Dch validity tests at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$12.33
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.
$45.00
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.
$2.15 with Partnership Health Plan vs $45.00 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 |
|---|---|---|---|
| Partnership Health Plan | Medicaid|All Plans | $2.15 | ↓ -83% |
| United | Medicaid|> 21 | $3.08 | ↓ -75% |
| United | Medicaid|< 21 | $3.08 | ↓ -75% |
| BCBS - Anthem | Medicare|All Other Plans | $3.28 | ↓ -73% |
| Hill Physicians | Medicaid|All Plans | $3.39 | ↓ -73% |
| Blue Shield CA | Medicare|PPO | $3.48 | ↓ -72% |
| Kaiser | Medicare|All Plans | $3.48 | ↓ -72% |
| United | Medicare|All Plans | $3.48 | ↓ -72% |
| Molina | Medicare|All Plans | $3.48 | ↓ -72% |
| Humana | Medicare|All Plans | $3.48 | ↓ -72% |
| Humana | Commercial|All Plans | $3.48 | ↓ -72% |
| Hill Physicians | Commercial|All Plans | $3.48 | ↓ -72% |
| Aetna | Medicare|All Plans | $3.48 | ↓ -72% |
| Blue Shield CA | Medicare|HMO | $3.48 | ↓ -72% |
| BCBS - Anthem | Medicare|Imperial | $3.58 | ↓ -71% |
| BrightHealth | Commercial|All Plans | $3.83 | ↓ -69% |
| Molina | Medicaid|All Plans | $4.04 | ↓ -67% |
| United | Commercial|Options PPO | $4.18 | ↓ -66% |
| United | Commercial|All Other Plans | $4.18 | ↓ -66% |
| United | Commercial|Non-Options PPO | $4.18 | ↓ -66% |
| United | Commercial|HMO | $4.18 | ↓ -66% |
| BlueShield | Medicare|Trauma | $4.35 | ↓ -65% |
| WCMG | Commercial|All Plans | $4.95 | ↓ -60% |
| Prison Healthcare | Medicaid|All Plans | $5.22 | ↓ -58% |
| BCBS - Anthem | Medicaid|All Plans | $6.71 | ↓ -46% |
| California Health & Wellness | Medicaid|All Plans | $7.05 | ↓ -43% |
| Health Net | Medicaid|All Plans | $7.05 | ↓ -43% |
| Cigna | Commercial|LocalPlus | $7.70 | ↓ -38% |
| Aetna | Commercial|All Other Plans | $9.65 | ↓ -22% |
| Aetna | Commercial|PPO | $9.65 | ↓ -22% |
| Aetna | Commercial|HMO | $9.65 | ↓ -22% |
| Cigna | Commercial|All Other Plans | $10.27 | ↓ -17% |
| Blue Shield CA | Commercial|ACO Trio | $13.95 | ↑ +13% |
| Western Health Advantage | Commercial|All Plans | $15.75 | ↑ +28% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $18.00 | ↑ +46% |
| Kaiser | Medicaid|All Plans | $18.45 | ↑ +50% |
| Blue Shield CA | Commercial|Exchange | $18.90 | ↑ +53% |
| Kaiser | Commercial|All Plans | $24.30 | ↑ +97% |
| Blue Shield CA | Commercial|PPO Tandem | $24.75 | ↑ +101% |
| Blue Shield CA | Commercial|HMO | $26.55 | ↑ +115% |
| Blue Shield CA | Commercial|CalPers | $27.90 | ↑ +126% |
| Blue Shield CA | Commercial|PPO | $29.70 | ↑ +141% |
| Healthsmart | Commercial|All Plans | $33.75 | ↑ +174% |
| First Health | Commercial|All Plans | $33.75 | ↑ +174% |
| Sutter Health | Commercial|All Plans | $36.00 | ↑ +192% |
| BCBS - Anthem | Commercial|Connection EPO | $36.00 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $37.35 | ↑ +203% |
| BCBS - Anthem | Commercial|MCS | $45.00 | ↑ +265% |
| BCBS - Anthem | Commercial|All Other Plans | $45.00 | ↑ +265% |
Visitor-reported prices
Comments
Dch validity tests at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $42.05 | $3.48 – $10.86 |
| Banner Lassen Medical Center | Susanville | $21.79 | $0.70 – $35.89 |
| Petaluma Valley Hospital | Petaluma | $49.47 | $3.41 – $19.40 |
| Arroyo Grande Hospital | Santa Maria | $62.49 | $3.08 – $9.80 |
| Mark Twain Medical Center | San Andreas | $9.33 | $3.08 – $13.72 |
| French Hospital | San Luis Obispo | $58.41 | $2.70 – $10.53 |
| Mercy Hospitals – Bakersfield | Bakersfield | $27.09 | $3.02 – $24.00 |
| Bakersfield Memorial Hospital | Bakersfield | $26.80 | $3.02 – $23.70 |