Benign lesion paring 4+ at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$365.67
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.
$717.00
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.
$270.38 with Healthnet vs $10,997.00 with Aetna — 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 |
|---|---|---|---|
| Healthnet | Medicare Managed Care Plan | $270.38 | ↓ -26% |
| Aetna | Medicare Managed Care Plan | $275.89 | ↓ -25% |
| Blue Shield | Epn Exchange | $593.00 | ↑ +62% |
| Blue Shield | Hmo/Pos/Ppo | $724.00 | ↑ +98% |
| Healthnet | Hmo/Pos/Ppo | $1,333.00 | ↑ +265% |
| Unitedhealthcare | Select/Navigate Hmo | $1,687.00 | ↑ +361% |
| Unitedhealthcare | All Commercial Plans | $1,886.00 | ↑ +416% |
| Aetna | All Commercial Plans | $10,997.00 | ↑ +2907% |
Visitor-reported prices
Comments
Benign lesion paring 4+ at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $111.22 | $37.85 – $453.26 |
| Mark Twain Medical Center | San Andreas | $95.91 | $30.77 – $141.12 |
| Bakersfield Memorial Hospital | Bakersfield | $212.13 | $30.77 – $456.62 |
| Queen of The Valley Medical Center | Napa | $406.98 | $284.87 – $2,747.00 |
| Providence St Joseph Hospital Eureka | Eureka | $409.53 | $258.05 – $2,699.00 |
| Healdsburg Hospital | Healdsburg | $552.33 | $270.32 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $241.74 | $1,333.00 – $20,799.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $391.68 | $279.18 – $1,716.00 |