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 |
|---|---|---|---|---|
| Ghs reticulocyte count CPT 85044 | not published | not published | $3.66 – $8.62 | 5 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $144.00 | $300.00 | $11.82 – $27.82 | 5 |
| Ghs sedimentation rate CPT 85651 | $6.24 | $13.00 | $3.63 – $8.54 | 5 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $10.46 – $24.62 | 5 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $8.36 – $19.68 | 5 |
| Ghs sensitivity (per antimicro) CPT 87184 | $67.20 | $140.00 | $6.36 – $14.96 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $1,056.48 | $2,201.00 | $444.42 – $6,920.00 | 6 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $1,056.48 | $2,201.00 | $444.42 – $6,920.00 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $1,056.48 | $2,201.00 | $444.42 – $6,920.00 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $731.04 | $1,523.00 | $444.42 – $6,920.00 | 6 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $1,056.48 | $2,201.00 | $219.34 – $1,597.00 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $1,056.48 | $2,201.00 | $219.34 – $1,597.00 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $1,056.48 | $2,201.00 | $219.34 – $1,597.00 | 6 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $1,056.48 | $2,201.00 | $219.34 – $6,920.00 | 6 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $1,056.48 | $2,201.00 | $219.34 – $6,920.00 | 6 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $236.06 – $513.77 | 4 |
| Ghs somatosensory testing lower extremit CPT 95926 | $530.40 | $1,105.00 | $236.06 – $513.77 | 4 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $938.81 – $1,999.00 | 4 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $45.20 – $98.38 | 3 |
| Ghs sphenopalatine ganglion block CPT 64505 | $740.16 | $1,542.00 | $335.57 – $5,171.00 | 6 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $145.45 – $316.58 | 4 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $290.88 | $606.00 | $96.30 – $209.60 | 3 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $40.83 – $88.87 | 4 |
| Ghs strapping shoulder - 29240 CPT 29240 | $338.88 | $706.00 | $145.45 – $1,597.00 | 6 |
| Ghs st - re-eval for alt comm CPT 92597 | $305.76 | $637.00 | $65.78 – $143.17 | 3 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $114.24 | $238.00 | $51.19 – $111.42 | 4 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $252.96 | $527.00 | $232.54 – $506.11 | 4 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,512.48 | $3,151.00 | $807.98 – $5,171.00 | 6 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $1,375.20 | $2,865.00 | $444.42 – $5,171.00 | 6 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,244.48 | $4,676.00 | $1,696.26 – $5,171.00 | 6 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $6.20 – $14.60 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $618.24 | $1,288.00 | $269.67 – $1,597.00 | 6 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $547.20 | $1,140.00 | $269.67 – $1,597.00 | 6 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $7.13 – $48.60 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | $63.00 | $131.25 | $12.50 – $29.42 | 5 |
| Ghs vaginal delivery only CPT 59409 | $5,116.32 | $10,659.00 | $3,429.00 – $7,702.45 | 6 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,504.80 | $3,135.00 | $407.95 – $887.89 | 4 |
| Ghs windowing of cast CPT 29730 | $324.48 | $676.00 | $177.65 – $1,597.00 | 6 |
| Giardia ag if CPT 87269 | not published | not published | $11.57 – $27.22 | 5 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $10.67 – $29.44 | 5 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $260.85 – $567.73 | 5 |
| Gi inhouse confirmation CPT 87045 | $129.12 | $269.00 | $8.02 – $18.88 | 5 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $3,624.60 – $7,888.83 | 6 |
| Gi protein loss CPT 78282 | not published | not published | $437.05 – $951.22 | 5 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $815.52 | $1,699.00 | $991.55 – $3,281.00 | 5 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $1,016.67 – $2,212.75 | 4 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $991.55 – $3,281.00 | 5 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $991.55 – $6,920.00 | 6 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $85.95 – $202.24 | 5 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $52.29 – $123.04 | 5 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $29.75 – $70.00 | 5 |
| Glassia injection HCPCS J0257 | not published | not published | $4.81 – $11.72 | 6 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $31.62 – $68.82 | 4 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $40.83 – $88.87 | 4 |
| Glaucoma surgery CPT 66150 | not published | not published | $4,518.83 – $9,835.10 | 6 |
| Glaucoma surgery CPT 66155 | not published | not published | $4,518.83 – $9,835.10 | 6 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,523.01 – $6,920.00 | 6 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,523.01 – $9,779.00 | 6 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $70.78 – $410.13 | 6 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $379.92 | $791.50 | $114.75 – $323.45 | 6 |
| Glucagon plasma - sendout CPT 82943 | $65.24 | $135.92 | $12.15 – $28.58 | 5 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $39.16 – $92.14 | 5 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $42.92 – $101.00 | 5 |
| Glucagon tolerance test CPT 82946 | not published | not published | $15.10 – $35.54 | 5 |
| Glucose 1 hr post dose CPT 82950 | $89.28 | $186.00 | $4.04 – $9.50 | 5 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.14 – $12.10 | 5 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $2.79 – $6.56 | 5 |
| Glucose blood quantitative CPT 82947 | $61.92 | $129.00 | $3.34 – $7.86 | 5 |
| Glucose body fluid CPT 82945 | $59.04 | $123.00 | $3.34 – $7.86 | 5 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $64.49 – $140.37 | 4 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $59.04 | $123.00 | $9.49 – $25.74 | 5 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $59.04 | $123.00 | $3.33 – $7.84 | 5 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $44.76 | $93.25 | $0.73 – $1.10 | 4 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $17.35 – $28.51 | 2 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $9.59 – $23.16 | 6 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $103.68 | $216.00 | $10.15 – $37.16 | 5 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $126.15 – $296.82 | 5 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $103.68 | $216.00 | $15.74 – $37.04 | 5 |
| Gonioscopy CPT 92020 | not published | not published | $145.45 – $316.58 | 4 |
| Goniotomy CPT 65820 | not published | not published | $3,429.00 – $9,835.10 | 6 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,690.91 | $3,522.73 | $766.60 – $1,516.05 | 4 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $3,384.36 | $7,050.75 | $43.53 – $296.10 | 6 |
| Graft axiofill 1000mg HCPCS J3590 | $27,504.00 | $57,300.00 | not published | 0 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $136.05 – $2,270.34 | 6 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $25,774.72 | $53,697.33 | $91.23 – $296.10 | 6 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,577.09 – $7,908.00 | 6 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $43,722.17 | $91,087.85 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $1,317.44 – $4,294.63 | 2 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $57,600.00 | $120,000.00 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $51,285.84 | $106,845.50 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $44,378.43 | $92,455.06 | $61.65 – $296.10 | 6 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $12,188.88 | $25,393.50 | $136.05 – $1,597.00 | 7 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $4,666.00 – $13,634.00 | 3 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $21,168.00 | $44,100.00 | $136.05 – $296.10 | 6 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $74.27 – $296.10 | 6 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $54,552.02 | $113,650.05 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $6,674.40 | $13,905.00 | $53.78 – $296.10 | 6 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $61,102.08 | $127,296.00 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $4,422.72 | $9,214.00 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | $29.68 | $61.84 | $84.39 – $110.94 | 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.