $14.46 – $35.91 | 9 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | not published | not published | $21.67 – $53.82 | 9 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $135.80 | $388.00 | $109.31 – $402.17 | 2 |
| Mayo hemosiderin qualitative urine CPT 83070 | not published | not published | $4.75 – $14.74 | 9 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | not published | not published | $35.09 – $108.86 | 9 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | not published | not published | $35.09 – $108.86 | 9 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | not published | not published | $13.79 – $38.78 | 9 |
| Mayo hla typing a/b/c single antigen CPT 86812 | not published | not published | $25.81 – $80.07 | 9 |
| Mayo hvdip HIV 1 antibody CPT 86701 | not published | not published | $8.89 – $27.55 | 9 |
| Mayo hvdip HIV 2 antibody CPT 86702 | not published | not published | $13.52 – $41.92 | 9 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | not published | not published | $27.17 – $84.27 | 9 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | not published | not published | $17.27 – $42.90 | 9 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | not published | not published | $14.99 – $46.52 | 9 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $198.80 | $568.00 | $20.81 – $64.56 | 9 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | not published | not published | $20.81 – $64.56 | 9 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $35.09 – $155.45 | 9 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $55.30 | $158.00 | $16.07 – $39.92 | 9 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | not published | not published | $11.98 – $29.76 | 9 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | not published | not published | $35.09 – $108.86 | 9 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | not published | not published | $35.09 – $87.13 | 9 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | not published | not published | $35.09 – $108.86 | 9 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | not published | not published | $35.09 – $155.45 | 9 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | not published | not published | $42.84 – $132.87 | 9 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | not published | not published | $72.19 – $179.23 | 9 |
| Mayo infliximab therapeutic drug level CPT 80230 | not published | not published | $38.57 – $95.77 | 9 |
| Mayo inhab inhibin a CPT 86336 | not published | not published | $15.59 – $48.33 | 9 |
| Mayo insft insulin free CPT 83527 | not published | not published | $12.95 – $40.16 | 9 |
| Mayo insulin antibodies CPT 86337 | not published | not published | $21.41 – $66.42 | 9 |
| Mayo iodine CPT 83789 | $15.05 | $43.00 | $24.11 – $59.86 | 9 |
| Mayo itraconazole therapeutic drug level CPT 80189 | not published | not published | $27.11 – $67.31 | 9 |
| Mayo lacosamide therapeutic drug level CPT 80235 | not published | not published | $27.11 – $67.31 | 9 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | not published | not published | $13.25 – $39.51 | 9 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | not published | not published | $12.79 – $39.70 | 9 |
| Mayo legionella antibody CPT 86713 | not published | not published | $15.30 – $47.46 | 9 |
| Mayo leptospira antibody igm CPT 86720 | not published | not published | $16.20 – $40.22 | 9 |
| Mayo lipoprotein electrophoresis CPT 83700 | not published | not published | $11.26 – $34.93 | 9 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | not published | not published | $15.49 – $48.05 | 9 |
| Mayo manganese CPT 83785 | not published | not published | $26.65 – $76.28 | 9 |
| Mayo metanephrines plasma CPT 83835 | not published | not published | $16.94 – $52.56 | 9 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | not published | not published | $0.02 – $102.61 | 2 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | not published | not published | $12.05 – $40.30 | 9 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | not published | not published | $18.40 – $81.51 | 9 |
| Mayo microsomal antibody liver-kidney CPT 86376 | not published | not published | $14.55 – $45.14 | 9 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $51.65 | $147.58 | $18.64 – $46.30 | 9 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | not published | not published | $94.73 – $340.17 | 8 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $185.20 – $459.85 | 9 |
| Mayo muramidase CPT 85549 | not published | not published | $18.75 – $58.19 | 9 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | not published | not published | $18.40 – $81.51 | 9 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | not published | not published | $18.05 – $53.81 | 9 |
| Mayo myoglobin CPT 83874 | not published | not published | $12.92 – $40.06 | 9 |
| Mayo nickel CPT 83885 | not published | not published | $24.51 – $75.99 | 9 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | not published | not published | $0.02 – $122.20 | 2 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | not published | not published | $0.02 – $122.20 | 2 |
| Mayo opatu oxycodone definitive assay CPT 80365 | not published | not published | $0.02 – $122.20 | 2 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | not published | not published | $21.21 – $52.68 | 9 |
| Mayo organic acids qualitative each specimen CPT 83919 | not published | not published | $16.45 – $51.05 | 9 |
| Mayo oxalate 24 hour urine CPT 83945 | not published | not published | $14.45 – $39.92 | 9 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $11.53 – $28.80 | 9 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | not published | not published | $15.03 – $46.65 | 9 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | not published | not published | $12.05 – $37.38 | 9 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | not published | not published | $35.09 – $108.86 | 9 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | not published | not published | $17.98 – $55.76 | 9 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | not published | not published | $13.76 – $42.71 | 9 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | not published | not published | $8.44 – $26.19 | 9 |
| Mayo pregnenolone CPT 84140 | not published | not published | $20.67 – $64.15 | 9 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | not published | not published | $16.59 – $51.49 | 9 |
| Mayo proinsulin CPT 84206 | not published | not published | $26.69 – $66.28 | 9 |
| Mayo psaft prostate specific antigen free CPT 84154 | $164.50 | $470.00 | $18.39 – $57.07 | 9 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | not published | not published | $18.40 – $45.69 | 9 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | not published | not published | $13.36 – $41.43 | 9 |
| Mayo receptor assay transferrin soluble CPT 84238 | not published | not published | $36.57 – $113.42 | 9 |
| Mayo renin CPT 84244 | not published | not published | $21.99 – $68.22 | 9 |
| Mayo repu protein electrophoresis urine CPT 84166 | $145.95 | $417.00 | $17.83 – $55.32 | 9 |
| Mayo selenium CPT 84255 | not published | not published | $25.53 – $79.19 | 9 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $15.50 – $48.09 | 9 |
| Mayo serotonin CPT 84260 | not published | not published | $30.98 – $96.08 | 9 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | not published | not published | $19.35 – $60.03 | 9 |
| Mayo sirolimus therapeutic drug level CPT 80195 | not published | not published | $13.73 – $42.60 | 9 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | not published | not published | $18.26 – $170.26 | 6 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $156.10 | $446.00 | $4.27 – $13.25 | 9 |
| Mayo tau phosphorylated 217 each CPT 84393 | not published | not published | $126.43 – $238.50 | 6 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $175.00 | $500.00 | $208.92 – $518.76 | 8 |
| Mayo tgrp testosterone free CPT 84402 | not published | not published | $25.47 – $78.99 | 9 |
| Mayo tgrp testosterone total CPT 84403 | $94.85 | $271.00 | $25.81 – $80.09 | 9 |
| Mayo thiopurine s-methyltransferase CPT 84433 | not published | not published | $22.17 – $98.21 | 9 |
| Mayo thyroglobulin CPT 84432 | not published | not published | $16.06 – $49.84 | 9 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | not published | not published | $10.18 – $31.58 | 9 |
| Mayo ticks babesia microti antibody igg CPT 86753 | not published | not published | $12.39 – $38.43 | 9 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | not published | not published | $0.02 – $122.20 | 2 |
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.