Pr egd flexible transoral w/placement percutaneous gastrostomy tube at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$1,726.75
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.
$6,302.00
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.
$197.46 with Hill Physicians vs $12,615.00 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 | $197.46 | ↓ -89% |
| United | Medicaid|< 21 | $277.70 | ↓ -84% |
| United | Medicaid|> 21 | $277.70 | ↓ -84% |
| Molina | Medicaid|All Plans | $454.96 | ↓ -74% |
| Hill Physicians | Medicaid|All Plans | $481.52 | ↓ -72% |
| BCBS - Anthem | Medicaid|All Plans | $659.53 | ↓ -62% |
| WCMG | Commercial|All Plans | $660.22 | ↓ -62% |
| California Health & Wellness | Medicaid|All Plans | $1,002.45 | ↓ -42% |
| Health Net | Medicaid|All Plans | $1,002.45 | ↓ -42% |
| Partnership Health Plan | Medicaid|All Plans | $1,492.64 | ↓ -14% |
| Western Health Advantage | Commercial|All Plans | $2,100.70 | ↑ +22% |
| BCBS - Anthem | Medicare|All Other Plans | $2,350.74 | ↑ +36% |
| Kaiser | Medicaid|All Plans | $2,460.82 | ↑ +43% |
| Kaiser | Medicare|All Plans | $2,492.83 | ↑ +44% |
| Humana | Medicare|All Plans | $2,492.83 | ↑ +44% |
| Humana | Commercial|All Plans | $2,492.83 | ↑ +44% |
| Aetna | Medicare|All Plans | $2,492.83 | ↑ +44% |
| Molina | Medicare|All Plans | $2,492.83 | ↑ +44% |
| United | Medicare|All Plans | $2,492.83 | ↑ +44% |
| Blue Shield CA | Medicare|PPO | $2,492.83 | ↑ +44% |
| Blue Shield CA | Medicare|HMO | $2,492.83 | ↑ +44% |
| BCBS - Anthem | Medicare|Imperial | $2,567.61 | ↑ +49% |
| BrightHealth | Commercial|All Plans | $2,742.11 | ↑ +59% |
| BlueShield | Medicare|Trauma | $3,116.04 | ↑ +80% |
| Kaiser | Commercial|All Plans | $3,241.08 | ↑ +88% |
| Prison Healthcare | Medicaid|All Plans | $3,739.24 | ↑ +117% |
| Blue Shield CA | Commercial|ACO Trio | $4,430.00 | ↑ +157% |
| Healthsmart | Commercial|All Plans | $4,501.50 | ↑ +161% |
| First Health | Commercial|All Plans | $4,501.50 | ↑ +161% |
| Sutter Health | Commercial|All Plans | $4,801.60 | ↑ +178% |
| MultiPlan | Commercial|All Plans | $4,981.66 | ↑ +188% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $5,645.00 | ↑ +227% |
| Blue Shield CA | Commercial|Exchange | $5,727.00 | ↑ +232% |
| Health Net | Commercial|EPPO | $5,780.00 | ↑ +235% |
| United | Commercial|Non-Options PPO | $6,002.00 | ↑ +248% |
| United | Commercial|Options PPO | $6,002.00 | ↑ +248% |
| United | Commercial|HMO | $6,002.00 | ↑ +248% |
| United | Commercial|All Other Plans | $6,002.00 | ↑ +248% |
| BCBS - Anthem | Commercial|Connection EPO | $7,209.00 | ↑ +317% |
| Aetna | Commercial|HMO | $7,251.00 | ↑ +320% |
| Aetna | Commercial|PPO | $7,251.00 | ↑ +320% |
| Aetna | Commercial|All Other Plans | $7,251.00 | ↑ +320% |
| Blue Shield CA | Commercial|PPO Tandem | $7,528.00 | ↑ +336% |
| Blue Shield CA | Commercial|HMO | $8,370.00 | ↑ +385% |
| Blue Shield CA | Commercial|CalPers | $8,811.00 | ↑ +410% |
| BCBS - Anthem | Commercial|All Other Plans | $9,011.00 | ↑ +422% |
| Blue Shield CA | Commercial|PPO | $9,068.00 | ↑ +425% |
| Health Net | Commercial|FFS | $10,485.00 | ↑ +507% |
| BCBS - Anthem | Commercial|MCS | $12,615.00 | ↑ +631% |
Visitor-reported prices
Comments
Pr egd flexible transoral w/placement percutaneous gastrostomy tube at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $3,205.35 | $2,570.00 – $4,657.00 |
| Mark Twain Medical Center | San Andreas | $495.51 | $192.48 – $729.12 |
| Mercy Hospitals – Bakersfield | Bakersfield | $1,735.54 | $277.70 – $3,742.40 |
| Bakersfield Memorial Hospital | Bakersfield | $1,716.83 | $277.70 – $3,695.62 |
| Queen of The Valley Medical Center | Napa | $3,379.77 | $2,724.58 – $9,858.00 |
| Providence St Joseph Hospital Eureka | Eureka | $2,657.10 | $2,468.04 – $9,858.00 |
| Healdsburg Hospital | Healdsburg | $1,776.33 | $2,585.43 – $5,198.77 |
| Redwood Memorial Hospital | Fortuna | $2,664.75 | $8,005.00 – $25,998.00 |