Pr visit complexity e&m service serious/complex condition at ADVENTIST HEALTH DELANO
1401 Garces Hwy, Delano, CA · Adventisthealth · · NPI 1144237272
$10.20
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.
$51.00
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.
$11.17 with BLUE SHIELD EPN - ALL OTHER PLANS vs $65.79 with KERN HEALTH SYSTEM MCAL — 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 |
|---|---|---|---|
| BLUE SHIELD EPN - ALL OTHER PLANS | BLUE SHIELD EPN - ALL OTHER PLANS | $11.17 | ↑ +10% |
| UNIVERSAL CARE MCR- ALL OTHER PLANS | UNIVERSAL CARE MCR- ALL OTHER PLANS | $14.57 | ↑ +43% |
| KAISER MEDICARE IP/OP ONLY | KAISER MEDICARE IP/OP ONLY | $14.57 | ↑ +43% |
| HEALTHNET MCR ADV | HEALTHNET MCR ADV | $14.57 | ↑ +43% |
| UHC MCR ADV | UHC MCR ADV | $14.57 | ↑ +43% |
| BAKERSFIELD FAM MED GRP-ALL PLANS | BAKERSFIELD FAM MED GRP-ALL PLANS | $14.57 | ↑ +43% |
| TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $14.57 | ↑ +43% |
| KERN MCR ADV DUAL DNSP-ALL OTHER PLANS | KERN MCR ADV DUAL DNSP-ALL OTHER PLANS | $14.57 | ↑ +43% |
| OSCAR MEDICARE ADVANTAGE-ALL PLANS | OSCAR MEDICARE ADVANTAGE-ALL PLANS | $23.31 | ↑ +129% |
| KAISER COMM IP/OP ONLY- ALL OTHER PLANS | KAISER COMM IP/OP ONLY- ALL OTHER PLANS | $25.06 | ↑ +146% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $26.23 | ↑ +157% |
| COVENTRY- ALL PLANS | COVENTRY- ALL PLANS | $30.60 | ↑ +200% |
| CENTIVO - ALL PLANS | CENTIVO - ALL PLANS | $32.78 | ↑ +221% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $33.15 | ↑ +225% |
| HEALTHNET- ALL OTHER PLANS | HEALTHNET- ALL OTHER PLANS | $34.32 | ↑ +236% |
| UHC HMO | UHC HMO | $34.86 | ↑ +242% |
| COUNTY OF KERN NETWORK - ALL PLANS | COUNTY OF KERN NETWORK - ALL PLANS | $35.70 | ↑ +250% |
| GEM CARE- ALL PLANS | GEM CARE- ALL PLANS | $35.70 | ↑ +250% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $36.70 | ↑ +260% |
| UHC JLL | UHC JLL | $36.70 | ↑ +260% |
| AETNA- ALL PLANS | AETNA- ALL PLANS | $37.64 | ↑ +269% |
| FOUNDATION FOR MEDICAL CARE OF KERN COUNTY - ALL P | FOUNDATION FOR MEDICAL CARE OF KERN COUNTY - ALL P | $38.25 | ↑ +275% |
| CIGNA- ALL PLANS | CIGNA- ALL PLANS | $40.80 | ↑ +300% |
| WESTERN GROWERS - ALL PLANS | WESTERN GROWERS - ALL PLANS | $41.31 | ↑ +305% |
| ANTHEM - ALL OTHER PLANS | ANTHEM - ALL OTHER PLANS | $42.44 | ↑ +316% |
| KAISER MEDI-CAL IP/OP ONLY | KAISER MEDI-CAL IP/OP ONLY | $51.00 | ↑ +400% |
| DIGNTY HLTH MCAL OP ONLY | DIGNTY HLTH MCAL OP ONLY | $51.00 | ↑ +400% |
| UNIVERSAL CARE MCAL | UNIVERSAL CARE MCAL | $51.00 | ↑ +400% |
| MEDI-CAL | MEDI-CAL | $51.00 | ↑ +400% |
| HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $60.74 | ↑ +495% |
| KERN HEALTH SYSTEM MCAL | KERN HEALTH SYSTEM MCAL | $65.79 | ↑ +545% |
Visitor-reported prices
Comments
Pr visit complexity e&m service serious/complex condition at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $27.98 | $10.87 – $41.16 |
| Healdsburg Hospital | Healdsburg | $57.63 | not published |
| Redwood Memorial Hospital | Fortuna | $26.52 | not published |
| REEDLEY COMMUNITY HOSPITAL | Reedley | $7.41 | $0.01 – $78.00 |
| ST HELENA HOSPITAL | Vallejo | $6.45 | $0.01 – $82.75 |
| HANFORD COMMUNITY HOSPITAL | Selma | $7.41 | $0.01 – $74.00 |
| SAN JOAQUIN COMMUNITY HOSPITAL | Bakersfield | $7.08 | $0.05 – $75.60 |
| ADVENTIST HEALTH MENDOCINO COAST | Fort Bragg | $25.74 | $14.50 – $56.55 |