Ortho elbow without jnt cstm w/fit&adj at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$147.69
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.
$539.00
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.
$59.29 with WCMG vs $522.83 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 | $59.29 | ↓ -60% |
| Kaiser | Medicaid|All Plans | $123.97 | ↓ -16% |
| Kaiser | Commercial|All Plans | $123.97 | ↓ -16% |
| Kaiser | Medicare|All Plans | $123.97 | ↓ -16% |
| BCBS - Anthem | Medicaid|All Plans | $129.36 | ↓ -12% |
| Partnership Health Plan | Medicaid|All Plans | $134.75 | ↓ -9% |
| Molina | Medicaid|All Plans | $140.14 | ↓ -5% |
| Health Net | Medicaid|All Plans | $150.92 | ↑ +2% |
| California Health & Wellness | Medicaid|All Plans | $150.92 | ↑ +2% |
| United | Medicaid|< 21 | $165.19 | ↑ +12% |
| United | Medicaid|> 21 | $165.19 | ↑ +12% |
| Hill Physicians | Medicaid|All Plans | $181.71 | ↑ +23% |
| Health Net | Commercial|EPPO | $210.21 | ↑ +42% |
| Cigna | Commercial|LocalPlus | $215.60 | ↑ +46% |
| United | Commercial|Non-Options PPO | $280.28 | ↑ +90% |
| Cigna | Commercial|All Other Plans | $285.67 | ↑ +93% |
| United | Commercial|Options PPO | $301.84 | ↑ +104% |
| United | Commercial|HMO | $301.84 | ↑ +104% |
| United | Commercial|All Other Plans | $301.84 | ↑ +104% |
| Blue Shield CA | Commercial|ACO Trio | $350.35 | ↑ +137% |
| Western Health Advantage | Commercial|All Plans | $350.35 | ↑ +137% |
| Health Net | Commercial|FFS | $382.69 | ↑ +159% |
| First Health | Commercial|All Plans | $404.25 | ↑ +174% |
| Healthsmart | Commercial|All Plans | $404.25 | ↑ +174% |
| BCBS - Anthem | Commercial|Connection EPO | $420.42 | ↑ +185% |
| Sutter Health | Commercial|All Plans | $431.20 | ↑ +192% |
| Blue Shield CA | Commercial|Exchange | $441.98 | ↑ +199% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $441.98 | ↑ +199% |
| MultiPlan | Commercial|All Plans | $447.37 | ↑ +203% |
| Aetna | Commercial|HMO | $458.15 | ↑ +210% |
| Aetna | Commercial|All Other Plans | $458.15 | ↑ +210% |
| Aetna | Commercial|PPO | $458.15 | ↑ +210% |
| Blue Shield CA | Commercial|HMO | $485.10 | ↑ +228% |
| Blue Shield CA | Commercial|PPO | $485.10 | ↑ +228% |
| Blue Shield CA | Commercial|PPO Tandem | $485.10 | ↑ +228% |
| Blue Shield CA | Commercial|CalPers | $495.88 | ↑ +236% |
| BCBS - Anthem | Commercial|MCS | $522.83 | ↑ +254% |
| BCBS - Anthem | Commercial|All Other Plans | $522.83 | ↑ +254% |
Visitor-reported prices
Comments
Ortho elbow without jnt cstm w/fit&adj at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $333.42 | $165.19 – $763.42 |
| French Hospital | San Luis Obispo | $305.37 | $148.01 – $763.42 |
| Mercy Hospitals – Bakersfield | Bakersfield | $27.83 | $18.75 – $75.00 |
| Bakersfield Memorial Hospital | Bakersfield | $27.53 | $18.75 – $75.00 |
| St. Joseph's Medical Center Stockton | Stockton | $20.00 | $17.68 – $68.00 |
| Mercy Medical Center Merced | Merced | $30.90 | $13.80 – $60.00 |
| Providence Saint Joseph Medical Center | Burbank | $43.05 | $315.21 – $583.14 |
| Mercy General Hospital | Sacramento | $117.51 | $123.97 – $479.71 |