Established Patient Office Visit (level 1) at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$63.66
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.
$292.00
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.
$8.82 with Hill Physicians vs $22,221.00 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 | $8.82 | ↓ -86% |
| United | Medicaid|> 21 | $21.37 | ↓ -66% |
| United | Medicaid|< 21 | $21.37 | ↓ -66% |
| Hill Physicians | Medicaid|All Plans | $23.51 | ↓ -63% |
| Hill Physicians | Medicare|All Plans | $24.41 | ↓ -62% |
| Molina | Medicaid|All Plans | $28.01 | ↓ -56% |
| BCBS - Anthem | Medicaid|All Plans | $32.70 | ↓ -49% |
| California Health & Wellness | Medicaid|All Plans | $49.58 | ↓ -22% |
| Health Net | Medicaid|All Plans | $49.58 | ↓ -22% |
| Western Health Advantage | Commercial|All Plans | $89.25 | ↑ +40% |
| Partnership Health Plan | Medicaid|All Plans | $91.89 | ↑ +44% |
| Kaiser | Medicaid|All Plans | $104.55 | ↑ +64% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $113.00 | ↑ +78% |
| Blue Shield CA | Commercial|Exchange | $119.00 | ↑ +87% |
| Blue Shield CA | Commercial|HMO | $158.00 | ↑ +148% |
| BCBS - Anthem | Commercial|Connection EPO | $160.65 | ↑ +152% |
| Cigna | Commercial|LocalPlus | $168.00 | ↑ +164% |
| Blue Shield CA | Commercial|All Other Plans | $177.00 | ↑ +178% |
| Blue Shield CA | Commercial|CalPers | $178.00 | ↑ +180% |
| Healthsmart | Commercial|All Plans | $183.60 | ↑ +188% |
| First Health | Commercial|All Plans | $191.25 | ↑ +200% |
| BCBS - Anthem | Commercial|All Other Plans | $201.45 | ↑ +216% |
| Kaiser | Commercial|All Plans | $201.45 | ↑ +216% |
| MultiPlan | Commercial|All Plans | $204.00 | ↑ +220% |
| Sutter Health | Commercial|All Plans | $204.00 | ↑ +220% |
| Cigna | Commercial|All Other Plans | $225.00 | ↑ +253% |
| BCBS - Anthem | Commercial|MCS | $255.00 | ↑ +301% |
| United | Commercial|Non-Options PPO | $255.00 | ↑ +301% |
| BrightHealth | Commercial|All Plans | $3,245.00 | ↑ +4997% |
| United | Commercial|HMO | $10,710.00 | ↑ +16724% |
| United | Commercial|All Other Plans | $22,221.00 | ↑ +34806% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $84.10 | $8.82 – $211.65 |
| St. John's Camarillo Hospital | Camarillo | $500.91 | $12.38 – $204.18 |
| Banner Lassen Medical Center | Susanville | $290.87 | $19.80 – $150.35 |
| Arroyo Grande Hospital | Santa Maria | $145.10 | $17.21 – $232.00 |
| Mark Twain Medical Center | San Andreas | $51.95 | $3.11 – $12.00 |
| French Hospital | San Luis Obispo | $112.90 | $17.21 – $234.00 |
| Mercy Hospitals – Bakersfield | Bakersfield | $86.08 | $21.37 – $232.00 |
| Bakersfield Memorial Hospital | Bakersfield | $93.59 | $21.37 – $232.00 |