Npsy tst eval phsy/qhp 1st hr at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$420.59
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.
$1,535.00
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.
$106.88 with Hill Physicians vs $16,950.00 with United — 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 | $106.88 | ↓ -75% |
| United | Medicaid|< 21 | $113.37 | ↓ -73% |
| United | Medicaid|> 21 | $113.37 | ↓ -73% |
| Hill Physicians | Medicaid|All Plans | $124.71 | ↓ -70% |
| WCMG | Commercial|All Plans | $168.85 | ↓ -60% |
| Molina | Medicaid|All Plans | $213.14 | ↓ -49% |
| BCBS - Anthem | Medicaid|All Plans | $215.40 | ↓ -49% |
| Health Net | Medicaid|All Plans | $259.62 | ↓ -38% |
| California Health & Wellness | Medicaid|All Plans | $259.62 | ↓ -38% |
| Partnership Health Plan | Medicaid|All Plans | $487.49 | ↑ +16% |
| Western Health Advantage | Commercial|All Plans | $537.25 | ↑ +28% |
| Kaiser | Medicaid|All Plans | $629.35 | ↑ +50% |
| BCBS - Anthem | Medicare|All Other Plans | $657.52 | ↑ +56% |
| Blue Shield CA | Medicare|HMO | $697.26 | ↑ +66% |
| Humana | Medicare|All Plans | $697.26 | ↑ +66% |
| Humana | Commercial|All Plans | $697.26 | ↑ +66% |
| Aetna | Medicare|All Plans | $697.26 | ↑ +66% |
| Molina | Medicare|All Plans | $697.26 | ↑ +66% |
| United | Medicare|All Plans | $697.26 | ↑ +66% |
| Kaiser | Medicare|All Plans | $697.26 | ↑ +66% |
| Blue Shield CA | Medicare|PPO | $697.26 | ↑ +66% |
| BCBS - Anthem | Medicare|Imperial | $718.18 | ↑ +71% |
| BrightHealth | Commercial|All Plans | $766.99 | ↑ +82% |
| Kaiser | Commercial|All Plans | $828.90 | ↑ +97% |
| BlueShield | Medicare|Trauma | $871.58 | ↑ +107% |
| Prison Healthcare | Medicaid|All Plans | $1,045.89 | ↑ +149% |
| Healthsmart | Commercial|All Plans | $1,151.25 | ↑ +174% |
| First Health | Commercial|All Plans | $1,151.25 | ↑ +174% |
| Sutter Health | Commercial|All Plans | $1,228.00 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $1,274.05 | ↑ +203% |
| United | Commercial|Non-Options PPO | $1,535.00 | ↑ +265% |
| United | Commercial|HMO | $1,535.00 | ↑ +265% |
| Blue Shield CA | Commercial|ACO Trio | $3,310.00 | ↑ +687% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $4,218.00 | ↑ +903% |
| Blue Shield CA | Commercial|Exchange | $4,280.00 | ↑ +918% |
| Blue Shield CA | Commercial|PPO Tandem | $5,625.00 | ↑ +1237% |
| Blue Shield CA | Commercial|HMO | $6,255.00 | ↑ +1387% |
| Blue Shield CA | Commercial|CalPers | $6,584.00 | ↑ +1465% |
| Blue Shield CA | Commercial|PPO | $6,776.00 | ↑ +1511% |
| United | Commercial|All Other Plans | $16,950.00 | ↑ +3930% |
| United | Commercial|Options PPO | $16,950.00 | ↑ +3930% |
Visitor-reported prices
Comments
Npsy tst eval phsy/qhp 1st hr at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $179.52 | $407.95 – $5,171.00 |
| St Jude Medical Center | Fullerton | $241.44 | $407.95 – $4,188.00 |
| Providence St Joseph Hospital Orange | Orange | $191.04 | $407.95 – $4,971.00 |
| Mercy General Hospital | Sacramento | $334.63 | $106.88 – $1,228.00 |
| Mercy Hospital of Folsom | Folsom | $597.12 | $106.88 – $1,258.70 |
| Woodland Memorial Hospital | Woodland | $420.59 | $113.37 – $1,535.00 |
| Methodist Hospital of Sacramento | Sacramento | $442.08 | $106.88 – $1,274.05 |
| Petaluma Valley Hospital | Petaluma | not published | $502.87 – $1,921.00 |