Providence St. Joseph Hospital
Providence St. Joseph Hospital in Orange, CA charges 5.0x the Medicare reimbursement rate across 80 analyzed procedures, according to our pricing data analysis.
Orange, CA 92868 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Billing patterns — nonprofit-religious
Nonprofit religious hospitals, representing 203 facilities in the dataset, demonstrate an average markup of 5.4x Medicare rates, positioning them in the mid-range compared to other ownership types. These institutions typically maintain standardized charge structures across their health system networks, often reflecting their mission-driven approach to healthcare delivery. Patients at nonprofit religious hospitals may encounter charges above the benchmark for routine procedures, though many offer financial assistance programs and charity care policies that can significantly reduce out-of-pocket expenses for qualifying individuals. Common billing patterns include transparent pricing for elective procedures and comprehensive financial counseling services. The potential difference between listed charges and actual patient responsibility can be substantial, particularly for uninsured patients who may qualify for sliding-scale payment options. Patients should inquire about available financial assistance programs during the admissions process, as these hospitals often have more flexible payment arrangements compared to for-profit facilities, reflecting their tax-exempt status and community benefit obligations.
Pricing grade
D
High
Avg markup vs Medicare
5.04x
Charge / Medicare rate
Max markup
7.2x
Worst procedure
Procedures analyzed
80
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| KIDNEY TRANSPLANT | 652 | $183,209 | $91,605 | — | 7.2x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $129,835 | $64,918 | — | 6.9x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $90,616 | $45,308 | — | 6.9x |
| CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | 847 | $65,794 | $32,897 | — | 6.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $34,767 | $17,384 | — | 6.7x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $39,373 | $19,687 | — | 6.6x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $56,388 | $28,194 | — | 6.5x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $91,604 | $45,802 | — | 6.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $40,220 | $20,110 | — | 6.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $45,045 | $22,523 | — | 6.3x |
| RENAL FAILURE WITH MCC | 682 | $79,125 | $39,563 | — | 6.3x |
| DIABETES WITH CC | 638 | $45,402 | $22,701 | — | 6.2x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $227,604 | $113,802 | — | 6.2x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | 270 | $212,494 | $106,247 | — | 6.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $36,859 | $18,429 | — | 6.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $47,083 | $23,541 | — | 6x |
| KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC | 650 | $272,956 | $136,478 | — | 6x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | 331 | $78,801 | $39,401 | — | 5.9x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $80,990 | $40,495 | — | 5.9x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $85,382 | $42,691 | — | 5.8x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $57,405 | $28,702 | — | 5.8x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $62,068 | $31,034 | — | 5.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $34,809 | $17,405 | — | 5.8x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $44,344 | $22,172 | — | 5.7x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $107,024 | $53,512 | — | 5.7x |
| SEIZURES WITH MCC | 100 | $92,844 | $46,422 | — | 5.7x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $82,657 | $41,328 | — | 5.6x |
| MAJOR CHEST PROCEDURES WITH MCC | 163 | $207,910 | $103,955 | — | 5.6x |
| POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | 857 | $80,863 | $40,432 | — | 5.6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $81,078 | $40,539 | — | 5.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $72,288 | $36,144 | — | 5.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $39,813 | $19,907 | — | 5.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $40,981 | $20,491 | — | 5.2x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $109,828 | $54,914 | — | 5.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $258,088 | $129,044 | — | 5.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $167,635 | $83,817 | — | 5.1x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $183,303 | $91,651 | — | 5.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $109,599 | $54,800 | — | 5.1x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $66,849 | $33,424 | — | 5.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $71,244 | $35,622 | — | 5x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $190,750 | $95,375 | — | 5x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $88,648 | $44,324 | — | 5x |
| AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | 239 | $194,976 | $97,488 | — | 4.9x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $66,399 | $33,200 | — | 4.8x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $45,028 | $22,514 | — | 4.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $75,966 | $37,983 | — | 4.8x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $234,340 | $117,170 | — | 4.8x |
| RENAL FAILURE WITH CC | 683 | $31,929 | $15,965 | — | 4.8x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $84,993 | $42,497 | — | 4.7x |
| CELLULITIS WITHOUT MCC | 603 | $33,004 | $16,502 | — | 4.7x |
Showing 50 of 80 procedures
How PROVIDENCE ST. JOSEPH HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — nonprofit-religious hospital billing
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use