Biopsy of salivary gland 42400 at French Hospital
1911 Johnson Ave, San Luis Obispo, CA · CommonSpirit Health · · NPI 1881760452
$1,087.41
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.
$2,774.00
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.
$57.67 with Partnership Health Plan vs $5,432.00 with BCBS - Anthem — 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 |
|---|---|---|---|
| Partnership Health Plan | Medicaid|> 21 | $57.67 | ↓ -95% |
| BCBS - Anthem | Medicaid|All Plans | $57.67 | ↓ -95% |
| Partnership Health Plan | Medicaid|< 21 | $57.67 | ↓ -95% |
| Molina | Medicaid|< 21 | $57.67 | ↓ -95% |
| Molina | Medicaid|> 21 | $57.67 | ↓ -95% |
| Health Net | Medicaid|< 21 | $70.93 | ↓ -93% |
| Health Net | Medicaid|> 21 | $70.93 | ↓ -93% |
| CenCal | Medicaid|< 21 | $90.91 | ↓ -92% |
| CenCal | Medicaid|> 21 | $90.91 | ↓ -92% |
| MHS HSPCC | Commercial|All Plans | $534.60 | ↓ -51% |
| MHS Hospice | Commercial|All Plans | $712.67 | ↓ -34% |
| Humana | Commercial|All Plans | $893.98 | ↓ -18% |
| Humana | Medicare|All Plans | $893.98 | ↓ -18% |
| Aetna | Medicare|All Plans | $893.98 | ↓ -18% |
| United | Medicare|All Plans | $893.98 | ↓ -18% |
| Health Net | Medicare|All Plans | $893.98 | ↓ -18% |
| Kaiser | Medicare|All Plans | $893.98 | ↓ -18% |
| BCBS - Anthem | Medicare|All Plans | $893.98 | ↓ -18% |
| Alignment | Medicare|All Plans | $893.98 | ↓ -18% |
| Blue Shield CA | Medicare|All Plans | $893.98 | ↓ -18% |
| Western Growers | Commercial|All Plans | $1,089.00 | ↑ +0% |
| Health Net | Commercial|FFS | $1,108.80 | ↑ +2% |
| Kaiser | Commercial|All Plans | $1,227.60 | ↑ +13% |
| Blue Shield CA | Commercial|Exchange | $1,282.00 | ↑ +18% |
| Healthsmart | Commercial|All Plans | $1,683.00 | ↑ +55% |
| First Health | Commercial|All Plans | $1,683.00 | ↑ +55% |
| United | Commercial|Non-Options PPO | $1,821.60 | ↑ +68% |
| Blue Shield CA | Commercial|FFS | $1,890.00 | ↑ +74% |
| MultiPlan | Commercial|All Plans | $1,940.40 | ↑ +78% |
| Aetna | Commercial|Gatekeeper | $4,063.00 | ↑ +274% |
| Aetna | Commercial|Non-Gatekeeper | $4,363.00 | ↑ +301% |
| BCBS - Anthem | Commercial|MCS | $5,243.00 | ↑ +382% |
| BCBS - Anthem | Commercial|Non-MCS | $5,432.00 | ↑ +400% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $723.14 | $70.93 – $1,628.92 |
| Banner Lassen Medical Center | Susanville | $854.51 | $82.93 – $1,587.89 |
| Arroyo Grande Hospital | Santa Maria | $1,322.95 | $57.67 – $2,940.98 |
| Mark Twain Medical Center | San Andreas | $1,341.99 | $57.67 – $864.36 |
| Mercy Hospitals – Bakersfield | Bakersfield | $912.66 | $57.67 – $1,968.00 |
| Bakersfield Memorial Hospital | Bakersfield | $902.82 | $57.67 – $1,943.40 |
| Queen of The Valley Medical Center | Napa | $843.03 | $1,005.45 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $1,043.46 | $910.78 – $8,018.00 |