Biopsy skin incisional single lesion at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$107.04
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.
$491.00
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.
$56.70 with Hill Physicians vs $6,582.00 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 |
|---|---|---|---|
| Hill Physicians | Commercial|All Plans | $56.70 | ↓ -47% |
| United | Medicaid|< 21 | $108.71 | ↑ +2% |
| United | Medicaid|> 21 | $108.71 | ↑ +2% |
| Hill Physicians | Medicaid|All Plans | $119.58 | ↑ +12% |
| Western Health Advantage | Commercial|All Plans | $171.85 | ↑ +61% |
| Hill Physicians | Medicare|All Plans | $172.46 | ↑ +61% |
| Kaiser | Medicaid|All Plans | $201.31 | ↑ +88% |
| Health Net | Medicaid|All Plans | $252.21 | ↑ +136% |
| California Health & Wellness | Medicaid|All Plans | $252.21 | ↑ +136% |
| Molina | Medicaid|All Plans | $255.47 | ↑ +139% |
| BCBS - Anthem | Medicaid|All Plans | $258.19 | ↑ +141% |
| Healthsmart | Commercial|All Plans | $353.52 | ↑ +230% |
| First Health | Commercial|All Plans | $368.25 | ↑ +244% |
| Kaiser | Commercial|All Plans | $387.89 | ↑ +262% |
| Sutter Health | Commercial|All Plans | $392.80 | ↑ +267% |
| MultiPlan | Commercial|All Plans | $392.80 | ↑ +267% |
| BCBS - Anthem | Medicare|All Other Plans | $463.02 | ↑ +333% |
| Aetna | Medicare|All Plans | $491.00 | ↑ +359% |
| Humana | Commercial|All Plans | $491.00 | ↑ +359% |
| United | Commercial|Non-Options PPO | $491.00 | ↑ +359% |
| Blue Shield CA | Medicare|PPO | $491.00 | ↑ +359% |
| Partnership Health Plan | Medicaid|All Plans | $491.00 | ↑ +359% |
| Molina | Medicare|All Plans | $491.00 | ↑ +359% |
| BCBS - Anthem | Medicare|Imperial | $505.73 | ↑ +372% |
| BrightHealth | Commercial|All Plans | $540.10 | ↑ +405% |
| Kaiser | Medicare|All Plans | $804.40 | ↑ +651% |
| Blue Shield CA | Medicare|HMO | $804.40 | ↑ +651% |
| United | Medicare|All Plans | $804.40 | ↑ +651% |
| Prison Healthcare | Medicaid|All Plans | $1,206.60 | ↑ +1027% |
| Health Net | Commercial|EPPO | $2,811.00 | ↑ +2526% |
| BCBS - Anthem | Commercial|Connection EPO | $3,631.00 | ↑ +3292% |
| BCBS - Anthem | Commercial|All Other Plans | $4,539.00 | ↑ +4140% |
| Aetna | Commercial|PPO | $5,002.00 | ↑ +4573% |
| Aetna | Commercial|All Other Plans | $5,002.00 | ↑ +4573% |
| Aetna | Commercial|HMO | $5,002.00 | ↑ +4573% |
| Health Net | Commercial|FFS | $5,183.00 | ↑ +4742% |
| BCBS - Anthem | Commercial|MCS | $6,582.00 | ↑ +6049% |
Visitor-reported prices
Comments
Biopsy skin incisional single lesion at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $141.41 | $56.70 – $491.00 |
| St. John's Camarillo Hospital | Camarillo | $552.37 | $164.46 – $1,458.18 |
| Petaluma Valley Hospital | Petaluma | $1,176.57 | $995.98 – $2,695.00 |
| Mark Twain Medical Center | San Andreas | $114.56 | $42.17 – $159.74 |
| Mercy Hospitals – Bakersfield | Bakersfield | $148.40 | $108.71 – $400.00 |
| Bakersfield Memorial Hospital | Bakersfield | $153.41 | $108.71 – $400.00 |
| Queen of The Valley Medical Center | Napa | $1,308.15 | $1,049.38 – $7,483.00 |
| Providence St Joseph Hospital Eureka | Eureka | $1,315.80 | $950.57 – $8,018.00 |