Coombs direct at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$54.26
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.
$198.00
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.
$2.64 with WCMG vs $117.09 with Prison Healthcare — 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 | $2.64 | ↓ -95% |
| Partnership Health Plan | Medicaid|All Plans | $4.79 | ↓ -91% |
| Hill Physicians | Commercial|All Plans | $5.39 | ↓ -90% |
| United | Commercial|Non-Options PPO | $6.47 | ↓ -88% |
| United | Commercial|All Other Plans | $6.47 | ↓ -88% |
| United | Commercial|HMO | $6.47 | ↓ -88% |
| United | Commercial|Options PPO | $6.47 | ↓ -88% |
| United | Medicaid|> 21 | $6.87 | ↓ -87% |
| United | Medicaid|< 21 | $6.87 | ↓ -87% |
| Blue Shield CA | Commercial|ACO Trio | $7.44 | ↓ -86% |
| Hill Physicians | Medicaid|All Plans | $7.56 | ↓ -86% |
| Western Health Advantage | Commercial|All Plans | $8.40 | ↓ -85% |
| Molina | Medicaid|All Plans | $9.01 | ↓ -83% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $9.60 | ↓ -82% |
| Kaiser | Medicaid|All Plans | $9.84 | ↓ -82% |
| Blue Shield CA | Commercial|Exchange | $10.08 | ↓ -81% |
| Cigna | Commercial|LocalPlus | $11.92 | ↓ -78% |
| BCBS - Anthem | Medicaid|All Plans | $12.90 | ↓ -76% |
| Kaiser | Commercial|All Plans | $12.96 | ↓ -76% |
| Blue Shield CA | Commercial|PPO Tandem | $13.20 | ↓ -76% |
| Blue Shield CA | Commercial|HMO | $14.16 | ↓ -74% |
| Blue Shield CA | Commercial|CalPers | $14.88 | ↓ -73% |
| Health Net | Medicaid|All Plans | $15.73 | ↓ -71% |
| California Health & Wellness | Medicaid|All Plans | $15.73 | ↓ -71% |
| Blue Shield CA | Commercial|PPO | $15.84 | ↓ -71% |
| Cigna | Commercial|All Other Plans | $15.90 | ↓ -71% |
| First Health | Commercial|All Plans | $18.00 | ↓ -67% |
| Healthsmart | Commercial|All Plans | $18.00 | ↓ -67% |
| BCBS - Anthem | Commercial|Connection EPO | $19.20 | ↓ -65% |
| Sutter Health | Commercial|All Plans | $19.20 | ↓ -65% |
| MultiPlan | Commercial|All Plans | $19.92 | ↓ -63% |
| Aetna | Commercial|PPO | $20.23 | ↓ -63% |
| Aetna | Commercial|All Other Plans | $20.23 | ↓ -63% |
| Aetna | Commercial|HMO | $20.23 | ↓ -63% |
| BCBS - Anthem | Medicare|All Other Plans | $22.64 | ↓ -58% |
| BCBS - Anthem | Commercial|All Other Plans | $24.00 | ↓ -56% |
| BCBS - Anthem | Commercial|MCS | $24.00 | ↓ -56% |
| Humana | Commercial|All Plans | $24.00 | ↓ -56% |
| United | Medicare|All Plans | $24.00 | ↓ -56% |
| Molina | Medicare|All Plans | $24.00 | ↓ -56% |
| Blue Shield CA | Medicare|PPO | $24.00 | ↓ -56% |
| Aetna | Medicare|All Plans | $24.00 | ↓ -56% |
| Humana | Medicare|All Plans | $24.00 | ↓ -56% |
| BCBS - Anthem | Medicare|Imperial | $24.72 | ↓ -54% |
| BrightHealth | Commercial|All Plans | $26.40 | ↓ -51% |
| BlueShield | Medicare|Trauma | $30.00 | ↓ -45% |
| Blue Shield CA | Medicare|HMO | $78.06 | ↑ +44% |
| Kaiser | Medicare|All Plans | $78.06 | ↑ +44% |
| Prison Healthcare | Medicaid|All Plans | $117.09 | ↑ +116% |
Visitor-reported prices
Comments
Coombs direct at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $90.67 | $5.83 – $43.12 |
| Banner Lassen Medical Center | Susanville | $80.90 | $1.08 – $7.90 |
| Petaluma Valley Hospital | Petaluma | $85.17 | $10.78 – $79.50 |
| Arroyo Grande Hospital | Santa Maria | $141.57 | $6.18 – $16.00 |
| Mark Twain Medical Center | San Andreas | $97.24 | $5.39 – $27.01 |
| French Hospital | San Luis Obispo | $129.66 | $4.32 – $16.31 |
| Mercy Hospitals – Bakersfield | Bakersfield | $111.30 | $6.47 – $26.25 |
| Bakersfield Memorial Hospital | Bakersfield | $110.10 | $6.47 – $26.25 |