Providence St Mary Medical Center
Providence St Mary Medical Center in Apple Valley, CA charges 5.6x the Medicare reimbursement rate across 51 analyzed procedures, reflecting the hospital's nonprofit pricing structure.
Apple Valley, CA 92307 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Pricing grade
D
High
Avg markup vs Medicare
5.6x
Charge / Medicare rate
Max markup
8.49x
Worst procedure
Procedures analyzed
51
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 |
|---|---|---|---|---|---|
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $56,706 | $28,353 | — | 8.5x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $63,966 | $31,983 | — | 8.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $43,296 | $21,648 | — | 7.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $36,884 | $18,442 | — | 7x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $164,243 | $82,122 | — | 6.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $83,722 | $41,861 | — | 6.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $43,070 | $21,535 | — | 6.8x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | 521 | $176,230 | $88,115 | — | 6.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $50,528 | $25,264 | — | 6.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $71,903 | $35,951 | — | 6.3x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $46,174 | $23,087 | — | 6.2x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $106,823 | $53,412 | — | 6.1x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $46,580 | $23,290 | — | 6.1x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $53,548 | $26,774 | — | 6x |
| RENAL FAILURE WITH CC | 683 | $42,161 | $21,080 | — | 6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $81,082 | $40,541 | — | 6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $47,349 | $23,675 | — | 6x |
| DIABETES WITH CC | 638 | $44,848 | $22,424 | — | 5.9x |
| SEIZURES WITHOUT MCC | 101 | $44,685 | $22,343 | — | 5.8x |
| CELLULITIS WITHOUT MCC | 603 | $41,819 | $20,910 | — | 5.8x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $100,012 | $50,006 | — | 5.8x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $109,704 | $54,852 | — | 5.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $54,221 | $27,111 | — | 5.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $79,360 | $39,680 | — | 5.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $55,466 | $27,733 | — | 5.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $45,622 | $22,811 | — | 5.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $77,867 | $38,933 | — | 5.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $36,757 | $18,378 | — | 5.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $95,215 | $47,608 | — | 5.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $137,169 | $68,585 | — | 5.4x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $62,168 | $31,084 | — | 5.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $376,495 | $188,248 | — | 5.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $49,623 | $24,812 | — | 5.2x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $80,672 | $40,336 | — | 5.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $53,898 | $26,949 | — | 5.1x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $55,002 | $27,501 | — | 5.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $159,937 | $79,969 | — | 5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $67,531 | $33,766 | — | 5x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $51,724 | $25,862 | — | 4.9x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | 432 | $79,278 | $39,639 | — | 4.8x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $77,908 | $38,954 | — | 4.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $71,117 | $35,558 | — | 4.7x |
| DIABETES WITH MCC | 637 | $49,982 | $24,991 | — | 4.7x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $79,193 | $39,597 | — | 4.6x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $68,414 | $34,207 | — | 4.5x |
| RENAL FAILURE WITH MCC | 682 | $56,257 | $28,128 | — | 4.4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $183,907 | $91,954 | — | 4.2x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $63,813 | $31,907 | — | 4.2x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $124,668 | $62,334 | — | 4.1x |
| SEIZURES WITH MCC | 100 | $66,875 | $33,438 | — | 4x |
Showing 50 of 51 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.
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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