Providence Mission Hospital

27700 Medical Center Rd, Mission Viejo, CA 92691 · Acute care hospital · Emergency room

These are Providence Mission Hospital's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

222 of the services we track have a posted price here; 152 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge
Critical care, first 30 to 74 minutes CPT 99291	$4,854.72	$10,114.00
Emergency room visit, level 1 (minor) CPT 99281	$390.24	$813.00
Emergency room visit, level 2 CPT 99282	$708.96	$1,477.00
Emergency room visit, level 3 (moderate) CPT 99283	$1,666.56	$3,472.00
Emergency room visit, level 4 CPT 99284	$2,459.04	$5,123.00
Emergency room visit, level 5 (most severe) CPT 99285	$3,332.64	$6,943.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$1,056.48	$2,201.00

Imaging

Service	Cash price	Gross charge
3D screening mammogram (tomosynthesis), add-on CPT 77063	$217.92	$454.00
Abdominal X-ray, 1 view CPT 74018	$329.76	$687.00
Ankle X-ray, 3 or more views CPT 73610	$434.88	$906.00
Bone density scan (DEXA), hips and spine CPT 77080	$520.80	$1,085.00
Breast ultrasound, one breast, complete CPT 76641	$525.12	$1,094.00
Breast ultrasound, one breast, limited CPT 76642	$469.44	$978.00
Chest X-ray, 1 view CPT 71045	$357.12	$744.00
Chest X-ray, 2 views CPT 71046	$443.04	$923.00
CT angiogram of the chest (checks for lung clots) CPT 71275	$2,543.52	$5,299.00
CT angiogram of the head CPT 70496	$1,587.36	$3,307.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$2,328.00	$4,850.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$2,915.04	$6,073.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$2,082.72	$4,339.00
CT scan of the abdomen, without contrast CPT 74150	$1,441.44	$3,003.00
CT scan of the chest, with contrast CPT 71260	$2,202.24	$4,588.00
CT scan of the chest, without contrast CPT 71250	$1,900.80	$3,960.00
CT scan of the head, without contrast CPT 70450	$1,587.36	$3,307.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$1,893.60	$3,945.00
CT scan of the pelvis, with contrast CPT 72193	$1,572.96	$3,277.00
CT scan of the sinuses or face, without contrast CPT 70486	$1,705.44	$3,553.00
Diagnostic mammogram, both breasts CPT 77066	$702.72	$1,464.00
Diagnostic mammogram, one breast CPT 77065	$548.64	$1,143.00
Foot X-ray, 3 or more views CPT 73630	$434.88	$906.00
Hand X-ray, 3 or more views CPT 73130	$434.88	$906.00
Knee X-ray, 3 views CPT 73562	$383.52	$799.00
Leg or arm vein ultrasound, both sides CPT 93970	$1,200.00	$2,500.00
Leg or arm vein ultrasound, one side CPT 93971	$1,200.00	$2,500.00
Lower back X-ray, 2 or 3 views CPT 72100	$434.88	$906.00
MRI of both breasts, without and with contrast CPT 77049	$3,455.52	$7,199.00
MRI of the abdomen, without and with contrast CPT 74183	$5,371.20	$11,190.00
MRI of the brain, without and with contrast CPT 70553	$4,906.08	$10,221.00
MRI of the brain, without contrast CPT 70551	$2,491.20	$5,190.00
MRI of the knee or other leg joint, without contrast CPT 73721	$2,652.96	$5,527.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$2,634.24	$5,488.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$2,637.60	$5,495.00
MRI of the neck (cervical spine), without contrast CPT 72141	$2,492.64	$5,193.00
MRI of the pelvis, without and with contrast CPT 72197	$6,444.96	$13,427.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$2,841.12	$5,919.00
Neck X-ray, 2 or 3 views CPT 72040	$350.88	$731.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$831.36	$1,732.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$634.56	$1,322.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$615.36	$1,282.00
Screening mammogram, both breasts CPT 77067	$579.84	$1,208.00
Shoulder X-ray, 2 or more views CPT 73030	$474.72	$989.00
Transvaginal pregnancy ultrasound CPT 76817	$542.88	$1,131.00
Transvaginal ultrasound CPT 76830	$754.56	$1,572.00
Ultrasound of the abdomen, complete CPT 76700	$984.96	$2,052.00
Ultrasound of the neck or thyroid CPT 76536	$708.00	$1,475.00
Wrist X-ray, 3 or more views CPT 73110	$383.52	$799.00
X-ray of the lower back, 4 or more views CPT 72110	$434.88	$906.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$59.04	$123.00
Blood culture CPT 87040	$241.92	$504.00
Blood draw (venipuncture) CPT 36415	$18.72	$39.00
BNP test (heart failure) CPT 83880	$182.40	$380.00
C-reactive protein (CRP) test CPT 86140	$43.68	$91.00
Chlamydia test (DNA/NAAT) CPT 87491	$50.08	$104.34
Complete blood count (CBC) with differential CPT 85025	$84.00	$175.00
Complete blood count (CBC), automated CPT 85027	$46.56	$97.00
Comprehensive metabolic panel (blood test) CPT 80053	$59.04	$123.00
COVID-19 PCR test CPT 87635	$83.04	$173.00
D-dimer test (blood clots) CPT 85379	$95.52	$199.00
Drug screen, instrument chemistry CPT 80307	$280.80	$585.00
Ferritin (iron stores) test CPT 82728	$72.96	$152.00
Free T4 (thyroid) test CPT 84439	$80.16	$167.00
General health panel (blood tests) CPT 80050	not posted		$94.56 – $471.77
Glucose (blood sugar) test CPT 82947	$61.92	$129.00
Gonorrhea test (DNA/NAAT) CPT 87591	$49.92	$104.00
Hemoglobin A1c test CPT 83036	$52.32	$109.00
Hepatitis C antibody test CPT 86803	$142.08	$296.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$179.04	$373.00
Iron test CPT 83540	$59.04	$123.00
Kidney function panel CPT 80069	$59.04	$123.00
Lipase test (pancreas) CPT 83690	$74.40	$155.00
Lipid panel, cholesterol and triglycerides CPT 80061	$108.00	$225.00
Liver function panel CPT 80076	$59.04	$123.00
Magnesium test CPT 83735	$59.04	$123.00
Obstetric blood test panel CPT 80055	not posted		$40.64 – $437.82
Partial thromboplastin time (PTT), clotting test CPT 85730	$83.04	$173.00
Pregnancy blood test (hCG), quantitative CPT 84702	$116.64	$243.00
Prothrombin time (PT/INR), clotting test CPT 85610	$73.44	$153.00
PSA (prostate specific antigen), free CPT 84154	$79.20	$165.00
PSA (prostate specific antigen), total CPT 84153	$77.28	$161.00
Rapid strep test CPT 87880	$76.32	$159.00
Sed rate (ESR) test CPT 85652	$42.72	$89.00
TB skin test CPT 86580	not posted		$31.62 – $111.86
Thyroid stimulating hormone (TSH) CPT 84443	$90.24	$188.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$192.48	$401.00
Troponin test (heart damage) CPT 84484	$102.24	$213.00
Urinalysis, automated, with microscope CPT 81001	$94.56	$197.00
Urinalysis, automated, without microscope CPT 81003	$78.24	$163.00
Urinalysis, manual, with microscope CPT 81000	not posted		$3.42 – $240.73
Urinalysis, manual, without microscope CPT 81002	$20.16	$42.00
Urine culture, colony count CPT 87086	$204.48	$426.00
Urine pregnancy test CPT 81025	$48.96	$102.00
Vitamin B12 test CPT 82607	$75.36	$157.00
Vitamin D test CPT 82306	$123.84	$258.00

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$1,378.56	$2,872.00
ECG tracing only (no interpretation) CPT 93005	$288.48	$601.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,971.84	$4,108.00
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$110.12 – $441.19
Holter monitor, up to 48 hours CPT 93224	not posted		$605.43 – $2,642.58
Left heart catheterization CPT 93452	$6,182.88	$12,881.00
Left heart catheterization with coronary angiogram CPT 93458	$7,164.00	$14,925.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$4,204.80	$8,760.00
Treadmill stress test, complete CPT 93015	not posted		$523.56 – $1,820.74

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$7,908.00 – $21,313.00
Appendix removal, laparoscopic CPT 44970	not posted		$6,609.22 – $17,648.00
Breast biopsy with ultrasound guidance CPT 19083	$3,090.24	$6,438.00
Carpal tunnel release CPT 64721	$1,156.80	$2,410.00
Colonoscopy with biopsy CPT 45380	not posted		$1,308.22 – $9,559.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$1,308.22 – $9,559.00
Colonoscopy, diagnostic CPT 45378	$1,204.32	$2,509.00
Colposcopy with biopsy CPT 57454	not posted		$333.14 – $7,143.00
Cystoscopy (bladder scope) CPT 52000	$1,092.48	$2,276.00
Ear tubes, under general anesthesia CPT 69436	not posted		$1,696.26 – $10,925.00
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,204.32	$2,509.00
Gallbladder removal, laparoscopic CPT 47562	not posted		$6,609.22 – $21,325.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$10,791.00 – $11,921.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$10,791.00 – $29,305.00
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$3,538.96 – $10,925.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$6,609.22 – $16,652.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$2,280.48	$4,751.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$3,853.66 – $28,699.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$3,577.09 – $16,361.00
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,308.22 – $7,143.00
Nasal endoscopy, diagnostic CPT 31231	$407.04	$848.00
Prostate biopsy CPT 55700	$3,636.00	$7,575.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$5,171.00 – $29,305.00
Removal of a breast lump, open surgery CPT 19120	not posted		$4,280.52 – $11,662.00
Rotator cuff repair, arthroscopic CPT 29827	not posted		$7,932.80 – $21,313.00
Screening colonoscopy, average risk HCPCS G0121	not posted		$1,016.67 – $6,428.00
Screening colonoscopy, high risk HCPCS G0105	not posted		$1,016.67 – $6,428.00
Septoplasty (nasal septum repair) CPT 30520	$4,803.84	$10,008.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$1,200.00 – $16,361.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$10,791.00 – $21,325.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$4,666.00 – $16,652.00
Total hip replacement CPT 27130	not posted		$7,908.00 – $39,963.00
Total knee replacement CPT 27447	not posted		$7,908.00 – $39,963.00
Upper endoscopy (EGD) with biopsy CPT 43239	$1,352.16	$2,817.00
Upper endoscopy (EGD), diagnostic CPT 43235	$1,352.16	$2,817.00
Vasectomy CPT 55250	not posted		$2,285.30 – $9,559.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted		$7,908.00 – $16,361.00
Fetal non-stress test CPT 59025	$751.68	$1,566.00
IUD insertion CPT 58300	$140.64	$293.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$6,920.00 – $16,361.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$6,920.00 – $16,361.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$8,961.73 – $21,144.57
C-section, without complications MS-DRG 788	not posted	$9,685.41 – $21,691.04
Chest pain MS-DRG 313	not posted	$7,411.51 – $17,096.37
COPD flare-up, with major complications MS-DRG 190	not posted	$11,103.27 – $26,923.25
COPD flare-up, without complications MS-DRG 192	not posted	$6,668.78 – $15,512.09
Fainting (syncope) MS-DRG 312	not posted	$8,855.08 – $20,883.32
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$9,893.95 – $23,630.05
Heart failure, with major complications MS-DRG 291	not posted	$12,780.13 – $31,275.84
Heart failure, without complications MS-DRG 293	not posted	$5,945.09 – $13,158.43
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$16,552.00 – $231,300.79
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$18,922.90 – $45,191.66
Irregular heartbeat, without complications MS-DRG 310	not posted	$5,946.05 – $13,410.10
Kidney failure, with complications MS-DRG 683	not posted	$8,895.07 – $21,305.16
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$8,263.75 – $19,236.72
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$10,137.00 – $60,562.00
Normal newborn care MS-DRG 795	not posted	$2,194.86 – $4,788.81
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$7,965.70 – $18,730.99
Pneumonia, with complications MS-DRG 194	not posted	$8,229.47 – $19,653.76
Pneumonia, with major complications MS-DRG 193	not posted	$13,071.51 – $31,585.03
Pneumonia, without complications MS-DRG 195	not posted	$6,540.23 – $14,927.27
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$13,856.13 – $33,782.90
Sepsis, with major complications MS-DRG 871	not posted	$19,052.40 – $47,032.41
Sepsis, without major complications MS-DRG 872	not posted	$10,299.59 – $24,711.01
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$8,848.41 – $21,113.41
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$10,137.00 – $87,672.55
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$7,979.03 – $18,702.23
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$10,175.81 – $24,375.46
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$9,565.00 – $28,728.04
Vaginal delivery, without complications MS-DRG 807	not posted	$6,975.40 – $15,272.41
Weight loss surgery, without complications MS-DRG 621	not posted	$14,918.81 – $35,034.03

Pain and spine

Service	Cash price	Gross charge
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$1,105.44	$2,303.00
Lower back nerve root injection with imaging guidance CPT 64483	$1,315.20	$2,740.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$2,509.92	$5,229.00
Lower back spinal injection (epidural), without imaging CPT 62322	$1,472.64	$3,068.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$2,523.01 – $20,778.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$145.55 – $316.79
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$601.28 – $9,559.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$154.08	$321.00

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$691.20	$1,440.00
Sleep study with CPAP titration CPT 95811	not posted		$938.81 – $3,509.40
Sleep study, overnight in a sleep lab CPT 95810	$1,382.88	$2,881.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$125.28	$261.00

Therapy

Service	Cash price	Gross charge
Manual therapy, 15 minutes CPT 97140	$97.44	$203.00
Physical therapy evaluation, low complexity CPT 97161	$125.76	$262.00
Physical therapy evaluation, moderate complexity CPT 97162	$187.68	$391.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$94.08	$196.00
Therapeutic activities, 15 minutes CPT 97530	$90.72	$189.00

Mental health

Service	Cash price	Gross charge
Family psychotherapy, with the patient, 50 minutes CPT 90847	$212.64	$443.00
Family psychotherapy, without the patient, 50 minutes CPT 90846	$178.08	$371.00
Group psychotherapy CPT 90853	$197.28	$411.00
Psychiatric diagnostic evaluation CPT 90791	$159.36	$332.00
Psychotherapy, 30 minutes CPT 90832	$144.48	$301.00
Psychotherapy, 45 minutes CPT 90834	$212.64	$443.00
Psychotherapy, 60 minutes CPT 90837	$280.80	$585.00

Infusions and injections

Service	Cash price	Gross charge
Injection under the skin or into a muscle CPT 96372	$95.52	$199.00
IV hydration, each additional hour CPT 96361	$95.52	$199.00
IV hydration, first hour CPT 96360	$287.52	$599.00
IV push injection of a drug, first CPT 96374	$176.64	$368.00
IV push injection, each additional drug CPT 96375	$130.08	$271.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$44.76	$93.25
Dexamethasone injection, per 1 mg HCPCS J1100	$44.76	$93.25
Fentanyl injection, per 0.1 mg HCPCS J3010	$130.60	$272.08
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$2.63 – $2.63
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$44.76	$93.25
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$83.64	$174.25
Morphine injection, up to 10 mg HCPCS J2270	$77.36	$161.16
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$44.76	$93.25
Propofol injection, per 10 mg HCPCS J2704	$113.02	$235.45
Saline IV solution, 1000 ml HCPCS J7030	$61.49	$128.10

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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