Closed tx/talus fracture without manip 28430 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.
$231.84 with Hill Physicians vs $7,484.00 with BCBS - Anthem — 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 | $231.84 | — |
| BCBS - Anthem | Medicare|All Other Plans | $297.26 | — |
| Humana | Commercial|All Plans | $315.23 | — |
| United | Medicare|All Plans | $315.23 | — |
| Blue Shield CA | Medicare|PPO | $315.23 | — |
| Aetna | Medicare|All Plans | $315.23 | — |
| Blue Shield CA | Medicare|HMO | $315.23 | — |
| Molina | Medicare|All Plans | $315.23 | — |
| Humana | Medicare|All Plans | $315.23 | — |
| Kaiser | Medicare|All Plans | $315.23 | — |
| BCBS - Anthem | Medicare|Imperial | $324.69 | — |
| United | Medicaid|> 21 | $329.38 | — |
| United | Medicaid|< 21 | $329.38 | — |
| BrightHealth | Commercial|All Plans | $346.75 | — |
| BlueShield | Medicare|Trauma | $394.04 | — |
| Prison Healthcare | Medicaid|All Plans | $472.85 | — |
| Molina | Medicaid|All Plans | $539.64 | — |
| Hill Physicians | Medicaid|All Plans | $571.14 | — |
| BCBS - Anthem | Medicaid|All Plans | $782.29 | — |
| Blue Shield CA | Commercial|ACO Trio | $1,022.00 | — |
| California Health & Wellness | Medicaid|All Plans | $1,189.01 | — |
| Health Net | Medicaid|All Plans | $1,189.01 | — |
| 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 | — |
| Partnership Health Plan | Medicaid|All Plans | $1,770.44 | — |
| 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 | — |
| Aetna | Commercial|HMO | $5,178.00 | — |
| Aetna | Commercial|All Other Plans | $5,178.00 | — |
| Aetna | Commercial|PPO | $5,178.00 | — |
| BCBS - Anthem | Commercial|All Other Plans | $5,346.00 | — |
| Health Net | Commercial|FFS | $5,805.00 | — |
| BCBS - Anthem | Commercial|MCS | $7,484.00 | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| United | Commercial|Options PPO | not published by hospital | — |
| United | Commercial|HMO | not published by hospital | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| Kaiser | Medicaid|All Plans | 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 | — |
| United | Commercial|Non-Options PPO | not published by hospital | — |
Visitor-reported prices
Comments
Closed tx/talus fracture without manip 28430 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $419.73 | $332.41 – $1,687.00 |
| Mark Twain Medical Center | San Andreas | $478.19 | $98.57 – $373.38 |
| Queen of The Valley Medical Center | Napa | $466.14 | $350.23 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $469.20 | $317.26 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $254.49 | $332.35 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $276.93 | $1,333.00 – $20,799.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $448.80 | $343.23 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $475.68 | $269.67 – $1,597.00 |