Egd/remov tum/polyp/hot bx forcep 43250 at ST HELENA HOSPITAL
10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082
$93.90
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.
$626.00
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.
$165.12 with KAISER MCR ADV vs $853.40 with BLUE SHIELD NON-EPN — 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 MCR ADV | KAISER MCR ADV | $165.12 | ↑ +76% |
| BLUE SHIELD MCR ADV | BLUE SHIELD MCR ADV | $165.12 | ↑ +76% |
| BLUE SHIELD BH MCR ADV | BLUE SHIELD BH MCR ADV | $165.12 | ↑ +76% |
| TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $165.12 | ↑ +76% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $181.63 | ↑ +93% |
| INTERPLAN-ALL PLANS | INTERPLAN-ALL PLANS | $198.14 | ↑ +111% |
| KAISER-ALL OTHER PLANS | KAISER-ALL OTHER PLANS | $198.14 | ↑ +111% |
| CIGNA-ALL OTHER PLANS | CIGNA-ALL OTHER PLANS | $209.30 | ↑ +123% |
| UHC JLL | UHC JLL | $225.03 | ↑ +140% |
| UHC SELECT/SELECT PLUS | UHC SELECT/SELECT PLUS | $225.03 | ↑ +140% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $225.03 | ↑ +140% |
| UHC OPTIONS PPO | UHC OPTIONS PPO | $225.03 | ↑ +140% |
| WESTERN GROWERS-ALL PLANS | WESTERN GROWERS-ALL PLANS | $236.12 | ↑ +151% |
| MEDI-CAL | MEDI-CAL | $244.97 | ↑ +161% |
| AETNA-ALL PLANS | AETNA-ALL PLANS | $277.93 | ↑ +196% |
| PHCS-ALL PLANS | PHCS-ALL PLANS | $344.30 | ↑ +267% |
| BLUE CROSS NON MCS | BLUE CROSS NON MCS | $500.45 | ↑ +433% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $500.45 | ↑ +433% |
| HEALTH MANAGEMENT NETWORK-ALL PLANS | HEALTH MANAGEMENT NETWORK-ALL PLANS | $532.10 | ↑ +467% |
| THREE RIVERS-ALL PLANS | THREE RIVERS-ALL PLANS | $563.40 | ↑ +500% |
| BLUE SHIELD EPN-ALL OTHER PLANS | BLUE SHIELD EPN-ALL OTHER PLANS | $807.55 | ↑ +760% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $853.40 | ↑ +809% |
Visitor-reported prices
Comments
Egd/remov tum/polyp/hot bx forcep 43250 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Vallejo Medical Center | VALLEJO | $6,490.40 | not published |
| Fresno Medical Center | FRESNO | $6,490.40 | not published |
| Antioch Medical Center | ANTIOCH | $6,490.40 | not published |
| Redwood City Medical Center | Redwood City | $6,490.40 | not published |
| Santa Clara Medical Center | SANTA CLARA | $6,490.40 | not published |
| Baldwin Park Medical Center | BALDWIN PARK | $2,704.00 | not published |
| Riverside Medical Center | RIVERSIDE | $2,704.00 | not published |
| Fremont Medical Center | FREMONT | $6,490.40 | not published |