Arthrp w/prostc dstl rds at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
not published by hospital
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.
not published by hospital
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.
$967.34 with Hill Physicians vs $28,092.00 with Health Net — 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 |
|---|---|---|---|
| Hill Physicians | Commercial|All Plans | $967.34 | — |
| United | Medicaid|< 21 | $968.94 | — |
| United | Medicaid|> 21 | $968.94 | — |
| Molina | Medicaid|All Plans | $1,587.43 | — |
| Hill Physicians | Medicaid|All Plans | $1,680.13 | — |
| BCBS - Anthem | Medicaid|All Plans | $2,301.24 | — |
| Health Net | Medicaid|All Plans | $3,497.72 | — |
| California Health & Wellness | Medicaid|All Plans | $3,497.72 | — |
| Partnership Health Plan | Medicaid|All Plans | $5,208.07 | — |
| Blue Shield CA | Commercial|ACO Trio | $8,882.00 | — |
| Blue Shield CA | Commercial|ACO Trio CalPers | $11,325.00 | — |
| Aetna | Commercial|HMO | $11,393.00 | — |
| Aetna | Commercial|PPO | $11,393.00 | — |
| Aetna | Commercial|All Other Plans | $11,393.00 | — |
| Blue Shield CA | Commercial|Exchange | $12,281.00 | — |
| BCBS - Anthem | Commercial|Connection EPO | $13,725.00 | — |
| Health Net | Commercial|EPPO | $15,484.00 | — |
| Blue Shield CA | Commercial|PPO Tandem | $15,836.00 | — |
| BCBS - Anthem | Medicare|All Other Plans | $15,944.52 | — |
| Blue Shield CA | Commercial|HMO | $16,792.00 | — |
| Kaiser | Medicare|All Plans | $16,908.29 | — |
| Humana | Commercial|All Plans | $16,908.29 | — |
| Aetna | Medicare|All Plans | $16,908.29 | — |
| Blue Shield CA | Medicare|PPO | $16,908.29 | — |
| Humana | Medicare|All Plans | $16,908.29 | — |
| United | Medicare|All Plans | $16,908.29 | — |
| Blue Shield CA | Medicare|HMO | $16,908.29 | — |
| Molina | Medicare|All Plans | $16,908.29 | — |
| BCBS - Anthem | Commercial|All Other Plans | $17,156.00 | — |
| BCBS - Anthem | Medicare|Imperial | $17,415.54 | — |
| Blue Shield CA | Commercial|CalPers | $17,679.00 | — |
| BrightHealth | Commercial|All Plans | $18,599.12 | — |
| Blue Shield CA | Commercial|PPO | $19,040.00 | — |
| BlueShield | Medicare|Trauma | $21,135.36 | — |
| BCBS - Anthem | Commercial|MCS | $24,018.00 | — |
| Prison Healthcare | Medicaid|All Plans | $25,362.44 | — |
| Health Net | Commercial|FFS | $28,092.00 | — |
| United | Commercial|Options PPO | not published by hospital | — |
| United | Commercial|HMO | not published by hospital | — |
| United | Commercial|All Other Plans | not published by hospital | — |
| Kaiser | Medicaid|All Plans | not published by hospital | — |
| First Health | Commercial|All Plans | not published by hospital | — |
| MultiPlan | Commercial|All Plans | not published by hospital | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| Sutter Health | Commercial|All Plans | not published by hospital | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| Western Health Advantage | Commercial|All Plans | not published by hospital | — |
| WCMG | Commercial|All Plans | not published by hospital | — |
| United | Commercial|Non-Options PPO | not published by hospital | — |
Visitor-reported prices
Comments
Arthrp w/prostc dstl rds at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | not published | $1,191.80 – $32,697.16 |
| Petaluma Valley Hospital | Petaluma | not published | $4,129.00 – $20,143.00 |
| Arroyo Grande Hospital | Santa Maria | not published | $968.94 – $16,348.58 |
| Mark Twain Medical Center | San Andreas | not published | $968.94 – $968.94 |
| French Hospital | San Luis Obispo | not published | $968.94 – $16,348.58 |
| Mercy Hospitals – Bakersfield | Bakersfield | not published | $968.94 – $16,348.58 |
| Bakersfield Memorial Hospital | Bakersfield | not published | $968.94 – $16,348.58 |
| Queen of The Valley Medical Center | Napa | not published | $9,256.00 – $62,607.00 |