Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet at WHITE MEMORIAL MEDICAL CENTER

1720 E Cesar E Chavez Ave Los Angeles CA 90033|309 W Beverly Blvd, MONTEBELLO, CA · Adventisthealth · · NPI 1215927470

Source: hospital's published price file ↗ · Published May 23, 2026 · Ingested Sep 16, 2026

$3,996.00

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$22,200.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$1,600.00 with BELLA VISTA MCR ADV OP/PROFEE ONLY - ALL OTHER PLA vs $77,700.00 with CARE FIRST MEDI-CAL — 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 →

Payer
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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
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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
BELLA VISTA MCR ADV OP/PROFEE ONLY - ALL OTHER PLA BELLA VISTA MCR ADV OP/PROFEE ONLY - ALL OTHER PLA $1,600.00 ↓ -60%
SCAN HEALTH MCARE - ALL PLANS SCAN HEALTH MCARE - ALL PLANS $2,500.00 ↓ -37%
BLUE SHIELD MCR ADV BLUE SHIELD MCR ADV $3,000.00 ↓ -25%
BLUE SHIELD EPN BLUE SHIELD EPN $3,723.00 ↓ -7%
BLUE SHIELD - ALL OTHER PLANS BLUE SHIELD - ALL OTHER PLANS $4,293.00 ↑ +7%
BC MEDI-CAL BC MEDI-CAL $4,817.40 ↑ +21%
OPTUM MCR ADV OPTUM MCR ADV $5,083.80 ↑ +27%
OPTUM HMO - ALL OTHER PLANS OPTUM HMO - ALL OTHER PLANS $5,083.80 ↑ +27%
HCPAMG - ALL PLANS HCPAMG - ALL PLANS $5,328.00 ↑ +33%
CAREMORE MCARE - ALL PLANS CAREMORE MCARE - ALL PLANS $5,550.00 ↑ +39%
UHC JLL UHC JLL $6,056.16 ↑ +52%
UHC HMO UHC HMO $6,366.96 ↑ +59%
UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $6,375.84 ↑ +60%
BRIGHT HEALTH - ALL PLANS BRIGHT HEALTH - ALL PLANS $6,660.00 ↑ +67%
MOLINA MEDI-CAL MOLINA MEDI-CAL $6,660.00 ↑ +67%
PHP-PROSPECT HEALTH PLAN CAP - ALL PLANS PHP-PROSPECT HEALTH PLAN CAP - ALL PLANS $6,660.00 ↑ +67%
AVANTI MCR ADV - ALL OTHER PLANS AVANTI MCR ADV - ALL OTHER PLANS $6,660.00 ↑ +67%
AVANTI MCAL AVANTI MCAL $6,660.00 ↑ +67%
CLEVER CARE - ALL PLANS CLEVER CARE - ALL PLANS $7,104.00 ↑ +78%
UHC SIGNATURE UHC SIGNATURE $7,747.80 ↑ +94%
ALTAMED MEDI-CAL - ALL OTHER PLANS ALTAMED MEDI-CAL - ALL OTHER PLANS $7,770.00 ↑ +94%
ALTA LOS ANGELES MCAL 1/1/19 ALTA LOS ANGELES MCAL 1/1/19 $7,770.00 ↑ +94%
ALTA LOS ANGELES MCR 1/1/19-ALL OTHER PLANS ALTA LOS ANGELES MCR 1/1/19-ALL OTHER PLANS $7,770.00 ↑ +94%
HEALTHCARE INC - ALL OTHER PLANS HEALTHCARE INC - ALL OTHER PLANS $7,770.00 ↑ +94%
PACIFIC IPA - ALL OTHER PLANS PACIFIC IPA - ALL OTHER PLANS $8,436.00 ↑ +111%
HEALTHNET - ALL OTHER PLANS HEALTHNET - ALL OTHER PLANS $8,493.72 ↑ +113%
HEALTHNET COMM CARE HEALTHNET COMM CARE $8,766.78 ↑ +119%
LA CARE MCR ADV - ALL PLANS LA CARE MCR ADV - ALL PLANS $8,880.00 ↑ +122%
PACIFIC ALLIANCE MCARE - ALL OTHER PLANS PACIFIC ALLIANCE MCARE - ALL OTHER PLANS $8,880.00 ↑ +122%
BLUE SHIELD MEDI-CAL BLUE SHIELD MEDI-CAL $8,880.00 ↑ +122%
PACIFIC ALLIANCE MEDI-CAL PACIFIC ALLIANCE MEDI-CAL $8,880.00 ↑ +122%
KAISER- ALL PLANS KAISER- ALL PLANS $9,102.00 ↑ +128%
CIGNA CIGNA $9,390.60 ↑ +135%
CIGNA ALL OTHER - ALL OTHER PLANS CIGNA ALL OTHER - ALL OTHER PLANS $9,390.60 ↑ +135%
AETNA - ALL PLANS AETNA - ALL PLANS $10,767.00 ↑ +169%
WESTERN GROWERS/PINNACLE - ALL PLANS WESTERN GROWERS/PINNACLE - ALL PLANS $11,322.00 ↑ +183%
FIRST HEATLH PPO - ALL PLANS FIRST HEATLH PPO - ALL PLANS $12,876.00 ↑ +222%
PHCS PPO - ALL PLANS PHCS PPO - ALL PLANS $14,430.00 ↑ +261%
AHF - ALL PLANS AHF - ALL PLANS $16,650.00 ↑ +317%
INTERPLAN PPO - ALL PLANS INTERPLAN PPO - ALL PLANS $16,650.00 ↑ +317%
BEECH STREET - ALL PLANS BEECH STREET - ALL PLANS $16,650.00 ↑ +317%
CORVEL CORP - ALL PLANS CORVEL CORP - ALL PLANS $17,760.00 ↑ +344%
MULTIPLAN PPO - ALL PLANS MULTIPLAN PPO - ALL PLANS $18,426.00 ↑ +361%
HEALTHMANNET - ALL PLANS HEALTHMANNET - ALL PLANS $18,870.00 ↑ +372%
TRPN - ALL PLANS TRPN - ALL PLANS $18,870.00 ↑ +372%
NEXT INC PPO - ALL PLANS NEXT INC PPO - ALL PLANS $18,870.00 ↑ +372%
FPN PPO - ALL PLANS FPN PPO - ALL PLANS $19,980.00 ↑ +400%
MEDI-CAL MEDI-CAL $22,200.00 ↑ +456%
BELLA VISTA MEDI-CAL OP/PROFEE ONLY BELLA VISTA MEDI-CAL OP/PROFEE ONLY $22,200.00 ↑ +456%
HEALTHCARE INC MEDI-CAL HEALTHCARE INC MEDI-CAL $22,200.00 ↑ +456%
AHP MEDI-CAL AHP MEDI-CAL $22,200.00 ↑ +456%
ACCESS MEDI-CAL ACCESS MEDI-CAL $22,200.00 ↑ +456%
LASALLE MG MEDI-CAL LASALLE MG MEDI-CAL $22,200.00 ↑ +456%
PACIFIC IPA MEDI-CAL PACIFIC IPA MEDI-CAL $22,200.00 ↑ +456%
PREFERRED IPA LA CARE MCAL CAP PREFERRED IPA LA CARE MCAL CAP $22,200.00 ↑ +456%
PREFERRED MEDI-CAL PREFERRED MEDI-CAL $22,200.00 ↑ +456%
HEALTHNET MCAL HEALTHNET MCAL $26,440.20 ↑ +562%
FCS IPA MEDI-CAL OP/PROFEE ONLY FCS IPA MEDI-CAL OP/PROFEE ONLY $26,640.00 ↑ +567%
PREFERRED HEALTHY PREFERRED HEALTHY $27,750.00 ↑ +594%
ASSOC HISPANIC PHYSCNS MCAL ASSOC HISPANIC PHYSCNS MCAL $31,080.00 ↑ +678%
HEALTHNET MCR ADV HEALTHNET MCR ADV $33,966.00 ↑ +750%
CARE FIRST MEDI-CAL CARE FIRST MEDI-CAL $77,700.00 ↑ +1844%

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Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet at other California hospitals

Hospital City Cash price Negotiated range
St. John's Camarillo Hospital Camarillo $17,578.26 $186.24 – $605.28
Petaluma Valley Hospital Petaluma $45,440.26 not published
Arroyo Grande Hospital Santa Maria $17,178.21 $303.37 – $1,292.62
Mark Twain Medical Center San Andreas $7,277.39 $584.93 – $2,215.78
French Hospital San Luis Obispo $15,733.32 $250.61 – $1,292.62
Mercy Hospitals – Bakersfield Bakersfield $16,544.75 $250.85 – $778.50
Bakersfield Memorial Hospital Bakersfield $16,366.37 $216.25 – $839.05
Queen of The Valley Medical Center Napa $33,892.73 not published

All California hospitals for this procedure →