Avul nail plate addl at Mercy Medical Center Merced
333 Mercy Ave., Merced, CA · CommonSpirit Health · · NPI 1518018191
$169.44
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.
$329.00
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.
$17.09 with Inland Empire Health Plan vs $8,557.00 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 |
|---|---|---|---|
| Inland Empire Health Plan | Medicaid|> 21 | $17.09 | ↓ -90% |
| Molina | Medicaid|< 21 | $17.09 | ↓ -90% |
| Molina | Medicaid|> 21 | $17.09 | ↓ -90% |
| Kaiser | Medicaid|< 21 | $17.09 | ↓ -90% |
| Kaiser | Medicaid|> 21 | $17.09 | ↓ -90% |
| Partnership Health Plan | Medicaid|< 21 | $17.09 | ↓ -90% |
| Partnership Health Plan | Medicaid|> 21 | $17.09 | ↓ -90% |
| Kern Health System | Medicaid|< 21 | $17.09 | ↓ -90% |
| Kern Health System | Medicaid|> 21 | $17.09 | ↓ -90% |
| California Health & Wellness | Medicaid|< 21 | $17.09 | ↓ -90% |
| California Health & Wellness | Medicaid|> 21 | $17.09 | ↓ -90% |
| Health Plan of San Joaquin | Medicaid|< 21 | $17.09 | ↓ -90% |
| Health Plan of San Joaquin | Medicaid|> 21 | $17.09 | ↓ -90% |
| Inland Empire Health Plan | Medicaid|< 21 | $17.09 | ↓ -90% |
| BCBS - Anthem | Medicaid|< 21 | $24.56 | ↓ -86% |
| BCBS - Anthem | Medicaid|> 21 | $24.56 | ↓ -86% |
| Central California Alliance for Health | Medicaid|All Plans | $26.94 | ↓ -84% |
| Health Net | Medicaid|All Plans | $58.19 | ↓ -66% |
| Healthsmart | Commercial|All Plans | $197.40 | ↑ +17% |
| Cigna | Commercial|PPO | $213.85 | ↑ +26% |
| Cigna | Commercial|All Other Plans | $213.85 | ↑ +26% |
| Kaiser | Commercial|All Plans | $227.01 | ↑ +34% |
| First Health | Commercial|All Plans | $263.20 | ↑ +55% |
| MultiPlan | Commercial|All Plans | $309.26 | ↑ +83% |
| United | Commercial|HMO | $325.71 | ↑ +92% |
| United | Commercial|Non-Options PPO | $329.00 | ↑ +94% |
| United | Commercial|All Other Plans | $329.00 | ↑ +94% |
| United | Commercial|Options PPO | $329.00 | ↑ +94% |
| BCBS - Anthem | Commercial|Exchange | $4,116.00 | ↑ +2329% |
| Aetna | Commercial|All Other Plans | $5,322.00 | ↑ +3041% |
| Aetna | Commercial|PPO | $5,322.00 | ↑ +3041% |
| Aetna | Commercial|HMO | $5,322.00 | ↑ +3041% |
| BCBS - Anthem | Commercial|All Other Plans | $5,416.00 | ↑ +3096% |
| BCBS - Anthem | Commercial|MCS | $8,557.00 | ↑ +4950% |
Visitor-reported prices
Comments
Avul nail plate addl at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. John's Camarillo Hospital | Camarillo | $87.15 | $21.02 – $226.00 |
| Petaluma Valley Hospital | Petaluma | $763.47 | $1,687.00 – $10,997.00 |
| Mark Twain Medical Center | San Andreas | $67.94 | $12.42 – $47.04 |
| Bakersfield Memorial Hospital | Bakersfield | $55.79 | $17.09 – $150.48 |
| Queen of The Valley Medical Center | Napa | $1,080.18 | $2,747.00 – $8,621.00 |
| Providence St Joseph Hospital Eureka | Eureka | $308.04 | $2,699.00 – $21,319.00 |
| Healdsburg Hospital | Healdsburg | $150.96 | $2,335.00 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $280.50 | $5,981.00 – $20,799.00 |