Observation/inpatient hospital care mod severity 99235 at ST HELENA HOSPITAL

10 Woodland Rd Saint Helena CA 94574|525 Oregon St, Vallejo, CA · Adventisthealth · · NPI 1720078082

Source: hospital's published price file ↗ · Published Jul 15, 2026 · Ingested Sep 16, 2026

$51.90

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$346.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$103.50 with MEDI-CAL vs $336.44 with BLUE CROSS NON MCS — 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 →

Payer
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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
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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 $103.50 ↑ +99%
KAISER MCR ADV KAISER MCR ADV $154.06 ↑ +197%
BLUE SHIELD MCR ADV BLUE SHIELD MCR ADV $154.06 ↑ +197%
BLUE SHIELD BH MCR ADV BLUE SHIELD BH MCR ADV $154.06 ↑ +197%
TRICARE BLUE SHIELD TRICARE BLUE SHIELD $154.06 ↑ +197%
AH EMPLOYEE HEALTH PLAN - ALL PLANS AH EMPLOYEE HEALTH PLAN - ALL PLANS $169.47 ↑ +227%
INTERPLAN-ALL PLANS INTERPLAN-ALL PLANS $184.87 ↑ +256%
KAISER-ALL OTHER PLANS KAISER-ALL OTHER PLANS $184.87 ↑ +256%
PHCS-ALL PLANS PHCS-ALL PLANS $190.30 ↑ +267%
CIGNA-ALL OTHER PLANS CIGNA-ALL OTHER PLANS $205.42 ↑ +296%
UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $217.29 ↑ +319%
UHC JLL UHC JLL $217.29 ↑ +319%
UHC SELECT/SELECT PLUS UHC SELECT/SELECT PLUS $217.29 ↑ +319%
UHC OPTIONS PPO UHC OPTIONS PPO $217.29 ↑ +319%
WESTERN GROWERS-ALL PLANS WESTERN GROWERS-ALL PLANS $220.31 ↑ +324%
AETNA-ALL PLANS AETNA-ALL PLANS $270.62 ↑ +421%
HEALTH MANAGEMENT NETWORK-ALL PLANS HEALTH MANAGEMENT NETWORK-ALL PLANS $294.10 ↑ +467%
BLUE SHIELD EPN-ALL OTHER PLANS BLUE SHIELD EPN-ALL OTHER PLANS $296.59 ↑ +471%
THREE RIVERS-ALL PLANS THREE RIVERS-ALL PLANS $311.40 ↑ +500%
BLUE SHIELD NON-EPN BLUE SHIELD NON-EPN $313.43 ↑ +504%
BLUE CROSS MCS - ALL OTHER PLANS BLUE CROSS MCS - ALL OTHER PLANS $336.44 ↑ +548%
BLUE CROSS NON MCS BLUE CROSS NON MCS $336.44 ↑ +548%

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Observation/inpatient hospital care mod severity 99235 at other California hospitals

Hospital City Cash price Negotiated range
REEDLEY COMMUNITY HOSPITAL Reedley $73.34 $4.77 – $303.42
HANFORD COMMUNITY HOSPITAL Selma $73.34 $103.50 – $303.42
SAN JOAQUIN COMMUNITY HOSPITAL Bakersfield $57.90 $103.50 – $307.52
ADVENTIST HEALTH MENDOCINO COAST Fort Bragg $254.76 $103.50 – $292.09
WILLITS HOSPITAL INC Willits $165.90 $103.50 – $308.00
LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi $27.86 $103.50 – $303.42
SONORA COMMUNITY HOSPITAL Sonora $65.62 $103.50 – $308.00
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi $104.22 $103.50 – $523.31

All California hospitals for this procedure →