Debrid/rmv fgn bdy/open fx/skin/sq 11010 at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
not published by hospital
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.
not published by hospital
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.
$258.47 with United vs $9,068.00 with Blue Shield CA — 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 |
|---|---|---|---|
| United | Medicaid|< 21 | $258.47 | — |
| United | Medicaid|> 21 | $258.47 | — |
| Hill Physicians | Commercial|All Plans | $280.68 | — |
| Molina | Medicaid|All Plans | $423.45 | — |
| Hill Physicians | Medicaid|All Plans | $448.18 | — |
| BCBS - Anthem | Medicaid|All Plans | $613.85 | — |
| BCBS - Anthem | Medicare|All Other Plans | $871.89 | — |
| United | Medicare|All Plans | $924.59 | — |
| Kaiser | Medicare|All Plans | $924.59 | — |
| Humana | Medicare|All Plans | $924.59 | — |
| Humana | Commercial|All Plans | $924.59 | — |
| Aetna | Medicare|All Plans | $924.59 | — |
| Blue Shield CA | Medicare|PPO | $924.59 | — |
| Molina | Medicare|All Plans | $924.59 | — |
| Blue Shield CA | Medicare|HMO | $924.59 | — |
| California Health & Wellness | Medicaid|All Plans | $933.04 | — |
| Health Net | Medicaid|All Plans | $933.04 | — |
| BCBS - Anthem | Medicare|Imperial | $952.33 | — |
| BrightHealth | Commercial|All Plans | $1,017.05 | — |
| BlueShield | Medicare|Trauma | $1,155.74 | — |
| Prison Healthcare | Medicaid|All Plans | $1,386.88 | — |
| Partnership Health Plan | Medicaid|All Plans | $1,389.26 | — |
| Health Net | Commercial|EPPO | $3,898.00 | — |
| BCBS - Anthem | Commercial|Connection EPO | $4,277.00 | — |
| Blue Shield CA | Commercial|ACO Trio | $4,430.00 | — |
| BCBS - Anthem | Commercial|All Other Plans | $5,346.00 | — |
| Blue Shield CA | Commercial|ACO Trio CalPers | $5,645.00 | — |
| Blue Shield CA | Commercial|Exchange | $5,727.00 | — |
| Health Net | Commercial|FFS | $7,070.00 | — |
| Aetna | Commercial|HMO | $7,251.00 | — |
| Aetna | Commercial|All Other Plans | $7,251.00 | — |
| Aetna | Commercial|PPO | $7,251.00 | — |
| BCBS - Anthem | Commercial|MCS | $7,484.00 | — |
| Blue Shield CA | Commercial|PPO Tandem | $7,528.00 | — |
| Blue Shield CA | Commercial|HMO | $8,370.00 | — |
| Blue Shield CA | Commercial|CalPers | $8,811.00 | — |
| Blue Shield CA | Commercial|PPO | $9,068.00 | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| Kaiser | Commercial|All Plans | not published by hospital | — |
| Kaiser | Medicaid|All Plans | not published by hospital | — |
| United | Commercial|Non-Options PPO | not published by hospital | — |
| United | Commercial|Options PPO | not published by hospital | — |
| United | Commercial|HMO | not published by hospital | — |
| United | Commercial|All Other Plans | not published by hospital | — |
| First Health | Commercial|All Plans | not published by hospital | — |
| MultiPlan | Commercial|All Plans | not published by hospital | — |
| Sutter Health | Commercial|All Plans | not published by hospital | — |
| Western Health Advantage | Commercial|All Plans | not published by hospital | — |
| WCMG | Commercial|All Plans | not published by hospital | — |
Visitor-reported prices
Comments
Debrid/rmv fgn bdy/open fx/skin/sq 11010 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $1,313.76 | $954.29 – $2,695.00 |
| Mark Twain Medical Center | San Andreas | $508.83 | $197.65 – $748.72 |
| Queen of The Valley Medical Center | Napa | $1,461.15 | $1,005.45 – $7,483.00 |
| Providence St Joseph Hospital Eureka | Eureka | $1,469.82 | $910.78 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $797.64 | $954.10 – $5,198.77 |
| Redwood Memorial Hospital | Fortuna | $868.02 | $3,331.00 – $25,998.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $1,358.64 | $985.34 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $1,152.96 | $774.16 – $6,920.00 |