Biopsy of salivary gland 42400 at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$529.37
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.
$1,932.00
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.
$55.03 with Hill Physicians vs $7,484.00 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 |
|---|---|---|---|
| Hill Physicians | Commercial|All Plans | $55.03 | ↓ -90% |
| United | Medicaid|< 21 | $57.67 | ↓ -89% |
| United | Medicaid|> 21 | $57.67 | ↓ -89% |
| Molina | Medicaid|All Plans | $94.49 | ↓ -82% |
| Hill Physicians | Medicaid|All Plans | $100.00 | ↓ -81% |
| BCBS - Anthem | Medicaid|All Plans | $136.97 | ↓ -74% |
| WCMG | Commercial|All Plans | $204.27 | ↓ -61% |
| Health Net | Medicaid|All Plans | $208.18 | ↓ -61% |
| California Health & Wellness | Medicaid|All Plans | $208.18 | ↓ -61% |
| Partnership Health Plan | Medicaid|All Plans | $310.00 | ↓ -41% |
| Western Health Advantage | Commercial|All Plans | $649.95 | ↑ +23% |
| Kaiser | Medicaid|All Plans | $761.37 | ↑ +44% |
| BCBS - Anthem | Medicare|All Other Plans | $871.89 | ↑ +65% |
| United | Medicare|All Plans | $924.59 | ↑ +75% |
| Blue Shield CA | Medicare|PPO | $924.59 | ↑ +75% |
| Blue Shield CA | Medicare|HMO | $924.59 | ↑ +75% |
| Aetna | Medicare|All Plans | $924.59 | ↑ +75% |
| Humana | Commercial|All Plans | $924.59 | ↑ +75% |
| Kaiser | Medicare|All Plans | $924.59 | ↑ +75% |
| Humana | Medicare|All Plans | $924.59 | ↑ +75% |
| Molina | Medicare|All Plans | $924.59 | ↑ +75% |
| BCBS - Anthem | Medicare|Imperial | $952.33 | ↑ +80% |
| Kaiser | Commercial|All Plans | $1,002.78 | ↑ +89% |
| BrightHealth | Commercial|All Plans | $1,017.05 | ↑ +92% |
| Blue Shield CA | Commercial|ACO Trio | $1,022.00 | ↑ +93% |
| BlueShield | Medicare|Trauma | $1,155.74 | ↑ +118% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $1,303.00 | ↑ +146% |
| Blue Shield CA | Commercial|Exchange | $1,322.00 | ↑ +150% |
| Prison Healthcare | Medicaid|All Plans | $1,386.88 | ↑ +162% |
| First Health | Commercial|All Plans | $1,392.75 | ↑ +163% |
| Healthsmart | Commercial|All Plans | $1,392.75 | ↑ +163% |
| Sutter Health | Commercial|All Plans | $1,485.60 | ↑ +181% |
| MultiPlan | Commercial|All Plans | $1,541.31 | ↑ +191% |
| Blue Shield CA | Commercial|PPO Tandem | $1,737.00 | ↑ +228% |
| United | Commercial|Options PPO | $1,857.00 | ↑ +251% |
| United | Commercial|Non-Options PPO | $1,857.00 | ↑ +251% |
| United | Commercial|HMO | $1,857.00 | ↑ +251% |
| United | Commercial|All Other Plans | $1,857.00 | ↑ +251% |
| Blue Shield CA | Commercial|HMO | $1,932.00 | ↑ +265% |
| Blue Shield CA | Commercial|CalPers | $2,033.00 | ↑ +284% |
| Blue Shield CA | Commercial|PPO | $2,093.00 | ↑ +295% |
| Health Net | Commercial|EPPO | $3,898.00 | ↑ +636% |
| BCBS - Anthem | Commercial|Connection EPO | $4,277.00 | ↑ +708% |
| Aetna | Commercial|HMO | $5,178.00 | ↑ +878% |
| Aetna | Commercial|All Other Plans | $5,178.00 | ↑ +878% |
| Aetna | Commercial|PPO | $5,178.00 | ↑ +878% |
| BCBS - Anthem | Commercial|All Other Plans | $5,346.00 | ↑ +910% |
| Health Net | Commercial|FFS | $7,070.00 | ↑ +1236% |
| BCBS - Anthem | Commercial|MCS | $7,484.00 | ↑ +1314% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $723.14 | $70.93 – $1,628.92 |
| Banner Lassen Medical Center | Susanville | $854.51 | $82.93 – $1,587.89 |
| Arroyo Grande Hospital | Santa Maria | $1,322.95 | $57.67 – $2,940.98 |
| Mark Twain Medical Center | San Andreas | $1,341.99 | $57.67 – $864.36 |
| French Hospital | San Luis Obispo | $1,087.41 | $57.67 – $1,940.40 |
| Mercy Hospitals – Bakersfield | Bakersfield | $912.66 | $57.67 – $1,968.00 |
| Bakersfield Memorial Hospital | Bakersfield | $902.82 | $57.67 – $1,943.40 |
| Queen of The Valley Medical Center | Napa | $843.03 | $1,005.45 – $6,200.00 |