Ins/rpl pm gen exist sgl lead at Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
$11,231.04
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.
$23,398.00
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.
$8,912.00 with Aetna vs $29,305.00 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 |
|---|---|---|---|
| Aetna | Gatekeeper Hmo | $8,912.00 | ↓ -21% |
| Providence | Oscar All Commercial Plans | $9,047.00 | ↓ -19% |
| Aetna | Medicare Managed Care Plan | $10,643.53 | ↓ -5% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $11,151.00 | ↓ -1% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $12,559.20 | ↑ +12% |
| Unitedhealthcare | Select/Navigate Hmo | $14,208.00 | ↑ +27% |
| Unitedhealthcare | All Commercial Plans | $15,667.00 | ↑ +39% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $16,338.00 | ↑ +45% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $19,606.00 | ↑ +75% |
| Healthnet | Ambetter Hmo | $19,690.54 | ↑ +75% |
| Blue Shield | Epn Exchange | $20,774.00 | ↑ +85% |
| Blue Shield | Tandem Ppo | $25,813.00 | ↑ +130% |
| Blue Shield | Hmo/Ppo | $28,699.00 | ↑ +156% |
| Healthnet | Hmo/Pos/Ppo | $29,305.00 | ↑ +161% |
Visitor-reported prices
Comments
Ins/rpl pm gen exist sgl lead at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $9,930.34 | $416.70 – $20,488.56 |
| Arroyo Grande Hospital | Santa Maria | $9,845.72 | $338.78 – $22,543.92 |
| French Hospital | San Luis Obispo | $8,908.20 | $338.78 – $22,270.50 |
| Bakersfield Memorial Hospital | Bakersfield | $10,879.35 | $338.78 – $23,418.76 |
| Queen of The Valley Medical Center | Napa | $21,783.63 | $11,749.91 – $46,622.00 |
| St. Joseph's Medical Center Stockton | Stockton | $8,370.18 | $338.78 – $23,914.80 |
| Mercy Medical Center Merced | Merced | $14,863.42 | $338.78 – $28,572.39 |
| Northridge Hospital Medical Center | Northridge | $6,818.49 | $338.78 – $24,439.00 |