Aco cmplx chron care without pt visit, 60 min 99487aco at Healdsburg Hospital
1375 University Ave, Healdsburg, CA · Providence · · NPI 1295342012
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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$239.15 with Sutter Health Plus vs $239.15 with Sutter Health Plus — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Sutter Health Plus | All Commercial Plans | $239.15 | — |
Visitor-reported prices
Comments
Aco cmplx chron care without pt visit, 60 min 99487aco at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Santa Rosa Memorial Hospital | Santa Rosa | not published | $246.98 – $252.02 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | not published | $194.05 – $422.33 |
| St Jude Medical Center | Fullerton | not published | $194.05 – $422.33 |
| Providence St Joseph Hospital Orange | Orange | not published | $194.05 – $422.33 |
| Providence Saint John's Health Center | Santa Monica | not published | $228.29 – $422.33 |