Cdna analysis for variants at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$112.34
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.
$410.00
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.
$21.89 with WCMG vs $546.89 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 | $21.89 | ↓ -81% |
| Western Health Advantage | Commercial|All Plans | $69.65 | ↓ -38% |
| Kaiser | Medicaid|All Plans | $81.59 | ↓ -27% |
| Kaiser | Commercial|All Plans | $107.46 | ↓ -4% |
| Healthsmart | Commercial|All Plans | $149.25 | ↑ +33% |
| First Health | Commercial|All Plans | $149.25 | ↑ +33% |
| BCBS - Anthem | Commercial|Connection EPO | $159.20 | ↑ +42% |
| Sutter Health | Commercial|All Plans | $159.20 | ↑ +42% |
| MultiPlan | Commercial|All Plans | $165.17 | ↑ +47% |
| BCBS - Anthem | Medicare|All Other Plans | $174.64 | ↑ +55% |
| Humana | Commercial|All Plans | $185.20 | ↑ +65% |
| Humana | Medicare|All Plans | $185.20 | ↑ +65% |
| Aetna | Medicare|All Plans | $185.20 | ↑ +65% |
| Molina | Medicare|All Plans | $185.20 | ↑ +65% |
| United | Medicare|All Plans | $185.20 | ↑ +65% |
| United | Medicaid|< 21 | $185.20 | ↑ +65% |
| United | Medicaid|> 21 | $185.20 | ↑ +65% |
| Kaiser | Medicare|All Plans | $185.20 | ↑ +65% |
| Blue Shield CA | Medicare|HMO | $185.20 | ↑ +65% |
| Blue Shield CA | Medicare|PPO | $185.20 | ↑ +65% |
| Partnership Health Plan | Medicaid|All Plans | $185.20 | ↑ +65% |
| Hill Physicians | Commercial|All Plans | $185.20 | ↑ +65% |
| BCBS - Anthem | Medicare|Imperial | $190.76 | ↑ +70% |
| Aetna | Commercial|HMO | $193.56 | ↑ +72% |
| Aetna | Commercial|All Other Plans | $193.56 | ↑ +72% |
| Aetna | Commercial|PPO | $193.56 | ↑ +72% |
| BCBS - Anthem | Commercial|MCS | $199.00 | ↑ +77% |
| Molina | Medicaid|All Plans | $199.00 | ↑ +77% |
| United | Commercial|Options PPO | $199.00 | ↑ +77% |
| BCBS - Anthem | Commercial|All Other Plans | $199.00 | ↑ +77% |
| BCBS - Anthem | Medicaid|All Plans | $199.00 | ↑ +77% |
| United | Commercial|All Other Plans | $199.00 | ↑ +77% |
| California Health & Wellness | Medicaid|All Plans | $199.00 | ↑ +77% |
| United | Commercial|Non-Options PPO | $199.00 | ↑ +77% |
| Hill Physicians | Medicaid|All Plans | $199.00 | ↑ +77% |
| Health Net | Medicaid|All Plans | $199.00 | ↑ +77% |
| United | Commercial|HMO | $199.00 | ↑ +77% |
| BrightHealth | Commercial|All Plans | $203.72 | ↑ +81% |
| BlueShield | Medicare|Trauma | $231.50 | ↑ +106% |
| Prison Healthcare | Medicaid|All Plans | $277.80 | ↑ +147% |
| Cigna | Commercial|LocalPlus | $410.13 | ↑ +265% |
| Cigna | Commercial|All Other Plans | $546.89 | ↑ +387% |
Visitor-reported prices
Comments
Cdna analysis for variants at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $99.43 | $61.29 – $491.39 |
| Banner Lassen Medical Center | Susanville | $318.09 | $37.04 – $549.99 |
| Petaluma Valley Hospital | Petaluma | $484.50 | $181.50 – $1,169.65 |
| Arroyo Grande Hospital | Santa Maria | $586.79 | $72.77 – $477.19 |
| Mark Twain Medical Center | San Andreas | $113.22 | $92.03 – $170.00 |
| French Hospital | San Luis Obispo | $537.44 | $39.30 – $560.97 |
| Mercy Hospitals – Bakersfield | Bakersfield | $166.95 | $153.63 – $532.20 |
| Bakersfield Memorial Hospital | Bakersfield | $165.15 | $153.63 – $532.20 |