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 |
|---|---|---|---|---|
| X-ray exam of teeth CPT 70300 | not published | not published | $49.69 – $207.07 | 5 |
| X-ray exam of teeth CPT 70310 | not published | not published | $159.27 – $567.73 | 5 |
| X-ray exam si joints CPT 72200 | $350.88 | $731.00 | $114.29 – $248.76 | 5 |
| X-ray exam thorac spine4/>vw CPT 72074 | $595.68 | $1,241.00 | $114.29 – $248.76 | 5 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $250.08 | $521.00 | $95.14 – $207.07 | 5 |
| X-ray facial bones complete > 3 views CPT 70150 | $491.04 | $1,023.00 | $114.29 – $248.76 | 5 |
| X-ray fallopian tube CPT 74742 | not published | not published | $321.75 – $1,174.05 | 2 |
| X-ray femur >=2 views (both sides) CPT 73552 | $434.88 | $906.00 | $95.14 – $207.07 | 5 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray foot 2 views (both sides) CPT 73620 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray forearm 2 views (both sides) CPT 73090 | $434.88 | $906.00 | $95.14 – $207.07 | 5 |
| X-ray hand 2 views (both sides) CPT 73120 | $350.88 | $731.00 | $111.82 – $248.76 | 5 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $67.18 – $207.07 | 5 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $516.96 | $1,077.00 | $114.29 – $248.76 | 5 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $516.96 | $1,077.00 | $114.29 – $248.76 | 5 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $516.96 | $1,077.00 | $114.29 – $248.76 | 5 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $526.56 | $1,097.00 | $114.29 – $248.76 | 5 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray humerus >= 2 views left CPT 73060 | $434.88 | $906.00 | $95.14 – $207.07 | 5 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $114.29 – $248.76 | 5 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $347.52 | $724.00 | $95.14 – $207.07 | 5 |
| X-ray knee 3 views (both sides) CPT 73562 | $383.52 | $799.00 | $95.14 – $207.07 | 5 |
| X-ray knee ap standing bilateral CPT 73565 | $217.44 | $453.00 | $95.14 – $207.07 | 5 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $360.96 | $752.00 | $95.14 – $207.07 | 5 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $350.88 | $731.00 | $114.29 – $248.76 | 5 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $434.88 | $906.00 | $114.29 – $248.76 | 5 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $595.68 | $1,241.00 | $114.29 – $248.76 | 5 |
| X-ray male genital tract CPT 74440 | not published | not published | $260.85 – $567.73 | 5 |
| X-ray mandible complete > 4 views CPT 70110 | $491.04 | $1,023.00 | $114.29 – $248.76 | 5 |
| X-ray mandible ltd <4 views CPT 70100 | $311.04 | $648.00 | $95.14 – $207.07 | 5 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $394.29 – $394.29 | 1 |
| X-ray nasal bones complete > 3 views CPT 70160 | $320.16 | $667.00 | $95.14 – $207.07 | 5 |
| X-ray neck soft tissue CPT 70360 | $174.72 | $364.00 | $95.14 – $207.07 | 5 |
| X-ray nose to rectum for foreign body child CPT 76010 | $520.80 | $1,085.00 | $95.14 – $207.07 | 5 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $260.85 – $567.73 | 5 |
| X-ray optic foramina CPT 70190 | not published | not published | $95.14 – $207.07 | 5 |
| X-ray pelvis 1-2 views CPT 72170 | $350.88 | $731.00 | $102.11 – $248.76 | 5 |
| X-ray pelvis complete > 3 views CPT 72190 | $434.88 | $906.00 | $114.29 – $248.76 | 5 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $880.79 – $2,598.19 | 2 |
| Xray place prox ext thor ao CPT 75958 | $2,004.96 | $4,177.00 | $1,003.68 – $2,967.61 | 2 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $762.24 | $1,588.00 | $381.40 – $830.11 | 5 |
| X-ray ribs 2 views left CPT 71100 | $177.60 | $370.00 | $95.14 – $207.07 | 5 |
| X-ray ribs 3 views bilateral CPT 71110 | $516.96 | $1,077.00 | $114.29 – $248.76 | 5 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $489.60 | $1,020.00 | $114.29 – $248.76 | 5 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $581.76 | $1,212.00 | $114.29 – $248.76 | 5 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $434.88 | $906.00 | $114.29 – $248.76 | 5 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $459.36 | $957.00 | $95.14 – $207.07 | 5 |
| X-ray scapula complete (both sides) CPT 73010 | $350.88 | $731.00 | $114.29 – $248.76 | 5 |
| X-ray sella turcica CPT 70240 | not published | not published | $95.14 – $207.07 | 5 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $350.88 | $731.00 | $92.41 – $207.07 | 5 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $369.12 | $769.00 | $95.14 – $207.07 | 5 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $340.32 | $709.00 | $203.07 – $1,300.14 | 5 |
| X-ray skull < 4 views CPT 70250 | $326.40 | $680.00 | $114.29 – $248.76 | 5 |
| X-ray skull > 4 views complete CPT 70260 | $540.00 | $1,125.00 | $114.29 – $248.76 | 5 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $114.29 – $248.76 | 5 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $456.00 | $950.00 | $191.76 – $417.35 | 5 |
| X-ray small intestine follow-through study CPT 74248 | $299.52 | $624.00 | $253.80 – $483.80 | 2 |
| X-ray spine single view CPT 72020 | $295.68 | $616.00 | $92.41 – $207.07 | 5 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $205.44 | $428.00 | $95.14 – $207.07 | 5 |
| X-ray sternum > 2 views CPT 71120 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray surgical specimen CPT 76098 | $349.92 | $729.00 | $63.29 – $1,300.14 | 5 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $757.92 | $1,579.00 | $191.76 – $417.35 | 5 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $241.92 | $504.00 | $95.14 – $207.07 | 5 |
| X-ray thoracic spine 2 views CPT 72070 | $153.12 | $319.00 | $114.29 – $248.76 | 5 |
| X-ray thoracic spine 3 views CPT 72072 | $242.40 | $505.00 | $114.29 – $248.76 | 5 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $319.20 | $665.00 | $95.14 – $207.07 | 5 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $371.04 | $773.00 | $114.29 – $248.76 | 5 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $345.60 | $720.00 | $191.76 – $417.35 | 5 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $345.60 | $720.00 | $191.76 – $417.35 | 5 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $559.99 – $559.99 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $833.55 – $833.55 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $350.88 | $731.00 | $95.14 – $207.07 | 5 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $409.44 | $853.00 | $191.76 – $417.35 | 5 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $407.41 – $407.41 | 1 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $605.43 – $2,202.14 | 2 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $136.05 – $6,297.39 | 7 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $10.97 – $25.82 | 5 |
| Xyntha inj HCPCS J7185 | $3,745.70 | $7,803.55 | $1.27 – $3.20 | 6 |
| Yersinia antibody CPT 86793 | not published | not published | $8.01 – $26.38 | 5 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $48,300.87 – $122,172.78 | 5 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $102.52 – $296.10 | 6 |
| Ziconotide injection HCPCS J2278 | not published | not published | $8.89 – $20.86 | 6 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $110.40 | $230.01 | $1.29 – $3.25 | 6 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.92 – $1.92 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $240.00 | $500.00 | $16.95 – $102.62 | 5 |
| Zika virus igm antibody CPT 86794 | $132.00 | $275.00 | $8.01 – $33.70 | 5 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | $14.38 | $29.96 | not published | 0 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $52.36 | $109.09 | $6.28 – $32.19 | 4 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.32 – $17.85 | 6 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $130.89 | $272.68 | $10.41 – $301.28 | 4 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $285.82 – $310.77 | 2 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $76.48 – $386.50 | 5 |
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.