Biliary endo perq dx w/speci at St Jude Medical Center
101 E Valencia Mesa Dr, Fullerton, CA · Providence · · NPI 1194926279
not published by hospital
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.
not published by hospital
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.
$4,035.00 with Aetna vs $15,614.00 with Blue Cross — 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 |
|---|---|---|---|
| Aetna | Gatekeeper Hmo | $4,035.00 | — |
| Blue Shield | Epn Exchange | $5,605.00 | — |
| Blue Shield | Tandem Ppo | $6,929.00 | — |
| Providence | Oscar All Commercial Plans | $7,077.45 | — |
| Blue Shield | Hmo/Ppo | $7,704.00 | — |
| Aetna | Medicare Managed Care Plan | $8,326.41 | — |
| Unitedhealthcare | Select/Navigate Hmo | $8,335.00 | — |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $8,723.40 | — |
| Unitedhealthcare | All Commercial Plans | $8,987.00 | — |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $9,825.04 | — |
| Healthnet | Hmo/Pos/Ppo | $9,990.00 | — |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $13,012.00 | — |
| Healthnet | Ambetter Hmo | $15,403.87 | — |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $15,614.00 | — |
Visitor-reported prices
Comments
Biliary endo perq dx w/speci at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $2,333.23 | $234.38 – $8,890.24 |
| St. Joseph's Medical Center Stockton | Stockton | $1,506.75 | $0.80 – $5,125.00 |
| Mercy Medical Center Mt. Shasta | Mt Shasta | $4,702.24 | $323.92 – $5,923.12 |
| California Hospital Medical Center | Los Angeles | $6,999.52 | $190.55 – $11,401.28 |
| Mercy Medical Center Redding | Redding | $4,223.31 | $378.71 – $8,163.40 |
| Petaluma Valley Hospital | Petaluma | not published | $2,570.00 – $11,185.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $190.55 – $7,928.23 |
| Mark Twain Medical Center | San Andreas | not published | $190.55 – $190.55 |