Biliary endoscopy thru skin 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.
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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.
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The hospital's undiscounted list price — almost no one pays this.
$3,423.00 with Blue Shield vs $19,505.00 with Aetna — 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 | Epn Exchange | $3,423.00 | — |
| Blue Shield | Hmo/Pos/Ppo | $4,172.00 | — |
| Blue Cross | Epo Exchange | $5,318.00 | — |
| Blue Cross | Nonmcs All Commercial Plans | $6,358.00 | — |
| Blue Cross | Mcs All Commercial Plans | $7,630.00 | — |
| Healthnet | Medicare Managed Care Plan | $9,008.09 | — |
| Aetna | Medicare Managed Care Plan | $9,191.93 | — |
| Unitedhealthcare | Select/Navigate Hmo | $11,377.00 | — |
| Unitedhealthcare | All Commercial Plans | $12,866.00 | — |
| Healthnet | Hmo/Pos/Ppo | $16,652.00 | — |
| Aetna | All Commercial Plans | $19,505.00 | — |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $2,333.23 | $325.80 – $8,890.24 |
| Arroyo Grande Hospital | Santa Maria | $1,916.59 | $264.88 – $4,478.00 |
| French Hospital | San Luis Obispo | $1,755.38 | $264.88 – $4,478.00 |
| Mercy Hospitals – Bakersfield | Bakersfield | $3,687.00 | $264.88 – $7,950.40 |
| Bakersfield Memorial Hospital | Bakersfield | $3,039.50 | $264.88 – $6,542.78 |
| St. Joseph's Medical Center Stockton | Stockton | $5,673.03 | $264.88 – $6,617.52 |
| Mercy Medical Center Merced | Merced | $4,152.45 | $264.88 – $7,982.37 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $2,424.80 | $1,747.00 – $10,824.34 |