Closed tx sesamoid fx 28530 at Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
$475.68
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.
$991.00
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.
$269.67 with Providence vs $6,428.00 with Blue Cross — 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 |
|---|---|---|---|
| Providence | Oscar All Commercial Plans | $269.67 | ↓ -43% |
| Aetna | Medicare Managed Care Plan | $317.26 | ↓ -33% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $332.38 | ↓ -30% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $374.36 | ↓ -21% |
| Healthnet | Ambetter Hmo | $586.92 | ↑ +23% |
| Healthnet | Hmo/Pos/Ppo | $799.00 | ↑ +68% |
| Unitedhealthcare | Select/Navigate Hmo | $1,200.00 | ↑ +152% |
| Unitedhealthcare | All Commercial Plans | $1,312.00 | ↑ +176% |
| Blue Shield | Epn Exchange | $1,597.00 | ↑ +236% |
| Blue Shield | Tandem Ppo | $1,984.00 | ↑ +317% |
| Blue Shield | Hmo/Ppo | $2,206.00 | ↑ +364% |
| Aetna | Gatekeeper Hmo | $3,429.00 | ↑ +621% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $5,357.00 | ↑ +1026% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $6,428.00 | ↑ +1251% |
Visitor-reported prices
Comments
Closed tx sesamoid fx 28530 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $419.73 | $332.41 – $1,687.00 |
| Queen of The Valley Medical Center | Napa | $466.14 | $350.23 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $469.20 | $317.26 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $254.49 | $332.35 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $276.93 | $1,333.00 – $20,799.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $448.80 | $343.23 – $4,042.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $140.00 | $203.00 – $1,287.00 |
| Providence Saint Joseph Medical Center | Burbank | $523.25 | $202.00 – $1,311.00 |