Visits & medical services prices at Providence Little Co of Mary Med Ctr San Pedro
San Pedro, CA · every code in this section with a posted price and a Medicare benchmark.
197 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $30.45 | $87 | 0.6× |
| Aep neurodiagnostic i&r (92653) | $271.95 | $777 | 1.0× |
| Aep threshold estimation mlt frequencies i&r (92652) | $851.90 | $2,434 | 3.1× |
| Airway Inhalation Treatment (94640) | $446.95 | $1,277 | 1.6× |
| Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) | $312.90 | $894 | 1.2× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $80.85 | $231 | 5.6× |
| Application Modality 1/> Areas Infrared (97026) | $80.85 | $231 | 12.1× |
| Art pressure waveform analys (93050) | $77 | $220 | 2.1× |
| Behavral qualit analys voice (92524) | $292.95 | $837 | 2.7× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $322 | $920 | 0.7× |
| C motor evoked uppr limbs (95928) | $1,218 | $3,480 | 1.1× |
| C motor evoked upr&lwr limbs (95939) | $2,436 | $6,960 | 2.2× |
| Canalith repositioning proc (95992) | $285.25 | $815 | 7.0× |
| Car seat/bed test 60 min (94780) | $69.30 | $198 | 1.4× |
| Cardiac Stress Tst,Tracing Only (93017) | $612.15 | $1,749 | 2.2× |
| Cardiopulmonary resuscitation (92950) | $1,540.35 | $4,401 | 5.5× |
| Cardioversion (92960) | $1,502.20 | $4,292 | 1.8× |
| Cbt 1st hour (94644) | $465.85 | $1,331 | 2.7× |
| Chemo Anti-Neopl Sq/Im (96401) | $201.60 | $576 | 2.2× |
| Chemo Hormon Antineopl Sq/Im (96402) | $201.60 | $576 | 2.2× |
| Chemo IV infusion addl hr (96415) | $152.25 | $435 | 1.6× |
| Chemo IV push addl drug (96411) | $364.70 | $1,042 | 3.9× |
| Chemotherapy Into Cns (96450) | $389.20 | $1,112 | 0.9× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $124.60 | $356 | 1.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $676.55 | $1,933 | 1.6× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $364.70 | $1,042 | 0.9× |
| Chest Wall Manipulation (94668) | $187.60 | $536 | 1.1× |
| Color/duplex Doppler, complete (93975) | $509.60 | $1,456 | 1.7× |
| Color/duplex Doppler, limited (93976) | $404.25 | $1,155 | 3.0× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $80.85 | $231 | 2.5× |
| Continuous Pulse Ox (94762) | $214.20 | $612 | 1.3× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $473.55 | $1,353 | 1.7× |
| Cpt initial (94667) | $281.40 | $804 | 1.6× |
| Critical care first hour (99291) | $2,053.10 | $5,866 | 1.9× |
| Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) | $1,218 | $3,480 | 2.5× |
| Debridement Open Wound 20 Sq Cm< (97597) | $317.45 | $907 | 1.2× |
| Dialysis One Evaluation (90945) | $880.25 | $2,515 | 1.6× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $477.40 | $1,364 | 1.6× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $889.70 | $2,542 | 2.9× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $370.30 | $1,058 | 2.8× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $889.70 | $2,542 | 2.9× |
| Dup-scan xtr veins unilateral/limited study (93971) | $497 | $1,420 | 3.7× |
| Duplex Scan Hemodialysis Access (93990) | $358.40 | $1,024 | 2.7× |
| Duplex up extrem art bilat (93930) | $867.65 | $2,479 | 2.8× |
| Duplex up extrem art unilat/ltd (93931) | $370.30 | $1,058 | 2.8× |
| Echo Congenital Complete (93303) | $1,473.15 | $4,209 | 2.1× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$641.20–$679.70 | $1,832–$1,942 | varies |
| Echo transesophag montr cardiac pump functj (93318) | $1,277.85 | $3,651 | 1.8× |
| Echo transesophageal (93312) | $1,277.85 | $3,651 | 1.8× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $1,246.35 | $3,561 | 1.8× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $657.65 | $1,879 | 0.9× |
| EEG awake and asleep (95819) | $705.95 | $2,017 | 2.5× |
| EEG awake drowsy (95816) | $561.40 | $1,604 | 2.0× |
| EEG cerebral death evaluation (95824) | $753.20 | $2,152 | 1.6× |
| EEG cont rec w/video by tech min 8 channels (95700) | $322.70 | $922 | 1.2× |
| EEG extended monitoring 61-119 minutes (95813) | $705.95 | $2,017 | 2.5× |
| Eeg Sleep Only (95822) | $537.60 | $1,536 | 1.9× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $322.70 | $922 | 1.2× |
| EEG w/o vid 2-12hr cont mntr (95707) | $432.60 | $1,236 | 1.6× |
| EEG w/o vid ea 12-26hr intmt (95709) | $971.25 | $2,775 | 2.0× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) | $1,294.30 | $3,698 | 2.7× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) | $333.90 | $954 | 1.2× |
| EEG wo vid ea 12-26hr unmntr (95708) | $648.55 | $1,853 | 1.4× |
| EKG signal averaged (93278) | $361.90 | $1,034 | 4.8× |
| Electrical Stimulation Ea 15 Min (97032) | $80.85 | $231 | 5.5× |
| Electrocardiogram Tracing (93005) | $195.65 | $559 | 2.6× |
| Electroconvulsive Therapy (90870) | $2,552.20 | $7,292 | 2.3× |
| Emergency Dept Visit Level 2 (99282) | $352.10 | $1,006 | 1.8× |
| Emergency Dept Visit Level 3 (99283) | $569.45 | $1,627 | 1.6× |
| Emergency Dept Visit Level 4 (99284) | $1,169.35 | $3,341 | 2.2× |
| Emg 3 Extremities (95863) | $497.35 | $1,421 | 3.0× |
| Emg 4 Extremities (95864) | $570.50 | $1,630 | 3.4× |
| Er level 1 (99281) | $245 | $700 | 2.3× |
| Er level v (99285) | $1,809.85 | $5,171 | 2.4× |
| Evaluate pt use of inhaler (94664) | $341.60 | $976 | 1.2× |
| Evaluate Speech Production (92522) | $292.95 | $837 | 2.6× |
| Evaluate Swallowing Function (92610) | $270.20 | $772 | 3.2× |
| Evaluation of speech fluency (92521) | $292.95 | $837 | 2.2× |
| Exercise test for bronchospasm (94617) | $784 | $2,240 | 4.6× |
| External Ecg Scanning Analysis Report (93226) | $870.10 | $2,486 | 11.5× |
| Extracranial Bilat Study (93880) | $988.05 | $2,823 | 3.2× |
| Extracranial Uni/Ltd Study (93882) | $453.95 | $1,297 | 3.4× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $662.90 | $1,894 | 0.9× |
| Flexible endoscopic eval swallow c/v rec (92612) | $201.25 | $575 | 1.0× |
| Group Therapeutic Procedures (97150) | $172.20 | $492 | 9.5× |
| Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935) range across 2 matching MRF lines |
$2,016–$2,197.30 | $5,760–$6,278 | varies |
| High altitude simulation test (94452) | $348.25 | $995 | 2.0× |
| High Altitude Simulatj W/Phys I&R W/O2 Titration (94453) | $406.70 | $1,162 | 2.4× |
| Holter monitor recording (93225) | $375.90 | $1,074 | 2.2× |
| Immunization administration (90471) | $46.20 | $132 | 0.5× |
| Iontophoresis 15 min (97033) | $80.85 | $231 | 4.2× |
| Irrig Drug Delivery Device (96523) | $80.85 | $231 | 1.1× |
| IV infusion hydration each additional hour (96361) | $150.85 | $431 | 2.5× |
| IV infusion hydration initial 31 min-1 hour (96360) | $231.35 | $661 | 0.8× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $128.45 | $367 | 1.4× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $185.50 | $530 | 3.1× |
| IV push initial (96374) | $214.55 | $613 | 0.8× |
| Lung Function Test (Mbc/Mvv) (94200) | $140.70 | $402 | 1.9× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $963.20 | $2,752 | 3.5× |
| Mechanical chest wall oscillation per session (94669) | $366.45 | $1,047 | 1.3× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $61.95 | $177 | 2.0× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $61.95 | $177 | 1.7× |
| Methacholine challenge (94070) | $254.10 | $726 | 0.5× |
| Motion Fluoroscopy/Swallow (92611) | $270.20 | $772 | 3.0× |
| Multiple Sleep Latency Test (95805) | $568.05 | $1,623 | 0.5× |
| Muscle Test 2 Limbs (95861) | $408.10 | $1,166 | 2.4× |
| Muscle Test One Limb (95860) | $324.10 | $926 | 1.9× |
| Nasopharyngoscopy (92511) | $359.10 | $1,026 | 1.4× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) | $121.10 | $346 | 0.4× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $444.15 | $1,269 | 0.8× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $444.15 | $1,269 | 0.8× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $266.35 | $761 | 1.0× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $317.45 | $907 | 0.6× |
| Nerve Conduction Studies 1-2 Studies (95907) | $283.15 | $809 | 1.0× |
| Nerve Conduction Studies 11-12 Studies (95912) | $721.70 | $2,062 | 1.5× |
| Nerve conduction studies 13 or more studies (95913) | $2,432.85 | $6,951 | 5.1× |
| Nerve Conduction Studies 3-4 Studies (95908) | $566.65 | $1,619 | 2.0× |
| Nerve conduction studies 5-6 studies (95909) | $933.10 | $2,666 | 3.4× |
| Nerve conduction studies 7-8 studies (95910) | $399.70 | $1,142 | 0.8× |
| Nerve Conduction Studies 9-10 Studies (95911) | $1,582.70 | $4,522 | 3.3× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $147.70 | $422 | 0.9× |
| Neuromuscular Reeducation (97112) range across 3 matching MRF lines |
$76.30–$80.85 | $218–$231 | varies |
| Newborn resuscitation (99465) | $441 | $1,260 | 0.5× |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) | $76.65 | $219 | 0.4× |
| Oral Function Therapy (92526) | $225.05 | $643 | 2.7× |
| Oral Speech Device Eval (92597) | $270.20 | $772 | 3.8× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $80.85 | $231 | 1.6× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $80.85 | $231 | 1.8× |
| Ot Contrast Bath Ea 15 Min (97034) | $80.85 | $231 | 5.8× |
| Ot eval high complexity (97167) range across 3 matching MRF lines |
$253.75–$268.80 | $725–$768 | varies |
| Ot Eval Low Complex (97165) range across 3 matching MRF lines |
$243.95–$258.65 | $697–$739 | varies |
| Ot Eval Moderate Complexity (97166) range across 3 matching MRF lines |
$248.85–$263.90 | $711–$754 | varies |
| Ot manual therapy 15 min (97140) | $80.85 | $231 | 2.9× |
| Ot paraffin bath (97018) | $80.85 | $231 | 13.5× |
| Ot Prosthetic Training, Each 15 Min (97761) | $80.85 | $231 | 2.0× |
| Ot Re-Eval Est Plan Care (97168) range across 2 matching MRF lines |
$165.90–$175.70 | $474–$502 | varies |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $453.95 | $1,297 | 1.6× |
| Phlebotomy therapeutic (99195) | $316.05 | $903 | 1.8× |
| Plethysmography (94726) | $295.40 | $844 | 0.6× |
| Prq trl rvs ch occ ant&rtrgr (92945) | $23,835 | $68,100 | 1.6× |
| Psytx Crisis Initial 60 Min (90839) | $365.75 | $1,045 | 1.6× |
| Pt Eval High Complex (97163) range across 3 matching MRF lines |
$253.75–$268.80 | $725–$768 | varies |
| Pt eval low complex 20 min (97161) range across 3 matching MRF lines |
$243.95–$258.65 | $697–$739 | varies |
| Pt Eval Mod Complex (97162) range across 3 matching MRF lines |
$248.85–$263.90 | $711–$754 | varies |
| Pt gait training 15 min (97116) range across 3 matching MRF lines |
$76.30–$80.85 | $218–$231 | varies |
| Pt mechanical traction (97012) | $80.85 | $231 | 5.6× |
| Pt Re-Eval Est Plan Care (97164) range across 3 matching MRF lines |
$165.90–$175.70 | $474–$502 | varies |
| Pulm function test by gas (94727) | $267.75 | $765 | 1.0× |
| Pulmonary service/procedure (94799) | $615.30 | $1,758 | 3.7× |
| Pulmonary Stress Testing (94618) | $784 | $2,240 | 4.6× |
| Refill/Maint Pump/Resvr Syst (96522) | $161.70 | $462 | 0.6× |
| Remote 30 Day Ecg Rev/Report (93270) | $44.45 | $127 | 0.9× |
| Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) | $66.50 | $190 | 0.4× |
| Respiratory flow volume loop (94375) | $255.50 | $730 | 0.9× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $87.15 | $249 | 1.1× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $266.35 | $761 | 1.0× |
| Self Care Mngment Training (97535) range across 3 matching MRF lines |
$76.30–$80.85 | $218–$231 | varies |
| Short-latency somatosens ep std upr limbs (95925) | $1,226.75 | $3,505 | 4.4× |
| Somatosensory Testing (95938) | $2,452.80 | $7,008 | 2.2× |
| Speech sound lang comprehen (92523) | $416.85 | $1,191 | 1.8× |
| Spirometry (94010) | $302.40 | $864 | 1.1× |
| Ssep lower limbs (95926) | $1,226.75 | $3,505 | 4.4× |
| Standardized Cognitive Performance Testing (96125) | $365.05 | $1,043 | 3.5× |
| Stress Tte Only (93350) | $1,586.90 | $4,534 | 2.3× |
| Subcutaneous Infusion Each Additional Hour (96370) | $138.60 | $396 | 2.3× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $197.05 | $563 | 0.7× |
| Subq Infusion Additional Pump Infusion Site (96371) | $154.35 | $441 | 1.7× |
| Surfactant Admin Thru Tube (94610) | $615.30 | $1,758 | 2.2× |
| Temp transcutaneous pacing (92953) | $822.50 | $2,350 | 1.0× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 2 matching MRF lines |
$76.30–$80.85 | $218–$231 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) range across 2 matching MRF lines |
$76.30–$80.85 | $218–$231 | varies |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $80.85 | $231 | 2.7× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) | $190.05 | $543 | 1.9× |
| Ther/Proph/Diag Inj Ia (96373) | $231.35 | $661 | 0.8× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $168 | $480 | 1.8× |
| Ther/Proph/Diag Iv Inf Init (96365) | $248.50 | $710 | 0.9× |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$76.30–$80.85 | $218–$231 | varies |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,817.90 | $5,194 | 3.8× |
| Tte w/doppler, complete (93306) | $1,977.50 | $5,650 | 2.8× |
| Tte W/O Doppler Complete (93307) | $1,195.95 | $3,417 | 3.9× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $225.05 | $643 | 3.0× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $140 | $400 | 5.8× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $168 | $480 | 2.8× |
| Upr/L Xtremity Art 2 Levels (93922) | $392.35 | $1,121 | 2.3× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $963.20 | $2,752 | 3.5× |
| Veeg 2-12 Hr Cont Mntr (95713) | $453.60 | $1,296 | 0.9× |
| Veeg 2-12 hr intmt mntr (95712) | $351.05 | $1,003 | 0.7× |
| Veeg 2-12 hr unmonitored (95711) | $340.20 | $972 | 1.2× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) | $1,018.50 | $2,910 | 2.1× |
| Veeg Ea 12-26 Hr Unmntr (95714) | $680.40 | $1,944 | 1.4× |
| Veeg ea 12-26hr cont mntr (95716) | $1,358.70 | $3,882 | 1.2× |
| Vent Mgmt Inpat Init Day (94002) | $1,905.75 | $5,445 | 2.4× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,905.75 | $5,445 | 2.4× |
| Visual Evoked Potential Test (95930) | $1,130.15 | $3,229 | 4.1× |
| Vital capacity, total (94150) | $112 | $320 | 0.7× |
| Wheelchair Mgmt Ea 15 Min (97542) | $83.30 | $238 | 2.7× |
| Whirlpool Therapy (97022) | $80.85 | $231 | 5.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.