M/phmtrc alys ishquant/semiq at ST HELENA HOSPITAL
10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082
$72.00
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.
$480.00
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.
$62.06 with UHC SELECT/SELECT PLUS vs $1,603.91 with BLUE CROSS 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 |
|---|---|---|---|
| UHC SELECT/SELECT PLUS | UHC SELECT/SELECT PLUS | $62.06 | ↓ -14% |
| BLUE SHIELD BEHAV HLTH | BLUE SHIELD BEHAV HLTH | $63.00 | ↓ -13% |
| BLUE SHIELD NON-EPN | BLUE SHIELD NON-EPN | $64.96 | ↓ -10% |
| BLUE SHIELD EPN-ALL OTHER PLANS | BLUE SHIELD EPN-ALL OTHER PLANS | $65.94 | ↓ -8% |
| UHC JLL | UHC JLL | $66.85 | ↓ -7% |
| UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $70.36 | ↓ -2% |
| WESTERN GROWERS-ALL PLANS | WESTERN GROWERS-ALL PLANS | $74.20 | ↑ +3% |
| PHCS-ALL PLANS | PHCS-ALL PLANS | $77.00 | ↑ +7% |
| UMR UHC PPO | UMR UHC PPO | $89.11 | ↑ +24% |
| UHC OPTIONS PPO | UHC OPTIONS PPO | $89.25 | ↑ +24% |
| INTERPLAN-ALL PLANS | INTERPLAN-ALL PLANS | $91.00 | ↑ +26% |
| CHOICECARE-ALL PLANS | CHOICECARE-ALL PLANS | $98.00 | ↑ +36% |
| BEECH STREET-ALL PLANS | BEECH STREET-ALL PLANS | $105.00 | ↑ +46% |
| CIGNA-ALL OTHER PLANS | CIGNA-ALL OTHER PLANS | $112.00 | ↑ +56% |
| KAISER-ALL OTHER PLANS | KAISER-ALL OTHER PLANS | $114.80 | ↑ +59% |
| HEALTH MANAGEMENT NETWORK-ALL PLANS | HEALTH MANAGEMENT NETWORK-ALL PLANS | $119.00 | ↑ +65% |
| GALAXY NETWORK-ALL PLANS | GALAXY NETWORK-ALL PLANS | $126.00 | ↑ +75% |
| THREE RIVERS-ALL PLANS | THREE RIVERS-ALL PLANS | $126.00 | ↑ +75% |
| VA MEDI-CAL | VA MEDI-CAL | $140.00 | ↑ +94% |
| KAISER MCR ADV | KAISER MCR ADV | $226.33 | ↑ +214% |
| BLUE SHIELD MCR ADV | BLUE SHIELD MCR ADV | $226.33 | ↑ +214% |
| UHC MCR ADV | UHC MCR ADV | $226.33 | ↑ +214% |
| BLUE SHIELD BH MCR ADV | BLUE SHIELD BH MCR ADV | $226.33 | ↑ +214% |
| TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $226.33 | ↑ +214% |
| VA MCR - ALL OTHER PLANS | VA MCR - ALL OTHER PLANS | $226.33 | ↑ +214% |
| AH EMPLOYEE HEALTH PLAN - ALL PLANS | AH EMPLOYEE HEALTH PLAN - ALL PLANS | $407.39 | ↑ +466% |
| AETNA-ALL PLANS | AETNA-ALL PLANS | $793.09 | ↑ +1002% |
| HEALTHNET-ALL PLANS | HEALTHNET-ALL PLANS | $1,175.58 | ↑ +1533% |
| BLUE CROSS EXCHANGE | BLUE CROSS EXCHANGE | $1,202.94 | ↑ +1571% |
| BLUE CROSS NON MCS | BLUE CROSS NON MCS | $1,336.60 | ↑ +1756% |
| BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $1,603.91 | ↑ +2128% |
Visitor-reported prices
Comments
M/phmtrc alys ishquant/semiq at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Vallejo Medical Center | VALLEJO | $888.16 | $390.00 – $390.00 |
| Fresno Medical Center | FRESNO | $888.16 | $390.00 – $390.00 |
| St. John's Camarillo Hospital | Camarillo | $220.76 | $70.20 – $923.72 |
| Antioch Medical Center | ANTIOCH | $888.16 | $390.00 – $390.00 |
| Redwood City Medical Center | Redwood City | $888.16 | $390.00 – $390.00 |
| Santa Clara Medical Center | SANTA CLARA | $888.16 | $390.00 – $390.00 |
| Fremont Medical Center | FREMONT | $888.16 | $390.00 – $390.00 |
| Banner Lassen Medical Center | Susanville | $109.30 | $34.27 – $316.93 |