Established Patient Office Visit (level 5) at ST HELENA HOSPITAL
10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082
$47.40
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.
$316.00
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.
$57.20 with MEDI-CAL vs $284.40 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 | $57.20 | ↑ +21% |
| CIGNA-ALL OTHER PLANS | CIGNA-ALL OTHER PLANS | $135.75 | ↑ +186% |
| TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $135.99 | ↑ +187% |
| UHC SELECT/SELECT PLUS | UHC SELECT/SELECT PLUS | $143.49 | ↑ +203% |
| UHC OPTIONS PPO | UHC OPTIONS PPO | $143.49 | ↑ +203% |
| UHC JLL | UHC JLL | $143.49 | ↑ +203% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $143.49 | ↑ +203% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $149.59 | ↑ +216% |
| INTERPLAN-ALL PLANS | INTERPLAN-ALL PLANS | $163.19 | ↑ +244% |
| KAISER-ALL OTHER PLANS | KAISER-ALL OTHER PLANS | $163.19 | ↑ +244% |
| AETNA-ALL PLANS | AETNA-ALL PLANS | $168.34 | ↑ +255% |
| PHCS-ALL PLANS | PHCS-ALL PLANS | $173.80 | ↑ +267% |
| WESTERN GROWERS-ALL PLANS | WESTERN GROWERS-ALL PLANS | $194.47 | ↑ +310% |
| BLUE SHIELD EPN-ALL OTHER PLANS | BLUE SHIELD EPN-ALL OTHER PLANS | $195.58 | ↑ +313% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $206.69 | ↑ +336% |
| BLUE CROSS NON MCS | BLUE CROSS NON MCS | $246.21 | ↑ +419% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $246.21 | ↑ +419% |
| HEALTH MANAGEMENT NETWORK-ALL PLANS | HEALTH MANAGEMENT NETWORK-ALL PLANS | $268.60 | ↑ +467% |
| THREE RIVERS-ALL PLANS | THREE RIVERS-ALL PLANS | $284.40 | ↑ +500% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $822.12 | $102.00 – $313.56 |
| Arroyo Grande Hospital | Santa Maria | $254.66 | $82.05 – $480.00 |
| Mark Twain Medical Center | San Andreas | $317.69 | $71.92 – $272.44 |
| French Hospital | San Luis Obispo | $233.24 | $82.05 – $470.40 |
| Bakersfield Memorial Hospital | Bakersfield | $148.27 | $101.90 – $232.00 |
| Healdsburg Hospital | Healdsburg | $538.56 | not published |
| Redwood Memorial Hospital | Fortuna | $161.16 | not published |
| St. Joseph's Medical Center Stockton | Stockton | $143.18 | $82.05 – $399.34 |