Conversion ext bil drg cath at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$2,509.40
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.
$11,511.00
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.
$190.95 with Hill Physicians vs $11,051.00 with United — 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 | $190.95 | ↓ -92% |
| United | Medicaid|< 21 | $1,014.52 | ↓ -60% |
| United | Medicaid|> 21 | $1,014.52 | ↓ -60% |
| Hill Physicians | Medicare|All Plans | $1,076.05 | ↓ -57% |
| Hill Physicians | Medicaid|All Plans | $1,115.97 | ↓ -56% |
| Molina | Medicaid|All Plans | $1,907.30 | ↓ -24% |
| BCBS - Anthem | Medicaid|All Plans | $1,927.59 | ↓ -23% |
| Health Net | Medicaid|All Plans | $2,353.69 | ↓ -6% |
| California Health & Wellness | Medicaid|All Plans | $2,353.69 | ↓ -6% |
| BCBS - Anthem | Commercial|Connection EPO | $3,631.00 | ↑ +45% |
| Western Health Advantage | Commercial|All Plans | $3,867.85 | ↑ +54% |
| Partnership Health Plan | Medicaid|All Plans | $4,362.44 | ↑ +74% |
| BCBS - Anthem | Medicare|All Other Plans | $4,373.20 | ↑ +74% |
| Kaiser | Medicaid|All Plans | $4,530.91 | ↑ +81% |
| BCBS - Anthem | Commercial|All Other Plans | $4,539.00 | ↑ +81% |
| Kaiser | Medicare|All Plans | $4,637.54 | ↑ +85% |
| Aetna | Medicare|All Plans | $4,637.54 | ↑ +85% |
| Molina | Medicare|All Plans | $4,637.54 | ↑ +85% |
| United | Medicare|All Plans | $4,637.54 | ↑ +85% |
| Humana | Commercial|All Plans | $4,637.54 | ↑ +85% |
| Blue Shield CA | Medicare|HMO | $4,637.54 | ↑ +85% |
| Blue Shield CA | Medicare|PPO | $4,637.54 | ↑ +85% |
| BCBS - Anthem | Medicare|Imperial | $4,776.67 | ↑ +90% |
| BrightHealth | Commercial|All Plans | $5,101.29 | ↑ +103% |
| BCBS - Anthem | Commercial|MCS | $6,582.00 | ↑ +162% |
| Prison Healthcare | Medicaid|All Plans | $6,956.31 | ↑ +177% |
| Aetna | Commercial|HMO | $7,003.00 | ↑ +179% |
| Aetna | Commercial|PPO | $7,003.00 | ↑ +179% |
| Aetna | Commercial|All Other Plans | $7,003.00 | ↑ +179% |
| Healthsmart | Commercial|All Plans | $7,956.72 | ↑ +217% |
| First Health | Commercial|All Plans | $8,288.25 | ↑ +230% |
| Kaiser | Commercial|All Plans | $8,730.29 | ↑ +248% |
| MultiPlan | Commercial|All Plans | $8,840.80 | ↑ +252% |
| Sutter Health | Commercial|All Plans | $8,840.80 | ↑ +252% |
| Health Net | Commercial|FFS | $9,992.00 | ↑ +298% |
| United | Commercial|Non-Options PPO | $11,051.00 | ↑ +340% |
Visitor-reported prices
Comments
Conversion ext bil drg cath at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $3,315.17 | $190.95 – $9,172.33 |
| St. John's Camarillo Hospital | Camarillo | $3,075.64 | $1,534.87 – $8,890.24 |
| Petaluma Valley Hospital | Petaluma | $7,210.38 | $2,937.00 – $11,185.00 |
| Arroyo Grande Hospital | Santa Maria | $2,524.35 | $1,014.52 – $5,780.04 |
| French Hospital | San Luis Obispo | $2,312.02 | $1,014.52 – $5,780.04 |
| Mercy Hospitals – Bakersfield | Bakersfield | $2,054.60 | $1,014.52 – $4,484.02 |
| Bakersfield Memorial Hospital | Bakersfield | $1,693.71 | $1,014.52 – $4,484.02 |
| Queen of The Valley Medical Center | Napa | $7,805.04 | $5,083.67 – $17,909.00 |