Biopsy of heart lining at Arroyo Grande Hospital
1400 E Church St, Santa Maria, CA · CommonSpirit Health · · NPI 1760510937
$2,223.46
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.
$5,195.00
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.
$272.83 with Partnership Health Plan vs $16,569.00 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 |
|---|---|---|---|
| Partnership Health Plan | Medicaid|> 21 | $272.83 | ↓ -88% |
| Partnership Health Plan | Medicaid|< 21 | $272.83 | ↓ -88% |
| Health Net | Medicaid|< 21 | $335.58 | ↓ -85% |
| Health Net | Medicaid|> 21 | $335.58 | ↓ -85% |
| CenCal | Medicaid|> 21 | $432.54 | ↓ -81% |
| CenCal | Medicaid|< 21 | $432.54 | ↓ -81% |
| Western Growers | Commercial|All Plans | $2,597.50 | ↑ +17% |
| Kaiser | Commercial|All Plans | $3,272.85 | ↑ +47% |
| United | Medicare|All Plans | $3,999.21 | ↑ +80% |
| Humana | Medicare|All Plans | $3,999.21 | ↑ +80% |
| Aetna | Medicare|All Plans | $3,999.21 | ↑ +80% |
| Kaiser | Medicare|All Plans | $3,999.21 | ↑ +80% |
| BCBS - Anthem | Medicare|All Plans | $3,999.21 | ↑ +80% |
| Alignment | Medicare|All Plans | $3,999.21 | ↑ +80% |
| Scan Health Plan | Medicare|All Plans | $3,999.21 | ↑ +80% |
| First Health | Commercial|All Plans | $4,363.80 | ↑ +96% |
| Blue Shield CA | Commercial|Exchange | $4,486.00 | ↑ +102% |
| United | Commercial|Non-Options PPO | $4,571.60 | ↑ +106% |
| United | Commercial|All Other Plans | $4,623.55 | ↑ +108% |
| Healthsmart | Commercial|All Plans | $4,779.40 | ↑ +115% |
| United | Commercial|Options PPO | $4,831.35 | ↑ +117% |
| MultiPlan | Commercial|All Plans | $5,091.10 | ↑ +129% |
| United | Commercial|HMO | $5,143.05 | ↑ +131% |
| Blue Shield CA | Commercial|FFS | $6,515.00 | ↑ +193% |
| Health Net | Commercial|Care Product | $9,300.00 | ↑ +318% |
| BCBS - Anthem | Commercial|Non-MCS | $9,303.00 | ↑ +318% |
| Health Net | Commercial|FFS | $10,531.00 | ↑ +374% |
| BCBS - Anthem | Commercial|MCS | $12,466.00 | ↑ +461% |
| Aetna | Commercial|PPO | $16,569.00 | ↑ +645% |
| Aetna | Commercial|All Other Plans | $16,569.00 | ↑ +645% |
| Aetna | Commercial|HMO | $16,569.00 | ↑ +645% |
Visitor-reported prices
Comments
Biopsy of heart lining at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| French Hospital | San Luis Obispo | $1,973.72 | $272.83 – $4,934.30 |
| Bakersfield Memorial Hospital | Bakersfield | $2,251.55 | $272.83 – $4,846.65 |
| St. Joseph's Medical Center Stockton | Stockton | $1,803.69 | $272.83 – $5,153.40 |
| Santa Rosa Memorial Hospital | Santa Rosa | $3,796.44 | $2,238.00 – $11,377.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $2,006.88 | $3,429.00 – $7,883.00 |
| Mercy Medical Center Merced | Merced | $3,159.53 | $272.83 – $6,073.65 |
| Dominican Hospital | Santa Cruz | $1,465.65 | $272.83 – $10,194.41 |
| St. Mary Medical Center | Long Beach | $1,976.28 | $272.83 – $6,398.74 |