Drainage absc/cyst/hmtma/vestibule mouth smpl at Santa Rosa Memorial Hospital
1165 Montgomery Dr, Santa Rosa, CA · Providence · · NPI 1134152549
$1,160.76
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.
$2,276.00
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.
$691.00 with Blue Shield vs $5,803.00 with Blue Cross — 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 | $691.00 | ↓ -40% |
| Blue Shield | Hmo/Pos/Ppo | $842.00 | ↓ -27% |
| Healthnet | Medicare Managed Care Plan | $985.34 | ↓ -15% |
| Aetna | Medicare Managed Care Plan | $1,005.45 | ↓ -13% |
| Unitedhealthcare | Select/Navigate Hmo | $2,741.00 | ↑ +136% |
| Unitedhealthcare | All Commercial Plans | $3,100.00 | ↑ +167% |
| Healthnet | Hmo/Pos/Ppo | $3,331.00 | ↑ +187% |
| Blue Cross | Epo Exchange | $4,042.00 | ↑ +248% |
| Blue Cross | Nonmcs All Commercial Plans | $4,836.00 | ↑ +317% |
| Blue Cross | Mcs All Commercial Plans | $5,803.00 | ↑ +400% |
Visitor-reported prices
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Drainage absc/cyst/hmtma/vestibule mouth smpl at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $962.88 | $593.00 – $2,695.00 |
| Queen of The Valley Medical Center | Napa | $1,145.97 | $1,005.45 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $1,043.46 | $910.78 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $469.20 | $721.00 – $954.10 |
| Redwood Memorial Hospital | Fortuna | $774.18 | $1,847.00 – $8,222.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $779.52 | $774.16 – $1,894.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $387.80 | $203.00 – $1,775.00 |
| Providence Saint Joseph Medical Center | Burbank | $793.10 | $202.00 – $1,807.00 |