Excision breast lesion at Dominican Hospital
1555 Soquel Dr, Santa Cruz, CA · CommonSpirit Health · · NPI 1427181007
$3,749.85
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.
$8,333.00
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.
$275.99 with BCBS - Anthem vs $23,352.00 with Aetna — 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 | $275.99 | ↓ -93% |
| Health Net | Medicaid|> 21 | $339.47 | ↓ -91% |
| Health Net | Medicaid|< 21 | $339.47 | ↓ -91% |
| COSC Psych | Medicaid|All Plans | $435.05 | ↓ -88% |
| Central California Alliance for Health | Medicaid|All Plans | $435.05 | ↓ -88% |
| Health Net | Medicare|All Plans | $5,260.89 | ↑ +40% |
| Blue Shield CA | Medicare|All Plans | $5,260.89 | ↑ +40% |
| United | Medicare|All Plans | $5,260.89 | ↑ +40% |
| Kaiser | Medicare|All Plans | $5,260.89 | ↑ +40% |
| Kaiser | Commercial|All Plans | $5,416.45 | ↑ +44% |
| Western Growers | Commercial|All Plans | $5,666.44 | ↑ +51% |
| Blue Shield CA | Commercial|DHMF | $5,997.41 | ↑ +60% |
| Healthsmart | Commercial|All Plans | $6,666.40 | ↑ +78% |
| Multiplan | Commercial|All Plans | $7,083.05 | ↑ +89% |
| First Health | Commercial|All Plans | $7,083.05 | ↑ +89% |
| United | Commercial|All Other Plans | $7,499.70 | ↑ +100% |
| United | Commercial|Options PPO | $7,999.68 | ↑ +113% |
| United | Commercial|HMO | $7,999.68 | ↑ +113% |
| United | Commercial|Non-Options PPO | $8,333.00 | ↑ +122% |
| Health Net | Commercial|Community Care | $9,380.00 | ↑ +150% |
| Blue Shield CA | Commercial|Exchange | $9,630.00 | ↑ +157% |
| Blue Shield CA | Commercial|ACO Trio | $10,065.00 | ↑ +168% |
| Health Net | Commercial|Care Product | $11,420.00 | ↑ +205% |
| BCBS - Anthem | Commercial|All Other Plans | $11,529.00 | ↑ +207% |
| Health Net | Commercial|Blue Gold | $11,553.00 | ↑ +208% |
| Blue Shield CA | Commercial|All Other Plans | $12,303.00 | ↑ +228% |
| Health Net | Commercial|All Other Plans | $12,689.00 | ↑ +238% |
| BCBS - Anthem | Commercial|MCS | $16,016.00 | ↑ +327% |
| Sutter Health | Commercial|All Plans | $16,466.59 | ↑ +339% |
| Aetna | Commercial|HMO | $23,174.00 | ↑ +518% |
| Aetna | Commercial|PPO | $23,352.00 | ↑ +523% |
Visitor-reported prices
Comments
Excision breast lesion at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $798.54 | $275.99 – $1,175.02 |
| St. John's Camarillo Hospital | Camarillo | not published | $339.47 – $8,628.88 |
| Petaluma Valley Hospital | Petaluma | not published | $2,937.00 – $6,619.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $275.99 – $4,865.48 |
| French Hospital | San Luis Obispo | not published | $275.99 – $4,865.48 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $275.99 – $4,865.48 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $275.99 – $4,865.48 |
| Queen of The Valley Medical Center | Napa | not published | $5,559.37 – $16,652.00 |