Adh-sendout at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$15.30
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.
?
What you pay up front if you don't use insurance.
$30.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$33.26 with Healthnet vs $399.80 with Blue Cross — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Healthnet | Medicare Managed Care Plan | $33.26 | ↑ +117% |
| Aetna | Medicare Managed Care Plan | $33.94 | ↑ +122% |
| Unitedhealthcare | All Commercial Plans | $67.88 | ↑ +344% |
| Unitedhealthcare | Select/Navigate Hmo | $67.88 | ↑ +344% |
| Aetna | All Commercial Plans | $236.87 | ↑ +1448% |
| Blue Cross | Epo Exchange | $278.14 | ↑ +1718% |
| Blue Cross | Nonmcs All Commercial Plans | $333.17 | ↑ +2078% |
| Blue Cross | Mcs All Commercial Plans | $399.80 | ↑ +2513% |
Visitor-reported prices
Comments
Adh-sendout at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $19.71 | $12.15 – $90.05 |
| Banner Lassen Medical Center | Susanville | $29.42 | $6.79 – $49.78 |
| Arroyo Grande Hospital | Santa Maria | $96.84 | $22.50 – $87.45 |
| Mark Twain Medical Center | San Andreas | $29.97 | $24.36 – $44.10 |
| French Hospital | San Luis Obispo | $88.69 | $12.15 – $102.80 |
| Mercy Hospitals – Bakersfield | Bakersfield | $16.70 | $8.50 – $97.53 |
| Bakersfield Memorial Hospital | Bakersfield | $16.52 | $8.50 – $97.53 |
| Queen of The Valley Medical Center | Napa | $15.30 | $33.94 – $351.50 |