Bx pleura pq ndl at Santa Rosa Memorial Hospital
1165 Montgomery Dr, Santa Rosa, CA · Providence · · NPI 1134152549
$2,022.15
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.
$3,965.00
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 $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 | ↑ +11% |
| Healthnet | Medicare Managed Care Plan | $2,298.14 | ↑ +14% |
| Aetna | Medicare Managed Care Plan | $2,345.04 | ↑ +16% |
| Blue Shield | Hmo/Pos/Ppo | $2,728.00 | ↑ +35% |
| Blue Cross | Epo Exchange | $4,042.00 | ↑ +100% |
| Unitedhealthcare | Select/Navigate Hmo | $4,737.00 | ↑ +134% |
| Blue Cross | Nonmcs All Commercial Plans | $4,836.00 | ↑ +139% |
| Unitedhealthcare | All Commercial Plans | $5,357.00 | ↑ +165% |
| Blue Cross | Mcs All Commercial Plans | $5,803.00 | ↑ +187% |
| Healthnet | Hmo/Pos/Ppo | $9,858.00 | ↑ +388% |
| Aetna | All Commercial Plans | $12,908.00 | ↑ +538% |
Visitor-reported prices
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Bx pleura pq ndl at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $833.52 | $189.17 – $3,763.88 |
| Arroyo Grande Hospital | Santa Maria | $2,385.25 | $153.80 – $5,251.82 |
| Mark Twain Medical Center | San Andreas | $2,068.60 | $153.80 – $1,332.80 |
| French Hospital | San Luis Obispo | $2,019.98 | $153.80 – $3,448.62 |
| Mercy Hospitals – Bakersfield | Bakersfield | $2,038.65 | $153.80 – $1,306.00 |
| Bakersfield Memorial Hospital | Bakersfield | $2,016.67 | $153.80 – $1,306.00 |
| Providence St Joseph Hospital Eureka | Eureka | $3,032.97 | $2,124.23 – $9,858.00 |
| St. Joseph's Medical Center Stockton | Stockton | $1,474.41 | $0.80 – $557.00 |