Bx nasopharynx/unknown pri lesion 42806 at Sequoia Hospital
170 Alameda de las Pulgas, Redwood City, CA · CommonSpirit Health · · NPI 1568646735
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.
$159.78 with BCBS - Anthem vs $14,886.15 with Sutter Health — 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 |
|---|---|---|---|
| BCBS - Anthem | Medicaid|< 21 | $159.78 | — |
| Partnership Health Plan | Medicaid|< 21 | $159.78 | — |
| Partnership Health Plan | Medicaid|> 21 | $159.78 | — |
| Kaiser | Medicaid|< 21 | $159.78 | — |
| Kaiser | Medicaid|> 21 | $159.78 | — |
| BCBS - Anthem | Medicaid|> 21 | $159.78 | — |
| Health Net | Medicaid|> 21 | $196.53 | — |
| Health Net | Medicaid|< 21 | $196.53 | — |
| Brown Toland | Medicare|All Plans | $298.49 | — |
| Health Plan San Mateo | Medicaid|< 21 | $309.80 | — |
| Health Plan San Mateo | Medicaid|> 21 | $309.80 | — |
| Humana | Commercial|All Plans | $4,755.96 | — |
| Humana | Medicare|All Plans | $4,755.96 | — |
| Aetna | Medicare|All Plans | $4,755.96 | — |
| United | Medicare|All Plans | $4,755.96 | — |
| Health Net | Medicare|All Plans | $4,755.96 | — |
| Health Net | Commercial|Canopy Health | $4,755.96 | — |
| Kaiser | Medicare|All Plans | $4,755.96 | — |
| BCBS - Anthem | Medicare|All Plans | $4,755.96 | — |
| Blue Shield CA | Medicare|All Plans | $4,755.96 | — |
| Chinese Community | Medicare|All Plans | $4,755.96 | — |
| Health Plan San Mateo | Medicare|All Plans | $4,755.96 | — |
| Brown Toland | Commercial|All Plans | $5,231.56 | — |
| Aetna | Commercial|All Plans | $5,324.00 | — |
| Blue Shield CA | Commercial|Exchange | $5,581.00 | — |
| Blue Shield CA | Commercial|ACO Trio | $5,749.00 | — |
| BCBS - Anthem | Commercial|All Other Plans | $6,138.00 | — |
| Blue Shield CA | Commercial|All Other Plans | $7,448.00 | — |
| BCBS - Anthem | Commercial|MCS | $10,404.00 | — |
| Health Net | Commercial|FFS | $11,896.00 | — |
| Sutter Health | Commercial|All Plans | $14,886.15 | — |
| Multiplan | Commercial|All Plans | not published by hospital | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| Connected Care | Commercial|Intel | not published by hospital | — |
Visitor-reported prices
Comments
Bx nasopharynx/unknown pri lesion 42806 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | not published | $196.53 – $7,141.02 |
| Petaluma Valley Hospital | Petaluma | not published | $2,570.00 – $6,619.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $159.78 – $4,120.64 |
| Mark Twain Medical Center | San Andreas | not published | $159.78 – $159.78 |
| French Hospital | San Luis Obispo | not published | $159.78 – $4,120.64 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $159.78 – $4,120.64 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $159.78 – $4,120.64 |
| Queen of The Valley Medical Center | Napa | not published | $4,707.49 – $16,652.00 |