Children's Hospital at Mission
27700 Medical Center Rd, 5Th Floor, Mission Viejo, CA 92691 · 82 Priced Procedures
Typical commercial prices here are +214% above the fair benchmark (3.14×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Specialty Drug & Surgical Margin Engine
Children's Hospital at Mission concentrates commercial margin in outpatient surgical suites (2.1× Medicare) and specialty drug infusions (5.1× Medicare) relative to routine diagnostics (2.7×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 2.03× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 16% of shoppable procedures (25/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (55.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
- Commercial insurance median sits at 3.61× Fair BaseRate (4.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 5.1× Medicare — verify per-unit billing on itemized statements
- Unnegotiated chargemaster list prices average 18.0× Medicare (19¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Children's Hospital at Mission
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 82 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| MRI, lower back (no contrast) CPT Code: 72148 | $6,931 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $3,864 | 28.8× |
| Ultrasound, pelvis CPT Code: 76856 | $3,259 | unverified |
| Ultrasound, thyroid and neck CPT Code: 76536 | $2,777 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,660 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $2,660 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $2,494 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,240 | 2.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,617 | 3.6× |
| X-ray, lower back CPT Code: 72110 | $1,610 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,403 | 3.8× |
| Blood transfusion CPT Code: 36430 | $1,387 | 2.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,314 | 4.3× |
| X-ray, pelvis CPT Code: 72170 | $1,295 | unverified |
| Speech therapy (language evaluation) CPT Code: 92507 | $1,213 | 14.1× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,150 | 4.8× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,150 | 4.5× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,100 | 4.0× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,119 | 1.9× |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $1,085 | unverified |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $852 | 4.7× |
| CT scan, pelvis CPT Code: 72192 | $745 | 4.6× |
| CT scan, chest (no contrast) CPT Code: 71250 | $746 | 4.5× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $746 | 4.4× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $746 | 4.4× |
Audit a Bill or Quote at Children's Hospital at Mission (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,812
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (55.0% of gross = $3,812).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Children's Hospital at Mission's published 45 CFR § 180 self-pay cash rate is $6,931 (vs. $6,931 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $338 Fair BaseRate ($244 Medicare)
Your bill ($6,931) is $6,593 above the denoised Fair BaseRate ($338) and 28.4× the $244 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (55.0% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Children's Hospital at Mission.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.