Providence Mission Hospital - Mission Viejo
27700 Medical Center Rd, Mission Viejo, CA · Providence · · NPI 1003956913
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $3,194.40 | $6,655.00 | $381.40 – $830.11 | 5 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,637.60 | $5,495.00 | $260.85 – $567.73 | 5 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,352.16 | $2,817.00 | $991.55 – $5,171.00 | 6 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $1,352.16 | $2,817.00 | $991.55 – $6,920.00 | 6 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $4,666.00 – $5,357.00 | 3 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $991.55 – $6,920.00 | 6 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $6,609.22 – $14,384.78 | 6 |
| Urea nitrogen CPT 84520 | $61.92 | $129.00 | $3.36 – $7.90 | 5 |
| Urea nitrogen 24 hour urine CPT 84540 | $59.04 | $123.00 | $4.73 – $11.12 | 5 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $6.12 – $14.40 | 5 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $4.36 – $10.26 | 5 |
| Ureteral embolization/occl CPT 50705 | $3,574.08 | $7,446.00 | $1,200.00 – $5,357.00 | 3 |
| Ureteral reflux study CPT 78740 | not published | not published | $437.05 – $951.22 | 5 |
| Ureter endoscopy CPT 50970 | not published | not published | $1,894.00 – $5,995.00 | 6 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $3,429.00 – $12,757.91 | 6 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $3,281.00 – $12,757.91 | 6 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $1,894.00 – $8,387.37 | 6 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $3,429.00 – $12,757.91 | 6 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $3,429.00 – $12,757.91 | 6 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $3,281.00 – $12,757.91 | 6 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $3,429.00 – $12,757.91 | 6 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $4,666.00 – $13,634.00 | 3 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $4,666.00 – $13,634.00 | 3 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $350.40 | $730.00 | $260.85 – $567.73 | 5 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,853.66 – $12,775.00 | 6 |
| Urethrocystography void s&i CPT 74455 | $350.40 | $730.00 | $260.85 – $567.73 | 5 |
| Uric acid blood CPT 84550 | $61.92 | $129.00 | $3.84 – $9.04 | 5 |
| Uric acid urine CPT 84560 | $59.04 | $123.00 | $4.32 – $10.16 | 5 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.00 – $9.40 | 5 |
| Urinalysis microscopic only CPT 81015 | $33.12 | $69.00 | $2.59 – $6.10 | 5 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.84 – $4.34 | 5 |
| Urinalysis (with microscopy) CPT 81001 | $94.56 | $197.00 | $2.69 – $6.34 | 5 |
| Urinalysis (without microscopy) CPT 81003 | $78.24 | $163.00 | $1.91 – $4.50 | 5 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $379.82 – $611.23 | 2 |
| Urinary reflex study CPT 51792 | not published | not published | $64.49 – $1,597.00 | 6 |
| Urine Culture Test CPT 87086 | $204.48 | $426.00 | $6.86 – $16.14 | 5 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $145.45 – $1,597.00 | 6 |
| Urine pregnancy test CPT 81025 | $48.96 | $102.00 | $7.32 – $17.22 | 5 |
| Urine screen for bacteria CPT 81007 | not published | not published | $21.04 – $59.96 | 5 |
| Urine shunt to intestine CPT 50815 | not published | not published | $4,666.00 – $16,338.00 | 3 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $6.00 – $3,429.00 | 3 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $127.26 – $139.62 | 2 |
| Urography, antegrade CPT 74425 | $586.08 | $1,221.00 | $381.40 – $830.11 | 5 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $191.76 – $417.35 | 5 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $800.28 – $800.28 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $97.27 – $97.27 | 1 |
| Use 1st target lesion CPT 76982 | not published | not published | $114.29 – $248.76 | 5 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $9.88 – $27.54 | 6 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $191.45 – $327.64 | 2 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $5,357.00 – $30,548.47 | 4 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $229.28 – $347.55 | 2 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $208.59 – $316.18 | 2 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $221.13 – $335.19 | 2 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $124.51 – $188.73 | 2 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $92.98 – $140.93 | 2 |
| Vaccine dtap < 7 years im CPT 90700 | $97.43 | $202.98 | $35.31 – $76.76 | 2 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $118.75 – $265.72 | 2 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $91.22 – $329.32 | 2 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $232.53 – $804.51 | 2 |
| Vaccine dtap-ipv/hib im CPT 90698 | $242.83 | $505.90 | $87.99 – $290.23 | 2 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $78.56 – $91.58 | 2 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $49.50 | $103.12 | $33.95 – $43.33 | 2 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $103.47 – $155.14 | 3 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $167.95 – $286.10 | 2 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $53.51 – $90.99 | 2 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $53.51 – $62.59 | 2 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $106.59 – $161.57 | 2 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $180.23 | $375.48 | $96.73 – $151.32 | 2 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $222.81 – $381.75 | 2 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $77.46 | $161.38 | $43.64 – $68.09 | 2 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $300.95 – $793.31 | 2 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $226.03 – $230.92 | 2 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $49.92 – $179.50 | 2 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $91.98 – $179.50 | 2 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $14.97 – $47.00 | 2 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $26.21 – $48.05 | 2 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $27.30 – $27.30 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $34.23 – $34.23 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $39.39 – $39.39 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $32.44 – $32.44 | 1 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $14.81 – $14.81 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $39.86 – $65.34 | 2 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $65.01 – $65.01 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $103.88 | $216.41 | $52.27 – $79.23 | 2 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $7.53 – $23.50 | 2 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $619.21 | $1,290.02 | $337.51 – $552.94 | 2 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $534.55 – $1,494.92 | 2 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $248.89 – $443.35 | 2 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $137.42 – $398.93 | 2 |
| Vaccine mmr live subcutaneous CPT 90707 | $287.76 | $599.51 | $74.94 – $244.65 | 2 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $201.24 – $716.36 | 2 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $360.57 | $751.18 | $31.48 – $286.96 | 2 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $211.76 – $554.68 | 2 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $359.65 – $561.47 | 2 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $715.41 | $1,490.44 | $422.74 – $672.74 | 2 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $49.92 – $115.09 | 2 |
| Vaccine rabies im CPT 90675 | $1,360.90 | $2,835.21 | $264.08 – $682.99 | 6 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $869.57 | $1,811.60 | $544.79 – $791.54 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $1,568.70 | $3,268.13 | $914.22 – $2,869.65 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $914.22 – $1,434.82 | 2 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.