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.
$5,318.00 with Blue Cross vs $27,307.00 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 Cross | Epo Exchange | $5,318.00 | — |
| Blue Cross | Nonmcs All Commercial Plans | $6,358.00 | — |
| Blue Cross | Mcs All Commercial Plans | $7,630.00 | — |
| Blue Shield | Epn Exchange | $8,992.00 | — |
| Blue Shield | Hmo/Pos/Ppo | $10,959.00 | — |
| Healthnet | Medicare Managed Care Plan | $14,791.03 | — |
| Aetna | Medicare Managed Care Plan | $15,092.89 | — |
| Unitedhealthcare | Select/Navigate Hmo | $15,575.00 | — |
| Unitedhealthcare | All Commercial Plans | $17,615.00 | — |
| Aetna | All Commercial Plans | $19,505.00 | — |
| Healthnet | Hmo/Pos/Ppo | $27,307.00 | — |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $2,776.92 | $485.55 – $12,680.00 |
| Arroyo Grande Hospital | Santa Maria | $2,499.10 | $394.76 – $5,839.00 |
| French Hospital | San Luis Obispo | $2,288.89 | $394.76 – $5,839.00 |
| Mercy Hospitals – Bakersfield | Bakersfield | $7,389.95 | $394.76 – $15,935.20 |
| Bakersfield Memorial Hospital | Bakersfield | $7,310.28 | $394.76 – $15,736.01 |
| St. Joseph's Medical Center Stockton | Stockton | $6,438.90 | $394.76 – $15,917.16 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $2,858.40 | $8,912.00 – $20,774.00 |
| Mercy Medical Center Merced | Merced | $9,987.91 | $394.76 – $19,200.06 |