Ins/rpl pm gen exist dual lead 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.
$330.71 with Hill Physicians vs $35,615.00 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 |
|---|---|---|---|
| Hill Physicians | Commercial|All Plans | $330.71 | — |
| United | Medicaid|> 21 | $408.43 | — |
| United | Medicaid|< 21 | $408.43 | — |
| Molina | Medicaid|All Plans | $669.13 | — |
| Hill Physicians | Medicaid|All Plans | $708.20 | — |
| BCBS - Anthem | Medicaid|All Plans | $970.01 | — |
| California Health & Wellness | Medicaid|All Plans | $1,474.35 | — |
| Health Net | Medicaid|All Plans | $1,474.35 | — |
| Partnership Health Plan | Medicaid|All Plans | $2,195.29 | — |
| Aetna | Commercial|HMO | $8,286.00 | — |
| Aetna | Commercial|PPO | $8,286.00 | — |
| Aetna | Commercial|All Other Plans | $8,286.00 | — |
| BCBS - Anthem | Medicare|All Other Plans | $12,968.60 | — |
| Humana | Medicare|All Plans | $13,752.49 | — |
| United | Medicare|All Plans | $13,752.49 | — |
| Blue Shield CA | Medicare|PPO | $13,752.49 | — |
| Molina | Medicare|All Plans | $13,752.49 | — |
| Aetna | Medicare|All Plans | $13,752.49 | — |
| Humana | Commercial|All Plans | $13,752.49 | — |
| Blue Shield CA | Medicare|HMO | $13,752.49 | — |
| Kaiser | Medicare|All Plans | $13,752.49 | — |
| BCBS - Anthem | Medicare|Imperial | $14,165.06 | — |
| BrightHealth | Commercial|All Plans | $15,127.74 | — |
| Health Net | Commercial|EPPO | $15,484.00 | — |
| Blue Shield CA | Commercial|ACO Trio | $16,598.00 | — |
| BlueShield | Medicare|Trauma | $17,190.61 | — |
| BCBS - Anthem | Commercial|Connection EPO | $20,351.00 | — |
| Prison Healthcare | Medicaid|All Plans | $20,628.74 | — |
| Blue Shield CA | Commercial|ACO Trio CalPers | $21,162.00 | — |
| Blue Shield CA | Commercial|Exchange | $22,950.00 | — |
| BCBS - Anthem | Commercial|All Other Plans | $25,439.00 | — |
| Health Net | Commercial|FFS | $28,092.00 | — |
| Blue Shield CA | Commercial|PPO Tandem | $29,592.00 | — |
| Blue Shield CA | Commercial|HMO | $31,379.00 | — |
| Blue Shield CA | Commercial|CalPers | $33,036.00 | — |
| Blue Shield CA | Commercial|PPO | $35,580.00 | — |
| BCBS - Anthem | Commercial|MCS | $35,615.00 | — |
| WCMG | Commercial|All Plans | not published by hospital | — |
| Healthsmart | Commercial|All Plans | not published by hospital | — |
| Kaiser | Medicaid|All Plans | not published by hospital | — |
| Kaiser | Commercial|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 | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $11,555.76 | $502.37 – $25,925.22 |
| Bakersfield Memorial Hospital | Bakersfield | $11,988.43 | $408.43 – $25,806.14 |
| Queen of The Valley Medical Center | Napa | $23,962.86 | $12,159.00 – $62,607.00 |
| St. Joseph's Medical Center Stockton | Stockton | $9,223.96 | $408.43 – $26,354.16 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $16,258.08 | $8,912.00 – $24,869.57 |
| Mercy Medical Center Merced | Merced | $16,379.58 | $408.43 – $31,486.95 |
| Northridge Hospital Medical Center | Northridge | $7,101.95 | $408.43 – $25,455.00 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | $4,134.20 | $3,969.00 – $24,869.57 |