Deep muscle biopsy 20205 at Providence St Joseph Hospital Orange
1100 W Stewart Dr, Orange, CA · Providence · · NPI 1912982216
$5,081.76
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.
$10,587.00
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.
$3,175.56 with Providence vs $14,208.00 with Blue Cross — 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 |
|---|---|---|---|
| Providence | Oscar All Commercial Plans | $3,175.56 | ↓ -38% |
| Aetna | Medicare Managed Care Plan | $3,735.95 | ↓ -26% |
| Unitedhealthcare | Select/Navigate Hmo | $3,845.00 | ↓ -24% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $3,914.07 | ↓ -23% |
| Unitedhealthcare | All Commercial Plans | $4,218.00 | ↓ -17% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $4,408.36 | ↓ -13% |
| Healthnet | Ambetter Hmo | $6,911.51 | ↑ +36% |
| Blue Shield | Epn Exchange | $7,602.00 | ↑ +50% |
| Aetna | Gatekeeper Hmo | $8,741.00 | ↑ +72% |
| Blue Shield | Tandem Ppo | $9,422.00 | ↑ +85% |
| Healthnet | Hmo/Pos/Ppo | $9,990.00 | ↑ +97% |
| Blue Shield | Hmo/Ppo | $10,471.00 | ↑ +106% |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $11,840.00 | ↑ +133% |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $14,208.00 | ↑ +180% |
Visitor-reported prices
Comments
Deep muscle biopsy 20205 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $2,874.45 | $125.17 – $6,581.68 |
| Mark Twain Medical Center | San Andreas | $273.73 | $106.33 – $402.78 |
| French Hospital | San Luis Obispo | $3,186.96 | $125.17 – $7,735.14 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $4,093.44 | $3,175.56 – $7,908.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $2,276.05 | $1,747.00 – $6,911.51 |
| St Jude Medical Center | Fullerton | $2,547.84 | $3,175.56 – $6,911.51 |
| Providence Saint John's Health Center | Santa Monica | $7,548.80 | $1,746.72 – $10,103.00 |
| St. John's Camarillo Hospital | Camarillo | not published | $153.96 – $6,483.96 |