Ortho ewh rgd without jnt cstm w/fit&adj at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$655.14
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.
$2,391.00
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.
$263.01 with WCMG vs $2,319.27 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 | $263.01 | ↓ -60% |
| Kaiser | Medicaid|All Plans | $549.93 | ↓ -16% |
| Kaiser | Commercial|All Plans | $549.93 | ↓ -16% |
| Kaiser | Medicare|All Plans | $549.93 | ↓ -16% |
| BCBS - Anthem | Medicaid|All Plans | $573.84 | ↓ -12% |
| Partnership Health Plan | Medicaid|All Plans | $597.75 | ↓ -9% |
| Molina | Medicaid|All Plans | $621.66 | ↓ -5% |
| Health Net | Medicaid|All Plans | $669.48 | ↑ +2% |
| California Health & Wellness | Medicaid|All Plans | $669.48 | ↑ +2% |
| United | Medicaid|< 21 | $733.55 | ↑ +12% |
| United | Medicaid|> 21 | $733.55 | ↑ +12% |
| Hill Physicians | Medicaid|All Plans | $806.90 | ↑ +23% |
| Health Net | Commercial|EPPO | $932.49 | ↑ +42% |
| Cigna | Commercial|LocalPlus | $956.40 | ↑ +46% |
| United | Commercial|Non-Options PPO | $1,243.32 | ↑ +90% |
| Cigna | Commercial|All Other Plans | $1,267.23 | ↑ +93% |
| United | Commercial|Options PPO | $1,338.96 | ↑ +104% |
| United | Commercial|HMO | $1,338.96 | ↑ +104% |
| United | Commercial|All Other Plans | $1,338.96 | ↑ +104% |
| Blue Shield CA | Commercial|ACO Trio | $1,554.15 | ↑ +137% |
| Western Health Advantage | Commercial|All Plans | $1,554.15 | ↑ +137% |
| Health Net | Commercial|FFS | $1,697.61 | ↑ +159% |
| First Health | Commercial|All Plans | $1,793.25 | ↑ +174% |
| Healthsmart | Commercial|All Plans | $1,793.25 | ↑ +174% |
| BCBS - Anthem | Commercial|Connection EPO | $1,864.98 | ↑ +185% |
| Sutter Health | Commercial|All Plans | $1,912.80 | ↑ +192% |
| Blue Shield CA | Commercial|Exchange | $1,960.62 | ↑ +199% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $1,960.62 | ↑ +199% |
| MultiPlan | Commercial|All Plans | $1,984.53 | ↑ +203% |
| Aetna | Commercial|HMO | $2,032.35 | ↑ +210% |
| Aetna | Commercial|All Other Plans | $2,032.35 | ↑ +210% |
| Aetna | Commercial|PPO | $2,032.35 | ↑ +210% |
| Blue Shield CA | Commercial|HMO | $2,151.90 | ↑ +228% |
| Blue Shield CA | Commercial|PPO | $2,151.90 | ↑ +228% |
| Blue Shield CA | Commercial|PPO Tandem | $2,151.90 | ↑ +228% |
| Blue Shield CA | Commercial|CalPers | $2,199.72 | ↑ +236% |
| BCBS - Anthem | Commercial|MCS | $2,319.27 | ↑ +254% |
| BCBS - Anthem | Commercial|All Other Plans | $2,319.27 | ↑ +254% |
Visitor-reported prices
Comments
Ortho ewh rgd without jnt cstm w/fit&adj at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $196.46 | $133.00 – $266.00 |
| French Hospital | San Luis Obispo | $179.93 | $50.54 – $266.00 |
| Dominican Hospital | Santa Cruz | $854.10 | $733.55 – $1,898.00 |
| Mercy General Hospital | Sacramento | $521.24 | $549.93 – $2,127.99 |
| Mercy Hospital of Folsom | Folsom | $930.10 | $263.01 – $2,295.36 |
| Woodland Memorial Hospital | Woodland | $655.14 | $263.01 – $2,391.00 |
| Methodist Hospital of Sacramento | Sacramento | $688.61 | $549.93 – $2,151.90 |
| Providence Cedars-Sinai Tarzana Medical Center | Tarzana | not published | $920.62 – $1,703.15 |