Established Patient Office Visit (level 1) at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$80.01
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.
$292.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$8.82 with Hill Physicians vs $3,245.00 with BrightHealth — 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 |
|---|---|---|---|
| Hill Physicians | Commercial|All Plans | $8.82 | ↓ -89% |
| United | Medicaid|> 21 | $21.37 | ↓ -73% |
| United | Medicaid|< 21 | $21.37 | ↓ -73% |
| Hill Physicians | Medicaid|All Plans | $23.51 | ↓ -71% |
| Molina | Medicaid|All Plans | $28.01 | ↓ -65% |
| WCMG | Commercial|All Plans | $28.05 | ↓ -65% |
| BCBS - Anthem | Medicaid|All Plans | $32.70 | ↓ -59% |
| Health Net | Medicaid|All Plans | $48.94 | ↓ -39% |
| California Health & Wellness | Medicaid|All Plans | $48.94 | ↓ -39% |
| Western Health Advantage | Commercial|All Plans | $89.25 | ↑ +12% |
| Partnership Health Plan | Medicaid|All Plans | $91.89 | ↑ +15% |
| Blue Shield CA | Commercial|ACO Trio | $94.00 | ↑ +17% |
| Kaiser | Medicaid|All Plans | $104.55 | ↑ +31% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $118.00 | ↑ +47% |
| Blue Shield CA | Commercial|Exchange | $121.00 | ↑ +51% |
| Kaiser | Commercial|All Plans | $137.70 | ↑ +72% |
| Blue Shield CA | Commercial|PPO Tandem | $163.00 | ↑ +104% |
| Blue Shield CA | Commercial|HMO | $165.00 | ↑ +106% |
| Cigna | Commercial|LocalPlus | $168.00 | ↑ +110% |
| BCBS - Anthem | Commercial|Connection EPO | $170.85 | ↑ +114% |
| Blue Shield CA | Commercial|CalPers | $184.00 | ↑ +130% |
| Blue Shield CA | Commercial|PPO | $185.00 | ↑ +131% |
| Healthsmart | Commercial|All Plans | $191.25 | ↑ +139% |
| First Health | Commercial|All Plans | $191.25 | ↑ +139% |
| Sutter Health | Commercial|All Plans | $204.00 | ↑ +155% |
| MultiPlan | Commercial|All Plans | $211.65 | ↑ +165% |
| BCBS - Anthem | Commercial|All Other Plans | $214.20 | ↑ +168% |
| Cigna | Commercial|All Other Plans | $225.00 | ↑ +181% |
| United | Commercial|All Other Plans | $255.00 | ↑ +219% |
| United | Commercial|Options PPO | $255.00 | ↑ +219% |
| United | Commercial|Non-Options PPO | $255.00 | ↑ +219% |
| BCBS - Anthem | Commercial|MCS | $255.00 | ↑ +219% |
| United | Commercial|HMO | $255.00 | ↑ +219% |
| BrightHealth | Commercial|All Plans | $3,245.00 | ↑ +3956% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $500.91 | $12.38 – $204.18 |
| Banner Lassen Medical Center | Susanville | $290.87 | $19.80 – $150.35 |
| Arroyo Grande Hospital | Santa Maria | $145.10 | $17.21 – $232.00 |
| Mark Twain Medical Center | San Andreas | $51.95 | $3.11 – $12.00 |
| French Hospital | San Luis Obispo | $112.90 | $17.21 – $234.00 |
| Mercy Hospitals – Bakersfield | Bakersfield | $86.08 | $21.37 – $232.00 |
| Bakersfield Memorial Hospital | Bakersfield | $93.59 | $21.37 – $232.00 |
| Healdsburg Hospital | Healdsburg | $155.55 | not published |