Borrelia antibody at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
not published by hospital
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.
not published by hospital
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.
$13.11 with Healthnet vs $154.76 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 |
|---|---|---|---|
| Healthnet | Medicare Managed Care Plan | $13.11 | — |
| Aetna | Medicare Managed Care Plan | $13.38 | — |
| Unitedhealthcare | All Commercial Plans | $26.76 | — |
| Unitedhealthcare | Select/Navigate Hmo | $26.76 | — |
| Aetna | All Commercial Plans | $93.37 | — |
| Blue Cross | Epo Exchange | $107.66 | — |
| Blue Cross | Nonmcs All Commercial Plans | $128.96 | — |
| Blue Cross | Mcs All Commercial Plans | $154.76 | — |
Visitor-reported prices
Comments
Borrelia antibody at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sierra Nevada Memorial Hospital | Grass Valley | $50.20 | $13.38 – $90.26 |
| Mercy San Juan Medical Center | Carmichael | $25.24 | $10.14 – $76.45 |
| Mercy General Hospital | Sacramento | $20.08 | $11.89 – $73.68 |
| Mercy Hospital of Folsom | Folsom | $35.83 | $10.14 – $75.53 |
| Woodland Memorial Hospital | Woodland | $25.24 | $10.14 – $92.10 |
| Methodist Hospital of Sacramento | Sacramento | $26.53 | $11.89 – $76.45 |
| Queen of The Valley Medical Center | Napa | not published | $13.38 – $136.06 |
| Providence St Joseph Hospital Eureka | Eureka | not published | $13.38 – $154.29 |