Biopsy of salivary glnd;incisional 42405 at French Hospital
1911 Johnson Ave, San Luis Obispo, CA · CommonSpirit Health · · NPI 1881760452
$3,254.78
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.
$8,303.00
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.
$126.03 with BCBS - Anthem vs $8,190.00 with Blue Shield CA — 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 | $126.03 | ↓ -96% |
| Partnership Health Plan | Medicaid|> 21 | $126.03 | ↓ -96% |
| Partnership Health Plan | Medicaid|< 21 | $126.03 | ↓ -96% |
| Molina | Medicaid|< 21 | $126.03 | ↓ -96% |
| Molina | Medicaid|> 21 | $126.03 | ↓ -96% |
| Health Net | Medicaid|< 21 | $155.02 | ↓ -95% |
| Health Net | Medicaid|> 21 | $155.02 | ↓ -95% |
| CenCal | Medicaid|> 21 | $198.66 | ↓ -94% |
| CenCal | Medicaid|< 21 | $198.66 | ↓ -94% |
| Blue Shield CA | Medicare|All Plans | $1,882.11 | ↓ -42% |
| Health Net | Medicare|All Plans | $1,882.11 | ↓ -42% |
| Alignment | Medicare|All Plans | $1,882.11 | ↓ -42% |
| Humana | Medicare|All Plans | $1,882.11 | ↓ -42% |
| Humana | Commercial|All Plans | $1,882.11 | ↓ -42% |
| Aetna | Medicare|All Plans | $1,882.11 | ↓ -42% |
| BCBS - Anthem | Medicare|All Plans | $1,882.11 | ↓ -42% |
| Kaiser | Medicare|All Plans | $1,882.11 | ↓ -42% |
| United | Medicare|All Plans | $1,882.11 | ↓ -42% |
| MHS HSPCC | Commercial|All Plans | $2,241.81 | ↓ -31% |
| Western Growers | Commercial|All Plans | $4,566.65 | ↑ +40% |
| Aetna | Commercial|Gatekeeper | $4,567.00 | ↑ +40% |
| Health Net | Commercial|FFS | $4,649.68 | ↑ +43% |
| Aetna | Commercial|Non-Gatekeeper | $4,906.00 | ↑ +51% |
| Kaiser | Commercial|All Plans | $5,147.86 | ↑ +58% |
| BCBS - Anthem | Commercial|MCS | $5,243.00 | ↑ +61% |
| BCBS - Anthem | Commercial|Non-MCS | $5,432.00 | ↑ +67% |
| Blue Shield CA | Commercial|Exchange | $5,556.00 | ↑ +71% |
| Healthsmart | Commercial|All Plans | $7,057.55 | ↑ +117% |
| First Health | Commercial|All Plans | $7,057.55 | ↑ +117% |
| United | Commercial|Non-Options PPO | $7,638.76 | ↑ +135% |
| MultiPlan | Commercial|All Plans | $8,136.94 | ↑ +150% |
| Blue Shield CA | Commercial|FFS | $8,190.00 | ↑ +152% |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | not published | $155.02 – $3,484.24 |
| Petaluma Valley Hospital | Petaluma | not published | $2,090.93 – $4,657.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $126.03 – $1,882.11 |
| Mark Twain Medical Center | San Andreas | not published | $126.03 – $126.03 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $126.03 – $1,882.11 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $126.03 – $1,882.11 |
| Queen of The Valley Medical Center | Napa | not published | $2,203.03 – $16,652.00 |
| Providence St Joseph Hospital Eureka | Eureka | not published | $1,995.60 – $16,652.00 |