Culture typing added method at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$1.57
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.
?
What you pay up front if you don't use insurance.
$5.70
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.
?
The hospital's undiscounted list price — almost no one pays this.
$0.63 with WCMG vs $22.85 with Cigna — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $0.63 | ↓ -60% |
| Blue Shield CA | Commercial|ACO Trio | $1.77 | ↑ +13% |
| Western Health Advantage | Commercial|All Plans | $2.00 | ↑ +27% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $2.28 | ↑ +45% |
| Kaiser | Medicaid|All Plans | $2.34 | ↑ +49% |
| Blue Shield CA | Commercial|Exchange | $2.40 | ↑ +53% |
| Kaiser | Commercial|All Plans | $3.08 | ↑ +96% |
| Blue Shield CA | Commercial|PPO Tandem | $3.14 | ↑ +100% |
| Blue Shield CA | Commercial|HMO | $3.37 | ↑ +115% |
| Blue Shield CA | Commercial|CalPers | $3.54 | ↑ +125% |
| Blue Shield CA | Commercial|PPO | $3.77 | ↑ +140% |
| First Health | Commercial|All Plans | $4.28 | ↑ +173% |
| Healthsmart | Commercial|All Plans | $4.28 | ↑ +173% |
| Sutter Health | Commercial|All Plans | $4.56 | ↑ +190% |
| BCBS - Anthem | Commercial|Connection EPO | $4.56 | ↑ +190% |
| MultiPlan | Commercial|All Plans | $4.74 | ↑ +202% |
| BCBS - Anthem | Medicare|All Other Plans | $5.38 | ↑ +243% |
| BCBS - Anthem | Commercial|All Other Plans | $5.70 | ↑ +263% |
| BCBS - Anthem | Medicaid|All Plans | $5.70 | ↑ +263% |
| BCBS - Anthem | Commercial|MCS | $5.70 | ↑ +263% |
| Blue Shield CA | Medicare|HMO | $5.70 | ↑ +263% |
| Blue Shield CA | Medicare|PPO | $5.70 | ↑ +263% |
| Partnership Health Plan | Medicaid|All Plans | $5.70 | ↑ +263% |
| Hill Physicians | Commercial|All Plans | $5.70 | ↑ +263% |
| Humana | Medicare|All Plans | $5.70 | ↑ +263% |
| Aetna | Commercial|All Other Plans | $5.70 | ↑ +263% |
| Aetna | Commercial|PPO | $5.70 | ↑ +263% |
| Aetna | Medicare|All Plans | $5.70 | ↑ +263% |
| Aetna | Commercial|HMO | $5.70 | ↑ +263% |
| Molina | Medicaid|All Plans | $5.70 | ↑ +263% |
| Molina | Medicare|All Plans | $5.70 | ↑ +263% |
| United | Commercial|All Other Plans | $5.70 | ↑ +263% |
| United | Medicare|All Plans | $5.70 | ↑ +263% |
| United | Commercial|HMO | $5.70 | ↑ +263% |
| United | Commercial|Options PPO | $5.70 | ↑ +263% |
| United | Commercial|Non-Options PPO | $5.70 | ↑ +263% |
| United | Medicaid|< 21 | $5.70 | ↑ +263% |
| United | Medicaid|> 21 | $5.70 | ↑ +263% |
| Health Net | Medicaid|All Plans | $5.70 | ↑ +263% |
| Kaiser | Medicare|All Plans | $5.70 | ↑ +263% |
| California Health & Wellness | Medicaid|All Plans | $5.70 | ↑ +263% |
| Humana | Commercial|All Plans | $5.70 | ↑ +263% |
| Hill Physicians | Medicaid|All Plans | $5.70 | ↑ +263% |
| BCBS - Anthem | Medicare|Imperial | $5.88 | ↑ +275% |
| BrightHealth | Commercial|All Plans | $6.27 | ↑ +299% |
| BlueShield | Medicare|Trauma | $7.13 | ↑ +354% |
| Prison Healthcare | Medicaid|All Plans | $8.55 | ↑ +445% |
| Cigna | Commercial|LocalPlus | $17.14 | ↑ +992% |
| Cigna | Commercial|All Other Plans | $22.85 | ↑ +1355% |
Visitor-reported prices
Comments
Culture typing added method at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $64.20 | $7.74 – $147.00 |
| Mark Twain Medical Center | San Andreas | $19.98 | $7.74 – $29.40 |
| French Hospital | San Luis Obispo | $58.80 | $7.74 – $147.00 |
| Northridge Hospital Medical Center | Northridge | $55.80 | $7.74 – $200.00 |
| Sierra Nevada Memorial Hospital | Grass Valley | $3.11 | $3.82 – $5.70 |
| Mercy Hospital of Folsom | Folsom | $2.22 | $0.63 – $17.14 |
| St. Elizabeth Community Hospital | Red Bluff | $8.18 | $5.70 – $14.00 |
| Petaluma Valley Hospital | Petaluma | not published | $7.59 – $42.70 |