Fomepizole 1 gram/ml intravenous solution at Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
$3,542.74
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.
$10,122.11
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.
$3.22 with Blue Cross vs $25.65 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 Cross | All Commercial Plans | $3.22 | ↓ -100% |
| Aetna | Medicare Managed Care Plan | $6.54 | ↓ -100% |
| Humana | Choicecare Medicare Managed Care Plan | $6.67 | ↓ -100% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $6.85 | ↓ -100% |
| Central Health Plan | Medicare Managed Care Plan | $7.19 | ↓ -100% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $7.72 | ↓ -100% |
| La Care Health Plan | Covered Ca Exchange | $8.50 | ↓ -100% |
| Healthnet | Ambetter Hmo | $12.10 | ↓ -100% |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $12.89 | ↓ -100% |
| Blue Shield | Hmo | $12.89 | ↓ -100% |
| Blue Shield | Medicare Managed Care Plan | $12.89 | ↓ -100% |
| Blue Shield | Ppo/Epo | $12.89 | ↓ -100% |
| Unitedhealthcare | All Commercial Plans | $13.24 | ↓ -100% |
| Unitedhealthcare | Select/Navigate Hmo | $13.24 | ↓ -100% |
| Healthnet | Ambetter Ppo | $13.99 | ↓ -100% |
| Aetna | All Commercial Plans | $15.16 | ↓ -100% |
| Blue Shield | Epn/Ifp Benefit Exchange | $16.67 | ↓ -100% |
| Cigna | All Commercial Plans | $25.65 | ↓ -99% |
Visitor-reported prices
Comments
Fomepizole 1 gram/ml intravenous solution at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $1,461.61 | $1.57 – $2,340.00 |
| Petaluma Valley Hospital | Petaluma | $2,461.64 | $1.47 – $13.24 |
| Arroyo Grande Hospital | Santa Maria | $6,490.62 | $2.60 – $12,075.56 |
| French Hospital | San Luis Obispo | $4,830.23 | $7.66 – $12,075.56 |
| Mercy Hospitals – Bakersfield | Bakersfield | $3,068.55 | $5.58 – $3,606.40 |
| Bakersfield Memorial Hospital | Bakersfield | $3,035.46 | $2.34 – $3,561.32 |
| Healdsburg Hospital | Healdsburg | $1,533.82 | $3.74 – $25.16 |
| Redwood Memorial Hospital | Fortuna | $1,533.82 | $1.90 – $1.90 |