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 |
|---|---|---|---|---|
| Positional change of finger CPT 26555 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Post-coital mucous exam HCPCS Q0115 | not published | not published | $25.00 – $62.08 | 9 |
| Post non-seg/spine instrumentation 22840 CPT 22840 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Postop applicat rigid dsg on HCPCS L6388 | not published | not published | $669.26 – $1,238.13 | 7 |
| Postop app non-wgt bear dsg HCPCS L5450 | $726.56 | $2,075.88 | $498.76 – $922.71 | 7 |
| Postop app non-wgt bear dsg HCPCS L5460 | not published | not published | $667.56 – $1,234.99 | 7 |
| Postop dress & 1 cast chg bk HCPCS L5400 | not published | not published | $1,942.65 – $3,593.90 | 7 |
| Postop dsg & 1 cast chg ak/d HCPCS L5420 | not published | not published | $2,481.17 – $4,590.16 | 7 |
| Postop dsg ak ea add cast ch HCPCS L5430 | not published | not published | $691.54 – $1,279.35 | 7 |
| Postop dsg bk ea add cast ch HCPCS L5410 | not published | not published | $511.51 – $946.29 | 7 |
| Postop dsg cast chg elb dis/ HCPCS L6382 | not published | not published | $1,992.22 – $3,685.61 | 7 |
| Postop dsg cast chg wrst/elb HCPCS L6380 | not published | not published | $1,583.60 – $2,929.66 | 7 |
| Postop ea cast chg & realign HCPCS L6386 | not published | not published | $655.52 – $1,212.71 | 7 |
| Post-operative body jacket HCPCS L1310 | not published | not published | $2,405.14 – $4,449.51 | 7 |
| Post-op hip abduct custom fa HCPCS L1685 | not published | not published | $1,822.48 – $3,371.59 | 7 |
| Post op service lvrs min 6 HCPCS G0305 | not published | not published | $419.34 – $887.89 | 7 |
| Postpartum Care Only CPT 59430 | not published | not published | $352.70 – $352.70 | 1 |
| Post seg spine instrument/3-6 seg 22842 CPT 22842 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Potassium 24 hour urine CPT 84133 | $125.30 | $358.00 | $4.73 – $13.34 | 9 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $130.33 | $372.36 | $0.17 – $1.89 | 5 |
| Potassium hydroxide preps HCPCS Q0112 | not published | not published | $5.83 – $14.48 | 9 |
| Potassium serum/plasma/whole blood CPT 84132 | $105.70 | $302.00 | $4.76 – $14.26 | 9 |
| Pouch clsd w barr attached HCPCS A5051 | not published | not published | $4.08 – $4.86 | 2 |
| Pouch drainable w barrier at HCPCS A5061 | not published | not published | $7.01 – $8.30 | 2 |
| Pouch high output 2pc 50mm red HCPCS A4413 | not published | not published | $10.92 – $12.94 | 2 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | not published | not published | $8.64 – $10.27 | 2 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | not published | not published | $4.11 – $4.91 | 2 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | not published | not published | $7.11 – $8.45 | 2 |
| Powder prem protct 1oz HCPCS A4371 | not published | not published | $7.12 – $8.48 | 2 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $137.00 – $340.17 | 9 |
| Pq biliary strict dil s&i CPT 74363 | $1,834.35 | $5,241.00 | $207.19 – $1,113.16 | 3 |
| Pq dr cath chg w cont s&i CPT 75984 | $739.55 | $2,113.00 | $199.91 – $358.45 | 3 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $13,589.45 | $38,827.00 | $2,455.49 – $16,065.00 | 9 |
| Pq thr inj ext pse CPT 36002 | $325.50 | $930.00 | $375.10 – $5,977.00 | 9 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $7,921.55 | $22,633.00 | $1,487.00 – $15,861.00 | 4 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $4,812.50 | $13,750.00 | $2,455.49 – $15,861.00 | 9 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $4,812.50 | $13,750.00 | $2,455.49 – $15,861.00 | 9 |
| Pralatrexate injection HCPCS J9307 | $20,786.08 | $59,388.80 | $362.73 – $803.61 | 9 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $315.02 | $900.05 | $88.43 – $263.79 | 5 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $2,985.85 | $8,531.00 | $1,528.38 – $9,297.00 | 9 |
| Pr application of long arm splint CPT 29105 | $232.75 | $665.00 | $194.49 – $1,487.00 | 8 |
| Pr application splint static short arm CPT 29125 | $193.90 | $554.00 | $171.12 – $1,487.00 | 8 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | $3.10 | $8.86 | $38.20 – $88.87 | 7 |
| Pr biopsy skin punch single lesion CPT 11104 | $576.45 | $1,647.00 | $435.07 – $1,487.00 | 8 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $1,746.72 – $21,466.50 | 9 |
| Pr correction hammertoe CPT 28285 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | not published | not published | $48.19 – $89.15 | 7 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | $913.85 | $2,611.00 | $352.70 – $9,891.00 | 4 |
| Prcrd drg 6+yr without anomly CPT 33017 | $1,984.50 | $5,670.00 | $352.70 – $9,891.00 | 4 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $609.70 | $1,742.00 | $258.05 – $1,487.00 | 8 |
| Prealbumin CPT 84134 | $177.45 | $507.00 | $14.59 – $45.22 | 9 |
| Pr ecg 12 lead report only CPT 93010 | not published | not published | $11.16 – $77.70 | 2 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | not published | not published | $33.74 – $290.72 | 2 |
| Prednisolone acetate inj HCPCS J2650 | not published | not published | $0.50 – $2.46 | 3 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $4.73 | $13.50 | $0.27 – $2.36 | 5 |
| Prednisone 1 mg tablet HCPCS J7512 | $162.23 | $463.50 | $0.01 – $3.07 | 5 |
| Prefab glove for term device HCPCS L6890 | not published | not published | $277.64 – $513.63 | 7 |
| Pregabalin - sendout CPT 80366 | not published | not published | $0.02 – $0.02 | 1 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $1,086.40 | $3,104.00 | $1,528.38 – $9,297.00 | 9 |
| Pregnancy associated plasma protein-a CPT 84163 | not published | not published | $15.05 – $46.71 | 9 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $515.90 | $1,474.00 | $134.46 – $516.16 | 9 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $436.45 | $1,247.00 | $134.46 – $516.16 | 9 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $352.70 – $352.70 | 1 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $1,142.09 – $1,142.09 | 1 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $277.71 – $1,959.15 | 7 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $419.34 – $887.89 | 7 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $479.94 – $1,959.15 | 7 |
| Prep ak ischial direct form HCPCS L5570 | not published | not published | $3,155.30 – $5,837.30 | 7 |
| Prep ak ischial laminated HCPCS L5590 | not published | not published | $3,924.01 – $7,259.42 | 7 |
| Prep ak ischial plast molded HCPCS L5560 | not published | not published | $2,878.04 – $5,324.37 | 7 |
| Prep ak ischial thermo mold HCPCS L5580 | not published | not published | $3,829.74 – $7,085.02 | 7 |
| Preparation for bladder xray CPT 51605 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Preparation palate mold CPT 42280 | not published | not published | $352.70 – $1,487.00 | 8 |
| Prepare donor heart CPT 33944 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prepare donor intestine CPT 44715 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prepare donor lung double CPT 32856 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prepare donor lung single CPT 32855 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $67.02 – $142.17 | 8 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $1,142.09 – $9,891.00 | 3 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $1,746.72 – $9,891.00 | 4 |
| Prepare penis study CPT 54230 | not published | not published | $1,487.00 – $9,891.00 | 2 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $1,487.00 – $9,891.00 | 3 |
| Prep bk ptb laminated socket HCPCS L5540 | not published | not published | $2,952.49 – $5,462.11 | 7 |
| Prep bk ptb open end socket HCPCS L5535 | not published | not published | $2,768.11 – $5,121.00 | 7 |
| Prep bk ptb plaster molded HCPCS L5510 | not published | not published | $2,153.70 – $3,984.34 | 7 |
| Prep bk ptb thermopls molded HCPCS L5530 | not published | not published | $2,819.42 – $5,215.93 | 7 |
| Prep cadaver renal allograft CPT 50323 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Prep donor intestine/artery CPT 44721 | not published | not published | $4,005.00 – $9,891.00 | 3 |
| Prep donor intestine/venous CPT 44720 | not published | not published | $4,005.00 – $9,891.00 | 3 |
| Prep donor liver 3-segment CPT 47144 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prep donor liver/arterial CPT 47147 | not published | not published | $4,005.00 – $9,891.00 | 3 |
| Prep donor liver lobe split CPT 47145 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prep donor liver/venous CPT 47146 | not published | not published | $4,005.00 – $9,891.00 | 3 |
| Prep donor liver whole CPT 47143 | not published | not published | $5,821.00 – $9,891.00 | 3 |
| Prep donor pancreas CPT 48551 | not published | not published | $6,790.00 – $9,891.00 | 2 |
| Prep donor pancreas/venous CPT 48552 | not published | not published | $4,005.00 – $9,891.00 | 2 |
| Prep donor renal graft CPT 50325 | not published | not published | $5,821.00 – $9,891.00 | 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.