Established Patient Office Visit (level 2) at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$70.20
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.
$322.00
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.
$32.25 with United vs $322.00 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 |
|---|---|---|---|
| United | Medicaid|> 21 | $32.25 | ↓ -54% |
| United | Medicaid|< 21 | $32.25 | ↓ -54% |
| Hill Physicians | Medicaid|All Plans | $35.48 | ↓ -49% |
| Hill Physicians | Commercial|All Plans | $35.54 | ↓ -49% |
| Molina | Medicaid|All Plans | $42.26 | ↓ -40% |
| BCBS - Anthem | Medicaid|All Plans | $49.32 | ↓ -30% |
| Hill Physicians | Medicare|All Plans | $59.48 | ↓ -15% |
| Health Net | Medicaid|All Plans | $74.82 | ↑ +7% |
| California Health & Wellness | Medicaid|All Plans | $74.82 | ↑ +7% |
| Western Health Advantage | Commercial|All Plans | $112.70 | ↑ +61% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $113.00 | ↑ +61% |
| Blue Shield CA | Commercial|Exchange | $119.00 | ↑ +70% |
| Kaiser | Medicaid|All Plans | $132.02 | ↑ +88% |
| Partnership Health Plan | Medicaid|All Plans | $138.68 | ↑ +98% |
| Blue Shield CA | Commercial|HMO | $158.00 | ↑ +125% |
| Cigna | Commercial|LocalPlus | $168.00 | ↑ +139% |
| Blue Shield CA | Commercial|All Other Plans | $177.00 | ↑ +152% |
| Blue Shield CA | Commercial|CalPers | $178.00 | ↑ +154% |
| BCBS - Anthem | Commercial|Connection EPO | $202.86 | ↑ +189% |
| Cigna | Commercial|All Other Plans | $225.00 | ↑ +221% |
| Healthsmart | Commercial|All Plans | $231.84 | ↑ +230% |
| First Health | Commercial|All Plans | $241.50 | ↑ +244% |
| Kaiser | Commercial|All Plans | $254.38 | ↑ +262% |
| BCBS - Anthem | Commercial|All Other Plans | $254.38 | ↑ +262% |
| Sutter Health | Commercial|All Plans | $257.60 | ↑ +267% |
| MultiPlan | Commercial|All Plans | $257.60 | ↑ +267% |
| United | Commercial|Non-Options PPO | $322.00 | ↑ +359% |
| BCBS - Anthem | Commercial|MCS | $322.00 | ↑ +359% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 2) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $92.74 | $32.25 – $267.26 |
| St. John's Camarillo Hospital | Camarillo | $559.01 | $28.15 – $226.00 |
| Banner Lassen Medical Center | Susanville | $737.20 | $29.86 – $276.45 |
| Arroyo Grande Hospital | Santa Maria | $130.54 | $16.37 – $305.00 |
| Mark Twain Medical Center | San Andreas | $68.60 | $8.28 – $32.00 |
| French Hospital | San Luis Obispo | $119.56 | $16.37 – $298.90 |
| Bakersfield Memorial Hospital | Bakersfield | $86.25 | $32.25 – $232.00 |
| Healdsburg Hospital | Healdsburg | $205.02 | not published |