Allgrft implnt knee w/scope at Santa Rosa Memorial Hospital
1165 Montgomery Dr, Santa Rosa, CA · Providence · · NPI 1134152549
not published by hospital
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.
?
What you pay up front if you don't use insurance.
not published by hospital
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.
?
The hospital's undiscounted list price — almost no one pays this.
$8,992.00 with Blue Shield vs $62,607.00 with Healthnet — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | Epn Exchange | $8,992.00 | — |
| Blue Shield | Hmo/Pos/Ppo | $10,959.00 | — |
| Blue Cross | Epo Exchange | $12,568.00 | — |
| Blue Cross | Nonmcs All Commercial Plans | $15,025.00 | — |
| Unitedhealthcare | Select/Navigate Hmo | $15,575.00 | — |
| Unitedhealthcare | All Commercial Plans | $17,615.00 | — |
| Healthnet | Medicare Managed Care Plan | $17,864.57 | — |
| Blue Cross | Mcs All Commercial Plans | $18,030.00 | — |
| Aetna | Medicare Managed Care Plan | $18,229.15 | — |
| Aetna | All Commercial Plans | $19,505.00 | — |
| Healthnet | Hmo/Pos/Ppo | $62,607.00 | — |
Visitor-reported prices
Comments
Allgrft implnt knee w/scope at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $2,273.06 | $689.06 – $3,344.74 |
| St. John's Camarillo Hospital | Camarillo | not published | $847.54 – $32,697.16 |
| Petaluma Valley Hospital | Petaluma | not published | $7,716.00 – $17,301.54 |
| Arroyo Grande Hospital | Santa Maria | not published | $689.06 – $16,348.58 |
| French Hospital | San Luis Obispo | not published | $689.06 – $16,348.58 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $689.06 – $16,348.58 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $689.06 – $16,348.58 |
| Queen of The Valley Medical Center | Napa | not published | $12,159.00 – $62,607.00 |