Biopsy of salivary gland 42400 at St Jude Medical Center
101 E Valencia Mesa Dr, Fullerton, CA · Providence · · NPI 1194926279
$668.64
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.
$1,393.00
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.
$774.16 with Providence 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 |
|---|---|---|---|
| Providence | Oscar All Commercial Plans | $774.16 | ↑ +16% |
| Aetna | Medicare Managed Care Plan | $910.78 | ↑ +36% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $954.20 | ↑ +43% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $1,074.70 | ↑ +61% |
| Blue Shield | Epn Exchange | $1,293.00 | ↑ +93% |
| Blue Shield | Tandem Ppo | $1,599.00 | ↑ +139% |
| Healthnet | Ambetter Hmo | $1,684.94 | ↑ +152% |
| Blue Shield | Hmo/Ppo | $1,778.00 | ↑ +166% |
| Healthnet | Hmo/Pos/Ppo | $1,999.00 | ↑ +199% |
| Unitedhealthcare | Select/Navigate Hmo | $2,001.00 | ↑ +199% |
| Unitedhealthcare | All Commercial Plans | $2,158.00 | ↑ +223% |
| Aetna | Gatekeeper Hmo | $3,363.00 | ↑ +403% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $13,012.00 | ↑ +1846% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $15,614.00 | ↑ +2235% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $723.14 | $70.93 – $1,628.92 |
| Banner Lassen Medical Center | Susanville | $854.51 | $82.93 – $1,587.89 |
| Arroyo Grande Hospital | Santa Maria | $1,322.95 | $57.67 – $2,940.98 |
| Mark Twain Medical Center | San Andreas | $1,341.99 | $57.67 – $864.36 |
| French Hospital | San Luis Obispo | $1,087.41 | $57.67 – $1,940.40 |
| Mercy Hospitals – Bakersfield | Bakersfield | $912.66 | $57.67 – $1,968.00 |
| Bakersfield Memorial Hospital | Bakersfield | $902.82 | $57.67 – $1,943.40 |
| Queen of The Valley Medical Center | Napa | $843.03 | $1,005.45 – $6,200.00 |