Hlth bhv ivntj indiv 1st 30 at Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
not published by hospital
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.
not published by hospital
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.
$194.05 with Providence vs $422.33 with Healthnet — 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 | $194.05 | — |
| Aetna | Medicare Managed Care Plan | $228.29 | — |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $239.17 | — |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $269.38 | — |
| Healthnet | Ambetter Hmo | $422.33 | — |
Visitor-reported prices
Comments
Hlth bhv ivntj indiv 1st 30 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bakersfield Memorial Hospital | Bakersfield | $92.49 | $57.63 – $204.15 |
| St. Joseph's Medical Center Stockton | Stockton | $77.03 | $55.02 – $227.96 |
| St. Mary Medical Center | Long Beach | $112.23 | $51.87 – $326.64 |
| Mercy San Juan Medical Center | Carmichael | $82.75 | $28.93 – $263.92 |
| Mercy General Hospital | Sacramento | $65.84 | $57.63 – $247.81 |
| Mercy Hospital of Folsom | Folsom | $117.48 | $28.93 – $247.81 |
| Woodland Memorial Hospital | Woodland | $82.75 | $28.93 – $263.00 |
| Methodist Hospital of Sacramento | Sacramento | $86.98 | $57.63 – $247.81 |