Providence St. Jude Medical Center
Providence St. Jude Medical Center in Fullerton, CA charges 5.7x the Medicare reimbursement rate across 78 analyzed procedures at this nonprofit-religious hospital.
Fullerton, CA 92835 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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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
5.69x
Charge / Medicare rate
Max markup
8.73x
Worst procedure
Procedures analyzed
78
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 |
|---|---|---|---|---|---|
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $67,055 | $33,527 | — | 8.7x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $72,097 | $36,049 | — | 8.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $45,097 | $22,549 | — | 7.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $114,016 | $57,008 | — | 7.2x |
| DIGESTIVE MALIGNANCY WITH MCC | 374 | $107,268 | $53,634 | — | 7.2x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $54,358 | $27,179 | — | 7.2x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $54,624 | $27,312 | — | 7x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $46,630 | $23,315 | — | 7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $52,847 | $26,424 | — | 6.9x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $49,670 | $24,835 | — | 6.9x |
| DISORDERS OF THE BILIARY TRACT WITH MCC | 444 | $86,620 | $43,310 | — | 6.8x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $66,730 | $33,365 | — | 6.8x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $45,417 | $22,709 | — | 6.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $46,922 | $23,461 | — | 6.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $37,564 | $18,782 | — | 6.7x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $111,171 | $55,585 | — | 6.6x |
| SEIZURES WITH MCC | 100 | $93,913 | $46,956 | — | 6.6x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $92,796 | $46,398 | — | 6.6x |
| SYNCOPE AND COLLAPSE | 312 | $43,995 | $21,997 | — | 6.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $104,707 | $52,354 | — | 6.5x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $38,299 | $19,149 | — | 6.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $37,634 | $18,817 | — | 6.3x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $49,484 | $24,742 | — | 6.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $63,769 | $31,885 | — | 6.3x |
| RESPIRATORY NEOPLASMS WITH MCC | 180 | $91,942 | $45,971 | — | 6.2x |
| CELLULITIS WITHOUT MCC | 603 | $39,083 | $19,541 | — | 6.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $52,510 | $26,255 | — | 6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $42,265 | $21,132 | — | 6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $77,141 | $38,571 | — | 6x |
| RENAL FAILURE WITH CC | 683 | $39,483 | $19,742 | — | 6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $33,610 | $16,805 | — | 6x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $58,612 | $29,306 | — | 6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $80,102 | $40,051 | — | 6x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $119,974 | $59,987 | — | 6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $68,149 | $34,074 | — | 5.9x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $240,920 | $120,460 | — | 5.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $145,229 | $72,615 | — | 5.9x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $81,415 | $40,707 | — | 5.8x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $199,819 | $99,909 | — | 5.6x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $85,369 | $42,685 | — | 5.6x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $79,286 | $39,643 | — | 5.6x |
| DIABETES WITH MCC | 637 | $59,097 | $29,548 | — | 5.6x |
| TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOU | 004 | $460,167 | $230,084 | — | 5.5x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $42,047 | $21,024 | — | 5.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $55,289 | $27,645 | — | 5.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $83,050 | $41,525 | — | 5.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $231,019 | $115,510 | — | 5.5x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $79,550 | $39,775 | — | 5.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $52,156 | $26,078 | — | 5.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $285,751 | $142,876 | — | 5.4x |
Showing 50 of 78 procedures
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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