Biopsy eye muscle at Arroyo Grande Hospital
1400 E Church St, Santa Maria, CA · CommonSpirit Health · · NPI 1760510937
not published by hospital
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.
not published by hospital
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.
$153.02 with Partnership Health Plan vs $10,531.00 with Health Net — 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 | $153.02 | — |
| Partnership Health Plan | Medicaid|< 21 | $153.02 | — |
| CenCal | Medicaid|< 21 | $153.09 | — |
| CenCal | Medicaid|> 21 | $153.09 | — |
| Health Net | Medicaid|< 21 | $231.50 | — |
| Health Net | Medicaid|> 21 | $231.50 | — |
| Blue Shield CA | Commercial|Exchange | $4,486.00 | — |
| Kaiser | Medicare|All Plans | $4,791.43 | — |
| Scan Health Plan | Medicare|All Plans | $4,791.43 | — |
| Aetna | Medicare|All Plans | $4,791.43 | — |
| United | Medicare|All Plans | $4,791.43 | — |
| Humana | Medicare|All Plans | $4,791.43 | — |
| Alignment | Medicare|All Plans | $4,791.43 | — |
| BCBS - Anthem | Medicare|All Plans | $4,791.43 | — |
| Aetna | Commercial|All Other Plans | $5,710.00 | — |
| Aetna | Commercial|PPO | $5,710.00 | — |
| Aetna | Commercial|HMO | $5,710.00 | — |
| Blue Shield CA | Commercial|FFS | $6,515.00 | — |
| Health Net | Commercial|Care Product | $9,300.00 | — |
| Health Net | Commercial|FFS | $10,531.00 | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| United | Commercial|Non-Options PPO | not published by hospital | — |
| United | Commercial|Options PPO | not published by hospital | — |
| United | Commercial|HMO | not published by hospital | — |
| United | Commercial|All Other Plans | not published by hospital | — |
| First Health | Commercial|All Plans | not published by hospital | — |
| MultiPlan | Commercial|All Plans | not published by hospital | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| Western Growers | Commercial|All Plans | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy eye muscle at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | not published | $231.50 – $8,773.70 |
| Petaluma Valley Hospital | Petaluma | not published | $1,921.00 – $11,185.00 |
| Mark Twain Medical Center | San Andreas | not published | $153.02 – $153.02 |
| French Hospital | San Luis Obispo | not published | $153.02 – $4,791.43 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $153.02 – $4,791.43 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $153.02 – $4,791.43 |
| Queen of The Valley Medical Center | Napa | not published | $5,582.04 – $17,909.00 |
| Providence St Joseph Hospital Eureka | Eureka | not published | $5,056.43 – $17,611.00 |