Bx of breast open 19101 at Mark Twain Medical Center
768 Mountain Ranch Rd, San Andreas, CA · CommonSpirit Health · · NPI 1508968819
$3,912.09
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.
$5,874.00
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.
$236.25 with BCBS - Anthem vs $5,535.04 with Multiplan — 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|All Plans | $236.25 | ↓ -94% |
| Kaiser | Medicaid|All Plans | $236.25 | ↓ -94% |
| Health Net | Medicaid|All Plans | $236.25 | ↓ -94% |
| California Health & Wellness | Medicaid|All Plans | $236.25 | ↓ -94% |
| Health Plan of San Joaquin | Medicaid|All Plans | $236.25 | ↓ -94% |
| Care 1st | Medicare|All Plans | $1,461.14 | ↓ -63% |
| Humana | Medicare|All Plans | $1,461.14 | ↓ -63% |
| Aetna | Medicare|All Plans | $1,461.14 | ↓ -63% |
| United | Medicare|All Plans | $1,461.14 | ↓ -63% |
| Health Net | Medicare|All Plans | $1,461.14 | ↓ -63% |
| Kaiser | Medicare|All Plans | $1,461.14 | ↓ -63% |
| BCBS - Anthem | Medicare|All Plans | $1,461.14 | ↓ -63% |
| Blue Shield CA | Medicare|All Plans | $1,461.14 | ↓ -63% |
| Scan Health Plan | Medicare|All Plans | $1,461.14 | ↓ -63% |
| BCBS - Anthem | Commercial|Exchange | $3,057.27 | ↓ -22% |
| United | Commercial|Select | $3,284.88 | ↓ -16% |
| Blue Shield CA | Commercial|HMO | $3,614.72 | ↓ -8% |
| Blue Shield CA | Commercial|PPO | $3,614.72 | ↓ -8% |
| Blue Shield CA | Commercial|Exchange | $3,614.72 | ↓ -8% |
| United | Commercial|Choice | $3,769.48 | ↓ -4% |
| BCBS - Anthem | Commercial|All Other Plans | $3,919.72 | ↑ +0% |
| Health Net | Commercial|All Plans | $4,219.06 | ↑ +8% |
| First Health | Commercial|All Plans | $4,236.00 | ↑ +8% |
| United | Commercial|HMO | $4,428.60 | ↑ +13% |
| Aetna | Commercial|All Other Plans | $4,614.42 | ↑ +18% |
| Aetna | Commercial|HMO | $4,614.42 | ↑ +18% |
| Aetna | Commercial|PPO | $4,614.42 | ↑ +18% |
| Kaiser | Commercial|All Plans | $4,800.80 | ↑ +23% |
| Cigna | Commercial|PPO | $5,054.96 | ↑ +29% |
| Cigna | Commercial|All Other Plans | $5,054.96 | ↑ +29% |
| Multiplan | Commercial|All Plans | $5,535.04 | ↑ +41% |
Visitor-reported prices
Comments
Bx of breast open 19101 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. Joseph's Medical Center Stockton | Stockton | $6,389.21 | $236.25 – $18,254.88 |
| Providence St Joseph Hospital Orange | Orange | $5,204.64 | $4,035.00 – $9,316.42 |
| Providence Saint John's Health Center | Santa Monica | $4,322.15 | $1,528.38 – $9,297.00 |
| St. John's Camarillo Hospital | Camarillo | not published | $290.59 – $8,628.88 |
| Petaluma Valley Hospital | Petaluma | not published | $2,570.00 – $6,619.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $236.25 – $4,865.48 |
| French Hospital | San Luis Obispo | not published | $236.25 – $4,865.48 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $236.25 – $4,865.48 |