Removal of breast lesion at Mark Twain Medical Center
768 Mountain Ranch Rd, San Andreas, CA · CommonSpirit Health · · NPI 1508968819
$1,357.31
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.
$2,038.00
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.
$281.73 with Health Net vs $1,067.22 with Multiplan — 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 |
|---|---|---|---|
| Health Net | Medicare|All Plans | $281.73 | ↓ -79% |
| Humana | Medicare|All Plans | $281.73 | ↓ -79% |
| Care 1st | Medicare|All Plans | $281.73 | ↓ -79% |
| Scan Health Plan | Medicare|All Plans | $281.73 | ↓ -79% |
| Aetna | Medicare|All Plans | $281.73 | ↓ -79% |
| Blue Shield CA | Medicare|All Plans | $281.73 | ↓ -79% |
| BCBS - Anthem | Medicare|All Plans | $281.73 | ↓ -79% |
| Kaiser | Medicare|All Plans | $281.73 | ↓ -79% |
| United | Medicare|All Plans | $281.73 | ↓ -79% |
| Health Plan of San Joaquin | Medicaid|All Plans | $302.26 | ↓ -78% |
| Health Net | Medicaid|All Plans | $302.26 | ↓ -78% |
| Kaiser | Medicaid|All Plans | $302.26 | ↓ -78% |
| BCBS - Anthem | Medicaid|All Plans | $302.26 | ↓ -78% |
| California Health & Wellness | Medicaid|All Plans | $302.26 | ↓ -78% |
| BCBS - Anthem | Commercial|Exchange | $589.48 | ↓ -57% |
| United | Commercial|Select | $633.37 | ↓ -53% |
| Blue Shield CA | Commercial|PPO | $696.96 | ↓ -49% |
| Blue Shield CA | Commercial|HMO | $696.96 | ↓ -49% |
| Blue Shield CA | Commercial|Exchange | $696.96 | ↓ -49% |
| United | Commercial|Choice | $726.80 | ↓ -46% |
| BCBS - Anthem | Commercial|All Other Plans | $755.77 | ↓ -44% |
| Health Net | Commercial|All Plans | $813.49 | ↓ -40% |
| First Health | Commercial|All Plans | $816.75 | ↓ -40% |
| United | Commercial|HMO | $853.89 | ↓ -37% |
| Aetna | Commercial|All Other Plans | $889.72 | ↓ -34% |
| Aetna | Commercial|HMO | $889.72 | ↓ -34% |
| Aetna | Commercial|PPO | $889.72 | ↓ -34% |
| Kaiser | Commercial|All Plans | $925.65 | ↓ -32% |
| Cigna | Commercial|PPO | $974.66 | ↓ -28% |
| Cigna | Commercial|All Other Plans | $974.66 | ↓ -28% |
| Multiplan | Commercial|All Plans | $1,067.22 | ↓ -21% |
Visitor-reported prices
Comments
Removal of breast lesion at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| California Hospital Medical Center | Los Angeles | $2,752.38 | $272.03 – $5,420.15 |
| Providence St Joseph Hospital Orange | Orange | $6,502.56 | $4,280.52 – $9,316.42 |
| Providence Holy Cross Medical Center | Mission Hills | $3,510.50 | $1,747.00 – $7,332.00 |
| Providence Saint John's Health Center | Santa Monica | $3,583.65 | $1,746.72 – $10,103.00 |
| St. John's Camarillo Hospital | Camarillo | not published | $457.29 – $8,628.88 |
| Petaluma Valley Hospital | Petaluma | not published | $2,937.00 – $6,619.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $302.26 – $4,865.48 |
| French Hospital | San Luis Obispo | not published | $302.26 – $4,865.48 |