Puncture spinal lumbar diagnostic at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$887.26
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.
$4,070.00
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.
$61.96 with Hill Physicians vs $6,582.00 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 | $61.96 | ↓ -93% |
| United | Medicaid|< 21 | $93.99 | ↓ -89% |
| United | Medicaid|> 21 | $93.99 | ↓ -89% |
| Hill Physicians | Medicare|All Plans | $141.56 | ↓ -84% |
| Molina | Medicaid|All Plans | $153.99 | ↓ -83% |
| Hill Physicians | Medicaid|All Plans | $162.98 | ↓ -82% |
| BCBS - Anthem | Medicaid|All Plans | $223.23 | ↓ -75% |
| Health Net | Medicaid|All Plans | $343.73 | ↓ -61% |
| California Health & Wellness | Medicaid|All Plans | $343.73 | ↓ -61% |
| Partnership Health Plan | Medicaid|All Plans | $505.21 | ↓ -43% |
| BCBS - Anthem | Medicare|All Other Plans | $858.17 | ↓ -3% |
| Molina | Medicare|All Plans | $910.04 | ↑ +3% |
| Humana | Commercial|All Plans | $910.04 | ↑ +3% |
| Aetna | Medicare|All Plans | $910.04 | ↑ +3% |
| Kaiser | Medicare|All Plans | $910.04 | ↑ +3% |
| United | Medicare|All Plans | $910.04 | ↑ +3% |
| Blue Shield CA | Medicare|PPO | $910.04 | ↑ +3% |
| Blue Shield CA | Medicare|HMO | $910.04 | ↑ +3% |
| Western Health Advantage | Commercial|All Plans | $929.95 | ↑ +5% |
| BCBS - Anthem | Medicare|Imperial | $937.34 | ↑ +6% |
| BrightHealth | Commercial|All Plans | $1,001.04 | ↑ +13% |
| Kaiser | Medicaid|All Plans | $1,089.37 | ↑ +23% |
| Prison Healthcare | Medicaid|All Plans | $1,365.06 | ↑ +54% |
| Healthsmart | Commercial|All Plans | $1,913.04 | ↑ +116% |
| First Health | Commercial|All Plans | $1,992.75 | ↑ +125% |
| Kaiser | Commercial|All Plans | $2,099.03 | ↑ +137% |
| Sutter Health | Commercial|All Plans | $2,125.60 | ↑ +140% |
| MultiPlan | Commercial|All Plans | $2,125.60 | ↑ +140% |
| United | Commercial|Non-Options PPO | $2,657.00 | ↑ +199% |
| Health Net | Commercial|EPPO | $3,312.00 | ↑ +273% |
| BCBS - Anthem | Commercial|Connection EPO | $3,631.00 | ↑ +309% |
| BCBS - Anthem | Commercial|All Other Plans | $4,539.00 | ↑ +412% |
| Aetna | Commercial|All Other Plans | $5,002.00 | ↑ +464% |
| Aetna | Commercial|PPO | $5,002.00 | ↑ +464% |
| Aetna | Commercial|HMO | $5,002.00 | ↑ +464% |
| Health Net | Commercial|FFS | $6,108.00 | ↑ +588% |
| BCBS - Anthem | Commercial|MCS | $6,582.00 | ↑ +642% |
Visitor-reported prices
Comments
Puncture spinal lumbar diagnostic at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $1,172.16 | $61.96 – $2,205.31 |
| St. John's Camarillo Hospital | Camarillo | $743.29 | $115.61 – $1,617.30 |
| Banner Lassen Medical Center | Susanville | $393.59 | $116.85 – $276.45 |
| Petaluma Valley Hospital | Petaluma | $1,530.51 | $951.25 – $2,695.00 |
| Arroyo Grande Hospital | Santa Maria | $1,010.08 | $93.99 – $1,803.20 |
| Mark Twain Medical Center | San Andreas | $1,845.49 | $56.92 – $215.60 |
| French Hospital | San Luis Obispo | $1,296.74 | $93.99 – $1,803.20 |
| Mercy Hospitals – Bakersfield | Bakersfield | $782.44 | $93.99 – $1,687.20 |