Established Patient Office Visit (level 5) at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$133.72
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.
$488.00
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.
$53.68 with WCMG vs $488.00 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 |
|---|---|---|---|
| WCMG | Commercial|All Plans | $53.68 | ↓ -60% |
| Blue Shield CA | Commercial|ACO Trio | $94.00 | ↓ -30% |
| United | Medicaid|> 21 | $101.90 | ↓ -24% |
| United | Medicaid|< 21 | $101.90 | ↓ -24% |
| Hill Physicians | Medicaid|All Plans | $112.09 | ↓ -16% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $118.00 | ↓ -12% |
| Blue Shield CA | Commercial|Exchange | $121.00 | ↓ -10% |
| Molina | Medicaid|All Plans | $133.56 | ↓ -0% |
| Hill Physicians | Commercial|All Plans | $145.32 | ↑ +9% |
| BCBS - Anthem | Medicaid|All Plans | $155.90 | ↑ +17% |
| Blue Shield CA | Commercial|PPO Tandem | $163.00 | ↑ +22% |
| Blue Shield CA | Commercial|HMO | $165.00 | ↑ +23% |
| Cigna | Commercial|LocalPlus | $168.00 | ↑ +26% |
| Western Health Advantage | Commercial|All Plans | $170.80 | ↑ +28% |
| Blue Shield CA | Commercial|CalPers | $184.00 | ↑ +38% |
| Blue Shield CA | Commercial|PPO | $185.00 | ↑ +38% |
| Kaiser | Medicaid|All Plans | $200.08 | ↑ +50% |
| Cigna | Commercial|All Other Plans | $225.00 | ↑ +68% |
| Health Net | Medicaid|All Plans | $233.35 | ↑ +75% |
| California Health & Wellness | Medicaid|All Plans | $233.35 | ↑ +75% |
| Kaiser | Commercial|All Plans | $263.52 | ↑ +97% |
| BCBS - Anthem | Commercial|Connection EPO | $326.96 | ↑ +145% |
| Healthsmart | Commercial|All Plans | $366.00 | ↑ +174% |
| First Health | Commercial|All Plans | $366.00 | ↑ +174% |
| Sutter Health | Commercial|All Plans | $390.40 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $405.04 | ↑ +203% |
| BCBS - Anthem | Commercial|All Other Plans | $409.92 | ↑ +207% |
| Partnership Health Plan | Medicaid|All Plans | $438.17 | ↑ +228% |
| United | Commercial|All Other Plans | $488.00 | ↑ +265% |
| United | Commercial|Non-Options PPO | $488.00 | ↑ +265% |
| United | Commercial|HMO | $488.00 | ↑ +265% |
| United | Commercial|Options PPO | $488.00 | ↑ +265% |
| BCBS - Anthem | Commercial|MCS | $488.00 | ↑ +265% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $822.12 | $102.00 – $313.56 |
| Arroyo Grande Hospital | Santa Maria | $254.66 | $82.05 – $480.00 |
| Mark Twain Medical Center | San Andreas | $317.69 | $71.92 – $272.44 |
| French Hospital | San Luis Obispo | $233.24 | $82.05 – $470.40 |
| Bakersfield Memorial Hospital | Bakersfield | $148.27 | $101.90 – $232.00 |
| Healdsburg Hospital | Healdsburg | $538.56 | not published |
| Redwood Memorial Hospital | Fortuna | $161.16 | not published |
| St. Joseph's Medical Center Stockton | Stockton | $143.18 | $82.05 – $399.34 |