Plmt biliary drainage cath at Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
$4,555.20
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.
$9,490.00
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.
$3,914.24 with Providence vs $10,925.00 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 | $3,914.24 | ↓ -14% |
| Aetna | Gatekeeper Hmo | $4,114.00 | ↓ -10% |
| Aetna | Medicare Managed Care Plan | $4,604.99 | ↑ +1% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $4,824.55 | ↑ +6% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $5,357.00 | ↑ +18% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $5,433.82 | ↑ +19% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $6,428.00 | ↑ +41% |
| Unitedhealthcare | Select/Navigate Hmo | $7,883.00 | ↑ +73% |
| Blue Shield | Epn Exchange | $7,908.00 | ↑ +74% |
| Healthnet | Ambetter Hmo | $8,519.24 | ↑ +87% |
| Unitedhealthcare | All Commercial Plans | $8,704.00 | ↑ +91% |
| Blue Shield | Tandem Ppo | $9,826.00 | ↑ +116% |
| Healthnet | Hmo/Pos/Ppo | $9,990.00 | ↑ +119% |
| Blue Shield | Hmo/Ppo | $10,925.00 | ↑ +140% |
Visitor-reported prices
Comments
Plmt biliary drainage cath at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $3,075.64 | $1,895.94 – $8,890.24 |
| Arroyo Grande Hospital | Santa Maria | $5,416.34 | $1,507.82 – $6,588.54 |
| French Hospital | San Luis Obispo | $5,167.35 | $1,507.82 – $6,588.54 |
| Mercy Hospitals – Bakersfield | Bakersfield | $3,721.13 | $1,507.82 – $8,024.00 |
| Bakersfield Memorial Hospital | Bakersfield | $3,407.97 | $1,507.82 – $7,335.94 |
| Providence St Joseph Hospital Eureka | Eureka | $5,330.52 | $4,604.99 – $17,611.00 |
| St. Joseph's Medical Center Stockton | Stockton | $8,762.67 | $1,507.82 – $25,036.20 |
| Santa Rosa Memorial Hospital | Santa Rosa | $4,471.68 | $3,423.00 – $11,377.00 |