Breast Biopsy (ultrasound-guided, percutaneous) at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$1,263.53
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.
$5,796.00
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.
$151.37 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 | $151.37 | ↓ -88% |
| United | Medicaid|< 21 | $613.92 | ↓ -51% |
| United | Medicaid|> 21 | $613.92 | ↓ -51% |
| Hill Physicians | Medicare|All Plans | $625.87 | ↓ -50% |
| Hill Physicians | Medicaid|All Plans | $675.31 | ↓ -47% |
| Molina | Medicaid|All Plans | $1,154.17 | ↓ -9% |
| BCBS - Anthem | Medicaid|All Plans | $1,166.45 | ↓ -8% |
| California Health & Wellness | Medicaid|All Plans | $1,424.29 | ↑ +13% |
| Health Net | Medicaid|All Plans | $1,424.29 | ↑ +13% |
| Western Health Advantage | Commercial|All Plans | $1,823.15 | ↑ +44% |
| BCBS - Anthem | Medicare|All Other Plans | $2,007.80 | ↑ +59% |
| Humana | Commercial|All Plans | $2,129.16 | ↑ +69% |
| Aetna | Medicare|All Plans | $2,129.16 | ↑ +69% |
| Molina | Medicare|All Plans | $2,129.16 | ↑ +69% |
| United | Medicare|All Plans | $2,129.16 | ↑ +69% |
| Kaiser | Medicare|All Plans | $2,129.16 | ↑ +69% |
| Blue Shield CA | Medicare|HMO | $2,129.16 | ↑ +69% |
| Blue Shield CA | Medicare|PPO | $2,129.16 | ↑ +69% |
| Kaiser | Medicaid|All Plans | $2,135.69 | ↑ +69% |
| BCBS - Anthem | Medicare|Imperial | $2,193.03 | ↑ +74% |
| BrightHealth | Commercial|All Plans | $2,342.08 | ↑ +85% |
| Partnership Health Plan | Medicaid|All Plans | $2,639.86 | ↑ +109% |
| Prison Healthcare | Medicaid|All Plans | $3,193.74 | ↑ +153% |
| Healthsmart | Commercial|All Plans | $3,750.48 | ↑ +197% |
| First Health | Commercial|All Plans | $3,906.75 | ↑ +209% |
| Kaiser | Commercial|All Plans | $4,115.11 | ↑ +226% |
| MultiPlan | Commercial|All Plans | $4,167.20 | ↑ +230% |
| Sutter Health | Commercial|All Plans | $4,167.20 | ↑ +230% |
| Health Net | Commercial|EPPO | $4,599.00 | ↑ +264% |
| United | Commercial|Non-Options PPO | $5,209.00 | ↑ +312% |
| Aetna | Commercial|HMO | $7,003.00 | ↑ +454% |
| Aetna | Commercial|PPO | $7,003.00 | ↑ +454% |
| Aetna | Commercial|All Other Plans | $7,003.00 | ↑ +454% |
| BCBS - Anthem | Commercial|Connection EPO | $7,941.00 | ↑ +528% |
| Health Net | Commercial|FFS | $8,480.00 | ↑ +571% |
| BCBS - Anthem | Commercial|All Other Plans | $9,926.00 | ↑ +686% |
| BCBS - Anthem | Commercial|MCS | $14,393.00 | ↑ +1039% |
Visitor-reported prices
Comments
Breast Biopsy (ultrasound-guided, percutaneous) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $1,669.25 | $151.37 – $4,323.47 |
| St. John's Camarillo Hospital | Camarillo | $2,180.81 | $928.80 – $3,883.62 |
| Banner Lassen Medical Center | Susanville | $2,264.44 | $1,012.97 – $4,207.86 |
| Petaluma Valley Hospital | Petaluma | $3,603.15 | $2,225.71 – $4,657.00 |
| Arroyo Grande Hospital | Santa Maria | $4,430.66 | $613.92 – $9,431.52 |
| Mark Twain Medical Center | San Andreas | $2,835.83 | $97.53 – $377.00 |
| French Hospital | San Luis Obispo | $4,057.99 | $613.92 – $4,462.92 |
| Mercy Hospitals – Bakersfield | Bakersfield | $1,181.27 | $613.92 – $2,251.20 |