Breast Biopsy (ultrasound-guided, percutaneous) at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$3,603.15
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.
$7,065.00
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.
$2,225.71 with Healthnet vs $11,153.00 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 | $2,225.71 | ↓ -38% |
| Aetna | Medicare Managed Care Plan | $2,271.13 | ↓ -37% |
| Blue Shield | Epn Exchange | $2,570.00 | ↓ -29% |
| Blue Shield | Hmo/Pos/Ppo | $3,135.00 | ↓ -13% |
| Unitedhealthcare | Select/Navigate Hmo | $4,657.00 | ↑ +29% |
| Unitedhealthcare | All Commercial Plans | $5,208.00 | ↑ +45% |
| Healthnet | Hmo/Pos/Ppo | $9,858.00 | ↑ +174% |
| Aetna | All Commercial Plans | $11,153.00 | ↑ +210% |
Visitor-reported prices
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Breast Biopsy (ultrasound-guided, percutaneous) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $2,180.81 | $928.80 – $3,883.62 |
| Banner Lassen Medical Center | Susanville | $2,264.44 | $1,012.97 – $4,207.86 |
| Arroyo Grande Hospital | Santa Maria | $4,430.66 | $613.92 – $9,431.52 |
| Mark Twain Medical Center | San Andreas | $2,835.83 | $97.53 – $377.00 |
| French Hospital | San Luis Obispo | $4,057.99 | $613.92 – $4,462.92 |
| Mercy Hospitals – Bakersfield | Bakersfield | $1,181.27 | $613.92 – $2,251.20 |
| Bakersfield Memorial Hospital | Bakersfield | $1,168.53 | $613.92 – $2,223.06 |
| Queen of The Valley Medical Center | Napa | $5,258.10 | $2,345.04 – $9,858.00 |