Bld prd mix at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$290.19
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.
$569.00
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.
$116.25 with Aetna vs $287.00 with Unitedhealthcare — 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 | All Commercial Plans | $116.25 | ↓ -60% |
| Blue Cross | Epo Exchange | $146.90 | ↓ -49% |
| Blue Cross | Nonmcs All Commercial Plans | $175.97 | ↓ -39% |
| Blue Cross | Mcs All Commercial Plans | $211.16 | ↓ -27% |
| Healthnet | Medicare Managed Care Plan | $229.59 | ↓ -21% |
| Aetna | Medicare Managed Care Plan | $234.28 | ↓ -19% |
| Unitedhealthcare | Select/Navigate Hmo | $287.00 | ↓ -1% |
| Unitedhealthcare | All Commercial Plans | $287.00 | ↓ -1% |
Visitor-reported prices
Comments
Bld prd mix at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $150.52 | $58.47 – $221.48 |
| Mercy Hospitals – Bakersfield | Bakersfield | $107.97 | $89.30 – $232.80 |
| Bakersfield Memorial Hospital | Bakersfield | $106.80 | $85.90 – $229.89 |
| Queen of The Valley Medical Center | Napa | $278.97 | $163.83 – $287.00 |
| Providence St Joseph Hospital Eureka | Eureka | $161.67 | $210.52 – $287.00 |
| St. Joseph's Behavioral Health Center | Stockton | $193.57 | $33.90 – $271.20 |
| Redwood Memorial Hospital | Fortuna | $148.41 | $211.01 – $211.01 |
| St. Joseph's Medical Center Stockton | Stockton | $84.68 | $60.48 – $243.13 |