Biopsy lower leg soft tissue 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.
$2,238.00 with Blue Shield vs $12,908.00 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 | $2,238.00 | — |
| Healthnet | Medicare Managed Care Plan | $2,298.14 | — |
| Aetna | Medicare Managed Care Plan | $2,345.04 | — |
| Blue Shield | Hmo/Pos/Ppo | $2,728.00 | — |
| Unitedhealthcare | Select/Navigate Hmo | $2,741.00 | — |
| Unitedhealthcare | All Commercial Plans | $3,100.00 | — |
| Blue Cross | Epo Exchange | $4,042.00 | — |
| Blue Cross | Nonmcs All Commercial Plans | $4,836.00 | — |
| Blue Cross | Mcs All Commercial Plans | $5,803.00 | — |
| Healthnet | Hmo/Pos/Ppo | $9,858.00 | — |
| Aetna | All Commercial Plans | $12,908.00 | — |
Visitor-reported prices
Comments
Biopsy lower leg soft tissue at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $285.05 | $110.73 – $419.44 |
| Mercy Hospitals – Bakersfield | Bakersfield | $1,713.65 | $152.94 – $3,695.20 |
| Bakersfield Memorial Hospital | Bakersfield | $1,695.18 | $152.94 – $3,649.01 |
| St. Joseph's Medical Center Stockton | Stockton | $1,661.69 | $152.94 – $2,305.80 |
| Mercy Medical Center Merced | Merced | $2,440.59 | $152.94 – $4,691.61 |
| Sierra Nevada Memorial Hospital | Grass Valley | $2,673.77 | $152.94 – $2,997.82 |
| St. John's Camarillo Hospital | Camarillo | not published | $188.12 – $3,763.88 |
| Petaluma Valley Hospital | Petaluma | not published | $1,921.00 – $2,695.00 |