Biopsy of salivary gland 42400 at Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
$1,046.15
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.
$2,989.00
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.
$352.70 with Blue Shield vs $5,977.00 with Cigna — 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 | $352.70 | ↓ -66% |
| Aetna | Medicare Managed Care Plan | $910.78 | ↓ -13% |
| Humana | Choicecare Medicare Managed Care Plan | $928.99 | ↓ -11% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $954.20 | ↓ -9% |
| Central Health Plan | Medicare Managed Care Plan | $1,001.85 | ↓ -4% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $1,074.70 | ↑ +3% |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $1,178.65 | ↑ +13% |
| La Care Health Plan | Covered Ca Exchange | $1,184.01 | ↑ +13% |
| Blue Shield | Hmo | $1,309.24 | ↑ +25% |
| Blue Shield | Ppo/Epo | $1,309.24 | ↑ +25% |
| Blue Shield | Epn/Ifp Benefit Exchange | $1,406.90 | ↑ +34% |
| Healthnet | Blue And Gold Other Commercial Plan | $1,484.00 | ↑ +42% |
| Healthnet | Ambetter Hmo | $1,684.94 | ↑ +61% |
| Healthnet | Ambetter Ppo | $1,949.06 | ↑ +86% |
| Unitedhealthcare | Select/Navigate Hmo | $2,362.00 | ↑ +126% |
| Healthnet | All Commercial Plans | $2,391.00 | ↑ +129% |
| Unitedhealthcare | All Commercial Plans | $2,679.00 | ↑ +156% |
| Blue Cross | All Commercial Plans | $4,005.00 | ↑ +283% |
| Cigna | All Commercial Plans | $5,977.00 | ↑ +471% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $723.14 | $70.93 – $1,628.92 |
| Banner Lassen Medical Center | Susanville | $854.51 | $82.93 – $1,587.89 |
| Arroyo Grande Hospital | Santa Maria | $1,322.95 | $57.67 – $2,940.98 |
| Mark Twain Medical Center | San Andreas | $1,341.99 | $57.67 – $864.36 |
| French Hospital | San Luis Obispo | $1,087.41 | $57.67 – $1,940.40 |
| Mercy Hospitals – Bakersfield | Bakersfield | $912.66 | $57.67 – $1,968.00 |
| Bakersfield Memorial Hospital | Bakersfield | $902.82 | $57.67 – $1,943.40 |
| Queen of The Valley Medical Center | Napa | $843.03 | $1,005.45 – $6,200.00 |