Optx prox humrl fx w/int fix at Petaluma Valley Hospital
400 N Mcdowell Blvd, Petaluma, CA · Providence · · NPI 1235162645
$26,561.82
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.
?
What you pay up front if you don't use insurance.
$52,082.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$3,632.00 with Blue Shield vs $62,607.00 with Healthnet — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Blue Shield | Epn Exchange | $3,632.00 | ↓ -86% |
| Blue Shield | Hmo/Pos/Ppo | $4,431.00 | ↓ -83% |
| Unitedhealthcare | Select/Navigate Hmo | $15,313.00 | ↓ -42% |
| Unitedhealthcare | All Commercial Plans | $17,127.00 | ↓ -36% |
| Healthnet | Medicare Managed Care Plan | $17,301.54 | ↓ -35% |
| Aetna | Medicare Managed Care Plan | $17,654.63 | ↓ -34% |
| Aetna | All Commercial Plans | $20,618.00 | ↓ -22% |
| Healthnet | Hmo/Pos/Ppo | $62,607.00 | ↑ +136% |
Visitor-reported prices
Comments
Optx prox humrl fx w/int fix at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $1,537.80 | $580.60 – $2,262.82 |
| Queen of The Valley Medical Center | Napa | $28,751.76 | $9,256.00 – $62,607.00 |
| Providence St Joseph Hospital Eureka | Eureka | $25,677.48 | $11,036.00 – $62,607.00 |
| Healdsburg Hospital | Healdsburg | $7,540.86 | $4,417.00 – $17,298.12 |
| Redwood Memorial Hospital | Fortuna | $16,636.71 | $11,059.00 – $62,607.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $28,431.48 | $4,233.00 – $18,229.15 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $8,412.96 | $9,779.00 – $30,548.47 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $9,313.85 | $2,160.00 – $30,073.00 |