Biopsy of heart lining at Mercy Medical Center Merced
333 Mercy Ave., Merced, CA · CommonSpirit Health · · NPI 1518018191
$3,159.53
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.
$6,135.00
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.
$272.83 with Kern Health System vs $25,258.00 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 |
|---|---|---|---|
| Kern Health System | Medicaid|< 21 | $272.83 | ↓ -91% |
| Inland Empire Health Plan | Medicaid|< 21 | $272.83 | ↓ -91% |
| Kaiser | Medicaid|< 21 | $272.83 | ↓ -91% |
| Kaiser | Medicaid|> 21 | $272.83 | ↓ -91% |
| Health Plan of San Joaquin | Medicaid|> 21 | $272.83 | ↓ -91% |
| Partnership Health Plan | Medicaid|< 21 | $272.83 | ↓ -91% |
| Health Plan of San Joaquin | Medicaid|< 21 | $272.83 | ↓ -91% |
| Partnership Health Plan | Medicaid|> 21 | $272.83 | ↓ -91% |
| Molina | Medicaid|< 21 | $272.83 | ↓ -91% |
| Molina | Medicaid|> 21 | $272.83 | ↓ -91% |
| California Health & Wellness | Medicaid|> 21 | $272.83 | ↓ -91% |
| Inland Empire Health Plan | Medicaid|> 21 | $272.83 | ↓ -91% |
| California Health & Wellness | Medicaid|< 21 | $272.83 | ↓ -91% |
| Kern Health System | Medicaid|> 21 | $272.83 | ↓ -91% |
| BCBS - Anthem | Medicaid|> 21 | $392.20 | ↓ -88% |
| BCBS - Anthem | Medicaid|< 21 | $392.20 | ↓ -88% |
| Central California Alliance for Health | Medicaid|All Plans | $432.54 | ↓ -86% |
| Health Net | Medicaid|All Plans | $934.29 | ↓ -70% |
| Healthsmart | Commercial|All Plans | $3,681.00 | ↑ +17% |
| Cigna | Commercial|All Other Plans | $3,987.75 | ↑ +26% |
| Cigna | Commercial|PPO | $3,987.75 | ↑ +26% |
| Humana | Medicare|All Plans | $3,999.21 | ↑ +27% |
| Aetna | Medicare|All Plans | $3,999.21 | ↑ +27% |
| United | Medicare|All Plans | $3,999.21 | ↑ +27% |
| Health Net | Medicare|All Plans | $3,999.21 | ↑ +27% |
| Kaiser | Medicare|All Plans | $3,999.21 | ↑ +27% |
| BCBS - Anthem | Medicare|All Plans | $3,999.21 | ↑ +27% |
| Blue Shield CA | Medicare|All Plans | $3,999.21 | ↑ +27% |
| Scan Health Plan | Medicare|All Plans | $3,999.21 | ↑ +27% |
| LA Care | Medicare|All Plans | $3,999.21 | ↑ +27% |
| Kaiser | Commercial|All Plans | $4,233.15 | ↑ +34% |
| First Health | Commercial|All Plans | $4,908.00 | ↑ +55% |
| MultiPlan | Commercial|All Plans | $5,766.90 | ↑ +83% |
| United | Commercial|HMO | $6,073.65 | ↑ +92% |
| United | Commercial|Options PPO | $6,135.00 | ↑ +94% |
| United | Commercial|Non-Options PPO | $6,135.00 | ↑ +94% |
| United | Commercial|All Other Plans | $6,135.00 | ↑ +94% |
| BCBS - Anthem | Commercial|Exchange | $7,407.00 | ↑ +134% |
| BCBS - Anthem | Commercial|All Other Plans | $9,746.00 | ↑ +208% |
| Health Net | Commercial|Care Product | $14,225.00 | ↑ +350% |
| BCBS - Anthem | Commercial|MCS | $15,399.00 | ↑ +387% |
| Aetna | Commercial|All Other Plans | $15,877.00 | ↑ +403% |
| Aetna | Commercial|PPO | $15,877.00 | ↑ +403% |
| Aetna | Commercial|HMO | $15,877.00 | ↑ +403% |
| Health Net | Commercial|FFS | $16,193.00 | ↑ +413% |
| Blue Shield CA | Commercial|Exchange | $18,005.00 | ↑ +470% |
| Blue Shield CA | Commercial|All Other Plans | $25,258.00 | ↑ +699% |
Visitor-reported prices
Comments
Biopsy of heart lining at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Arroyo Grande Hospital | Santa Maria | $2,223.46 | $272.83 – $5,091.10 |
| French Hospital | San Luis Obispo | $1,973.72 | $272.83 – $4,934.30 |
| Bakersfield Memorial Hospital | Bakersfield | $2,251.55 | $272.83 – $4,846.65 |
| St. Joseph's Medical Center Stockton | Stockton | $1,803.69 | $272.83 – $5,153.40 |
| Santa Rosa Memorial Hospital | Santa Rosa | $3,796.44 | $2,238.00 – $11,377.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $2,006.88 | $3,429.00 – $7,883.00 |
| Dominican Hospital | Santa Cruz | $1,465.65 | $272.83 – $10,194.41 |
| St. Mary Medical Center | Long Beach | $1,976.28 | $272.83 – $6,398.74 |