Bone biopsy open superficial at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$940.46
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.
$4,314.00
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.
$141.16 with Hill Physicians vs $14,393.00 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 | $141.16 | ↓ -85% |
| United | Medicaid|< 21 | $145.25 | ↓ -85% |
| United | Medicaid|> 21 | $145.25 | ↓ -85% |
| Hill Physicians | Medicare|All Plans | $147.87 | ↓ -84% |
| Molina | Medicaid|All Plans | $237.97 | ↓ -75% |
| Hill Physicians | Medicaid|All Plans | $251.87 | ↓ -73% |
| BCBS - Anthem | Medicaid|All Plans | $344.98 | ↓ -63% |
| California Health & Wellness | Medicaid|All Plans | $531.21 | ↓ -44% |
| Health Net | Medicaid|All Plans | $531.21 | ↓ -44% |
| Partnership Health Plan | Medicaid|All Plans | $780.74 | ↓ -17% |
| Western Health Advantage | Commercial|All Plans | $1,509.90 | ↑ +61% |
| Kaiser | Medicaid|All Plans | $1,768.74 | ↑ +88% |
| Healthsmart | Commercial|All Plans | $3,106.08 | ↑ +230% |
| First Health | Commercial|All Plans | $3,235.50 | ↑ +244% |
| Kaiser | Commercial|All Plans | $3,408.06 | ↑ +262% |
| Sutter Health | Commercial|All Plans | $3,451.20 | ↑ +267% |
| MultiPlan | Commercial|All Plans | $3,451.20 | ↑ +267% |
| BCBS - Anthem | Medicare|All Other Plans | $3,546.64 | ↑ +277% |
| Blue Shield CA | Medicare|HMO | $3,761.02 | ↑ +300% |
| United | Medicare|All Plans | $3,761.02 | ↑ +300% |
| Molina | Medicare|All Plans | $3,761.02 | ↑ +300% |
| Humana | Commercial|All Plans | $3,761.02 | ↑ +300% |
| Kaiser | Medicare|All Plans | $3,761.02 | ↑ +300% |
| Aetna | Medicare|All Plans | $3,761.02 | ↑ +300% |
| Blue Shield CA | Medicare|PPO | $3,761.02 | ↑ +300% |
| BCBS - Anthem | Medicare|Imperial | $3,873.85 | ↑ +312% |
| BrightHealth | Commercial|All Plans | $4,137.12 | ↑ +340% |
| United | Commercial|Non-Options PPO | $4,314.00 | ↑ +359% |
| Health Net | Commercial|EPPO | $5,418.00 | ↑ +476% |
| Prison Healthcare | Medicaid|All Plans | $5,641.53 | ↑ +500% |
| Aetna | Commercial|All Other Plans | $7,003.00 | ↑ +645% |
| Aetna | Commercial|HMO | $7,003.00 | ↑ +645% |
| Aetna | Commercial|PPO | $7,003.00 | ↑ +645% |
| BCBS - Anthem | Commercial|Connection EPO | $7,941.00 | ↑ +744% |
| BCBS - Anthem | Commercial|All Other Plans | $9,926.00 | ↑ +955% |
| Health Net | Commercial|FFS | $9,992.00 | ↑ +962% |
| BCBS - Anthem | Commercial|MCS | $14,393.00 | ↑ +1430% |
Visitor-reported prices
Comments
Bone biopsy open superficial at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $1,242.44 | $141.16 – $3,761.02 |
| St. John's Camarillo Hospital | Camarillo | $4,420.17 | $178.66 – $8,520.80 |
| Petaluma Valley Hospital | Petaluma | $5,230.05 | $2,570.00 – $6,619.00 |
| Queen of The Valley Medical Center | Napa | $5,815.02 | $4,124.29 – $16,652.00 |
| Providence St Joseph Hospital Eureka | Eureka | $5,849.19 | $3,735.95 – $16,652.00 |
| Healdsburg Hospital | Healdsburg | $3,327.24 | $3,125.00 – $5,198.77 |
| Redwood Memorial Hospital | Fortuna | $3,455.25 | $8,005.00 – $25,998.00 |
| Santa Rosa Memorial Hospital | Santa Rosa | $5,595.21 | $2,995.00 – $6,732.00 |