Uci Health - Fountain Valley
UCI Health - Fountain Valley in Fountain Valley, CA charges 14.2x the Medicare reimbursement on average, with 98% of analyzed procedures showing significant price variations above typical benchmarks.
Fountain Valley, CA 92708 · Acute Care Hospitals · CMS Rating: 2/5
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 — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
14.25x
Charge / Medicare rate
Max markup
20.2x
Worst procedure
Procedures analyzed
57
With pricing data
Outlier procedures
98.2%
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 |
|---|---|---|---|---|---|
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $127,440 | $63,720 | — | 20.2x |
| CELLULITIS WITHOUT MCC | 603 | $147,238 | $73,619 | — | 19.8x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $298,600 | $149,300 | — | 18.9x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $149,721 | $74,861 | — | 18.9x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $170,517 | $85,259 | — | 18.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $202,085 | $101,043 | — | 18.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $122,090 | $61,045 | — | 18x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $230,689 | $115,344 | — | 17.7x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $114,883 | $57,442 | — | 17.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $154,393 | $77,196 | — | 17.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $108,922 | $54,461 | — | 17.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $139,487 | $69,743 | — | 17.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $142,875 | $71,437 | — | 16.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $172,680 | $86,340 | — | 16.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $284,404 | $142,202 | — | 16.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $138,293 | $69,146 | — | 15.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $104,104 | $52,052 | — | 15.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $162,676 | $81,338 | — | 15.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $192,085 | $96,043 | — | 15.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $194,449 | $97,225 | — | 15.5x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $438,253 | $219,127 | — | 15.5x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $238,653 | $119,326 | — | 15.3x |
| DIABETES WITH CC | 638 | $116,137 | $58,069 | — | 15.1x |
| RENAL FAILURE WITH MCC | 682 | $191,497 | $95,748 | — | 15x |
| DIABETES WITH MCC | 637 | $180,672 | $90,336 | — | 14.7x |
| RENAL FAILURE WITH CC | 683 | $112,044 | $56,022 | — | 14.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $86,629 | $43,314 | — | 14.5x |
| DYSEQUILIBRIUM | 149 | $79,867 | $39,934 | — | 14x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $215,097 | $107,548 | — | 14x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $115,931 | $57,965 | — | 14x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | 207 | $761,854 | $380,927 | — | 13.9x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $217,359 | $108,679 | — | 13.9x |
| CHEST PAIN | 313 | $75,898 | $37,949 | — | 13.8x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $298,521 | $149,261 | — | 13.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $237,016 | $118,508 | — | 13.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $134,480 | $67,240 | — | 13.4x |
| SYNCOPE AND COLLAPSE | 312 | $93,945 | $46,972 | — | 13.4x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $107,697 | $53,848 | — | 12.7x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $131,445 | $65,722 | — | 12.6x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | 270 | $686,957 | $343,478 | — | 12.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $398,622 | $199,311 | — | 12.4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $205,169 | $102,584 | — | 11.9x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $97,957 | $48,979 | — | 11.8x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $455,980 | $227,990 | — | 11.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $231,848 | $115,924 | — | 11.5x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $74,436 | $37,218 | — | 11.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $180,110 | $90,055 | — | 11.2x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $267,146 | $133,573 | — | 11.2x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $489,661 | $244,830 | — | 11.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $116,948 | $58,474 | — | 10.9x |
Showing 50 of 57 procedures
How UCI HEALTH - FOUNTAIN VALLEY 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.
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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