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 |
|---|---|---|---|---|
| Protein analysis w/probe CPT 88372 | not published | not published | $37.19 – $70.56 | 5 |
| Protein c activity CPT 85303 | $147.00 | $420.00 | $13.84 – $42.90 | 9 |
| Protein c concentrate HCPCS J2724 | not published | not published | $1.50 – $32.29 | 9 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $125.30 | $358.00 | $10.74 – $33.31 | 9 |
| Protein s total CPT 85305 | not published | not published | $11.61 – $35.98 | 9 |
| Protein total 24 hour urine CPT 84156 | $74.20 | $212.00 | $3.67 – $11.37 | 9 |
| Protein total body fluid CPT 84157 | $74.20 | $212.00 | $4.00 – $11.37 | 9 |
| Protein total serum plasma whole blood CPT 84155 | $82.25 | $235.00 | $3.67 – $11.37 | 9 |
| Protein western blot tissue CPT 88371 | not published | not published | $31.53 – $68.94 | 5 |
| Prothrombin complex kcentra HCPCS J7168 | $8,146.97 | $23,277.07 | $2.05 – $6.05 | 9 |
| Prothrombin time substitution plasma fractions each CPT 85611 | not published | not published | $3.94 – $12.22 | 9 |
| Proton treatment complex CPT 77525 | not published | not published | $1,232.69 – $3,379.55 | 7 |
| Proton trmt intermediate CPT 77523 | not published | not published | $1,186.26 – $3,379.55 | 7 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $875.39 – $2,973.65 | 7 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $710.66 – $2,233.54 | 7 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $9.74 – $26.72 | 9 |
| Provide inr test mater/equip HCPCS G0249 | not published | not published | $171.24 – $321.56 | 7 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $352.70 – $9,891.00 | 4 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $4,588.50 – $15,861.00 | 9 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | not published | not published | $1,142.09 – $43,618.46 | 9 |
| Prq av fstl crt uxtr sep acs CPT 36837 | not published | not published | $1,528.38 – $43,618.46 | 9 |
| Prq card angio/athrect addl CPT 92925 | $6,019.30 | $17,198.00 | $2,455.49 – $17,698.00 | 3 |
| Prq cardiac angio addl art CPT 92921 | $3,157.00 | $9,020.00 | $2,455.49 – $13,460.00 | 3 |
| Prq card revasc chronic addl CPT 92944 | $4,794.65 | $13,699.00 | $2,455.49 – $13,460.00 | 3 |
| Prq card revasc mi 1 vsl CPT 92941 | $5,119.45 | $14,627.00 | $2,455.49 – $15,227.00 | 3 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $4,716.25 | $13,475.00 | $2,455.49 – $12,235.00 | 4 |
| Prq card stent/ath/angio CPT 92934 | $4,794.65 | $13,699.00 | $2,455.49 – $13,460.00 | 3 |
| Prq card stent w/angio addl CPT 92929 | $3,450.65 | $9,859.00 | $2,455.49 – $13,460.00 | 3 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $4,794.65 | $13,699.00 | $2,455.49 – $27,468.35 | 8 |
| Prq revasc byp graft addl CPT 92938 | $4,794.65 | $13,699.00 | $2,455.49 – $13,460.00 | 3 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $1,528.38 – $16,065.00 | 9 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Prq skel fix sprcndlr hum fx CPT 24538 | $5,779.90 | $16,514.00 | $1,528.38 – $16,065.00 | 9 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $1,528.38 – $16,065.00 | 9 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $1,528.38 – $16,065.00 | 9 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $6,900.60 | $19,716.00 | $2,455.49 – $27,468.35 | 8 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | not published | not published | $23,577.55 – $43,618.46 | 6 |
| Prq trlml c athrc st angiop1 CPT 92933 | $7,991.20 | $22,832.00 | $2,455.49 – $42,841.00 | 8 |
| Prq trl rvs ch occ ant&rtrgr CPT 92945 | not published | not published | $14,847.76 – $27,468.35 | 6 |
| Prq trluml c angiop 1art&/br CPT 92920 | $3,157.00 | $9,020.00 | $2,455.49 – $13,460.00 | 8 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $6,019.30 | $17,198.00 | $2,455.49 – $27,468.35 | 8 |
| Prq trluml revsc ch occ ant CPT 92943 | $4,794.65 | $13,699.00 | $2,455.49 – $27,468.35 | 8 |
| Pr removal drug delivery implant CPT 11982 | $372.40 | $1,064.00 | $112.54 – $1,487.00 | 8 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $249.90 | $714.00 | $112.54 – $1,487.00 | 8 |
| Pr removal intrauterine device CPT 58301 | $347.90 | $994.00 | $273.20 – $5,977.00 | 9 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $576.45 | $1,647.00 | $522.85 – $1,487.00 | 8 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $167.65 | $479.00 | $206.01 – $1,487.00 | 8 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $208.95 | $597.00 | $206.01 – $1,487.00 | 8 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $167.65 | $479.00 | $206.01 – $1,487.00 | 8 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $208.95 | $597.00 | $206.01 – $1,487.00 | 8 |
| Pr robotic surgical system HCPCS S2900 | $0.35 | $1.00 | $9,891.00 – $9,891.00 | 1 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $1,528.38 – $9,297.00 | 9 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $1,528.38 – $9,834.00 | 9 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $1,746.72 – $16,065.00 | 9 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $567.42 – $5,977.00 | 9 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $2,159.89 – $12,557.00 | 9 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $4,272.45 | $12,207.00 | $950.02 – $5,977.00 | 9 |
| PSA (Prostate) Test CPT 84153 | $202.65 | $579.00 | $18.39 – $57.07 | 9 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | $3.10 | $8.86 | $37.20 – $68.82 | 7 |
| Psychoanalysis CPT 90845 | not published | not published | $57.69 – $422.33 | 7 |
| Psychophysiological therapy CPT 90875 | not published | not published | $51.16 – $51.16 | 1 |
| Psychophysiological therapy CPT 90876 | not published | not published | $78.63 – $78.63 | 1 |
| Psychotherapy group therapy CPT 90853 | not published | not published | $34.00 – $241.72 | 7 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $236.95 | $677.00 | $220.66 – $422.33 | 7 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $250.95 | $717.00 | $228.29 – $422.33 | 7 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $268.80 | $768.00 | $228.29 – $422.33 | 7 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $3.10 | $8.86 | $277.71 – $513.77 | 7 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | not published | not published | $352.70 – $352.70 | 1 |
| Psycl/nrpsyc tech 1st CPT 96138 | not published | not published | $42.33 – $1,062.94 | 7 |
| Psy evaluation of records CPT 90885 | $3.10 | $8.86 | $38.63 – $38.63 | 1 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $3.10 | $8.86 | $42.33 – $316.58 | 7 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | not published | not published | $352.70 – $352.70 | 1 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | not published | not published | $1,142.09 – $1,142.09 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $44.10 | $126.00 | $15.90 – $34.00 | 6 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | not published | not published | $12.79 – $14.30 | 2 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $74.55 | $213.00 | $19.99 – $73.16 | 6 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $28.35 | $81.00 | $15.82 – $29.27 | 6 |
| Pt application of modality traction mechanical CPT 97012 | $35.70 | $102.00 | $15.68 – $29.01 | 6 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $72.43 – $744.90 | 9 |
| Pten gene full sequence CPT 81321 | not published | not published | $89.14 – $1,489.80 | 9 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $127.57 | 9 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $2,159.89 – $12,111.00 | 9 |
| Pt evaluation high complexity patient/family CPT 97163 | $202.30 | $578.00 | $107.57 – $209.91 | 6 |
| Pt evaluation low complexity patient/family CPT 97161 | $194.95 | $557.00 | $106.80 – $209.91 | 6 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $198.45 | $567.00 | $103.01 – $209.91 | 6 |
| Pt-focused hlth risk assmt CPT 96160 | not published | not published | $48.19 – $89.15 | 7 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $25.37 – $141.50 | 7 |
| Pt prgrm for implt neurostim HCPCS L8681 | not published | not published | $1,320.72 – $2,443.33 | 7 |
| Pt re-evaluation patient/family CPT 97164 | $93.10 | $266.00 | $71.23 – $144.06 | 6 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $170.45 | $487.00 | $30.28 – $106.46 | 6 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | not published | not published | $13.96 – $35.04 | 6 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $70.00 | $200.00 | $30.48 – $56.39 | 6 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $59.15 | $169.00 | $33.15 – $61.33 | 6 |
| Pt wheelchair management each 15 minutes CPT 97542 | $51.80 | $148.00 | $34.30 – $63.46 | 6 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $842.83 – $27,468.35 | 8 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $398.91 – $13,460.00 | 3 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,409.60 – $13,519.94 | 9 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $5,821.00 – $15,227.00 | 3 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $1,142.09 – $11,276.00 | 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.