Bronchoscopy/lung bx each 31628 at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$1,109.98
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.
$4,051.00
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.
$172.97 with Hill Physicians vs $12,770.00 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 | $172.97 | ↓ -84% |
| United | Medicaid|> 21 | $241.81 | ↓ -78% |
| United | Medicaid|< 21 | $241.81 | ↓ -78% |
| Molina | Medicaid|All Plans | $396.15 | ↓ -64% |
| Hill Physicians | Medicaid|All Plans | $419.30 | ↓ -62% |
| WCMG | Commercial|All Plans | $445.61 | ↓ -60% |
| BCBS - Anthem | Medicaid|All Plans | $574.29 | ↓ -48% |
| California Health & Wellness | Medicaid|All Plans | $872.90 | ↓ -21% |
| Health Net | Medicaid|All Plans | $872.90 | ↓ -21% |
| Partnership Health Plan | Medicaid|All Plans | $1,299.70 | ↑ +17% |
| Western Health Advantage | Commercial|All Plans | $1,417.85 | ↑ +28% |
| Kaiser | Medicaid|All Plans | $1,660.91 | ↑ +50% |
| Kaiser | Commercial|All Plans | $2,187.54 | ↑ +97% |
| Healthsmart | Commercial|All Plans | $3,038.25 | ↑ +174% |
| First Health | Commercial|All Plans | $3,038.25 | ↑ +174% |
| Sutter Health | Commercial|All Plans | $3,240.80 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $3,362.33 | ↑ +203% |
| BCBS - Anthem | Medicare|All Other Plans | $3,820.10 | ↑ +244% |
| United | Medicare|All Plans | $4,051.00 | ↑ +265% |
| Humana | Medicare|All Plans | $4,051.00 | ↑ +265% |
| Aetna | Medicare|All Plans | $4,051.00 | ↑ +265% |
| Molina | Medicare|All Plans | $4,051.00 | ↑ +265% |
| United | Commercial|All Other Plans | $4,051.00 | ↑ +265% |
| Humana | Commercial|All Plans | $4,051.00 | ↑ +265% |
| United | Commercial|HMO | $4,051.00 | ↑ +265% |
| United | Commercial|Options PPO | $4,051.00 | ↑ +265% |
| United | Commercial|Non-Options PPO | $4,051.00 | ↑ +265% |
| Blue Shield CA | Medicare|PPO | $4,051.00 | ↑ +265% |
| BCBS - Anthem | Medicare|Imperial | $4,172.53 | ↑ +276% |
| Blue Shield CA | Commercial|ACO Trio | $4,430.00 | ↑ +299% |
| BrightHealth | Commercial|All Plans | $4,456.10 | ↑ +301% |
| Kaiser | Medicare|All Plans | $4,845.02 | ↑ +336% |
| Blue Shield CA | Medicare|HMO | $4,845.02 | ↑ +336% |
| BlueShield | Medicare|Trauma | $5,063.75 | ↑ +356% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $5,645.00 | ↑ +409% |
| Blue Shield CA | Commercial|Exchange | $5,727.00 | ↑ +416% |
| BCBS - Anthem | Commercial|Connection EPO | $7,209.00 | ↑ +549% |
| Aetna | Commercial|All Other Plans | $7,251.00 | ↑ +553% |
| Aetna | Commercial|PPO | $7,251.00 | ↑ +553% |
| Aetna | Commercial|HMO | $7,251.00 | ↑ +553% |
| Prison Healthcare | Medicaid|All Plans | $7,267.53 | ↑ +555% |
| Blue Shield CA | Commercial|PPO Tandem | $7,528.00 | ↑ +578% |
| Blue Shield CA | Commercial|HMO | $8,370.00 | ↑ +654% |
| Blue Shield CA | Commercial|CalPers | $8,811.00 | ↑ +694% |
| BCBS - Anthem | Commercial|All Other Plans | $9,011.00 | ↑ +712% |
| Blue Shield CA | Commercial|PPO | $9,068.00 | ↑ +717% |
| BCBS - Anthem | Commercial|MCS | $12,615.00 | ↑ +1037% |
| Health Net | Commercial|FFS | $12,770.00 | ↑ +1050% |
Visitor-reported prices
Comments
Bronchoscopy/lung bx each 31628 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $1,618.41 | $297.43 – $7,390.00 |
| Arroyo Grande Hospital | Santa Maria | $1,447.07 | $241.81 – $1,042.00 |
| French Hospital | San Luis Obispo | $396.32 | $241.81 – $1,011.00 |
| Mercy Hospitals – Bakersfield | Bakersfield | $483.05 | $241.81 – $1,302.00 |
| Bakersfield Memorial Hospital | Bakersfield | $477.84 | $241.81 – $1,302.00 |
| St. Joseph's Behavioral Health Center | Stockton | $732.03 | $128.20 – $1,282.00 |
| St. Joseph's Medical Center Stockton | Stockton | $372.21 | $241.81 – $1,266.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $2,836.80 | $3,281.00 – $8,871.26 |