Biopsy of salivary glnd;incisional 42405 at St. Mary Medical Center
1050 Linden Ave, Long Beach, CA · CommonSpirit Health · · NPI 1194840421
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.
$126.03 with Partnership Health Plan vs $6,851.00 with Health Net — 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 |
|---|---|---|---|
| Partnership Health Plan | Medicaid|> 21 | $126.03 | — |
| Partnership Health Plan | Medicaid|< 21 | $126.03 | — |
| HCLA | Medicaid|Preferred IPA > 21 | $126.03 | — |
| HCLA | Medicaid|Preferred IPA < 21 | $126.03 | — |
| Inland Empire Health Plan | Medicaid|All Plans | $126.03 | — |
| BCBS - Anthem | Medicaid|All Plans | $157.54 | — |
| Health Net | Medicaid|> 21 | $167.62 | — |
| Health Net | Medicaid|< 21 | $167.62 | — |
| Noble IPA | Medicaid|> 21 | $178.79 | — |
| Noble IPA | Medicaid|< 21 | $178.79 | — |
| Kaiser | Medicaid|< 21 | $189.05 | — |
| Kaiser | Medicaid|> 21 | $189.05 | — |
| Preferred IPA | Medicaid|Risk | $198.66 | — |
| Angeles IPA | Medicare|All Plans | $198.66 | — |
| Molina | Medicaid|All Plans | $278.12 | — |
| LA Care | Medicaid|All Plans | $519.24 | — |
| Blue Shield CA | Medicaid|All Plans | $993.30 | — |
| Care 1st | Medicaid|All Plans | $993.30 | — |
| Central Health Plan | Medicare|All Plans | $1,882.11 | — |
| HCLA | Medicare|Preferred IPA | $1,882.11 | — |
| BCBS - Anthem | Medicare|All Plans | $1,882.11 | — |
| EasyChoice | Medicare|All Plans | $1,882.11 | — |
| Health Net | Medicare|All Other Plans | $1,882.11 | — |
| Health Net | Medicare|HMO | $1,882.11 | — |
| Cigna | Medicare|All Plans | $1,882.11 | — |
| Humana | Medicare|All Plans | $1,882.11 | — |
| Kaiser | Medicare|All Plans | $1,882.11 | — |
| Blue Shield CA | Medicare|All Other Plans | $1,882.11 | — |
| Molina | Medicare|All Plans | $1,882.11 | — |
| Scan Health Plan | Medicare|All Plans | $1,882.11 | — |
| LA Care | Medicare|All Plans | $1,882.11 | — |
| United | Medicare|All Plans | $1,919.76 | — |
| HPN | Medicare|Senior | $2,070.32 | — |
| Blue Shield CA | Medicare|Trauma | $2,352.64 | — |
| HCLA | Commercial|Preferred IPA | $2,352.64 | — |
| LA Care | Commercial|All Plans | $2,352.64 | — |
| BCBS - Anthem | Commercial|Exchange | $2,617.00 | — |
| SevenCorners | Medicare|All Plans | $3,011.38 | — |
| BCBS - Anthem | Commercial|All Other Plans | $3,906.00 | — |
| Health Net | Commercial|EPPO | $4,909.00 | — |
| Health Net | Commercial|Care Product | $5,961.00 | — |
| BCBS - Anthem | Commercial|MCS | $6,054.00 | — |
| Health Net | Commercial|All Other Plans | $6,851.00 | — |
| United | Commercial|All Other Plans | not published by hospital | — |
| United | Commercial|HMO | not published by hospital | — |
| Blue Shield CA | Medicare|BlueShield Promise | not published by hospital | — |
| DHR | Medicaid|< 21 | not published by hospital | — |
| United | Commercial|Options PPO | not published by hospital | — |
| MultiPlan | Commercial|All Plans | not published by hospital | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| United | Commercial|Non-Options PPO | not published by hospital | — |
| DHR | Medicaid|> 21 | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| French Hospital | San Luis Obispo | $3,254.78 | $126.03 – $8,136.94 |
| St. John's Camarillo Hospital | Camarillo | not published | $155.02 – $3,484.24 |
| Petaluma Valley Hospital | Petaluma | not published | $2,090.93 – $4,657.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $126.03 – $1,882.11 |
| Mark Twain Medical Center | San Andreas | not published | $126.03 – $126.03 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $126.03 – $1,882.11 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $126.03 – $1,882.11 |
| Queen of The Valley Medical Center | Napa | not published | $2,203.03 – $16,652.00 |