Bx of breast open 19101 at ST HELENA HOSPITAL
10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082
$5,022.75
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.
$33,485.00
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.
$295.31 with VA MEDI-CAL vs $20,090.70 with GALAXY NETWORK-ALL 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 |
|---|---|---|---|
| VA MEDI-CAL | VA MEDI-CAL | $295.31 | ↓ -94% |
| BEECH STREET-ALL PLANS | BEECH STREET-ALL PLANS | $4,000.00 | ↓ -20% |
| HEALTHNET-ALL PLANS | HEALTHNET-ALL PLANS | $4,145.00 | ↓ -17% |
| TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $5,201.51 | ↑ +4% |
| BLUE SHIELD BH MCR ADV | BLUE SHIELD BH MCR ADV | $5,201.51 | ↑ +4% |
| KAISER MCR ADV | KAISER MCR ADV | $5,201.51 | ↑ +4% |
| VA MCR - ALL OTHER PLANS | VA MCR - ALL OTHER PLANS | $5,201.51 | ↑ +4% |
| BLUE SHIELD MCR ADV | BLUE SHIELD MCR ADV | $5,201.51 | ↑ +4% |
| UHC MCR ADV | UHC MCR ADV | $5,201.51 | ↑ +4% |
| BLUE CROSS EXCHANGE | BLUE CROSS EXCHANGE | $5,495.00 | ↑ +9% |
| AETNA-ALL PLANS | AETNA-ALL PLANS | $5,628.50 | ↑ +12% |
| BLUE CROSS NON MCS | BLUE CROSS NON MCS | $6,187.00 | ↑ +23% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $7,424.00 | ↑ +48% |
| INTERPLAN-ALL PLANS | INTERPLAN-ALL PLANS | $8,500.00 | ↑ +69% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $9,362.72 | ↑ +86% |
| UHC SELECT/SELECT PLUS | UHC SELECT/SELECT PLUS | $9,895.79 | ↑ +97% |
| BLUE SHIELD BEHAV HLTH | BLUE SHIELD BEHAV HLTH | $10,045.35 | ↑ +100% |
| BLUE SHIELD EPN-ALL OTHER PLANS | BLUE SHIELD EPN-ALL OTHER PLANS | $10,636.71 | ↑ +112% |
| UHC JLL | UHC JLL | $10,659.23 | ↑ +112% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $10,891.05 | ↑ +117% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $11,219.54 | ↑ +123% |
| PHCS-ALL PLANS | PHCS-ALL PLANS | $12,277.65 | ↑ +144% |
| UMR UHC PPO | UMR UHC PPO | $14,208.59 | ↑ +183% |
| UHC OPTIONS PPO | UHC OPTIONS PPO | $14,230.91 | ↑ +183% |
| CHOICECARE-ALL PLANS | CHOICECARE-ALL PLANS | $15,626.10 | ↑ +211% |
| CIGNA-ALL OTHER PLANS | CIGNA-ALL OTHER PLANS | $17,858.40 | ↑ +256% |
| KAISER-ALL OTHER PLANS | KAISER-ALL OTHER PLANS | $18,304.86 | ↑ +264% |
| WESTERN GROWERS-ALL PLANS | WESTERN GROWERS-ALL PLANS | $18,756.00 | ↑ +273% |
| HEALTH MANAGEMENT NETWORK-ALL PLANS | HEALTH MANAGEMENT NETWORK-ALL PLANS | $18,974.55 | ↑ +278% |
| THREE RIVERS-ALL PLANS | THREE RIVERS-ALL PLANS | $20,090.70 | ↑ +300% |
| GALAXY NETWORK-ALL PLANS | GALAXY NETWORK-ALL PLANS | $20,090.70 | ↑ +300% |
Visitor-reported prices
Comments
Bx of breast open 19101 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Vallejo Medical Center | VALLEJO | $11,121.60 | not published |
| Fresno Medical Center | FRESNO | $11,121.60 | not published |
| Antioch Medical Center | ANTIOCH | $11,121.60 | not published |
| Redwood City Medical Center | Redwood City | $11,121.60 | not published |
| Santa Clara Medical Center | SANTA CLARA | $11,121.60 | not published |
| Baldwin Park Medical Center | BALDWIN PARK | $4,992.00 | not published |
| Riverside Medical Center | RIVERSIDE | $4,992.00 | not published |
| Fremont Medical Center | FREMONT | $11,121.60 | not published |