Optx medial ankle fx at Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
$5,779.90
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.
$16,514.00
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.
$1,746.72 with Blue Shield vs $25,913.00 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 | $1,746.72 | ↓ -70% |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $5,837.15 | ↑ +1% |
| Blue Shield | Ppo/Epo | $6,483.87 | ↑ +12% |
| Blue Shield | Hmo | $6,483.87 | ↑ +12% |
| Blue Cross | All Commercial Plans | $6,790.00 | ↑ +17% |
| Blue Shield | Epn/Ifp Benefit Exchange | $8,609.61 | ↑ +49% |
| Aetna | Medicare Managed Care Plan | $9,332.70 | ↑ +61% |
| Humana | Choicecare Medicare Managed Care Plan | $9,519.36 | ↑ +65% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $9,777.67 | ↑ +69% |
| Cigna | All Commercial Plans | $10,103.00 | ↑ +75% |
| Central Health Plan | Medicare Managed Care Plan | $10,265.97 | ↑ +78% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $11,012.44 | ↑ +91% |
| La Care Health Plan | Covered Ca Exchange | $12,132.52 | ↑ +110% |
| Unitedhealthcare | Select/Navigate Hmo | $13,460.00 | ↑ +133% |
| Unitedhealthcare | All Commercial Plans | $15,269.00 | ↑ +164% |
| Healthnet | Blue And Gold Other Commercial Plan | $16,065.00 | ↑ +178% |
| Healthnet | Ambetter Hmo | $17,265.50 | ↑ +199% |
| Healthnet | Ambetter Ppo | $19,971.99 | ↑ +246% |
| Healthnet | All Commercial Plans | $25,913.00 | ↑ +348% |
Visitor-reported prices
Comments
Optx medial ankle fx at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $13,391.07 | $2,937.00 – $15,313.00 |
| Mark Twain Medical Center | San Andreas | $1,062.94 | $412.89 – $1,564.08 |
| Queen of The Valley Medical Center | Napa | $14,889.45 | $7,745.00 – $35,965.00 |
| Providence St Joseph Hospital Eureka | Eureka | $14,977.68 | $8,925.00 – $35,965.00 |
| Healdsburg Hospital | Healdsburg | $8,128.38 | $3,572.00 – $9,776.62 |
| Redwood Memorial Hospital | Fortuna | $8,846.46 | $9,031.00 – $36,398.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $14,326.92 | $3,423.00 – $15,575.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $4,258.08 | $7,908.00 – $17,265.50 |