Calculus analysis qual at Providence Holy Cross Medical Center
15031 Rinaldi St, Mission Hills, CA · Providence · · NPI 1477587632
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.
$11.58 with Aetna vs $110.28 with Blue Shield — 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 | Medicare Managed Care Plan | $11.58 | — |
| Humana | Choicecare Medicare Managed Care Plan | $11.81 | — |
| Central Health Plan | Medicare Managed Care Plan | $12.74 | — |
| La Care Health Plan | Exchange | $15.05 | — |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $16.43 | — |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $18.50 | — |
| Cigna | Ppo | $20.41 | — |
| Cigna | Oap Hmo/Pos | $20.41 | — |
| Healthnet | Ambetter Hmo | $21.42 | — |
| Unitedhealthcare | All Commercial Plans | $23.16 | — |
| First Health/Coventry | Coventry All Commercial Plans | $23.16 | — |
| Unitedhealthcare | Select/Navigate Hmo | $23.16 | — |
| Healthnet | Ambetter Ppo | $24.78 | — |
| Aetna | All Commercial Plans | $30.19 | — |
| Blue Shield | Epn/Ifp Benefit Exchange | $30.88 | — |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $33.80 | — |
| Blue Shield | Hmo/Ppo/Epo | $37.35 | — |
| Blue Cross | All Commercial Plans | $57.69 | — |
| Blue Shield | Medicare Managed Care Plan | $110.28 | — |
Visitor-reported prices
Comments
Calculus analysis qual at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $35.30 | $11.58 – $51.94 |
| Mercy Medical Center Mt. Shasta | Mt Shasta | $20.23 | $10.29 – $25.48 |
| Mercy Medical Center Redding | Redding | $13.18 | $10.29 – $25.99 |
| St. Elizabeth Community Hospital | Red Bluff | $15.18 | $10.29 – $25.99 |
| Petaluma Valley Hospital | Petaluma | not published | $11.35 – $94.47 |
| Queen of The Valley Medical Center | Napa | not published | $11.58 – $119.39 |
| Providence St Joseph Hospital Eureka | Eureka | not published | $11.58 – $135.39 |
| Healdsburg Hospital | Healdsburg | not published | $11.58 – $54.01 |