Exc ben+marg excep skin tag feenlm <0.5cm 11440 at Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
$1,152.96
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.
$2,402.00
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.
$774.16 with Providence vs $7,143.00 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 |
|---|---|---|---|
| Providence | Oscar All Commercial Plans | $774.16 | ↓ -33% |
| Aetna | Medicare Managed Care Plan | $910.78 | ↓ -21% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $954.20 | ↓ -17% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $1,074.70 | ↓ -7% |
| Healthnet | Ambetter Hmo | $1,684.94 | ↑ +46% |
| Unitedhealthcare | Select/Navigate Hmo | $1,894.00 | ↑ +64% |
| Healthnet | Hmo/Pos/Ppo | $1,999.00 | ↑ +73% |
| Unitedhealthcare | All Commercial Plans | $2,095.00 | ↑ +82% |
| Aetna | Gatekeeper Hmo | $4,114.00 | ↑ +257% |
| Blue Shield | Epn Exchange | $5,171.00 | ↑ +348% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $5,357.00 | ↑ +365% |
| Blue Shield | Tandem Ppo | $6,425.00 | ↑ +457% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $6,428.00 | ↑ +458% |
| Blue Shield | Hmo/Ppo | $7,143.00 | ↑ +520% |
Visitor-reported prices
Comments
Exc ben+marg excep skin tag feenlm <0.5cm 11440 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $1,313.76 | $954.29 – $2,695.00 |
| Mark Twain Medical Center | San Andreas | $282.39 | $73.91 – $280.28 |
| Queen of The Valley Medical Center | Napa | $1,889.55 | $1,005.45 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $1,469.82 | $910.78 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $797.64 | $954.10 – $5,198.77 |
| Redwood Memorial Hospital | Fortuna | $868.02 | $3,331.00 – $25,998.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $1,406.07 | $985.34 – $4,042.00 |
| Mercy Medical Center Merced | Merced | $173.56 | $73.91 – $370.70 |