Consult comp w/report rfrd material at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$73.44
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.
$268.00
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.
$29.48 with WCMG vs $400.60 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 | $29.48 | ↓ -60% |
| Western Health Advantage | Commercial|All Plans | $93.80 | ↑ +28% |
| Partnership Health Plan | Medicaid|All Plans | $101.51 | ↑ +38% |
| Kaiser | Medicaid|All Plans | $109.88 | ↑ +50% |
| Hill Physicians | Commercial|All Plans | $135.07 | ↑ +84% |
| Kaiser | Commercial|All Plans | $144.72 | ↑ +97% |
| United | Medicaid|< 21 | $145.61 | ↑ +98% |
| United | Medicaid|> 21 | $145.61 | ↑ +98% |
| Hill Physicians | Medicaid|All Plans | $160.17 | ↑ +118% |
| United | Commercial|Options PPO | $178.99 | ↑ +144% |
| United | Commercial|Non-Options PPO | $178.99 | ↑ +144% |
| United | Commercial|All Other Plans | $178.99 | ↑ +144% |
| United | Commercial|HMO | $178.99 | ↑ +144% |
| Molina | Medicaid|All Plans | $190.84 | ↑ +160% |
| Healthsmart | Commercial|All Plans | $201.00 | ↑ +174% |
| First Health | Commercial|All Plans | $201.00 | ↑ +174% |
| BCBS - Anthem | Medicare|All Other Plans | $212.34 | ↑ +189% |
| BCBS - Anthem | Commercial|Connection EPO | $214.40 | ↑ +192% |
| Sutter Health | Commercial|All Plans | $214.40 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $222.44 | ↑ +203% |
| Blue Shield CA | Medicare|PPO | $225.18 | ↑ +207% |
| Humana | Medicare|All Plans | $225.18 | ↑ +207% |
| Aetna | Medicare|All Plans | $225.18 | ↑ +207% |
| Molina | Medicare|All Plans | $225.18 | ↑ +207% |
| United | Medicare|All Plans | $225.18 | ↑ +207% |
| Kaiser | Medicare|All Plans | $225.18 | ↑ +207% |
| Blue Shield CA | Medicare|HMO | $225.18 | ↑ +207% |
| Humana | Commercial|All Plans | $225.18 | ↑ +207% |
| BCBS - Anthem | Medicare|Imperial | $231.94 | ↑ +216% |
| BrightHealth | Commercial|All Plans | $247.70 | ↑ +237% |
| BCBS - Anthem | Commercial|All Other Plans | $268.00 | ↑ +265% |
| Aetna | Commercial|All Other Plans | $268.00 | ↑ +265% |
| Aetna | Commercial|HMO | $268.00 | ↑ +265% |
| Aetna | Commercial|PPO | $268.00 | ↑ +265% |
| BCBS - Anthem | Medicaid|All Plans | $268.00 | ↑ +265% |
| BCBS - Anthem | Commercial|MCS | $268.00 | ↑ +265% |
| California Health & Wellness | Medicaid|All Plans | $268.00 | ↑ +265% |
| Health Net | Medicaid|All Plans | $268.00 | ↑ +265% |
| BlueShield | Medicare|Trauma | $281.48 | ↑ +283% |
| Cigna | Commercial|LocalPlus | $300.43 | ↑ +309% |
| Prison Healthcare | Medicaid|All Plans | $337.77 | ↑ +360% |
| Cigna | Commercial|All Other Plans | $400.60 | ↑ +445% |
Visitor-reported prices
Comments
Consult comp w/report rfrd material at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Banner Lassen Medical Center | Susanville | $76.38 | $34.27 – $175.57 |
| Petaluma Valley Hospital | Petaluma | $307.53 | $98.94 – $494.67 |
| Arroyo Grande Hospital | Santa Maria | $271.23 | $145.61 – $621.03 |
| French Hospital | San Luis Obispo | $248.42 | $145.61 – $621.03 |
| Mercy Hospitals – Bakersfield | Bakersfield | $51.20 | $34.50 – $389.84 |
| Bakersfield Memorial Hospital | Bakersfield | $50.65 | $34.50 – $389.84 |
| Queen of The Valley Medical Center | Napa | $402.90 | $98.94 – $625.14 |
| Providence St Joseph Hospital Eureka | Eureka | $226.44 | $98.94 – $708.91 |