Drainage mouth roof lesion at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$562.53
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.
$1,103.00
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.
$319.18 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 | $319.18 | ↓ -43% |
| Aetna | Medicare Managed Care Plan | $325.70 | ↓ -42% |
| Healthnet | Hmo/Pos/Ppo | $1,333.00 | ↑ +137% |
| Unitedhealthcare | Select/Navigate Hmo | $1,687.00 | ↑ +200% |
| Unitedhealthcare | All Commercial Plans | $1,886.00 | ↑ +235% |
| Blue Shield | Epn Exchange | $2,570.00 | ↑ +357% |
| Blue Shield | Hmo/Pos/Ppo | $3,135.00 | ↑ +457% |
| Aetna | All Commercial Plans | $11,153.00 | ↑ +1883% |
Visitor-reported prices
Comments
Drainage mouth roof lesion at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Queen of The Valley Medical Center | Napa | $468.18 | $336.29 – $7,483.00 |
| Providence St Joseph Hospital Eureka | Eureka | $470.73 | $304.63 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $255.51 | $319.12 – $5,198.77 |
| Redwood Memorial Hospital | Fortuna | $524.28 | $1,333.00 – $25,998.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $364.14 | $329.57 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $559.68 | $258.93 – $6,920.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $203.35 | $304.63 – $3,470.00 |
| Providence Saint Joseph Medical Center | Burbank | $365.05 | $304.63 – $3,452.00 |