Aco annual medicare visit (awv), initial g0438aco at Mercy Medical Center Merced
333 Mercy Ave., Merced, CA · CommonSpirit Health · · NPI 1518018191
$213.73
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.
$415.00
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.
$165.96 with United vs $415.00 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 |
|---|---|---|---|
| United | Medicare|All Plans | $165.96 | ↓ -22% |
| Blue Shield CA | Medicare|All Plans | $165.96 | ↓ -22% |
| Healthsmart | Commercial|All Plans | $249.00 | ↑ +17% |
| Cigna | Commercial|PPO | $269.75 | ↑ +26% |
| Cigna | Commercial|All Other Plans | $269.75 | ↑ +26% |
| Kaiser | Commercial|All Plans | $286.35 | ↑ +34% |
| First Health | Commercial|All Plans | $332.00 | ↑ +55% |
| MultiPlan | Commercial|All Plans | $390.10 | ↑ +83% |
| United | Commercial|HMO | $410.85 | ↑ +92% |
| United | Commercial|Non-Options PPO | $415.00 | ↑ +94% |
| United | Commercial|Options PPO | $415.00 | ↑ +94% |
| United | Commercial|All Other Plans | $415.00 | ↑ +94% |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), initial g0438aco at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mark Twain Medical Center | San Andreas | $293.04 | $54.85 – $207.76 |
| Healdsburg Hospital | Healdsburg | $576.30 | not published |
| Redwood Memorial Hospital | Fortuna | $270.30 | not published |
| Mercy Medical Center Redding | Redding | $196.72 | $165.96 – $380.24 |
| Queen of The Valley Medical Center | Napa | not published | $181.05 – $181.05 |
| Santa Rosa Memorial Hospital | Santa Rosa | not published | $177.43 – $181.05 |
| Providence Saint Joseph Medical Center | Burbank | not published | $190.40 – $352.24 |
| St Jude Medical Center | Fullerton | not published | $161.84 – $352.24 |