Bx pleura pq ndl at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$1,089.15
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.
$3,975.00
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.
$82.14 with Hill Physicians vs $10,485.00 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 | $82.14 | ↓ -92% |
| United | Medicaid|< 21 | $153.80 | ↓ -86% |
| United | Medicaid|> 21 | $153.80 | ↓ -86% |
| Molina | Medicaid|All Plans | $251.98 | ↓ -77% |
| BCBS - Anthem | Medicaid|All Plans | $254.66 | ↓ -77% |
| Hill Physicians | Medicaid|All Plans | $266.68 | ↓ -76% |
| WCMG | Commercial|All Plans | $416.46 | ↓ -62% |
| California Health & Wellness | Medicaid|All Plans | $555.19 | ↓ -49% |
| Health Net | Medicaid|All Plans | $555.19 | ↓ -49% |
| Partnership Health Plan | Medicaid|All Plans | $826.69 | ↓ -24% |
| Western Health Advantage | Commercial|All Plans | $1,325.10 | ↑ +22% |
| Kaiser | Medicaid|All Plans | $1,552.26 | ↑ +43% |
| BCBS - Anthem | Medicare|All Other Plans | $2,007.80 | ↑ +84% |
| Kaiser | Commercial|All Plans | $2,044.44 | ↑ +88% |
| Kaiser | Medicare|All Plans | $2,129.16 | ↑ +95% |
| Humana | Medicare|All Plans | $2,129.16 | ↑ +95% |
| Humana | Commercial|All Plans | $2,129.16 | ↑ +95% |
| Aetna | Medicare|All Plans | $2,129.16 | ↑ +95% |
| Molina | Medicare|All Plans | $2,129.16 | ↑ +95% |
| United | Medicare|All Plans | $2,129.16 | ↑ +95% |
| Blue Shield CA | Medicare|PPO | $2,129.16 | ↑ +95% |
| Blue Shield CA | Medicare|HMO | $2,129.16 | ↑ +95% |
| BCBS - Anthem | Medicare|Imperial | $2,193.03 | ↑ +101% |
| BrightHealth | Commercial|All Plans | $2,342.08 | ↑ +115% |
| BlueShield | Medicare|Trauma | $2,661.45 | ↑ +144% |
| Healthsmart | Commercial|All Plans | $2,839.50 | ↑ +161% |
| First Health | Commercial|All Plans | $2,839.50 | ↑ +161% |
| Sutter Health | Commercial|All Plans | $3,028.80 | ↑ +178% |
| MultiPlan | Commercial|All Plans | $3,142.38 | ↑ +189% |
| Prison Healthcare | Medicaid|All Plans | $3,193.74 | ↑ +193% |
| Blue Shield CA | Commercial|ACO Trio | $3,310.00 | ↑ +204% |
| United | Commercial|Options PPO | $3,786.00 | ↑ +248% |
| United | Commercial|Non-Options PPO | $3,786.00 | ↑ +248% |
| United | Commercial|HMO | $3,786.00 | ↑ +248% |
| United | Commercial|All Other Plans | $3,786.00 | ↑ +248% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $4,218.00 | ↑ +287% |
| BCBS - Anthem | Commercial|Connection EPO | $4,277.00 | ↑ +293% |
| Blue Shield CA | Commercial|Exchange | $4,280.00 | ↑ +293% |
| Aetna | Commercial|All Other Plans | $5,178.00 | ↑ +375% |
| Aetna | Commercial|HMO | $5,178.00 | ↑ +375% |
| Aetna | Commercial|PPO | $5,178.00 | ↑ +375% |
| BCBS - Anthem | Commercial|All Other Plans | $5,346.00 | ↑ +391% |
| Blue Shield CA | Commercial|PPO Tandem | $5,625.00 | ↑ +416% |
| Health Net | Commercial|EPPO | $5,780.00 | ↑ +431% |
| Blue Shield CA | Commercial|HMO | $6,255.00 | ↑ +474% |
| Blue Shield CA | Commercial|CalPers | $6,584.00 | ↑ +505% |
| Blue Shield CA | Commercial|PPO | $6,776.00 | ↑ +522% |
| BCBS - Anthem | Commercial|MCS | $7,484.00 | ↑ +587% |
| Health Net | Commercial|FFS | $10,485.00 | ↑ +863% |
Visitor-reported prices
Comments
Bx pleura pq ndl at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $833.52 | $189.17 – $3,763.88 |
| Arroyo Grande Hospital | Santa Maria | $2,385.25 | $153.80 – $5,251.82 |
| Mark Twain Medical Center | San Andreas | $2,068.60 | $153.80 – $1,332.80 |
| French Hospital | San Luis Obispo | $2,019.98 | $153.80 – $3,448.62 |
| Mercy Hospitals – Bakersfield | Bakersfield | $2,038.65 | $153.80 – $1,306.00 |
| Bakersfield Memorial Hospital | Bakersfield | $2,016.67 | $153.80 – $1,306.00 |
| Providence St Joseph Hospital Eureka | Eureka | $3,032.97 | $2,124.23 – $9,858.00 |
| St. Joseph's Medical Center Stockton | Stockton | $1,474.41 | $0.80 – $557.00 |