Adh-sendout at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$12.33
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.
$45.00
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.
$4.95 with WCMG vs $100.22 with Cigna — 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 |
|---|---|---|---|
| WCMG | Commercial|All Plans | $4.95 | ↓ -60% |
| Blue Shield CA | Commercial|ACO Trio | $13.95 | ↑ +13% |
| Western Health Advantage | Commercial|All Plans | $15.75 | ↑ +28% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $18.00 | ↑ +46% |
| Kaiser | Medicaid|All Plans | $18.45 | ↑ +50% |
| Blue Shield CA | Commercial|Exchange | $18.90 | ↑ +53% |
| Kaiser | Commercial|All Plans | $24.30 | ↑ +97% |
| Blue Shield CA | Commercial|PPO Tandem | $24.75 | ↑ +101% |
| Blue Shield CA | Commercial|HMO | $26.55 | ↑ +115% |
| Blue Shield CA | Commercial|CalPers | $27.90 | ↑ +126% |
| Blue Shield CA | Commercial|PPO | $29.70 | ↑ +141% |
| Partnership Health Plan | Medicaid|All Plans | $30.17 | ↑ +145% |
| BCBS - Anthem | Medicare|All Other Plans | $32.01 | ↑ +160% |
| First Health | Commercial|All Plans | $33.75 | ↑ +174% |
| Healthsmart | Commercial|All Plans | $33.75 | ↑ +174% |
| United | Medicare|All Plans | $33.94 | ↑ +175% |
| Humana | Medicare|All Plans | $33.94 | ↑ +175% |
| Aetna | Medicare|All Plans | $33.94 | ↑ +175% |
| Molina | Medicare|All Plans | $33.94 | ↑ +175% |
| Humana | Commercial|All Plans | $33.94 | ↑ +175% |
| Kaiser | Medicare|All Plans | $33.94 | ↑ +175% |
| Blue Shield CA | Medicare|HMO | $33.94 | ↑ +175% |
| Blue Shield CA | Medicare|PPO | $33.94 | ↑ +175% |
| Hill Physicians | Commercial|All Plans | $33.94 | ↑ +175% |
| BCBS - Anthem | Medicare|Imperial | $34.96 | ↑ +184% |
| Sutter Health | Commercial|All Plans | $36.00 | ↑ +192% |
| BCBS - Anthem | Commercial|Connection EPO | $36.00 | ↑ +192% |
| BrightHealth | Commercial|All Plans | $37.33 | ↑ +203% |
| MultiPlan | Commercial|All Plans | $37.35 | ↑ +203% |
| United | Commercial|All Other Plans | $40.73 | ↑ +230% |
| United | Commercial|Non-Options PPO | $40.73 | ↑ +230% |
| United | Commercial|Options PPO | $40.73 | ↑ +230% |
| United | Commercial|HMO | $40.73 | ↑ +230% |
| BlueShield | Medicare|Trauma | $42.42 | ↑ +244% |
| United | Medicaid|< 21 | $43.28 | ↑ +251% |
| United | Medicaid|> 21 | $43.28 | ↑ +251% |
| BCBS - Anthem | Commercial|All Other Plans | $45.00 | ↑ +265% |
| BCBS - Anthem | Medicaid|All Plans | $45.00 | ↑ +265% |
| BCBS - Anthem | Commercial|MCS | $45.00 | ↑ +265% |
| Aetna | Commercial|All Other Plans | $45.00 | ↑ +265% |
| Molina | Medicaid|All Plans | $45.00 | ↑ +265% |
| Aetna | Commercial|HMO | $45.00 | ↑ +265% |
| Aetna | Commercial|PPO | $45.00 | ↑ +265% |
| California Health & Wellness | Medicaid|All Plans | $45.00 | ↑ +265% |
| Hill Physicians | Medicaid|All Plans | $45.00 | ↑ +265% |
| Health Net | Medicaid|All Plans | $45.00 | ↑ +265% |
| Prison Healthcare | Medicaid|All Plans | $50.91 | ↑ +313% |
| Cigna | Commercial|LocalPlus | $75.16 | ↑ +510% |
| Cigna | Commercial|All Other Plans | $100.22 | ↑ +713% |
Visitor-reported prices
Comments
Adh-sendout at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $19.71 | $12.15 – $90.05 |
| Banner Lassen Medical Center | Susanville | $29.42 | $6.79 – $49.78 |
| Petaluma Valley Hospital | Petaluma | $15.30 | $33.26 – $278.14 |
| Arroyo Grande Hospital | Santa Maria | $96.84 | $22.50 – $87.45 |
| Mark Twain Medical Center | San Andreas | $29.97 | $24.36 – $44.10 |
| French Hospital | San Luis Obispo | $88.69 | $12.15 – $102.80 |
| Mercy Hospitals – Bakersfield | Bakersfield | $16.70 | $8.50 – $97.53 |
| Bakersfield Memorial Hospital | Bakersfield | $16.52 | $8.50 – $97.53 |