Bx of breast open 19101 at Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
$4,322.15
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.
$12,349.00
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.
$1,528.38 with Blue Shield vs $11,827.00 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 | $1,528.38 | ↓ -65% |
| Blue Shield | Epn/Ifp Benefit Exchange | $4,399.29 | ↑ +2% |
| Aetna | Medicare Managed Care Plan | $5,035.90 | ↑ +17% |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $5,107.50 | ↑ +18% |
| Humana | Choicecare Medicare Managed Care Plan | $5,136.62 | ↑ +19% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $5,276.01 | ↑ +22% |
| Central Health Plan | Medicare Managed Care Plan | $5,539.49 | ↑ +28% |
| Blue Cross | All Commercial Plans | $5,559.00 | ↑ +29% |
| Blue Shield | Ppo/Epo | $5,673.39 | ↑ +31% |
| Blue Shield | Hmo | $5,673.39 | ↑ +31% |
| Unitedhealthcare | Select/Navigate Hmo | $5,821.00 | ↑ +35% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $5,942.28 | ↑ +37% |
| La Care Health Plan | Covered Ca Exchange | $6,546.67 | ↑ +51% |
| Unitedhealthcare | All Commercial Plans | $6,603.00 | ↑ +53% |
| Healthnet | Blue And Gold Other Commercial Plan | $7,332.00 | ↑ +70% |
| Cigna | All Commercial Plans | $9,297.00 | ↑ +115% |
| Healthnet | Ambetter Hmo | $9,316.42 | ↑ +116% |
| Healthnet | Ambetter Ppo | $10,776.83 | ↑ +149% |
| Healthnet | All Commercial Plans | $11,827.00 | ↑ +174% |
Visitor-reported prices
Comments
Bx of breast open 19101 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $3,912.09 | $236.25 – $5,535.04 |
| St. Joseph's Medical Center Stockton | Stockton | $6,389.21 | $236.25 – $18,254.88 |
| Providence St Joseph Hospital Orange | Orange | $5,204.64 | $4,035.00 – $9,316.42 |
| St. John's Camarillo Hospital | Camarillo | not published | $290.59 – $8,628.88 |
| Petaluma Valley Hospital | Petaluma | not published | $2,570.00 – $6,619.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $236.25 – $4,865.48 |
| French Hospital | San Luis Obispo | not published | $236.25 – $4,865.48 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $236.25 – $4,865.48 |