Providence Holy Cross Medical Center

15031 Rinaldi St., Mission Hills, CA 91346 · Acute care hospital · Emergency room

These are Providence Holy Cross Medical Center's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

218 of the services we track have a posted price here; 142 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge
Critical care, first 30 to 74 minutes CPT 99291	$2,722.30	$7,778.00
Emergency room visit, level 1 (minor) CPT 99281	$380.80	$1,088.00
Emergency room visit, level 2 CPT 99282	$622.30	$1,778.00
Emergency room visit, level 3 (moderate) CPT 99283	$918.05	$2,623.00
Emergency room visit, level 4 CPT 99284	$1,221.85	$3,491.00
Emergency room visit, level 5 (most severe) CPT 99285	$1,823.50	$5,210.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$189.00	$540.00

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	not posted		$40.42 – $156.30
Abdominal X-ray, 1 view CPT 74018	$357.00	$1,020.00
Ankle X-ray, 3 or more views CPT 73610	$418.60	$1,196.00
Bone density scan (DEXA), hips and spine CPT 77080	$248.50	$710.00
Breast ultrasound, one breast, complete CPT 76641	$442.05	$1,263.00
Breast ultrasound, one breast, limited CPT 76642	$331.10	$946.00
Chest X-ray, 1 view CPT 71045	$292.25	$835.00
Chest X-ray, 2 views CPT 71046	$466.55	$1,333.00
CT angiogram of the chest (checks for lung clots) CPT 71275	$1,711.15	$4,889.00
CT angiogram of the head CPT 70496	$3,754.45	$10,727.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$2,744.00	$7,840.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$4,352.60	$12,436.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$2,238.25	$6,395.00
CT scan of the abdomen, without contrast CPT 74150	$1,174.25	$3,355.00
CT scan of the chest, with contrast CPT 71260	$1,570.10	$4,486.00
CT scan of the chest, without contrast CPT 71250	$1,420.30	$4,058.00
CT scan of the head, without contrast CPT 70450	$2,127.65	$6,079.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$3,364.90	$9,614.00
CT scan of the pelvis, with contrast CPT 72193	$1,174.25	$3,355.00
CT scan of the sinuses or face, without contrast CPT 70486	$2,249.80	$6,428.00
Diagnostic mammogram, both breasts CPT 77066	$420.35	$1,201.00
Diagnostic mammogram, one breast CPT 77065	$294.70	$842.00
Foot X-ray, 3 or more views CPT 73630	$418.60	$1,196.00
Hand X-ray, 3 or more views CPT 73130	$358.40	$1,024.00
Knee X-ray, 3 views CPT 73562	$475.30	$1,358.00
Leg or arm vein ultrasound, both sides CPT 93970	$1,194.90	$3,414.00
Leg or arm vein ultrasound, one side CPT 93971	$668.50	$1,910.00
Lower back X-ray, 2 or 3 views CPT 72100	$281.75	$805.00
MRI of both breasts, without and with contrast CPT 77049	$3,769.85	$10,771.00
MRI of the abdomen, without and with contrast CPT 74183	$6,729.10	$19,226.00
MRI of the brain, without and with contrast CPT 70553	$4,590.60	$13,116.00
MRI of the brain, without contrast CPT 70551	$3,023.30	$8,638.00
MRI of the knee or other leg joint, without contrast CPT 73721	$2,280.25	$6,515.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$3,473.05	$9,923.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$3,473.05	$9,923.00
MRI of the neck (cervical spine), without contrast CPT 72141	$3,473.05	$9,923.00
MRI of the pelvis, without and with contrast CPT 72197	$4,561.20	$13,032.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$2,280.25	$6,515.00
Neck X-ray, 2 or 3 views CPT 72040	$294.35	$841.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$502.60	$1,436.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$544.25	$1,555.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$486.15	$1,389.00
Screening mammogram, both breasts CPT 77067	$193.20	$552.00
Shoulder X-ray, 2 or more views CPT 73030	$471.80	$1,348.00
Transvaginal pregnancy ultrasound CPT 76817	$394.80	$1,128.00
Transvaginal ultrasound CPT 76830	$442.05	$1,263.00
Ultrasound of the abdomen, complete CPT 76700	$586.25	$1,675.00
Ultrasound of the neck or thyroid CPT 76536	$442.05	$1,263.00
Wrist X-ray, 3 or more views CPT 73110	$441.00	$1,260.00
X-ray of the lower back, 4 or more views CPT 72110	$812.35	$2,321.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$238.70	$682.00
Blood culture CPT 87040	$137.90	$394.00
Blood draw (venipuncture) CPT 36415	$21.00	$60.00
BNP test (heart failure) CPT 83880	$305.20	$872.00
C-reactive protein (CRP) test CPT 86140	$45.50	$130.00
Chlamydia test (DNA/NAAT) CPT 87491	$43.05	$123.00
Complete blood count (CBC) with differential CPT 85025	$115.50	$330.00
Complete blood count (CBC), automated CPT 85027	$91.00	$260.00
Comprehensive metabolic panel (blood test) CPT 80053	$415.45	$1,187.00
COVID-19 PCR test CPT 87635	$83.30	$238.00
D-dimer test (blood clots) CPT 85379	$164.15	$469.00
Drug screen, instrument chemistry CPT 80307	$314.30	$898.00
Ferritin (iron stores) test CPT 82728	$173.60	$496.00
Free T4 (thyroid) test CPT 84439	$116.90	$334.00
General health panel (blood tests) CPT 80050	not posted		$61.87 – $194.17
Glucose (blood sugar) test CPT 82947	$64.75	$185.00
Gonorrhea test (DNA/NAAT) CPT 87591	$43.05	$123.00
Hemoglobin A1c test CPT 83036	$196.70	$562.00
Hepatitis C antibody test CPT 86803	$171.15	$489.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$86.80	$248.00
Iron test CPT 83540	$148.40	$424.00
Kidney function panel CPT 80069	$298.20	$852.00
Lipase test (pancreas) CPT 83690	$148.40	$424.00
Lipid panel, cholesterol and triglycerides CPT 80061	$92.05	$263.00
Liver function panel CPT 80076	$207.55	$593.00
Magnesium test CPT 83735	$237.65	$679.00
Obstetric blood test panel CPT 80055	not posted		$47.81 – $221.91
Partial thromboplastin time (PTT), clotting test CPT 85730	$144.90	$414.00
Pregnancy blood test (hCG), quantitative CPT 84702	$178.85	$511.00
Prothrombin time (PT/INR), clotting test CPT 85610	$98.70	$282.00
PSA (prostate specific antigen), free CPT 84154	$88.20	$252.00
PSA (prostate specific antigen), total CPT 84153	$131.60	$376.00
Rapid strep test CPT 87880	$69.65	$199.00
Sed rate (ESR) test CPT 85652	$115.50	$330.00
TB skin test CPT 86580	$29.40	$84.00
Thyroid stimulating hormone (TSH) CPT 84443	$242.20	$692.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$134.75	$385.00
Troponin test (heart damage) CPT 84484	$168.70	$482.00
Urinalysis, automated, with microscope CPT 81001	$180.95	$517.00
Urinalysis, automated, without microscope CPT 81003	$128.45	$367.00
Urinalysis, manual, with microscope CPT 81000	not posted		$4.02 – $30.21
Urinalysis, manual, without microscope CPT 81002	$33.60	$96.00
Urine culture, colony count CPT 87086	$103.95	$297.00
Urine pregnancy test CPT 81025	$64.75	$185.00
Vitamin B12 test CPT 82607	$173.60	$496.00
Vitamin D test CPT 82306	$91.70	$262.00

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$824.60	$2,356.00
ECG tracing only (no interpretation) CPT 93005	$221.20	$632.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$2,338.00	$6,680.00
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$45.15 – $142.97
Holter monitor, up to 48 hours CPT 93224	not posted		$322.38 – $856.33
Left heart catheterization CPT 93452	$3,971.45	$11,347.00
Left heart catheterization with coronary angiogram CPT 93458	$5,987.10	$17,106.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,931.25	$8,375.00
Treadmill stress test, complete CPT 93015	not posted		$175.26 – $590.02

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$1,747.00 – $25,913.00
Appendix removal, laparoscopic CPT 44970	not posted		$2,822.00 – $19,534.00
Breast biopsy with ultrasound guidance CPT 19083	$2,079.70	$5,942.00
Carpal tunnel release CPT 64721	$992.25	$2,835.00
Colonoscopy with biopsy CPT 45380	not posted		$1,528.00 – $7,309.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$1,528.00 – $7,309.00
Colonoscopy, diagnostic CPT 45378	$610.75	$1,745.00
Colposcopy with biopsy CPT 57454	not posted		$391.93 – $3,757.00
Cystoscopy (bladder scope) CPT 52000	$256.55	$733.00
Ear tubes, under general anesthesia CPT 69436	not posted		$1,747.00 – $7,309.00
Flexible sigmoidoscopy, diagnostic CPT 45330	$610.75	$1,745.00
Gallbladder removal, laparoscopic CPT 47562	not posted		$3,409.00 – $19,534.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$12,477.00 – $14,186.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$2,455.00 – $35,214.00
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$1,747.00 – $11,827.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$2,160.00 – $19,534.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$1,955.10	$5,586.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$4,533.71 – $14,186.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$2,160.00 – $11,827.00
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,142.00 – $7,309.00
Nasal endoscopy, diagnostic CPT 31231	$78.40	$224.00
Prostate biopsy CPT 55700	not posted		$1,528.00 – $7,309.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$1,142.00 – $35,214.00
Removal of a breast lump, open surgery CPT 19120	$3,510.50	$10,030.00
Rotator cuff repair, arthroscopic CPT 29827	not posted		$2,455.00 – $25,913.00
Screening colonoscopy, average risk HCPCS G0121	not posted		$353.00 – $7,309.00
Screening colonoscopy, high risk HCPCS G0105	not posted		$353.00 – $7,309.00
Septoplasty (nasal septum repair) CPT 30520	$1,731.10	$4,946.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$1,528.00 – $7,309.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$3,409.00 – $14,186.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$1,747.00 – $19,534.00
Total hip replacement CPT 27130	not posted		$1,747.00 – $48,502.00
Total knee replacement CPT 27447	not posted		$1,747.00 – $48,502.00
Upper endoscopy (EGD) with biopsy CPT 43239	$622.65	$1,779.00
Upper endoscopy (EGD), diagnostic CPT 43235	$622.65	$1,779.00
Vasectomy CPT 55250	not posted		$1,528.00 – $7,309.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted		$1,747.00 – $6,749.00
Fetal non-stress test CPT 59025	$189.35	$541.00
IUD insertion CPT 58300	$197.75	$565.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$1,528.00 – $6,264.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$1,528.00 – $6,749.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$9,710.39 – $41,175.00
C-section, without complications MS-DRG 788	not posted	$10,580.53 – $22,642.33
Chest pain MS-DRG 313	not posted	$7,079.00 – $34,313.00
COPD flare-up, with major complications MS-DRG 190	not posted	$12,091.05 – $82,348.00
COPD flare-up, without complications MS-DRG 192	not posted	$7,366.76 – $48,035.00
Fainting (syncope) MS-DRG 312	not posted	$9,648.95 – $44,604.00
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$10,802.70 – $65,192.00
Heart failure, with major complications MS-DRG 291	not posted	$7,079.00 – $92,642.00
Heart failure, without complications MS-DRG 293	not posted	$6,595.77 – $48,035.00
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$43,335.00 – $648,490.00
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$14,157.00 – $130,383.00
Irregular heartbeat, without complications MS-DRG 310	not posted	$6,596.79 – $37,744.00
Kidney failure, with complications MS-DRG 683	not posted	$9,738.54 – $72,054.00
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$9,065.96 – $48,035.00
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$25,619.74 – $123,523.00
Normal newborn care MS-DRG 795	not posted	$2,213.14 – $10,294.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$8,748.44 – $44,604.00
Pneumonia, with complications MS-DRG 194	not posted	$9,029.44 – $65,192.00
Pneumonia, with major complications MS-DRG 193	not posted	$14,187.91 – $92,642.00
Pneumonia, without complications MS-DRG 195	not posted	$7,229.80 – $48,035.00
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$14,361.17 – $54,898.00
Sepsis, with major complications MS-DRG 871	not posted	$20,559.67 – $116,661.00
Sepsis, without major complications MS-DRG 872	not posted	$11,234.85 – $72,054.00
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$9,688.83 – $51,467.00
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$40,447.00 – $229,888.00
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$8,762.64 – $44,604.00
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$11,102.97 – $75,486.00
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$13,440.26 – $54,898.00
Vaginal delivery, without complications MS-DRG 807	not posted	$7,406.27 – $16,463.90
Weight loss surgery, without complications MS-DRG 621	not posted	$16,155.95 – $92,642.00

Pain and spine

Service	Cash price	Gross charge
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$480.90	$1,374.00
Lower back nerve root injection with imaging guidance CPT 64483	$915.60	$2,616.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$790.30	$2,258.00
Lower back spinal injection (epidural), without imaging CPT 62322	$796.25	$2,275.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$2,968.25 – $9,357.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$146.25 – $366.44
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$707.39 – $7,309.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$108.88 – $354.16

Sleep

Service	Cash price	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$277.71 – $812.80
Sleep study with CPAP titration CPT 95811	not posted	$1,104.48 – $2,862.07
Sleep study, overnight in a sleep lab CPT 95810	not posted	$987.23 – $2,642.06

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$441.00	$1,260.00

Therapy

Service	Cash price	Gross charge
Manual therapy, 15 minutes CPT 97140	$89.95	$257.00
Physical therapy evaluation, low complexity CPT 97161	$212.45	$607.00
Physical therapy evaluation, moderate complexity CPT 97162	$215.95	$617.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$89.95	$257.00
Therapeutic activities, 15 minutes CPT 97530	$89.95	$257.00

Mental health

Service	Cash price	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted	$44.88 – $488.54
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted	$39.11 – $488.54
Group psychotherapy CPT 90853	not posted	$17.58 – $279.62

Infusions and injections

Service	Cash price	Gross charge
Injection under the skin or into a muscle CPT 96372	$186.20	$532.00
IV hydration, each additional hour CPT 96361	$252.35	$721.00
IV hydration, first hour CPT 96360	$456.40	$1,304.00
IV push injection of a drug, first CPT 96374	$252.35	$721.00
IV push injection, each additional drug CPT 96375	$186.20	$532.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$58.02	$165.76
Dexamethasone injection, per 1 mg HCPCS J1100	$32.82	$93.77
Fentanyl injection, per 0.1 mg HCPCS J3010	$769.30	$2,198.00
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$3.89 – $6.38
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$32.76	$93.60
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$98.32	$280.92
Morphine injection, up to 10 mg HCPCS J2270	$145.85	$416.70
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$34.62	$98.91
Propofol injection, per 10 mg HCPCS J2704	$35.86	$102.45
Saline IV solution, 1000 ml HCPCS J7030	$68.93	$196.95

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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