Biopsy of prostate at Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
$3,636.00
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$7,575.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$3,281.00 with Unitedhealthcare vs $9,559.00 with Blue Shield — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Unitedhealthcare | Select/Navigate Hmo | $3,281.00 | ↓ -10% |
| Unitedhealthcare | All Commercial Plans | $3,633.00 | ↓ -0% |
| Aetna | Gatekeeper Hmo | $4,114.00 | ↑ +13% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $5,357.00 | ↑ +47% |
| Healthnet | Hmo/Pos/Ppo | $5,995.00 | ↑ +65% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $6,428.00 | ↑ +77% |
| Blue Shield | Epn Exchange | $6,920.00 | ↑ +90% |
| Blue Shield | Tandem Ppo | $8,598.00 | ↑ +136% |
| Blue Shield | Hmo/Ppo | $9,559.00 | ↑ +163% |
Visitor-reported prices
Comments
Biopsy of prostate at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $1,049.45 | $123.49 – $4,655.74 |
| Arroyo Grande Hospital | Santa Maria | $2,007.32 | $100.40 – $4,461.94 |
| Mark Twain Medical Center | San Andreas | $3,282.72 | $92.36 – $349.86 |
| French Hospital | San Luis Obispo | $2,255.18 | $100.40 – $4,461.94 |
| Mercy Hospitals – Bakersfield | Bakersfield | $2,915.32 | $100.40 – $6,286.40 |
| Bakersfield Memorial Hospital | Bakersfield | $2,883.89 | $100.40 – $6,207.82 |
| Queen of The Valley Medical Center | Napa | $2,609.16 | $6,200.00 – $9,858.00 |
| Providence St Joseph Hospital Eureka | Eureka | $2,655.06 | $7,327.00 – $26,648.00 |