Valvuloplasty aortic at Mercy San Juan Medical Center
6501 Coyle Avenue, Carmichael, CA · CommonSpirit Health · · NPI 1972541498
$5,774.83
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.
$21,076.00
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.
$1,108.37 with United vs $35,580.00 with Blue Shield CA — 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 |
|---|---|---|---|
| United | Medicaid|< 21 | $1,108.37 | ↓ -81% |
| United | Medicaid|> 21 | $1,108.37 | ↓ -81% |
| Hill Physicians | Commercial|All Plans | $1,274.17 | ↓ -78% |
| Molina | Medicaid|All Plans | $1,815.85 | ↓ -69% |
| Hill Physicians | Medicaid|All Plans | $1,932.89 | ↓ -67% |
| WCMG | Commercial|All Plans | $2,318.36 | ↓ -60% |
| BCBS - Anthem | Medicaid|All Plans | $2,632.37 | ↓ -54% |
| California Health & Wellness | Medicaid|All Plans | $4,023.92 | ↓ -30% |
| Health Net | Medicaid|All Plans | $4,023.92 | ↓ -30% |
| Partnership Health Plan | Medicaid|All Plans | $5,957.47 | ↑ +3% |
| BCBS - Anthem | Medicare|All Other Plans | $7,065.30 | ↑ +22% |
| Western Health Advantage | Commercial|All Plans | $7,376.60 | ↑ +28% |
| Kaiser | Medicare|All Plans | $7,492.37 | ↑ +30% |
| Humana | Medicare|All Plans | $7,492.37 | ↑ +30% |
| Humana | Commercial|All Plans | $7,492.37 | ↑ +30% |
| Aetna | Medicare|All Plans | $7,492.37 | ↑ +30% |
| Molina | Medicare|All Plans | $7,492.37 | ↑ +30% |
| United | Medicare|All Plans | $7,492.37 | ↑ +30% |
| Blue Shield CA | Medicare|PPO | $7,492.37 | ↑ +30% |
| Blue Shield CA | Medicare|HMO | $7,492.37 | ↑ +30% |
| BCBS - Anthem | Medicare|Imperial | $7,717.14 | ↑ +34% |
| BrightHealth | Commercial|All Plans | $8,241.61 | ↑ +43% |
| Health Net | Commercial|EPPO | $8,573.00 | ↑ +48% |
| Kaiser | Medicaid|All Plans | $8,641.16 | ↑ +50% |
| BlueShield | Medicare|Trauma | $9,365.46 | ↑ +62% |
| Prison Healthcare | Medicaid|All Plans | $11,238.56 | ↑ +95% |
| Kaiser | Commercial|All Plans | $11,381.04 | ↑ +97% |
| Health Net | Commercial|FFS | $15,552.00 | ↑ +169% |
| First Health | Commercial|All Plans | $15,807.00 | ↑ +174% |
| Healthsmart | Commercial|All Plans | $15,807.00 | ↑ +174% |
| Aetna | Commercial|PPO | $16,573.00 | ↑ +187% |
| Aetna | Commercial|All Other Plans | $16,573.00 | ↑ +187% |
| Aetna | Commercial|HMO | $16,573.00 | ↑ +187% |
| Blue Shield CA | Commercial|ACO Trio | $16,598.00 | ↑ +187% |
| Sutter Health | Commercial|All Plans | $16,860.80 | ↑ +192% |
| MultiPlan | Commercial|All Plans | $17,493.08 | ↑ +203% |
| BCBS - Anthem | Commercial|Connection EPO | $19,145.00 | ↑ +232% |
| United | Commercial|Options PPO | $21,076.00 | ↑ +265% |
| United | Commercial|Non-Options PPO | $21,076.00 | ↑ +265% |
| United | Commercial|HMO | $21,076.00 | ↑ +265% |
| United | Commercial|All Other Plans | $21,076.00 | ↑ +265% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $21,162.00 | ↑ +266% |
| Blue Shield CA | Commercial|Exchange | $22,950.00 | ↑ +297% |
| BCBS - Anthem | Commercial|All Other Plans | $23,931.00 | ↑ +314% |
| Blue Shield CA | Commercial|PPO Tandem | $29,592.00 | ↑ +412% |
| Blue Shield CA | Commercial|HMO | $31,379.00 | ↑ +443% |
| Blue Shield CA | Commercial|CalPers | $33,036.00 | ↑ +472% |
| BCBS - Anthem | Commercial|MCS | $33,503.00 | ↑ +480% |
| Blue Shield CA | Commercial|PPO | $35,580.00 | ↑ +516% |
Visitor-reported prices
Comments
Valvuloplasty aortic at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Fresno Medical Center | FRESNO | $14,980.00 | not published |
| St. John's Camarillo Hospital | Camarillo | $5,149.13 | $1,363.30 – $13,090.66 |
| Antioch Medical Center | ANTIOCH | $14,980.00 | not published |
| Redwood City Medical Center | Redwood City | $14,980.00 | not published |
| Santa Clara Medical Center | SANTA CLARA | $14,980.00 | not published |
| Baldwin Park Medical Center | BALDWIN PARK | $9,375.60 | not published |
| Riverside Medical Center | RIVERSIDE | $9,375.60 | not published |
| Fremont Medical Center | FREMONT | $14,980.00 | not published |