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 |
|---|---|---|---|---|
| Pulmonary vent imaging CPT 78579 | $1,025.15 | $2,929.00 | $360.17 – $1,950.38 | 9 |
| Pulse ox continuous overnight monitoring CPT 94762 | not published | not published | $78.95 – $306.17 | 7 |
| Pulse ox multiple CPT 94761 | $18.55 | $53.00 | $19.63 – $161.57 | 2 |
| Pulse ox single CPT 94760 | not published | not published | $9.26 – $62.50 | 2 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $728.88 | $2,082.50 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | $1,746.50 | $4,990.00 | $907.88 – $5,977.00 | 9 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $271.95 | $777.00 | $46.41 – $1,487.00 | 8 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $888.65 | $2,539.00 | $245.04 – $1,487.00 | 8 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $1,142.09 – $7,332.00 | 9 |
| Puncture spinal lumbar diagnostic CPT 62270 | $980.00 | $2,800.00 | $672.48 – $5,977.00 | 9 |
| Puraply 1 sq cm HCPCS Q4195 | $8,176.14 | $23,360.40 | $160.06 – $296.10 | 9 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $146.34 – $352.70 | 9 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $907.88 – $2,362.00 | 8 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $907.88 – $2,362.00 | 8 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $824.68 – $1,525.66 | 7 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $19,535.67 – $36,140.99 | 7 |
| Pyelotomy complicated CPT 50135 | not published | not published | $8,365.00 – $9,891.00 | 2 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $1,142.09 – $9,891.00 | 4 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $43.51 | $124.32 | $8.14 – $27.03 | 5 |
| Pyruvate CPT 84210 | not published | not published | $14.48 – $35.95 | 9 |
| Pyruvate kinase CPT 84220 | not published | not published | $9.44 – $29.26 | 9 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $344.15 – $636.68 | 7 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $26.55 – $352.70 | 7 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $525.35 | $1,501.00 | $625.81 – $2,612.61 | 9 |
| Quant diff pulm perf w/imaging CPT 78597 | $375.20 | $1,072.00 | $386.11 – $1,950.38 | 9 |
| Quest t3 uptake CPT 84479 | $84.00 | $240.00 | $6.47 – $20.08 | 9 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $586.48 – $1,084.99 | 7 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $6.04 – $945.91 | 5 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $1,803.04 | $5,151.55 | $221.62 – $1,008.69 | 9 |
| Rabies ig ht&sol human im/sc CPT 90377 | $8,568.65 | $24,481.85 | $242.18 – $794.73 | 8 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $8,741.91 | $24,976.89 | $224.64 – $747.15 | 9 |
| Rabies vaccine id CPT 90676 | not published | not published | $77.04 – $568.61 | 8 |
| Radial keratotomy CPT 65771 | not published | not published | $3,409.47 – $5,821.00 | 3 |
| Radiation handling CPT 77790 | $545.65 | $1,559.00 | $84.32 – $134.17 | 3 |
| Radiation physics consult CPT 77336 | $391.65 | $1,119.00 | $131.46 – $319.81 | 7 |
| Radiation therapy dose plan CPT 77300 | $593.25 | $1,695.00 | $97.21 – $319.81 | 7 |
| Radiation therapy management CPT 77431 | not published | not published | $221.16 – $548.62 | 2 |
| Radiation treatment aid(s) CPT 77332 | $417.90 | $1,194.00 | $129.73 – $319.81 | 7 |
| Radiation treatment aid(s) CPT 77333 | $419.30 | $1,198.00 | $44.16 – $325.07 | 7 |
| Radiation treatment aid(s) CPT 77334 | $914.20 | $2,612.00 | $230.73 – $890.92 | 7 |
| Radiation treatment delivery CPT 77401 | $260.05 | $743.00 | $63.83 – $407.04 | 3 |
| Radiation treatment delivery CPT 77402 | $436.45 | $1,247.00 | $131.23 – $245.13 | 7 |
| Radiation treatment delivery CPT 77412 | $679.35 | $1,941.00 | $399.60 – $1,314.72 | 7 |
| Radiation tx management x5 CPT 77427 | not published | not published | $402.22 – $1,227.31 | 2 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $1,528.38 – $15,227.00 | 4 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $1,528.38 – $17,265.50 | 9 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $1,746.72 – $17,265.50 | 9 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $1,528.38 – $17,265.50 | 9 |
| Radical resection of elbow CPT 24149 | not published | not published | $1,142.09 – $16,065.00 | 9 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,528.38 – $17,265.50 | 9 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $1,746.72 – $14,539.00 | 9 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $1,746.72 – $15,861.00 | 9 |
| Radiesse injection HCPCS Q2026 | not published | not published | $349.19 – $716.85 | 7 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $6,622.33 – $12,251.31 | 7 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $964.25 – $1,783.86 | 7 |
| Radiology port images(s) CPT 77417 | $293.30 | $838.00 | $37.31 – $150.51 | 3 |
| Radiotherapy dose plan imrt CPT 77301 | $3,014.55 | $8,613.00 | $1,780.22 – $3,293.41 | 7 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $171.09 – $363.48 | 9 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,085.30 | $5,958.00 | $698.35 – $6,336.39 | 9 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,210.95 | $6,317.00 | $698.35 – $6,336.39 | 9 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $1,561.94 – $6,336.39 | 9 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,397.50 | $6,850.00 | $698.35 – $6,336.39 | 9 |
| Radphm lcl tumor plr sgl day CPT 78800 | $743.05 | $2,123.00 | $388.35 – $1,950.38 | 9 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $202.07 – $518.04 | 3 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $3,409.47 – $16,065.00 | 9 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $1,746.72 – $15,861.00 | 9 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Rad resect abd tumor 5 cm/> CPT 22905 | $7,536.55 | $21,533.00 | $1,746.72 – $15,861.00 | 9 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $1,746.72 – $10,103.00 | 9 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $1,746.72 – $15,861.00 | 9 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $3,409.47 – $16,065.00 | 9 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $1,142.09 – $9,891.00 | 9 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $13,066.20 | $37,332.00 | $74.45 – $157.75 | 9 |
| Range of motion measurements CPT 95852 | not published | not published | $5.12 – $82.23 | 7 |
| Ranibizumab injection HCPCS J2778 | $4,563.47 | $13,038.48 | $67.85 – $397.80 | 9 |
| Rapid desensitization CPT 95180 | not published | not published | $196.07 – $1,062.94 | 7 |
| Rapid Strep Test CPT 87880 | not published | not published | $16.53 – $41.03 | 9 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $4,006.69 | $11,447.68 | $302.20 – $796.49 | 9 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $222.09 – $473.69 | 9 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $765.00 – $1,351.65 | 3 |
| Rbc count only automated CPT 85041 | not published | not published | $3.02 – $9.35 | 9 |
| Rbc deglycerolized each unit HCPCS P9039 | $382.20 | $1,092.00 | $313.00 – $579.05 | 7 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $567.42 – $5,977.00 | 9 |
| Rbc irradiated each unit HCPCS P9038 | $167.30 | $478.00 | $145.22 – $435.33 | 7 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.60 – $26.70 | 9 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $7.47 – $20.72 | 9 |
| Rbc serum pretx incubj drugs CPT 86975 | $62.13 | $177.50 | $2.25 – $1,062.94 | 9 |
| Rcm img acquisj&i&r 1st les CPT 96931 | not published | not published | $352.70 – $352.70 | 1 |
| Rcm img acquisj only 1st les CPT 96932 | not published | not published | $75.23 – $75.23 | 1 |
| Rcm i&r only 1st lesion CPT 96933 | not published | not published | $352.70 – $352.70 | 1 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $2,159.89 – $12,111.00 | 9 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $2,159.89 – $14,085.70 | 9 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $2,159.89 – $14,085.70 | 9 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $1,142.09 – $14,085.70 | 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.