Consultation pathology during surgery at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$60.28
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.
$220.00
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.
$24.20 with WCMG vs $220.00 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 |
|---|---|---|---|
| WCMG | Commercial|All Plans | $24.20 | ↓ -60% |
| Partnership Health Plan | Medicaid|All Plans | $32.48 | ↓ -46% |
| Hill Physicians | Commercial|All Plans | $35.10 | ↓ -42% |
| United | Commercial|HMO | $40.61 | ↓ -33% |
| United | Commercial|Options PPO | $40.61 | ↓ -33% |
| United | Commercial|Non-Options PPO | $40.61 | ↓ -33% |
| United | Commercial|All Other Plans | $40.61 | ↓ -33% |
| United | Medicaid|< 21 | $46.59 | ↓ -23% |
| United | Medicaid|> 21 | $46.59 | ↓ -23% |
| Hill Physicians | Medicaid|All Plans | $51.25 | ↓ -15% |
| Molina | Medicaid|All Plans | $61.06 | ↑ +1% |
| BCBS - Anthem | Medicare|All Other Plans | $73.61 | ↑ +22% |
| Western Health Advantage | Commercial|All Plans | $77.00 | ↑ +28% |
| Blue Shield CA | Medicare|PPO | $78.06 | ↑ +29% |
| Humana | Medicare|All Plans | $78.06 | ↑ +29% |
| Aetna | Medicare|All Plans | $78.06 | ↑ +29% |
| Molina | Medicare|All Plans | $78.06 | ↑ +29% |
| United | Medicare|All Plans | $78.06 | ↑ +29% |
| Kaiser | Medicare|All Plans | $78.06 | ↑ +29% |
| Blue Shield CA | Medicare|HMO | $78.06 | ↑ +29% |
| Humana | Commercial|All Plans | $78.06 | ↑ +29% |
| Cigna | Commercial|LocalPlus | $78.94 | ↑ +31% |
| BCBS - Anthem | Medicare|Imperial | $80.40 | ↑ +33% |
| BrightHealth | Commercial|All Plans | $85.87 | ↑ +42% |
| Kaiser | Medicaid|All Plans | $90.20 | ↑ +50% |
| Aetna | Commercial|HMO | $93.33 | ↑ +55% |
| Aetna | Commercial|All Other Plans | $93.33 | ↑ +55% |
| Aetna | Commercial|PPO | $93.33 | ↑ +55% |
| BCBS - Anthem | Medicaid|All Plans | $93.84 | ↑ +56% |
| BlueShield | Medicare|Trauma | $97.58 | ↑ +62% |
| Cigna | Commercial|All Other Plans | $105.26 | ↑ +75% |
| Health Net | Medicaid|All Plans | $106.69 | ↑ +77% |
| California Health & Wellness | Medicaid|All Plans | $106.69 | ↑ +77% |
| Prison Healthcare | Medicaid|All Plans | $117.09 | ↑ +94% |
| Kaiser | Commercial|All Plans | $118.80 | ↑ +97% |
| Healthsmart | Commercial|All Plans | $165.00 | ↑ +174% |
| First Health | Commercial|All Plans | $165.00 | ↑ +174% |
| Sutter Health | Commercial|All Plans | $176.00 | ↑ +192% |
| BCBS - Anthem | Commercial|Connection EPO | $176.00 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $182.60 | ↑ +203% |
| BCBS - Anthem | Commercial|All Other Plans | $220.00 | ↑ +265% |
| BCBS - Anthem | Commercial|MCS | $220.00 | ↑ +265% |
Visitor-reported prices
Comments
Consultation pathology during surgery at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $351.90 | $66.86 – $236.26 |
| Arroyo Grande Hospital | Santa Maria | $177.62 | $40.61 – $129.36 |
| Mark Twain Medical Center | San Andreas | $162.51 | $46.59 – $239.12 |
| French Hospital | San Luis Obispo | $162.68 | $35.64 – $129.36 |
| Mercy Hospitals – Bakersfield | Bakersfield | $79.77 | $34.50 – $102.43 |
| Bakersfield Memorial Hospital | Bakersfield | $78.91 | $34.50 – $102.43 |
| Queen of The Valley Medical Center | Napa | $286.11 | $66.86 – $298.57 |
| Providence St Joseph Hospital Eureka | Eureka | $591.09 | $66.86 – $338.58 |