New Patient Office Visit (level 3) at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$87.20
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.
$400.00
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.
$82.21 with Hill Physicians vs $400.00 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 | $82.21 | ↓ -6% |
| United | Medicaid|< 21 | $101.90 | ↑ +17% |
| United | Medicaid|> 21 | $101.90 | ↑ +17% |
| Hill Physicians | Medicaid|All Plans | $112.09 | ↑ +29% |
| Blue Shield CA | Commercial|ACO Trio CalPers | $113.00 | ↑ +30% |
| Hill Physicians | Medicare|All Plans | $117.81 | ↑ +35% |
| Blue Shield CA | Commercial|Exchange | $119.00 | ↑ +36% |
| Molina | Medicaid|All Plans | $133.56 | ↑ +53% |
| Western Health Advantage | Commercial|All Plans | $140.00 | ↑ +61% |
| BCBS - Anthem | Medicaid|All Plans | $155.90 | ↑ +79% |
| Blue Shield CA | Commercial|HMO | $158.00 | ↑ +81% |
| Kaiser | Medicaid|All Plans | $164.00 | ↑ +88% |
| Cigna | Commercial|LocalPlus | $168.00 | ↑ +93% |
| Blue Shield CA | Commercial|All Other Plans | $177.00 | ↑ +103% |
| Blue Shield CA | Commercial|CalPers | $178.00 | ↑ +104% |
| Cigna | Commercial|All Other Plans | $225.00 | ↑ +158% |
| Health Net | Medicaid|All Plans | $236.41 | ↑ +171% |
| California Health & Wellness | Medicaid|All Plans | $236.41 | ↑ +171% |
| BCBS - Anthem | Commercial|Connection EPO | $252.00 | ↑ +189% |
| Healthsmart | Commercial|All Plans | $288.00 | ↑ +230% |
| First Health | Commercial|All Plans | $300.00 | ↑ +244% |
| Kaiser | Commercial|All Plans | $316.00 | ↑ +262% |
| BCBS - Anthem | Commercial|All Other Plans | $316.00 | ↑ +262% |
| Sutter Health | Commercial|All Plans | $320.00 | ↑ +267% |
| MultiPlan | Commercial|All Plans | $320.00 | ↑ +267% |
| United | Commercial|Non-Options PPO | $400.00 | ↑ +359% |
| Partnership Health Plan | Medicaid|All Plans | $400.00 | ↑ +359% |
| BCBS - Anthem | Commercial|MCS | $400.00 | ↑ +359% |
Visitor-reported prices
Comments
New Patient Office Visit (level 3) at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $115.20 | $82.21 – $400.00 |
| St. John's Camarillo Hospital | Camarillo | $642.42 | $66.96 – $226.00 |
| Arroyo Grande Hospital | Santa Maria | $155.37 | $82.05 – $335.00 |
| Mark Twain Medical Center | San Andreas | $175.16 | $39.84 – $150.92 |
| French Hospital | San Luis Obispo | $142.30 | $82.05 – $328.30 |
| Bakersfield Memorial Hospital | Bakersfield | $116.71 | $101.90 – $232.00 |
| Healdsburg Hospital | Healdsburg | $475.83 | not published |
| Redwood Memorial Hospital | Fortuna | $109.65 | not published |