Excision of mouth lesion complex 40816 at REEDLEY COMMUNITY HOSPITAL
372 W Cypress Ave, Reedley, CA · Adventisthealth · · NPI 1336167550
$205.01
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.
$1,079.00
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.
$8.81 with DIGNITY MCR ADV OP/PROFEE ONLY vs $7,035.98 with AETNA MCR ADV — 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 |
|---|---|---|---|
| DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $8.81 | ↓ -96% |
| UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $45.00 | ↓ -78% |
| CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $45.00 | ↓ -78% |
| CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $45.00 | ↓ -78% |
| MEDI-CAL | MEDI-CAL | $45.00 | ↓ -78% |
| DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $45.00 | ↓ -78% |
| BC MCAL | BC MCAL | $45.00 | ↓ -78% |
| KERN HEALTH SYSTEMS MCAL-ALL PLANS | KERN HEALTH SYSTEMS MCAL-ALL PLANS | $56.25 | ↓ -73% |
| CENTRAL CA ALLIANCE CCS PROFEE ONLY | CENTRAL CA ALLIANCE CCS PROFEE ONLY | $67.50 | ↓ -67% |
| CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | $67.50 | ↓ -67% |
| CENTRAL CA ALLIANCE CHDP PROFEE ONLY | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | $90.00 | ↓ -56% |
| HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $161.85 | ↓ -21% |
| LASALLE MED ASSOC PROFEE ONLY - ALL PLANS | LASALLE MED ASSOC PROFEE ONLY - ALL PLANS | $287.89 | ↑ +40% |
| TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $287.89 | ↑ +40% |
| UHC MCR ADV | UHC MCR ADV | $287.89 | ↑ +40% |
| FHCN PACE MCR ADV-ALL PLANS | FHCN PACE MCR ADV-ALL PLANS | $287.89 | ↑ +40% |
| SANTE IPA MCAL/MCARE HMO PROFEE ONLY | SANTE IPA MCAL/MCARE HMO PROFEE ONLY | $287.89 | ↑ +40% |
| BLUE SHIELD MCARE | BLUE SHIELD MCARE | $287.89 | ↑ +40% |
| UPN MCR ADV PROFEE ONLY | UPN MCR ADV PROFEE ONLY | $287.89 | ↑ +40% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $316.68 | ↑ +54% |
| COMMUNITY CARE IPA MCAL-ALL PLANS | COMMUNITY CARE IPA MCAL-ALL PLANS | $329.11 | ↑ +61% |
| SANTE IPA HMO PROFEE ONLY - ALL OTHER PLANS | SANTE IPA HMO PROFEE ONLY - ALL OTHER PLANS | $345.47 | ↑ +69% |
| CIGNA- ALL PLANS | CIGNA- ALL PLANS | $374.72 | ↑ +83% |
| AETNA - ALL OTHER PLANS | AETNA - ALL OTHER PLANS | $381.95 | ↑ +86% |
| KAISER MCR ADV | KAISER MCR ADV | $388.65 | ↑ +90% |
| KAISER - ALL OTHER PLANS | KAISER - ALL OTHER PLANS | $388.65 | ↑ +90% |
| WESTERN GROWERS/PINNACLE- ALL PLANS | WESTERN GROWERS/PINNACLE- ALL PLANS | $400.17 | ↑ +95% |
| UHC JLL CSP | UHC JLL CSP | $408.63 | ↑ +99% |
| UHC HMO | UHC HMO | $408.63 | ↑ +99% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $408.63 | ↑ +99% |
| HEALTHNET- ALL OTHER PLANS | HEALTHNET- ALL OTHER PLANS | $419.46 | ↑ +105% |
| BLUE SHIELD EPN - ALL OTHER PLANS | BLUE SHIELD EPN - ALL OTHER PLANS | $538.79 | ↑ +163% |
| BLUE SHIELD NON EPN | BLUE SHIELD NON EPN | $569.38 | ↑ +178% |
| BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $653.60 | ↑ +219% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $653.60 | ↑ +219% |
| PHYSICIANS MED GROUP OP/PROFEE ONLY- ALL PLANS | PHYSICIANS MED GROUP OP/PROFEE ONLY- ALL PLANS | $863.20 | ↑ +321% |
| PHS PRIME HEALTH SRVCS | PHS PRIME HEALTH SRVCS | $4,264.23 | ↑ +1980% |
| HEALTHNET- MCR ADV | HEALTHNET- MCR ADV | $4,264.23 | ↑ +1980% |
| BLUE CROSS EXCHANGE | BLUE CROSS EXCHANGE | $6,290.00 | ↑ +2968% |
| BRIGHT HEALTH MCR ADV - ALL PLANS | BRIGHT HEALTH MCR ADV - ALL PLANS | $6,694.84 | ↑ +3166% |
| AETNA MCR ADV | AETNA MCR ADV | $7,035.98 | ↑ +3332% |
Visitor-reported prices
Comments
Excision of mouth lesion complex 40816 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Fresno Medical Center | FRESNO | $8,820.00 | not published |
| Antioch Medical Center | ANTIOCH | $8,820.00 | not published |
| Redwood City Medical Center | Redwood City | $8,820.00 | not published |
| Santa Clara Medical Center | SANTA CLARA | $8,820.00 | not published |
| Fremont Medical Center | FREMONT | $8,820.00 | not published |
| Sacramento Medical Center | SACRAMENTO | $8,820.00 | not published |
| Oakland Medical Center | Oakland | $8,820.00 | not published |
| Walnut Creek Medical Center | WALNUT CREEK | $8,820.00 | not published |