Established Patient Office Visit (level 4) at ST HELENA HOSPITAL
10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082
$31.80
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.
$212.00
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.
$37.50 with MEDI-CAL vs $190.80 with THREE RIVERS-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 |
|---|---|---|---|
| MEDI-CAL | MEDI-CAL | $37.50 | ↑ +18% |
| TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $91.24 | ↑ +187% |
| CIGNA-ALL OTHER PLANS | CIGNA-ALL OTHER PLANS | $96.01 | ↑ +202% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $100.36 | ↑ +216% |
| UHC SELECT/SELECT PLUS | UHC SELECT/SELECT PLUS | $101.59 | ↑ +219% |
| UHC OPTIONS PPO | UHC OPTIONS PPO | $101.59 | ↑ +219% |
| UHC JLL | UHC JLL | $101.59 | ↑ +219% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $101.59 | ↑ +219% |
| INTERPLAN-ALL PLANS | INTERPLAN-ALL PLANS | $109.49 | ↑ +244% |
| KAISER-ALL OTHER PLANS | KAISER-ALL OTHER PLANS | $109.49 | ↑ +244% |
| PHCS-ALL PLANS | PHCS-ALL PLANS | $116.60 | ↑ +267% |
| AETNA-ALL PLANS | AETNA-ALL PLANS | $119.08 | ↑ +274% |
| WESTERN GROWERS-ALL PLANS | WESTERN GROWERS-ALL PLANS | $130.47 | ↑ +310% |
| BLUE SHIELD EPN-ALL OTHER PLANS | BLUE SHIELD EPN-ALL OTHER PLANS | $163.56 | ↑ +414% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $172.85 | ↑ +444% |
| BLUE CROSS NON MCS | BLUE CROSS NON MCS | $173.42 | ↑ +445% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $173.42 | ↑ +445% |
| HEALTH MANAGEMENT NETWORK-ALL PLANS | HEALTH MANAGEMENT NETWORK-ALL PLANS | $180.20 | ↑ +467% |
| THREE RIVERS-ALL PLANS | THREE RIVERS-ALL PLANS | $190.80 | ↑ +500% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $1,166.40 | $83.70 – $241.80 |
| Banner Lassen Medical Center | Susanville | $2,281.82 | $61.88 – $475.30 |
| Arroyo Grande Hospital | Santa Maria | $1,129.07 | $53.79 – $381.00 |
| Mark Twain Medical Center | San Andreas | $212.46 | $55.63 – $210.70 |
| French Hospital | San Luis Obispo | $784.40 | $53.79 – $373.38 |
| Mercy Hospitals – Bakersfield | Bakersfield | $140.61 | $66.81 – $303.20 |
| Bakersfield Memorial Hospital | Bakersfield | $134.33 | $66.81 – $314.82 |
| St. Joseph's Behavioral Health Center | Stockton | $69.67 | $12.20 – $105.53 |