Closed tx humerus fx w/manip 24505 at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$2,021.64
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.
$3,964.00
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.
$1,687.00 with Unitedhealthcare 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 |
|---|---|---|---|
| Unitedhealthcare | Select/Navigate Hmo | $1,687.00 | ↓ -17% |
| Unitedhealthcare | All Commercial Plans | $1,886.00 | ↓ -7% |
| Blue Shield | Epn Exchange | $1,921.00 | ↓ -5% |
| Healthnet | Medicare Managed Care Plan | $2,166.95 | ↑ +7% |
| Aetna | Medicare Managed Care Plan | $2,211.17 | ↑ +9% |
| Blue Shield | Hmo/Pos/Ppo | $2,343.00 | ↑ +16% |
| Healthnet | Hmo/Pos/Ppo | $9,858.00 | ↑ +388% |
| Aetna | All Commercial Plans | $10,997.00 | ↑ +444% |
Visitor-reported prices
Comments
Closed tx humerus fx w/manip 24505 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Queen of The Valley Medical Center | Napa | $2,077.23 | $2,283.13 – $9,858.00 |
| Providence St Joseph Hospital Eureka | Eureka | $2,334.27 | $2,068.15 – $9,858.00 |
| Healdsburg Hospital | Healdsburg | $1,535.61 | $2,166.52 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $1,823.76 | $5,981.00 – $20,799.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $2,437.29 | $1,716.00 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $1,123.68 | $1,200.00 – $5,171.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $1,337.00 | $1,142.00 – $3,826.07 |
| Providence Saint Joseph Medical Center | Burbank | $1,774.50 | $1,142.00 – $3,826.07 |