Surgical pathology level 5 gross & microscopic examination at Providence Saint John's Health Center
2121 Santa Monica Blvd, Santa Monica, CA · Providence · · NPI 1124026273
$395.50
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.
$1,130.00
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.
$128.55 with Blue Cross vs $986.59 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 Cross | All Commercial Plans | $128.55 | ↓ -67% |
| Blue Shield | Epn/Ifp Benefit Exchange | $142.17 | ↓ -64% |
| Blue Shield | Medicare Managed Care Plan | $328.02 | ↓ -17% |
| Aetna | All Commercial Plans | $369.38 | ↓ -7% |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $398.84 | ↑ +1% |
| Blue Shield | Hmo | $443.57 | ↑ +12% |
| Blue Shield | Ppo/Epo | $443.57 | ↑ +12% |
| Aetna | Medicare Managed Care Plan | $461.02 | ↑ +17% |
| Humana | Choicecare Medicare Managed Care Plan | $470.24 | ↑ +19% |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $483.00 | ↑ +22% |
| Cigna | All Commercial Plans | $500.38 | ↑ +27% |
| Central Health Plan | Medicare Managed Care Plan | $507.12 | ↑ +28% |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $544.00 | ↑ +38% |
| Unitedhealthcare | All Commercial Plans | $566.82 | ↑ +43% |
| Unitedhealthcare | Select/Navigate Hmo | $566.82 | ↑ +43% |
| La Care Health Plan | Covered Ca Exchange | $599.33 | ↑ +52% |
| Healthnet | Ambetter Hmo | $852.89 | ↑ +116% |
| Healthnet | Ambetter Ppo | $986.59 | ↑ +149% |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $222.51 | $137.16 – $813.52 |
| Petaluma Valley Hospital | Petaluma | $653.82 | $163.66 – $566.82 |
| Arroyo Grande Hospital | Santa Maria | $141.24 | $109.34 – $536.77 |
| Mark Twain Medical Center | San Andreas | $291.05 | $56.81 – $215.18 |
| French Hospital | San Luis Obispo | $129.36 | $59.05 – $631.01 |
| Mercy Hospitals – Bakersfield | Bakersfield | $191.44 | $123.13 – $598.65 |
| Bakersfield Memorial Hospital | Bakersfield | $189.38 | $123.13 – $598.65 |
| Queen of The Valley Medical Center | Napa | $613.53 | $206.83 – $566.82 |