Oth resp proc, group at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$363.05
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.
$1,325.00
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.
$14.76 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 | $14.76 | ↓ -96% |
| WCMG | Commercial|All Plans | $18.59 | ↓ -95% |
| Aetna | Commercial|HMO | $39.09 | ↓ -89% |
| Aetna | Commercial|All Other Plans | $39.09 | ↓ -89% |
| Aetna | Commercial|PPO | $39.09 | ↓ -89% |
| BCBS - Anthem | Medicare|All Other Plans | $48.64 | ↓ -87% |
| Kaiser | Medicare|All Plans | $51.58 | ↓ -86% |
| Humana | Medicare|All Plans | $51.58 | ↓ -86% |
| Humana | Commercial|All Plans | $51.58 | ↓ -86% |
| Aetna | Medicare|All Plans | $51.58 | ↓ -86% |
| Molina | Medicare|All Plans | $51.58 | ↓ -86% |
| United | Medicare|All Plans | $51.58 | ↓ -86% |
| Blue Shield CA | Medicare|PPO | $51.58 | ↓ -86% |
| Blue Shield CA | Medicare|HMO | $51.58 | ↓ -86% |
| BCBS - Anthem | Medicare|Imperial | $53.13 | ↓ -85% |
| BrightHealth | Commercial|All Plans | $56.74 | ↓ -84% |
| Western Health Advantage | Commercial|All Plans | $59.15 | ↓ -84% |
| BlueShield | Medicare|Trauma | $64.47 | ↓ -82% |
| Kaiser | Medicaid|All Plans | $69.29 | ↓ -81% |
| Prison Healthcare | Medicaid|All Plans | $77.37 | ↓ -79% |
| Blue Shield CA | Commercial|ACO Trio | $86.19 | ↓ -76% |
| Kaiser | Commercial|All Plans | $91.26 | ↓ -75% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $109.85 | ↓ -70% |
| Blue Shield CA | Commercial|Exchange | $114.92 | ↓ -68% |
| Healthsmart | Commercial|All Plans | $126.75 | ↓ -65% |
| First Health | Commercial|All Plans | $126.75 | ↓ -65% |
| Sutter Health | Commercial|All Plans | $135.20 | ↓ -63% |
| Blue Shield CA | Commercial|PPO Tandem | $135.20 | ↓ -63% |
| MultiPlan | Commercial|All Plans | $140.27 | ↓ -61% |
| Blue Shield CA | Commercial|PPO | $152.10 | ↓ -58% |
| Blue Shield CA | Commercial|HMO | $152.10 | ↓ -58% |
| Blue Shield CA | Commercial|CalPers | $155.48 | ↓ -57% |
| BCBS - Anthem | Commercial|MCS | $169.00 | ↓ -53% |
| United | Commercial|HMO | $169.00 | ↓ -53% |
| United | Commercial|Non-Options PPO | $169.00 | ↓ -53% |
| BCBS - Anthem | Commercial|All Other Plans | $169.00 | ↓ -53% |
| BCBS - Anthem | Commercial|Connection EPO | $169.00 | ↓ -53% |
| Cigna | Commercial|LocalPlus | $1,867.00 | ↑ +414% |
| Cigna | Commercial|All Other Plans | $2,488.00 | ↑ +585% |
| United | Commercial|All Other Plans | $16,950.00 | ↑ +4569% |
| United | Commercial|Options PPO | $16,950.00 | ↑ +4569% |
Visitor-reported prices
Comments
Oth resp proc, group at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $67.89 | $41.85 – $1,834.00 |
| Arroyo Grande Hospital | Santa Maria | $290.62 | $49.87 – $746.00 |
| Mark Twain Medical Center | San Andreas | $247.76 | $41.66 – $157.78 |
| French Hospital | San Luis Obispo | $266.17 | $33.75 – $1,149.00 |
| Bakersfield Memorial Hospital | Bakersfield | $143.13 | $49.87 – $236.72 |
| St. Joseph's Medical Center Stockton | Stockton | $112.61 | $20.16 – $684.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $130.08 | $40.83 – $88.87 |
| Mercy Medical Center Merced | Merced | $644.78 | $43.92 – $745.00 |