Close lac/mouth vest/2.5 cm or < 40830 at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
not published by hospital
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.
not published by hospital
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.
$78.61 with United vs $16,573.00 with Aetna — 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 |
|---|---|---|---|
| United | Medicaid|< 21 | $78.61 | — |
| United | Medicaid|> 21 | $78.61 | — |
| Molina | Medicaid|All Plans | $128.78 | — |
| Hill Physicians | Medicaid|All Plans | $136.31 | — |
| Hill Physicians | Commercial|All Plans | $155.17 | — |
| BCBS - Anthem | Medicaid|All Plans | $186.69 | — |
| Health Net | Medicaid|All Plans | $283.78 | — |
| California Health & Wellness | Medicaid|All Plans | $283.78 | — |
| BCBS - Anthem | Medicare|All Other Plans | $287.77 | — |
| Molina | Medicare|All Plans | $305.16 | — |
| Blue Shield CA | Medicare|HMO | $305.16 | — |
| United | Medicare|All Plans | $305.16 | — |
| Blue Shield CA | Medicare|PPO | $305.16 | — |
| Humana | Medicare|All Plans | $305.16 | — |
| Kaiser | Medicare|All Plans | $305.16 | — |
| Aetna | Medicare|All Plans | $305.16 | — |
| Humana | Commercial|All Plans | $305.16 | — |
| BCBS - Anthem | Medicare|Imperial | $314.31 | — |
| BrightHealth | Commercial|All Plans | $335.68 | — |
| BlueShield | Medicare|Trauma | $381.45 | — |
| Partnership Health Plan | Medicaid|All Plans | $422.50 | — |
| Prison Healthcare | Medicaid|All Plans | $457.74 | — |
| Blue Shield CA | Commercial|ACO Trio | $1,022.00 | — |
| Blue Shield CA | Commercial|ACO Trio CalPers | $1,303.00 | — |
| Blue Shield CA | Commercial|Exchange | $1,322.00 | — |
| Blue Shield CA | Commercial|PPO Tandem | $1,737.00 | — |
| Blue Shield CA | Commercial|HMO | $1,932.00 | — |
| Blue Shield CA | Commercial|CalPers | $2,033.00 | — |
| Blue Shield CA | Commercial|PPO | $2,093.00 | — |
| Health Net | Commercial|EPPO | $3,200.00 | — |
| BCBS - Anthem | Commercial|Connection EPO | $4,277.00 | — |
| BCBS - Anthem | Commercial|All Other Plans | $5,346.00 | — |
| Health Net | Commercial|FFS | $5,805.00 | — |
| BCBS - Anthem | Commercial|MCS | $7,484.00 | — |
| Aetna | Commercial|PPO | $16,573.00 | — |
| Aetna | Commercial|HMO | $16,573.00 | — |
| Aetna | Commercial|All Other Plans | $16,573.00 | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| Kaiser | Medicaid|All Plans | not published by hospital | — |
| United | Commercial|Non-Options PPO | not published by hospital | — |
| United | Commercial|Options PPO | not published by hospital | — |
| United | Commercial|HMO | not published by hospital | — |
| United | Commercial|All Other Plans | not published by hospital | — |
| First Health | Commercial|All Plans | not published by hospital | — |
| MultiPlan | Commercial|All Plans | not published by hospital | — |
| Sutter Health | Commercial|All Plans | not published by hospital | — |
| Western Health Advantage | Commercial|All Plans | not published by hospital | — |
| WCMG | Commercial|All Plans | not published by hospital | — |
Visitor-reported prices
Comments
Close lac/mouth vest/2.5 cm or < 40830 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $453.90 | $319.18 – $1,687.00 |
| Queen of The Valley Medical Center | Napa | $468.18 | $336.29 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $470.73 | $304.63 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $255.51 | $319.12 – $721.00 |
| Redwood Memorial Hospital | Fortuna | $922.08 | $1,333.00 – $8,222.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $894.54 | $329.57 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $1,281.60 | $258.93 – $1,597.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $190.05 | $203.00 – $1,287.00 |