Pr visit complexity e&m service serious/complex condition at ADVENTIST HEALTH TULARE
869 N Cherry St, Tulare, CA · Adventisthealth · · NPI 1801366711
$7.41
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.
$39.00
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.
$0.01 with AETNA-ALL PLANS vs $66.41 with BLUE CROSS NON MCS - 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 |
|---|---|---|---|
| AETNA-ALL PLANS | AETNA-ALL PLANS | $0.01 | ↓ -100% |
| BLUE SHIELD MCARE | BLUE SHIELD MCARE | $14.50 | ↑ +96% |
| FHCN PACE MCR ADV - ALL PLANS | FHCN PACE MCR ADV - ALL PLANS | $14.50 | ↑ +96% |
| HEALTHNET MEDICARE | HEALTHNET MEDICARE | $14.50 | ↑ +96% |
| UHC MCR ADV | UHC MCR ADV | $14.50 | ↑ +96% |
| TRICARE BLUE SHIELD-ALL PLANS | TRICARE BLUE SHIELD-ALL PLANS | $14.50 | ↑ +96% |
| UPN-UNITED PHYSCN NTWRK MCR ADV PROFEE ONLY-ALL OT | UPN-UNITED PHYSCN NTWRK MCR ADV PROFEE ONLY-ALL OT | $14.50 | ↑ +96% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $15.95 | ↑ +115% |
| INCENTIVE HLTH - ALL PLANS | INCENTIVE HLTH - ALL PLANS | $15.95 | ↑ +115% |
| HS INTERPLAN-ALL PLANS | HS INTERPLAN-ALL PLANS | $18.13 | ↑ +145% |
| CAL FORENSIC MED GRP - ALL PLANS | CAL FORENSIC MED GRP - ALL PLANS | $18.85 | ↑ +154% |
| CIGNA-ALL PLANS | CIGNA-ALL PLANS | $19.50 | ↑ +163% |
| HEALTHNET HMO/PPO - ALL OTHER PLANS | HEALTHNET HMO/PPO - ALL OTHER PLANS | $21.13 | ↑ +185% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $22.32 | ↑ +201% |
| UHC JLL | UHC JLL | $22.32 | ↑ +201% |
| BLUE SHIELD EPN | BLUE SHIELD EPN | $23.17 | ↑ +213% |
| BLUE SHIELD-ALL OTHER PLANS | BLUE SHIELD-ALL OTHER PLANS | $24.48 | ↑ +230% |
| MEDI-CAL | MEDI-CAL | $39.00 | ↑ +426% |
| HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $39.00 | ↑ +426% |
| CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $39.00 | ↑ +426% |
| BLUE CROSS MCAL | BLUE CROSS MCAL | $39.00 | ↑ +426% |
| UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $39.00 | ↑ +426% |
| BLUE CROSS NON MCS - ALL OTHER PLANS | BLUE CROSS NON MCS - ALL OTHER PLANS | $66.41 | ↑ +796% |
Visitor-reported prices
Comments
Pr visit complexity e&m service serious/complex condition at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $27.98 | $10.87 – $41.16 |
| Healdsburg Hospital | Healdsburg | $57.63 | not published |
| Redwood Memorial Hospital | Fortuna | $26.52 | not published |
| REEDLEY COMMUNITY HOSPITAL | Reedley | $7.41 | $0.01 – $78.00 |
| ST HELENA HOSPITAL | Vallejo | $6.45 | $0.01 – $82.75 |
| HANFORD COMMUNITY HOSPITAL | Selma | $7.41 | $0.01 – $74.00 |
| SAN JOAQUIN COMMUNITY HOSPITAL | Bakersfield | $7.08 | $0.05 – $75.60 |
| ADVENTIST HEALTH DELANO | Delano | $10.20 | $14.57 – $65.79 |