Biopsy abdominal mass at Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
$1,450.05
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.
$4,143.00
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.
$1,142.09 with Blue Shield vs $7,176.00 with Healthnet — 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 |
|---|---|---|---|
| Blue Shield | Medicare Managed Care Plan | $1,142.09 | ↓ -21% |
| Blue Shield | Epn/Ifp Benefit Exchange | $1,668.52 | ↑ +15% |
| Aetna | Medicare Managed Care Plan | $2,124.23 | ↑ +46% |
| Humana | Choicecare Medicare Managed Care Plan | $2,166.71 | ↑ +49% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $2,225.51 | ↑ +53% |
| Central Health Plan | Medicare Managed Care Plan | $2,336.65 | ↑ +61% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $2,506.56 | ↑ +73% |
| La Care Health Plan | Covered Ca Exchange | $2,761.50 | ↑ +90% |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $3,816.60 | ↑ +163% |
| Healthnet | Ambetter Hmo | $3,929.83 | ↑ +171% |
| Blue Cross | All Commercial Plans | $4,005.00 | ↑ +176% |
| Unitedhealthcare | Select/Navigate Hmo | $4,099.00 | ↑ +183% |
| Blue Shield | Ppo/Epo | $4,239.46 | ↑ +192% |
| Blue Shield | Hmo | $4,239.46 | ↑ +192% |
| Healthnet | Blue And Gold Other Commercial Plan | $4,449.00 | ↑ +207% |
| Healthnet | Ambetter Ppo | $4,545.85 | ↑ +213% |
| Unitedhealthcare | All Commercial Plans | $4,649.00 | ↑ +221% |
| Cigna | All Commercial Plans | $5,977.00 | ↑ +312% |
| Healthnet | All Commercial Plans | $7,176.00 | ↑ +395% |
Visitor-reported prices
Comments
Biopsy abdominal mass at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $833.52 | $352.59 – $3,763.88 |
| Arroyo Grande Hospital | Santa Maria | $2,163.12 | $286.66 – $3,120.32 |
| Mark Twain Medical Center | San Andreas | $2,021.31 | $286.66 – $1,300.46 |
| French Hospital | San Luis Obispo | $1,842.40 | $286.66 – $3,317.30 |
| Mercy Hospitals – Bakersfield | Bakersfield | $1,941.45 | $286.66 – $4,186.40 |
| Bakersfield Memorial Hospital | Bakersfield | $1,920.52 | $286.66 – $4,134.07 |
| Queen of The Valley Medical Center | Napa | $4,687.92 | $2,345.04 – $9,858.00 |
| Providence St Joseph Hospital Eureka | Eureka | $5,381.01 | $2,124.23 – $9,858.00 |