Biopsy abdominal mass at Queen of The Valley Medical Center
1000 Trancas St, Napa, CA · Providence · · NPI 1013080084
$4,687.92
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.
$9,192.00
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.
$2,345.04 with Aetna vs $9,858.00 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 |
|---|---|---|---|
| Aetna | Medicare Managed Care Plan | $2,345.04 | ↓ -50% |
| Blue Shield | Epn Exchange | $5,592.00 | ↑ +19% |
| Blue Cross | Epo Exchange | $6,200.00 | ↑ +32% |
| Blue Shield | Hmo/Pos/Ppo | $6,812.00 | ↑ +45% |
| Unitedhealthcare | Select/Navigate Hmo | $7,455.00 | ↑ +59% |
| Blue Cross | Nonmcs All Commercial Plans | $7,480.00 | ↑ +60% |
| Unitedhealthcare | All Commercial Plans | $8,291.00 | ↑ +77% |
| Aetna | All Commercial Plans | $8,621.00 | ↑ +84% |
| Blue Cross | Mcs Ppo | $8,976.00 | ↑ +91% |
| Healthnet | Hmo/Pos/Ppo | $9,858.00 | ↑ +110% |
Visitor-reported prices
Comments
Biopsy abdominal mass at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $833.52 | $352.59 – $3,763.88 |
| Arroyo Grande Hospital | Santa Maria | $2,163.12 | $286.66 – $3,120.32 |
| Mark Twain Medical Center | San Andreas | $2,021.31 | $286.66 – $1,300.46 |
| French Hospital | San Luis Obispo | $1,842.40 | $286.66 – $3,317.30 |
| Mercy Hospitals – Bakersfield | Bakersfield | $1,941.45 | $286.66 – $4,186.40 |
| Bakersfield Memorial Hospital | Bakersfield | $1,920.52 | $286.66 – $4,134.07 |
| Providence St Joseph Hospital Eureka | Eureka | $5,381.01 | $2,124.23 – $9,858.00 |
| St. Joseph's Medical Center Stockton | Stockton | $1,388.27 | $286.66 – $3,966.48 |