Carotene at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$3.67
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.
$13.38
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.
$1.48 with WCMG vs $27.21 with Cigna — 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 |
|---|---|---|---|
| WCMG | Commercial|All Plans | $1.48 | ↓ -60% |
| Blue Shield CA | Commercial|ACO Trio | $4.15 | ↑ +13% |
| Western Health Advantage | Commercial|All Plans | $4.69 | ↑ +28% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $5.36 | ↑ +46% |
| Kaiser | Medicaid|All Plans | $5.49 | ↑ +50% |
| Blue Shield CA | Commercial|Exchange | $5.62 | ↑ +53% |
| Kaiser | Commercial|All Plans | $7.23 | ↑ +97% |
| Blue Shield CA | Commercial|PPO Tandem | $7.36 | ↑ +101% |
| Blue Shield CA | Commercial|HMO | $7.90 | ↑ +115% |
| Partnership Health Plan | Medicaid|All Plans | $8.20 | ↑ +123% |
| Blue Shield CA | Commercial|CalPers | $8.30 | ↑ +126% |
| BCBS - Anthem | Medicare|All Other Plans | $8.69 | ↑ +137% |
| Blue Shield CA | Commercial|PPO | $8.84 | ↑ +141% |
| United | Medicare|All Plans | $9.22 | ↑ +151% |
| Humana | Medicare|All Plans | $9.22 | ↑ +151% |
| Aetna | Medicare|All Plans | $9.22 | ↑ +151% |
| Molina | Medicare|All Plans | $9.22 | ↑ +151% |
| Humana | Commercial|All Plans | $9.22 | ↑ +151% |
| Kaiser | Medicare|All Plans | $9.22 | ↑ +151% |
| Blue Shield CA | Medicare|HMO | $9.22 | ↑ +151% |
| Blue Shield CA | Medicare|PPO | $9.22 | ↑ +151% |
| Hill Physicians | Commercial|All Plans | $9.22 | ↑ +151% |
| BCBS - Anthem | Medicare|Imperial | $9.50 | ↑ +159% |
| Healthsmart | Commercial|All Plans | $10.04 | ↑ +174% |
| First Health | Commercial|All Plans | $10.04 | ↑ +174% |
| BrightHealth | Commercial|All Plans | $10.14 | ↑ +176% |
| BCBS - Anthem | Commercial|Connection EPO | $10.71 | ↑ +192% |
| Sutter Health | Commercial|All Plans | $10.71 | ↑ +192% |
| United | Commercial|Non-Options PPO | $11.06 | ↑ +201% |
| United | Commercial|Options PPO | $11.06 | ↑ +201% |
| United | Commercial|HMO | $11.06 | ↑ +201% |
| United | Commercial|All Other Plans | $11.06 | ↑ +201% |
| MultiPlan | Commercial|All Plans | $11.11 | ↑ +203% |
| BlueShield | Medicare|Trauma | $11.53 | ↑ +214% |
| United | Medicaid|> 21 | $11.76 | ↑ +220% |
| United | Medicaid|< 21 | $11.76 | ↑ +220% |
| Hill Physicians | Medicaid|All Plans | $12.94 | ↑ +253% |
| BCBS - Anthem | Commercial|MCS | $13.38 | ↑ +265% |
| Aetna | Commercial|PPO | $13.38 | ↑ +265% |
| Aetna | Commercial|All Other Plans | $13.38 | ↑ +265% |
| BCBS - Anthem | Medicaid|All Plans | $13.38 | ↑ +265% |
| California Health & Wellness | Medicaid|All Plans | $13.38 | ↑ +265% |
| BCBS - Anthem | Commercial|All Other Plans | $13.38 | ↑ +265% |
| Molina | Medicaid|All Plans | $13.38 | ↑ +265% |
| Health Net | Medicaid|All Plans | $13.38 | ↑ +265% |
| Aetna | Commercial|HMO | $13.38 | ↑ +265% |
| Prison Healthcare | Medicaid|All Plans | $13.83 | ↑ +277% |
| Cigna | Commercial|LocalPlus | $20.41 | ↑ +456% |
| Cigna | Commercial|All Other Plans | $27.21 | ↑ +641% |
Visitor-reported prices
Comments
Carotene at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Banner Lassen Medical Center | Susanville | $10.02 | $1.84 – $15.52 |
| Petaluma Valley Hospital | Petaluma | $33.89 | $9.04 – $75.35 |
| Arroyo Grande Hospital | Santa Maria | $5.73 | $6.69 – $23.74 |
| Mark Twain Medical Center | San Andreas | $8.92 | $7.25 – $13.12 |
| French Hospital | San Luis Obispo | $5.25 | $3.62 – $27.91 |
| Mercy Hospitals – Bakersfield | Bakersfield | $4.97 | $6.00 – $26.48 |
| Bakersfield Memorial Hospital | Bakersfield | $4.92 | $6.00 – $26.48 |
| Queen of The Valley Medical Center | Napa | $33.89 | $9.22 – $95.22 |