Children's Hospital of Orange County
1201 W La Veta Ave, Orange, CA 92868 · 85 Priced Procedures
Typical commercial prices here are +199% above the fair benchmark (2.99×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Children's Hospital of Orange County prices routine shoppable procedures at 4.7× Medicare (median 2.91× Fair BaseRate) while upper-quartile commercial rates jump +61% to 4.69× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.55× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 23% 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 (56.8% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
- Commercial insurance median sits at 2.91× Fair BaseRate (4.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 4.69×) jump +61% above the median procedure ratio (Q50 2.91×)
- Unnegotiated chargemaster list prices average 17.8× Medicare (20¢ 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 of Orange County
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 85 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $7,180 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $4,408 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $3,624 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $3,048 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,702 | 5.3× |
| Ultrasound, pelvis CPT Code: 76856 | $2,668 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $2,341 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $1,949 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,897 | 5.1× |
| X-ray, chest (single view) CPT Code: 71045 | $1,912 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,812 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,740 | 6.7× |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,618 | 9.7× |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,586 | 4.7× |
| X-ray, lower back CPT Code: 72110 | $1,594 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $1,482 | 9.3× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,500 | 5.0× |
| Blood transfusion CPT Code: 36430 | $1,469 | 2.9× |
| CT scan, sinuses CPT Code: 70486 | $1,251 | 7.5× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,254 | 1.2× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,091 | 1.9× |
| Speech therapy (language evaluation) CPT Code: 92507 | $771 | 9.0× |
| CT scan, pelvis CPT Code: 72192 | $757 | 4.6× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $575 | 3.4× |
| Care planning with family CPT Code: 90887 | $557 | unverified |
Audit a Bill or Quote at Children's Hospital of Orange County (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $4,080
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (56.8% of gross = $4,080).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Children's Hospital of Orange County's published 45 CFR § 180 self-pay cash rate is $7,180 (vs. $7,180 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $448 Fair BaseRate ($356 Medicare)
Your bill ($7,180) is $6,732 above the denoised Fair BaseRate ($448) and 20.2× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (56.8% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Children's Hospital of Orange County. Prior administrative notices do not necessarily reflect current compliance status.
- 2026-02-12·administrative_or_closure
Closure Notice
Recorded - 2025-12-30·cap_corrective_action
CAP Request
Recorded - 2025-09-25·warning_notice
Warning Notice
Recorded - 2024-03-20·administrative_or_closure
Closure Notice
Recorded - 2023-06-16·cap_corrective_action
CAP Request
Recorded
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
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 of Orange County.
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.