Biopsy of heart lining at Santa Rosa Memorial Hospital
1165 Montgomery Dr, Santa Rosa, CA · Providence · · NPI 1134152549
$3,796.44
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.
$7,444.00
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.
$2,238.00 with Blue Shield vs $16,652.00 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 Shield | Epn Exchange | $2,238.00 | ↓ -41% |
| Blue Shield | Hmo/Pos/Ppo | $2,728.00 | ↓ -28% |
| Healthnet | Medicare Managed Care Plan | $4,393.52 | ↑ +16% |
| Aetna | Medicare Managed Care Plan | $4,483.19 | ↑ +18% |
| Blue Cross | Epo Exchange | $5,318.00 | ↑ +40% |
| Blue Cross | Nonmcs All Commercial Plans | $6,358.00 | ↑ +67% |
| Blue Cross | Mcs All Commercial Plans | $7,630.00 | ↑ +101% |
| Unitedhealthcare | Select/Navigate Hmo | $11,377.00 | ↑ +200% |
| Unitedhealthcare | All Commercial Plans | $12,866.00 | ↑ +239% |
| Aetna | All Commercial Plans | $12,908.00 | ↑ +240% |
| Healthnet | Hmo/Pos/Ppo | $16,652.00 | ↑ +339% |
Visitor-reported prices
Comments
Biopsy of heart lining at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $2,223.46 | $272.83 – $5,091.10 |
| French Hospital | San Luis Obispo | $1,973.72 | $272.83 – $4,934.30 |
| Bakersfield Memorial Hospital | Bakersfield | $2,251.55 | $272.83 – $4,846.65 |
| St. Joseph's Medical Center Stockton | Stockton | $1,803.69 | $272.83 – $5,153.40 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $2,006.88 | $3,429.00 – $7,883.00 |
| Mercy Medical Center Merced | Merced | $3,159.53 | $272.83 – $6,073.65 |
| Dominican Hospital | Santa Cruz | $1,465.65 | $272.83 – $10,194.41 |
| St. Mary Medical Center | Long Beach | $1,976.28 | $272.83 – $6,398.74 |