Biopsy of heart lining at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$1,032.98
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.
$3,770.00
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.
$272.83 with United vs $17,696.00 with BCBS - Anthem — 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 |
|---|---|---|---|
| United | Medicaid|< 21 | $272.83 | ↓ -74% |
| United | Medicaid|> 21 | $272.83 | ↓ -74% |
| WCMG | Commercial|All Plans | $414.70 | ↓ -60% |
| Hill Physicians | Commercial|All Plans | $444.59 | ↓ -57% |
| Molina | Medicaid|All Plans | $446.99 | ↓ -57% |
| Hill Physicians | Medicaid|All Plans | $475.79 | ↓ -54% |
| BCBS - Anthem | Medicaid|All Plans | $647.98 | ↓ -37% |
| Health Net | Medicaid|All Plans | $990.52 | ↓ -4% |
| California Health & Wellness | Medicaid|All Plans | $990.52 | ↓ -4% |
| Western Health Advantage | Commercial|All Plans | $1,319.50 | ↑ +28% |
| Partnership Health Plan | Medicaid|All Plans | $1,466.48 | ↑ +42% |
| Kaiser | Medicaid|All Plans | $1,545.70 | ↑ +50% |
| Kaiser | Commercial|All Plans | $2,035.80 | ↑ +97% |
| Healthsmart | Commercial|All Plans | $2,827.50 | ↑ +174% |
| First Health | Commercial|All Plans | $2,827.50 | ↑ +174% |
| Sutter Health | Commercial|All Plans | $3,016.00 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $3,129.10 | ↑ +203% |
| Blue Shield CA | Commercial|ACO Trio | $3,310.00 | ↑ +220% |
| BCBS - Anthem | Medicare|All Other Plans | $3,555.11 | ↑ +244% |
| United | Commercial|Non-Options PPO | $3,770.00 | ↑ +265% |
| Blue Shield CA | Medicare|PPO | $3,770.00 | ↑ +265% |
| Humana | Commercial|All Plans | $3,770.00 | ↑ +265% |
| Aetna | Medicare|All Plans | $3,770.00 | ↑ +265% |
| Molina | Medicare|All Plans | $3,770.00 | ↑ +265% |
| United | Commercial|All Other Plans | $3,770.00 | ↑ +265% |
| United | Medicare|All Plans | $3,770.00 | ↑ +265% |
| United | Commercial|HMO | $3,770.00 | ↑ +265% |
| United | Commercial|Options PPO | $3,770.00 | ↑ +265% |
| Humana | Medicare|All Plans | $3,770.00 | ↑ +265% |
| BCBS - Anthem | Medicare|Imperial | $3,883.10 | ↑ +276% |
| Blue Shield CA | Medicare|HMO | $4,136.13 | ↑ +300% |
| Kaiser | Medicare|All Plans | $4,136.13 | ↑ +300% |
| BrightHealth | Commercial|All Plans | $4,147.00 | ↑ +301% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $4,218.00 | ↑ +308% |
| Blue Shield CA | Commercial|Exchange | $4,280.00 | ↑ +314% |
| BlueShield | Medicare|Trauma | $4,712.50 | ↑ +356% |
| Blue Shield CA | Commercial|PPO Tandem | $5,625.00 | ↑ +445% |
| Prison Healthcare | Medicaid|All Plans | $6,204.19 | ↑ +501% |
| Blue Shield CA | Commercial|HMO | $6,255.00 | ↑ +506% |
| Blue Shield CA | Commercial|CalPers | $6,584.00 | ↑ +537% |
| Blue Shield CA | Commercial|PPO | $6,776.00 | ↑ +556% |
| Health Net | Commercial|EPPO | $7,039.00 | ↑ +581% |
| BCBS - Anthem | Commercial|Connection EPO | $10,112.00 | ↑ +879% |
| BCBS - Anthem | Commercial|All Other Plans | $12,640.00 | ↑ +1124% |
| Health Net | Commercial|FFS | $12,770.00 | ↑ +1136% |
| Aetna | Commercial|HMO | $16,573.00 | ↑ +1504% |
| Aetna | Commercial|PPO | $16,573.00 | ↑ +1504% |
| Aetna | Commercial|All Other Plans | $16,573.00 | ↑ +1504% |
| BCBS - Anthem | Commercial|MCS | $17,696.00 | ↑ +1613% |
Visitor-reported prices
Comments
Biopsy of heart lining at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $2,223.46 | $272.83 – $5,091.10 |
| French Hospital | San Luis Obispo | $1,973.72 | $272.83 – $4,934.30 |
| Bakersfield Memorial Hospital | Bakersfield | $2,251.55 | $272.83 – $4,846.65 |
| St. Joseph's Medical Center Stockton | Stockton | $1,803.69 | $272.83 – $5,153.40 |
| Santa Rosa Memorial Hospital | Santa Rosa | $3,796.44 | $2,238.00 – $11,377.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $2,006.88 | $3,429.00 – $7,883.00 |
| Mercy Medical Center Merced | Merced | $3,159.53 | $272.83 – $6,073.65 |
| Dominican Hospital | Santa Cruz | $1,465.65 | $272.83 – $10,194.41 |