Arthrd glenohumeral jt w/grf at Queen of The Valley Medical Center
1000 Trancas St, Napa, CA · Providence · · NPI 1013080084
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.
$12,563.00 with Blue Cross vs $62,607.00 with Healthnet — 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 |
|---|---|---|---|
| Blue Cross | Epo Exchange | $12,563.00 | — |
| Blue Cross | Nonmcs All Commercial Plans | $15,064.00 | — |
| Blue Shield | Epn Exchange | $16,692.00 | — |
| Blue Cross | Mcs Ppo | $18,077.00 | — |
| Aetna | Medicare Managed Care Plan | $18,229.15 | — |
| Aetna | All Commercial Plans | $19,158.00 | — |
| Blue Shield | Hmo/Pos/Ppo | $20,335.00 | — |
| Unitedhealthcare | Select/Navigate Hmo | $24,453.00 | — |
| Unitedhealthcare | All Commercial Plans | $27,195.00 | — |
| Healthnet | Hmo/Pos/Ppo | $62,607.00 | — |
Visitor-reported prices
Comments
Arthrd glenohumeral jt w/grf at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | not published | $1,190.22 – $32,697.16 |
| Petaluma Valley Hospital | Petaluma | not published | $5,734.00 – $17,654.63 |
| Arroyo Grande Hospital | Santa Maria | not published | $967.66 – $16,348.58 |
| Mark Twain Medical Center | San Andreas | not published | $967.66 – $967.66 |
| French Hospital | San Luis Obispo | not published | $967.66 – $16,348.58 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $967.66 – $16,348.58 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $967.66 – $16,348.58 |
| Providence St Joseph Hospital Eureka | Eureka | not published | $13,524.00 – $62,607.00 |