Bx nasopharynx/unknown pri lesion 42806 at LODI MEMORIAL HOSPITAL ASSOCIATION INC
975 S Fairmont Ave, Lodi, CA · Adventisthealth · · NPI 1316938301
$35.28
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.
$504.00
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.
$27.92 with MEDI-CAL vs $360.10 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 |
|---|---|---|---|
| MEDI-CAL | MEDI-CAL | $27.92 | ↓ -21% |
| BC MCAL | BC MCAL | $27.92 | ↓ -21% |
| KAISER MCAL | KAISER MCAL | $27.92 | ↓ -21% |
| CELTIC INS COMPANY - ALL PLANS | CELTIC INS COMPANY - ALL PLANS | $27.92 | ↓ -21% |
| HP MCAL PRO FEE | HP MCAL PRO FEE | $30.71 | ↓ -13% |
| HP OF SAN JOAQUIN MCAL | HP OF SAN JOAQUIN MCAL | $33.50 | ↓ -5% |
| HEALTHNET MCAL | HEALTHNET MCAL | $33.50 | ↓ -5% |
| KNNEX HEALTH - ALL PLANS | KNNEX HEALTH - ALL PLANS | $132.63 | ↑ +276% |
| UHC MCR ADV | UHC MCR ADV | $132.63 | ↑ +276% |
| TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $132.63 | ↑ +276% |
| ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS | ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS | $132.63 | ↑ +276% |
| BLUE SHIELD MCARE ADV | BLUE SHIELD MCARE ADV | $132.63 | ↑ +276% |
| HEALTHNET MCARE | HEALTHNET MCARE | $132.63 | ↑ +276% |
| HP OF SAN JOAQUIN MCR ADV | HP OF SAN JOAQUIN MCR ADV | $132.63 | ↑ +276% |
| HUMANA MCR ADV - ALL PLANS | HUMANA MCR ADV - ALL PLANS | $132.63 | ↑ +276% |
| HP HEALTHY KIDS PRO FEE | HP HEALTHY KIDS PRO FEE | $139.26 | ↑ +295% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $145.89 | ↑ +314% |
| CIGNA- ALL PLANS | CIGNA- ALL PLANS | $153.88 | ↑ +336% |
| FIRST HEALTH- ALL PLANS | FIRST HEALTH- ALL PLANS | $159.16 | ↑ +351% |
| BEECH STREET- ALL PLANS | BEECH STREET- ALL PLANS | $172.42 | ↑ +389% |
| MULTIPLAN- ALL PLANS | MULTIPLAN- ALL PLANS | $172.42 | ↑ +389% |
| HP OF SAN JOAQUIN PPO - ALL OTHER PLANS | HP OF SAN JOAQUIN PPO - ALL OTHER PLANS | $172.42 | ↑ +389% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $176.72 | ↑ +401% |
| UHC HMO | UHC HMO | $176.72 | ↑ +401% |
| UHC JLL | UHC JLL | $176.72 | ↑ +401% |
| KAISER COMMERCIAL - ALL OTHER PLANS | KAISER COMMERCIAL - ALL OTHER PLANS | $179.05 | ↑ +408% |
| NETWORKS BY DESIGN- ALL PLANS | NETWORKS BY DESIGN- ALL PLANS | $179.05 | ↑ +408% |
| KAISER MCR ADV | KAISER MCR ADV | $179.05 | ↑ +408% |
| AETNA - ALL PLANS | AETNA - ALL PLANS | $186.15 | ↑ +428% |
| WESTERN GROWERS- ALL PLANS | WESTERN GROWERS- ALL PLANS | $189.66 | ↑ +438% |
| HEALTHNET- ALL OTHER PLANS | HEALTHNET- ALL OTHER PLANS | $193.24 | ↑ +448% |
| BLUE CROSS NON-MCS - ALL OTHER PLANS | BLUE CROSS NON-MCS - ALL OTHER PLANS | $246.57 | ↑ +599% |
| BLUE SHIELD EPN - ALL OTHER PLANS | BLUE SHIELD EPN - ALL OTHER PLANS | $340.75 | ↑ +866% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $360.10 | ↑ +921% |
Visitor-reported prices
Comments
Bx nasopharynx/unknown pri lesion 42806 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Fresno Medical Center | FRESNO | $3,018.40 | not published |
| Antioch Medical Center | ANTIOCH | $3,018.40 | not published |
| Redwood City Medical Center | Redwood City | $3,018.40 | not published |
| Santa Clara Medical Center | SANTA CLARA | $3,018.40 | not published |
| Baldwin Park Medical Center | BALDWIN PARK | $3,213.60 | not published |
| Riverside Medical Center | RIVERSIDE | $3,213.60 | not published |
| Fremont Medical Center | FREMONT | $3,018.40 | not published |
| Panorama Medical Center | PANORAMA CITY | $3,213.60 | not published |