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 |
|---|---|---|---|---|
| Assay of pregnanetriol CPT 84138 | not published | not published | $21.05 – $58.74 | 9 |
| Assay of procainamide w/metab CPT 80192 | not published | not published | $16.75 – $51.95 | 9 |
| Assay of progesterone CPT 84234 | not published | not published | $64.88 – $201.24 | 9 |
| Assay of prostaglandin CPT 84150 | not published | not published | $41.77 – $103.71 | 9 |
| Assay of PSA complexed CPT 84152 | not published | not published | $18.39 – $57.07 | 9 |
| Assay of quinine CPT 84228 | not published | not published | $11.63 – $36.09 | 9 |
| Assay of rbc pg6d enzyme CPT 84085 | not published | not published | $9.44 – $23.45 | 9 |
| Assay of salicylate CPT 80179 | $87.15 | $249.00 | $18.64 – $46.30 | 9 |
| Assay of semen fructose CPT 82757 | not published | not published | $17.34 – $53.79 | 9 |
| Assay of sialic acid CPT 84275 | not published | not published | $13.44 – $41.68 | 9 |
| Assay of silica CPT 84285 | not published | not published | $25.21 – $73.04 | 9 |
| Assay of somatostatin CPT 84307 | not published | not published | $18.28 – $56.72 | 9 |
| Assay of thiocyanate CPT 84430 | not published | not published | $11.63 – $36.09 | 9 |
| Assay of troponin qual CPT 84512 | not published | not published | $10.09 – $25.06 | 9 |
| Assay of tyrosine CPT 84510 | not published | not published | $10.63 – $32.26 | 9 |
| Assay of urine sulfate CPT 84392 | not published | not published | $5.49 – $14.74 | 9 |
| Assay of urine urobilinogen CPT 84580 | not published | not published | $9.55 – $23.72 | 9 |
| Assay of urine urobilinogen CPT 84583 | not published | not published | $6.05 – $15.59 | 9 |
| Assay phosphatidylglycerol CPT 84081 | not published | not published | $16.52 – $51.25 | 9 |
| Assay phosphohexose enzymes CPT 84087 | not published | not published | $10.73 – $32.02 | 9 |
| Assay rbc glutathione CPT 82979 | not published | not published | $9.44 – $23.45 | 9 |
| Assay toxin or antitoxin CPT 87230 | not published | not published | $19.74 – $61.23 | 9 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $633.15 | $1,809.00 | $100.98 – $379.43 | 7 |
| Assess cyst contrast inject CPT 49424 | $162.75 | $465.00 | $1,487.00 – $9,891.00 | 3 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | not published | not published | $4.27 – $13.25 | 9 |
| Asses tinnit/pitch/loud/match/mask 92625 CPT 92625 | not published | not published | $165.49 – $306.17 | 7 |
| Assist-bilat spinal disk surgery add-on 63035 CPT 63035 | not published | not published | $1,487.00 – $18,416.00 | 4 |
| Assistive tech assessment, ot CPT 97755 | not published | not published | $40.26 – $74.48 | 6 |
| Assist oocyte fertilization CPT 89280 | not published | not published | $142.17 – $1,917.04 | 8 |
| Assist oocyte fertilization CPT 89281 | not published | not published | $142.17 – $405.38 | 8 |
| Ast/sgot CPT 84450 | $73.85 | $211.00 | $5.18 – $16.05 | 9 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | not published | not published | $91.02 – $192.19 | 9 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $5,866.00 | $16,760.00 | $2,159.89 – $30,073.00 | 5 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $5,072.90 | $14,494.00 | $2,159.89 – $42,841.00 | 5 |
| Atomic absorption CPT 82190 | not published | not published | $15.90 – $46.23 | 9 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $33.97 | $97.06 | $0.07 – $0.76 | 5 |
| Attach bladder/urethra comp 51841 CPT 51841 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Attach bladder/urethra simple 51840 CPT 51840 | not published | not published | $1,142.09 – $11,902.87 | 9 |
| Attach ocular implant CPT 65140 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Aud brainstem implt programg CPT 92640 | not published | not published | $165.49 – $306.17 | 7 |
| Audiometry air + bone CPT 92553 | not published | not published | $115.90 – $306.17 | 7 |
| Auditory function 60 min CPT 92620 | not published | not published | $165.49 – $306.17 | 7 |
| Augmentation cheek bone CPT 21270 | not published | not published | $2,455.49 – $13,207.00 | 9 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $2,159.89 – $14,539.00 | 9 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $4,588.50 – $15,861.00 | 9 |
| Augmentation of facial bones CPT 21208 | not published | not published | $3,409.47 – $14,539.00 | 9 |
| Augment injectable kit 3.0cc HCPCS C1734 | $4,673.76 | $13,353.60 | not published | 0 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $13,589.45 | $38,827.00 | $1,487.00 – $9,891.00 | 4 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $13,589.45 | $38,827.00 | $2,455.49 – $16,065.00 | 9 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $4,588.50 – $16,065.00 | 9 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $4,588.50 – $16,065.00 | 9 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $840.65 – $2,087.32 | 8 |
| Autologous blood op salvage CPT 86891 | not published | not published | $10.05 – $1,917.04 | 9 |
| Autologous blood process CPT 86890 | $365.40 | $1,044.00 | $7.11 – $405.38 | 9 |
| Autolog prp diab wound ulcer HCPCS G0465 | not published | not published | $2,653.72 – $4,909.39 | 7 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $2,653.72 – $4,909.39 | 6 |
| Automated diff wbc count CPT 85004 | not published | not published | $6.47 – $20.08 | 9 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $63.11 – $316.58 | 7 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $63.11 – $306.17 | 7 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $81.28 – $316.58 | 7 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $7,258.22 | $20,737.77 | $100.30 – $208.85 | 9 |
| Av fistula revision CPT 36833 | not published | not published | $2,159.89 – $13,460.00 | 9 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $1,746.72 – $13,460.00 | 9 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $3,409.47 – $13,460.00 | 9 |
| Av fusion direct any site CPT 36821 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $1,746.72 – $13,460.00 | 9 |
| Avul nail plate addl CPT 11732 | $244.65 | $699.00 | $151.53 – $9,891.00 | 4 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $303.10 | $866.00 | $151.53 – $1,487.00 | 8 |
| Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 | not published | not published | $53.55 – $135.45 | 8 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $0.01 – $1,081,107.57 | 8 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $1,528.38 – $13,460.00 | 9 |
| Azacitidine injection HCPCS J9025 | $289.79 | $827.97 | $0.21 – $10.98 | 5 |
| Azathioprine 50 mg tablet HCPCS J7500 | $0.61 | $1.75 | $2.01 – $294.06 | 5 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $229.35 – $507.45 | 9 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $35.02 | $100.05 | $2.61 – $64.15 | 5 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $213.77 | $610.76 | $2.67 – $8.70 | 5 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $90.27 – $375.82 | 9 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $33.63 – $210.99 | 5 |
| Baclofen eval charges CPT 97750 | $89.25 | $255.00 | $35.60 – $65.86 | 6 |
| Bacterial meningitis antigen CPT 86403 | not published | not published | $11.54 – $31.62 | 9 |
| Bacterial vaginosis pcr CPT 87801 | not published | not published | $70.20 – $217.73 | 9 |
| Bactericidal level serum CPT 87197 | not published | not published | $15.02 – $46.23 | 9 |
| #bac vag cand-c. albicans naa CPT 87481 | $102.20 | $292.00 | $35.09 – $108.86 | 9 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | not published | not published | $12.96 – $15.35 | 2 |
| Balloon dilate urtrl strix CPT 50706 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Barrier film 1.0ml wipe HCPCS A5120 | not published | not published | $0.45 – $0.59 | 2 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | not published | not published | $4.08 – $4.84 | 2 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | not published | not published | $19.56 – $23.21 | 2 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | not published | not published | $12.30 – $14.63 | 2 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | not published | not published | $9.74 – $11.59 | 2 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | not published | not published | $17.36 – $20.61 | 2 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | $3,679.90 | $10,514.00 | $1,528.38 – $9,297.00 | 9 |
| Bartonella dna pcr-sendout CPT 87471 | not published | not published | $35.09 – $108.86 | 9 |
| Basic vestibular evaluation CPT 92540 | not published | not published | $74.79 – $513.77 | 7 |
| Basiliximab HCPCS J0480 | not published | not published | $4,104.23 – $10,078.47 | 9 |
| Bausch health Ultrasound surg HCPCS V2788 | $1,733.29 | $4,952.25 | not published | 0 |
| B cells total count CPT 86355 | $156.45 | $447.00 | $37.73 – $117.01 | 9 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $637.24 | $1,820.69 | $3.12 – $9.16 | 9 |
| Bckdhb gene CPT 81205 | not published | not published | $94.99 – $235.85 | 8 |
| Becaplermin 0.01% gel 15 gm HCPCS S0157 | not published | not published | $46.23 – $105.94 | 4 |
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.