Biopsy of upper nose/throat at ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI
1100 Magellan Dr, Tehachapi, CA · Adventisthealth · · NPI 1275538530
$208.71
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.
$773.00
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.
$62.55 with KAISER MEDI-CAL IP/OP ONLY vs $523.31 with KAISER IP/OP ONLY- ALL OTHER PLANS — 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 |
|---|---|---|---|
| KAISER MEDI-CAL IP/OP ONLY | KAISER MEDI-CAL IP/OP ONLY | $62.55 | ↓ -70% |
| UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $62.55 | ↓ -70% |
| MEDI-CAL | MEDI-CAL | $62.55 | ↓ -70% |
| BC MCAL | BC MCAL | $64.43 | ↓ -69% |
| HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $76.75 | ↓ -63% |
| KHS-KERN HLTH SYSTM MCAL | KHS-KERN HLTH SYSTM MCAL | $80.69 | ↓ -61% |
| AETNA-ALL PLANS | AETNA-ALL PLANS | $112.12 | ↓ -46% |
| TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $117.56 | ↓ -44% |
| UHC MCR ADV | UHC MCR ADV | $117.56 | ↓ -44% |
| HEALTHNET MCARE | HEALTHNET MCARE | $117.56 | ↓ -44% |
| UNIVERSAL IPA MCR ADV OP/PROFEE ONLY-ALL OTHER PLA | UNIVERSAL IPA MCR ADV OP/PROFEE ONLY-ALL OTHER PLA | $117.56 | ↓ -44% |
| NETWORK PROVIDERS- ALL PLANS | NETWORK PROVIDERS- ALL PLANS | $128.14 | ↓ -39% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $129.32 | ↓ -38% |
| CIGNA- ALL PLANS | CIGNA- ALL PLANS | $132.55 | ↓ -36% |
| OSCAR HEALTH PLAN- ALL PLANS | OSCAR HEALTH PLAN- ALL PLANS | $135.19 | ↓ -35% |
| COVENTRY- ALL PLANS | COVENTRY- ALL PLANS | $141.07 | ↓ -32% |
| UHC JLL CSP | UHC JLL CSP | $148.96 | ↓ -29% |
| UHC ALL PAYER- ALL OTHER PLANS | UHC ALL PAYER- ALL OTHER PLANS | $148.96 | ↓ -29% |
| WESTERN GRWRS/PINNACLE - ALL PLANS | WESTERN GRWRS/PINNACLE - ALL PLANS | $163.41 | ↓ -22% |
| HEALTHNET- ALL OTHER PLANS | HEALTHNET- ALL OTHER PLANS | $171.28 | ↓ -18% |
| CENTIVO - ALL PLANS | CENTIVO - ALL PLANS | $176.34 | ↓ -16% |
| BLUE CROSS NON-MCS- ALL OTHER PLANS | BLUE CROSS NON-MCS- ALL OTHER PLANS | $217.48 | ↑ +4% |
| BLUE SHIELD EPN- ALL OTHER PLANS | BLUE SHIELD EPN- ALL OTHER PLANS | $300.05 | ↑ +44% |
| KAISER MEDICARE IP/OP ONLY | KAISER MEDICARE IP/OP ONLY | $304.25 | ↑ +46% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $317.09 | ↑ +52% |
| KLHP-KERN LEGACY EPO -ALL OTHER PLANS | KLHP-KERN LEGACY EPO -ALL OTHER PLANS | $386.50 | ↑ +85% |
| BLUE CROSS EXCHANGE | BLUE CROSS EXCHANGE | $401.34 | ↑ +92% |
| KAISER IP/OP ONLY- ALL OTHER PLANS | KAISER IP/OP ONLY- ALL OTHER PLANS | $523.31 | ↑ +151% |
Visitor-reported prices
Comments
Biopsy of upper nose/throat at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Fresno Medical Center | FRESNO | $8,965.60 | not published |
| Antioch Medical Center | ANTIOCH | $8,965.60 | not published |
| Redwood City Medical Center | Redwood City | $8,965.60 | not published |
| Santa Clara Medical Center | SANTA CLARA | $8,965.60 | not published |
| Baldwin Park Medical Center | BALDWIN PARK | $3,400.80 | not published |
| Riverside Medical Center | RIVERSIDE | $3,400.80 | not published |
| Fremont Medical Center | FREMONT | $8,965.60 | not published |
| Panorama Medical Center | PANORAMA CITY | $3,400.80 | not published |