Excision of mouth lesion complex 40816 at SONORA COMMUNITY HOSPITAL
1000 Greenley Rd, Sonora, CA · Adventisthealth · · NPI 1780673376
$183.43
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.
$1,079.00
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.
$20.00 with BC MCAL vs $6,054.00 with BC EXCHANGE — 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 |
|---|---|---|---|
| BC MCAL | BC MCAL | $20.00 | ↓ -89% |
| CENTRAL CA ALLIANCE MCAL | CENTRAL CA ALLIANCE MCAL | $20.00 | ↓ -89% |
| HEALTHNET MCAL | HEALTHNET MCAL | $20.00 | ↓ -89% |
| CELTIC CA HLTH WELL MCAL - ALL PLANS | CELTIC CA HLTH WELL MCAL - ALL PLANS | $20.00 | ↓ -89% |
| MEDI-CAL | MEDI-CAL | $20.00 | ↓ -89% |
| CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | $30.00 | ↓ -84% |
| CENTRAL CA ALLIANCE CCS MCAL | CENTRAL CA ALLIANCE CCS MCAL | $30.00 | ↓ -84% |
| CENTRAL CA ALLIANCE CHDP MCAL | CENTRAL CA ALLIANCE CHDP MCAL | $40.00 | ↓ -78% |
| KAISER - ALL PLANS | KAISER - ALL PLANS | $267.00 | ↑ +46% |
| UHC SELECT | UHC SELECT | $274.37 | ↑ +50% |
| TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $287.89 | ↑ +57% |
| HEALTHNET MCR ADV | HEALTHNET MCR ADV | $287.89 | ↑ +57% |
| BLUE SHIELD MCARE | BLUE SHIELD MCARE | $287.89 | ↑ +57% |
| UHC MCR ADV | UHC MCR ADV | $287.89 | ↑ +57% |
| CENTRAL CA ALLIANCE MCR ADV PROFEE ONLY | CENTRAL CA ALLIANCE MCR ADV PROFEE ONLY | $287.89 | ↑ +57% |
| UHC JLL BP | UHC JLL BP | $296.21 | ↑ +61% |
| UHC - ALL OTHER PLANS | UHC - ALL OTHER PLANS | $311.80 | ↑ +70% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $316.68 | ↑ +73% |
| WESTERN GROWERS/PINNACLE - ALL PLANS | WESTERN GROWERS/PINNACLE - ALL PLANS | $320.40 | ↑ +75% |
| CIGNA PPO - ALL PLANS | CIGNA PPO - ALL PLANS | $354.10 | ↑ +93% |
| GREATWEST OA/POS/HMO | GREATWEST OA/POS/HMO | $374.26 | ↑ +104% |
| GREATWEST PPO - ALL OTHER PLANS | GREATWEST PPO - ALL OTHER PLANS | $374.26 | ↑ +104% |
| BLUE SHIELD EPN | BLUE SHIELD EPN | $406.37 | ↑ +122% |
| BLUE SHIELD - ALL OTHER PLANS | BLUE SHIELD - ALL OTHER PLANS | $407.44 | ↑ +122% |
| HEALTHNET - ALL OTHER PLANS | HEALTHNET - ALL OTHER PLANS | $419.46 | ↑ +129% |
| TRPN - THREE RIVERS PPO - ALL PLANS | TRPN - THREE RIVERS PPO - ALL PLANS | $427.20 | ↑ +133% |
| BEECH STREET- ALL PLANS | BEECH STREET- ALL PLANS | $453.90 | ↑ +147% |
| UHC PPO | UHC PPO | $459.13 | ↑ +150% |
| MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $480.60 | ↑ +162% |
| AFFORDABLE HEALTH - ALL PLANS | AFFORDABLE HEALTH - ALL PLANS | $480.60 | ↑ +162% |
| INTERPLAN - ALL PLANS | INTERPLAN - ALL PLANS | $480.60 | ↑ +162% |
| PHCS PPO - ALL PLANS | PHCS PPO - ALL PLANS | $480.60 | ↑ +162% |
| STANILAUS FOUNDATION - ALL PLANS | STANILAUS FOUNDATION - ALL PLANS | $507.30 | ↑ +177% |
| AETNA - ALL OTHER PLANS | AETNA - ALL OTHER PLANS | $552.63 | ↑ +201% |
| BC NON-MCS - ALL OTHER PLANS | BC NON-MCS - ALL OTHER PLANS | $671.10 | ↑ +266% |
| BC MCS | BC MCS | $671.10 | ↑ +266% |
| PHS PRIME HEALTH SRVCS-ALL PLANS | PHS PRIME HEALTH SRVCS-ALL PLANS | $4,566.99 | ↑ +2390% |
| AETNA MCR ADV | AETNA MCR ADV | $4,566.99 | ↑ +2390% |
| BC EXCHANGE | BC EXCHANGE | $6,054.00 | ↑ +3200% |
Visitor-reported prices
Comments
Excision of mouth lesion complex 40816 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Fresno Medical Center | FRESNO | $8,820.00 | not published |
| Antioch Medical Center | ANTIOCH | $8,820.00 | not published |
| Redwood City Medical Center | Redwood City | $8,820.00 | not published |
| Santa Clara Medical Center | SANTA CLARA | $8,820.00 | not published |
| Fremont Medical Center | FREMONT | $8,820.00 | not published |
| Sacramento Medical Center | SACRAMENTO | $8,820.00 | not published |
| Oakland Medical Center | Oakland | $8,820.00 | not published |
| Walnut Creek Medical Center | WALNUT CREEK | $8,820.00 | not published |