Shoulder MRI (with and without contrast) at ADVENTIST HEALTH CLEARLAKE HOSPITAL
15630 18th Ave, Clearlake, CA · Adventisthealth · · NPI 1124018031
$1,871.28
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$5,198.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$611.50 with BC MANAGED MCAL vs $9,516.21 with BLUE SHIELD NON-EPN — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| BC MANAGED MCAL | BC MANAGED MCAL | $611.50 | ↓ -67% |
| MEDI-CAL | MEDI-CAL | $611.50 | ↓ -67% |
| TRICARE BLUE SHIELD- ALL PLANS | TRICARE BLUE SHIELD- ALL PLANS | $1,091.58 | ↓ -42% |
| BLUE SHIELD MCR ADV | BLUE SHIELD MCR ADV | $1,091.58 | ↓ -42% |
| KAISER MCR ADV | KAISER MCR ADV | $1,091.58 | ↓ -42% |
| BLUE CROSS MCR ADV | BLUE CROSS MCR ADV | $1,135.24 | ↓ -39% |
| UHC MCR ADV | UHC MCR ADV | $1,200.74 | ↓ -36% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $2,183.16 | ↑ +17% |
| BLUE CROSS EXCHANGE | BLUE CROSS EXCHANGE | $3,434.06 | ↑ +84% |
| BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $3,815.67 | ↑ +104% |
| AETNA- ALL PLANS | AETNA- ALL PLANS | $3,883.95 | ↑ +108% |
| WESTERN GROWERS- ALL PLANS | WESTERN GROWERS- ALL PLANS | $3,898.50 | ↑ +108% |
| UHC JLL | UHC JLL | $4,118.38 | ↑ +120% |
| FIRST HEALTH- ALL PLANS | FIRST HEALTH- ALL PLANS | $4,158.40 | ↑ +122% |
| HEALTHNET- ALL PLANS | HEALTHNET- ALL PLANS | $4,262.36 | ↑ +128% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $4,335.13 | ↑ +132% |
| PHCS- ALL PLANS | PHCS- ALL PLANS | $4,418.30 | ↑ +136% |
| FOUNDATION- ALL PLANS | FOUNDATION- ALL PLANS | $4,418.30 | ↑ +136% |
| HEALTH MGMT NETWORK- ALL PLANS | HEALTH MGMT NETWORK- ALL PLANS | $4,418.30 | ↑ +136% |
| HUMANA- ALL PLANS | HUMANA- ALL PLANS | $4,418.30 | ↑ +136% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $4,578.67 | ↑ +145% |
| KAISER- ALL OTHER PLANS | KAISER- ALL OTHER PLANS | $4,678.20 | ↑ +150% |
| INTERPLAN- ALL PLANS | INTERPLAN- ALL PLANS | $4,678.20 | ↑ +150% |
| THREE RIVERS PROVIDER NETWORK- ALL PLANS | THREE RIVERS PROVIDER NETWORK- ALL PLANS | $4,678.20 | ↑ +150% |
| CIGNA- ALL PLANS | CIGNA- ALL PLANS | $4,678.20 | ↑ +150% |
| PARTNERSHIP MCAL - ALL PLANS | PARTNERSHIP MCAL - ALL PLANS | $8,576.70 | ↑ +358% |
| BLUE SHIELD EPN - ALL OTHER PLANS | BLUE SHIELD EPN - ALL OTHER PLANS | $9,085.61 | ↑ +386% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $9,516.21 | ↑ +409% |
Visitor-reported prices
Comments
Shoulder MRI (with and without contrast) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Fresno Medical Center | FRESNO | $7,582.40 | $618.00 – $618.00 |
| St. John's Camarillo Hospital | Camarillo | $2,042.40 | $453.77 – $3,637.14 |
| Antioch Medical Center | ANTIOCH | $7,582.40 | $618.00 – $618.00 |
| Redwood City Medical Center | Redwood City | $7,582.40 | $618.00 – $618.00 |
| Santa Clara Medical Center | SANTA CLARA | $7,582.40 | $618.00 – $618.00 |
| Baldwin Park Medical Center | BALDWIN PARK | $3,484.00 | $405.00 – $405.00 |
| Riverside Medical Center | RIVERSIDE | $3,484.00 | $405.00 – $405.00 |
| Fremont Medical Center | FREMONT | $7,582.40 | $618.00 – $618.00 |