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 |
|---|---|---|---|---|
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $85.60 | $178.33 | $2.25 – $19.64 | 4 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $382.20 | $796.25 | not published | 0 |
| Loudness balance test CPT 92562 | not published | not published | $236.06 – $513.77 | 4 |
| Low back disk surgery CPT 63030 | not published | not published | $7,932.80 – $17,265.50 | 6 |
| Low cost skin substitute app HCPCS C5271 | $1,315.20 | $2,740.00 | $1,200.00 – $4,114.00 | 4 |
| Low cost skin substitute app HCPCS C5273 | $2,688.00 | $5,600.00 | $1,597.00 – $5,995.00 | 4 |
| Low cost skin substitute app HCPCS C5275 | $1,315.20 | $2,740.00 | $1,200.00 – $4,114.00 | 4 |
| Low cost skin substitute app HCPCS C5277 | $1,315.20 | $2,740.00 | $1,200.00 – $4,114.00 | 4 |
| Low cost skin substitute app HCPCS C5272 | $657.60 | $1,370.00 | $1,200.00 – $3,429.00 | 2 |
| Low cost skin substitute app HCPCS C5274 | $1,344.00 | $2,800.00 | $1,200.00 – $3,429.00 | 2 |
| Low cost skin substitute app HCPCS C5276 | $657.60 | $1,370.00 | $1,200.00 – $3,429.00 | 2 |
| Low cost skin substitute app HCPCS C5278 | $1,315.20 | $2,740.00 | $1,200.00 – $3,429.00 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,848.80 | $5,935.00 | $191.76 – $417.35 | 5 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,160.96 | $4,502.00 | $381.40 – $830.11 | 5 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,773.12 | $3,694.00 | $114.29 – $248.76 | 5 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,679.52 | $9,749.00 | $381.40 – $830.11 | 5 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,194.40 | $6,655.00 | $381.40 – $830.11 | 5 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,634.24 | $5,488.00 | $260.85 – $567.73 | 5 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $434.88 | $906.00 | $114.29 – $248.76 | 5 |
| Lower jaw bone graft CPT 21215 | not published | not published | $6,471.81 – $15,436.00 | 6 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $219.34 – $477.39 | 4 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $26.37 – $38.70 | 2 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $9,779.00 – $16,652.00 | 6 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $9,779.00 – $25,292.72 | 6 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $9,779.00 – $25,292.72 | 6 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $9,779.00 – $25,292.72 | 6 |
| Lso s/c shell/panel custom HCPCS L0640 | $2,691.97 | $5,608.28 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $5.05 – $43.98 | 5 |
| Lumbar diskogram s&i CPT 72295 | $2,149.44 | $4,478.00 | $504.09 – $4,646.33 | 5 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $10,791.00 – $39,963.00 | 6 |
| Lumizyme injection HCPCS J0221 | not published | not published | $176.39 – $433.38 | 6 |
| Lung function test (mbc/mvv) CPT 94200 | $98.88 | $206.00 | $64.49 – $140.37 | 4 |
| Lung Function Test (Spirometry) CPT 94010 | $125.28 | $261.00 | $201.95 – $513.77 | 4 |
| Lung perfusion imaging CPT 78580 | $750.72 | $1,564.00 | $437.05 – $951.22 | 5 |
| Lung transplant double CPT 32853 | not published | not published | $4,666.00 – $16,338.00 | 3 |
| Lung transplant single CPT 32851 | not published | not published | $4,666.00 – $16,338.00 | 3 |
| Lung transplant with bypass CPT 32852 | not published | not published | $4,666.00 – $16,338.00 | 3 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,666.00 – $16,338.00 | 3 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $4,666.00 – $16,338.00 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $180.28 – $440.84 | 6 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $23,110.91 | $48,147.72 | $36.34 – $88.67 | 6 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $271.95 – $636.94 | 5 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $220.66 – $516.43 | 5 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,427.67 | $2,974.32 | not published | 0 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $31.62 – $1,597.00 | 6 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $17.04 – $40.10 | 5 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $5,171.00 – $19,447.84 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $1,513.92 | $3,154.00 | $593.60 – $1,291.95 | 5 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $18.48 – $73.12 | 5 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $21.07 – $98.06 | 5 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $27.82 – $379.02 | 5 |
| Lymphocytotoxicity assay CPT 86806 | $96.00 | $200.00 | $26.94 – $95.18 | 5 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $685.79 – $1,492.61 | 5 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,512.32 | $5,234.00 | $1,720.93 – $3,745.56 | 5 |
| Lymph vessel x-ray trunk CPT 75805 | $2,565.12 | $5,344.00 | $2,286.27 – $7,512.94 | 5 |
| Lymph vessel x-ray trunk CPT 75807 | $4,973.76 | $10,362.00 | $2,274.19 – $7,512.94 | 5 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $589.62 – $6,920.00 | 6 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,429.00 – $7,702.45 | 6 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $2,285.30 – $6,920.00 | 6 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $21.98 – $32.96 | 4 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $14.44 – $79.63 | 3 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $3.63 – $8.54 | 5 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $3.66 – $8.62 | 5 |
| Magnesium CPT 83735 | $59.04 | $123.00 | $5.70 – $13.40 | 5 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $118.70 | $247.30 | $0.68 – $1.05 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $260.85 – $567.73 | 5 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $19.60 – $29.71 | 2 |
| Malaria antibody CPT 86750 | not published | not published | $11.21 – $26.38 | 5 |
| Male sling procedure CPT 53440 | not published | not published | $4,114.00 – $29,305.00 | 6 |
| Mammosite ced HCPCS C1728 | $6,180.00 | $12,875.00 | not published | 0 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $4,666.00 – $13,634.00 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,200.00 – $3,826.07 | 6 |
| Manipulate wrist w/anesthes CPT 25259 | $1,828.80 | $3,810.00 | $1,757.92 – $5,171.00 | 6 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $232.32 | $484.00 | $145.45 – $316.58 | 4 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $379.20 | $790.00 | $145.45 – $316.58 | 4 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,757.92 – $6,920.00 | 6 |
| Manipulation of spine CPT 22505 | not published | not published | $1,757.92 – $6,920.00 | 6 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $269.67 – $1,597.00 | 6 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $3.24 – $7.42 | 4 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $2.54 – $8.22 | 2 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $3.72 – $10.14 | 5 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $542.44 – $542.44 | 1 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $1,200.00 – $5,357.00 | 3 |
| Map tachycard site(s) CPT 93609 | not published | not published | $1,200.00 – $13,634.00 | 3 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $45.28 – $104.34 | 6 |
| Marker biop eviva buckle ss HCPCS A4648 | $6,519.80 | $13,582.91 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $2,565.46 | $5,344.70 | $1,065.90 – $2,446.61 | 5 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $4,666.00 – $13,634.00 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $4,280.52 – $9,316.42 | 6 |
| Mast mod rad CPT 19307 | not published | not published | $7,259.31 – $15,799.68 | 5 |
| Mastoidectomy CPT 69501 | not published | not published | $6,471.81 – $15,436.00 | 6 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $4,666.00 – $15,436.00 | 6 |
| Mastoids complete CPT 70130 | $504.00 | $1,050.00 | $114.29 – $248.76 | 5 |
| Mastoid surgery revision CPT 69603 | not published | not published | $6,471.81 – $15,436.00 | 6 |
| Mastopexy CPT 19316 | not published | not published | $7,259.31 – $15,799.68 | 6 |
| Mast radical CPT 19305 | not published | not published | $4,666.00 – $13,634.00 | 2 |
| Mast rad urban type CPT 19306 | not published | not published | $4,666.00 – $13,634.00 | 2 |
| Mast simple complete CPT 19303 | not published | not published | $7,259.31 – $15,799.68 | 6 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $123.82 – $1,597.00 | 7 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $5,518.34 – $5,518.34 | 1 |
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.