Biopsy skin incisional single lesion at Queen of The Valley Medical Center
1000 Trancas St, Napa, CA · Providence · · NPI 1013080084
$1,308.15
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.
$2,565.00
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.
$1,049.38 with Aetna vs $9,116.00 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 | $1,049.38 | ↓ -20% |
| Healthnet | Hmo/Pos/Ppo | $1,333.00 | ↑ +2% |
| Unitedhealthcare | Select/Navigate Hmo | $4,316.00 | ↑ +230% |
| Unitedhealthcare | All Commercial Plans | $4,800.00 | ↑ +267% |
| Blue Cross | Epo Exchange | $6,200.00 | ↑ +374% |
| Blue Cross | Nonmcs All Commercial Plans | $7,480.00 | ↑ +472% |
| Blue Shield | Epn Exchange | $7,483.00 | ↑ +472% |
| Aetna | All Commercial Plans | $8,621.00 | ↑ +559% |
| Blue Cross | Mcs Ppo | $8,976.00 | ↑ +586% |
| Blue Shield | Hmo/Pos/Ppo | $9,116.00 | ↑ +597% |
Visitor-reported prices
Comments
Biopsy skin incisional single lesion at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $552.37 | $164.46 – $1,458.18 |
| Petaluma Valley Hospital | Petaluma | $1,176.57 | $995.98 – $2,695.00 |
| Mark Twain Medical Center | San Andreas | $114.56 | $42.17 – $159.74 |
| Mercy Hospitals – Bakersfield | Bakersfield | $148.40 | $108.71 – $400.00 |
| Bakersfield Memorial Hospital | Bakersfield | $153.41 | $108.71 – $400.00 |
| Providence St Joseph Hospital Eureka | Eureka | $1,315.80 | $950.57 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $808.35 | $995.78 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $852.72 | $1,333.00 – $20,799.00 |