Clsd tx clavicle fracture w/manip 23505 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.
$173.45 with United 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 |
|---|---|---|---|
| United | Medicaid|< 21 | $173.45 | — |
| United | Medicaid|> 21 | $173.45 | — |
| Molina | Medicaid|All Plans | $284.16 | — |
| Hill Physicians | Medicaid|All Plans | $300.77 | — |
| Hill Physicians | Commercial|All Plans | $364.52 | — |
| BCBS - Anthem | Medicaid|All Plans | $411.94 | — |
| Health Net | Medicaid|All Plans | $626.15 | — |
| California Health & Wellness | Medicaid|All Plans | $626.15 | — |
| Partnership Health Plan | Medicaid|All Plans | $932.28 | — |
| BCBS - Anthem | Medicare|All Other Plans | $1,983.22 | — |
| Molina | Medicare|All Plans | $2,103.10 | — |
| Humana | Medicare|All Plans | $2,103.10 | — |
| Humana | Commercial|All Plans | $2,103.10 | — |
| Aetna | Medicare|All Plans | $2,103.10 | — |
| Kaiser | Medicare|All Plans | $2,103.10 | — |
| Blue Shield CA | Medicare|PPO | $2,103.10 | — |
| United | Medicare|All Plans | $2,103.10 | — |
| Blue Shield CA | Medicare|HMO | $2,103.10 | — |
| BCBS - Anthem | Medicare|Imperial | $2,166.19 | — |
| BrightHealth | Commercial|All Plans | $2,313.41 | — |
| BlueShield | Medicare|Trauma | $2,628.88 | — |
| Prison Healthcare | Medicaid|All Plans | $3,154.65 | — |
| Blue Shield CA | Commercial|ACO Trio | $3,310.00 | — |
| Blue Shield CA | Commercial|ACO Trio CalPers | $4,218.00 | — |
| BCBS - Anthem | Commercial|Connection EPO | $4,277.00 | — |
| Blue Shield CA | Commercial|Exchange | $4,280.00 | — |
| Aetna | Commercial|All Other Plans | $5,178.00 | — |
| Aetna | Commercial|PPO | $5,178.00 | — |
| Aetna | Commercial|HMO | $5,178.00 | — |
| BCBS - Anthem | Commercial|All Other Plans | $5,346.00 | — |
| Blue Shield CA | Commercial|PPO Tandem | $5,625.00 | — |
| Health Net | Commercial|EPPO | $5,780.00 | — |
| Blue Shield CA | Commercial|HMO | $6,255.00 | — |
| Blue Shield CA | Commercial|CalPers | $6,584.00 | — |
| Blue Shield CA | Commercial|PPO | $6,776.00 | — |
| BCBS - Anthem | Commercial|MCS | $7,484.00 | — |
| Health Net | Commercial|FFS | $10,485.00 | — |
| Healthsmart | 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 | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx clavicle fracture w/manip 23505 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $2,904.45 | $1,921.00 – $2,695.00 |
| Mark Twain Medical Center | San Andreas | $1,256.08 | $173.45 – $1,848.28 |
| Queen of The Valley Medical Center | Napa | $3,229.32 | $2,283.13 – $9,858.00 |
| Providence St Joseph Hospital Eureka | Eureka | $3,248.19 | $2,068.15 – $9,858.00 |
| Healdsburg Hospital | Healdsburg | $2,295.00 | $2,166.52 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $1,919.13 | $5,981.00 – $20,799.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $6,597.36 | $2,237.46 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $6,796.32 | $1,757.92 – $5,171.00 |