Clsd tx fx radius/ulna without manip 25560 at Mercy Medical Center Merced
333 Mercy Ave., Merced, CA · CommonSpirit Health · · NPI 1518018191
$1,127.34
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.
$2,189.00
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.
$170.95 with Partnership Health Plan vs $11,994.00 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 |
|---|---|---|---|
| Partnership Health Plan | Medicaid|< 21 | $170.95 | ↓ -85% |
| Health Plan of San Joaquin | Medicaid|> 21 | $170.95 | ↓ -85% |
| Kaiser | Medicaid|> 21 | $170.95 | ↓ -85% |
| Kaiser | Medicaid|< 21 | $170.95 | ↓ -85% |
| Health Plan of San Joaquin | Medicaid|< 21 | $170.95 | ↓ -85% |
| Inland Empire Health Plan | Medicaid|> 21 | $170.95 | ↓ -85% |
| Central California Alliance for Health | Medicaid|All Plans | $170.95 | ↓ -85% |
| California Health & Wellness | Medicaid|> 21 | $170.95 | ↓ -85% |
| Molina | Medicaid|< 21 | $170.95 | ↓ -85% |
| Molina | Medicaid|> 21 | $170.95 | ↓ -85% |
| California Health & Wellness | Medicaid|< 21 | $170.95 | ↓ -85% |
| Inland Empire Health Plan | Medicaid|< 21 | $170.95 | ↓ -85% |
| Kern Health System | Medicaid|> 21 | $170.95 | ↓ -85% |
| Kern Health System | Medicaid|< 21 | $170.95 | ↓ -85% |
| Partnership Health Plan | Medicaid|> 21 | $170.95 | ↓ -85% |
| BCBS - Anthem | Medicaid|> 21 | $245.73 | ↓ -78% |
| BCBS - Anthem | Medicaid|< 21 | $245.73 | ↓ -78% |
| Allcare | Commercial|All Plans | $283.33 | ↓ -75% |
| Humana | Medicare|All Plans | $304.79 | ↓ -73% |
| Aetna | Medicare|All Plans | $304.79 | ↓ -73% |
| United | Medicare|All Plans | $304.79 | ↓ -73% |
| Health Net | Medicare|All Plans | $304.79 | ↓ -73% |
| Kaiser | Medicare|All Plans | $304.79 | ↓ -73% |
| BCBS - Anthem | Medicare|All Plans | $304.79 | ↓ -73% |
| Blue Shield CA | Medicare|All Plans | $304.79 | ↓ -73% |
| Scan Health Plan | Medicare|All Plans | $304.79 | ↓ -73% |
| LA Care | Medicare|All Plans | $304.79 | ↓ -73% |
| Health Net | Medicaid|All Plans | $369.25 | ↓ -67% |
| Healthsmart | Commercial|All Plans | $1,313.40 | ↑ +17% |
| Cigna | Commercial|All Other Plans | $1,422.85 | ↑ +26% |
| Cigna | Commercial|PPO | $1,422.85 | ↑ +26% |
| Kaiser | Commercial|All Plans | $1,510.41 | ↑ +34% |
| First Health | Commercial|All Plans | $1,751.20 | ↑ +55% |
| MultiPlan | Commercial|All Plans | $2,057.66 | ↑ +83% |
| United | Commercial|HMO | $2,167.11 | ↑ +92% |
| United | Commercial|Non-Options PPO | $2,189.00 | ↑ +94% |
| United | Commercial|All Other Plans | $2,189.00 | ↑ +94% |
| United | Commercial|Options PPO | $2,189.00 | ↑ +94% |
| Aetna | Commercial|PPO | $5,322.00 | ↑ +372% |
| Aetna | Commercial|All Other Plans | $5,322.00 | ↑ +372% |
| Aetna | Commercial|HMO | $5,322.00 | ↑ +372% |
| BCBS - Anthem | Commercial|Exchange | $5,769.00 | ↑ +412% |
| Health Net | Commercial|Care Product | $6,629.00 | ↑ +488% |
| Health Net | Commercial|FFS | $7,546.00 | ↑ +569% |
| BCBS - Anthem | Commercial|All Other Plans | $7,591.00 | ↑ +573% |
| BCBS - Anthem | Commercial|MCS | $11,994.00 | ↑ +964% |
Visitor-reported prices
Comments
Clsd tx fx radius/ulna without manip 25560 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Petaluma Valley Hospital | Petaluma | $1,117.41 | $332.41 – $1,687.00 |
| Mark Twain Medical Center | San Andreas | $517.49 | $169.45 – $641.90 |
| Queen of The Valley Medical Center | Napa | $466.14 | $350.23 – $6,200.00 |
| Providence St Joseph Hospital Eureka | Eureka | $469.20 | $317.26 – $8,018.00 |
| Healdsburg Hospital | Healdsburg | $2,213.91 | $332.35 – $3,982.87 |
| Redwood Memorial Hospital | Fortuna | $276.93 | $1,333.00 – $20,799.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $448.80 | $343.23 – $4,042.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $739.20 | $269.67 – $1,597.00 |