Quant diff pulm perf w/imaging at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$962.26
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.
$4,414.00
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.
$165.44 with Hill Physicians vs $3,531.20 with MultiPlan — 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 | $165.44 | ↓ -83% |
| United | Medicaid|> 21 | $177.59 | ↓ -82% |
| United | Medicaid|< 21 | $177.59 | ↓ -82% |
| Hill Physicians | Medicaid|All Plans | $195.35 | ↓ -80% |
| Hill Physicians | Medicare|All Plans | $221.54 | ↓ -77% |
| Molina | Medicaid|All Plans | $333.87 | ↓ -65% |
| BCBS - Anthem | Medicaid|All Plans | $337.42 | ↓ -65% |
| Health Net | Medicaid|All Plans | $412.01 | ↓ -57% |
| California Health & Wellness | Medicaid|All Plans | $412.01 | ↓ -57% |
| BCBS - Anthem | Medicare|All Other Plans | $497.94 | ↓ -48% |
| Blue Shield CA | Medicare|HMO | $528.04 | ↓ -45% |
| Humana | Commercial|All Plans | $528.04 | ↓ -45% |
| Aetna | Medicare|All Plans | $528.04 | ↓ -45% |
| Molina | Medicare|All Plans | $528.04 | ↓ -45% |
| United | Medicare|All Plans | $528.04 | ↓ -45% |
| Kaiser | Medicare|All Plans | $528.04 | ↓ -45% |
| Blue Shield CA | Medicare|PPO | $528.04 | ↓ -45% |
| BCBS - Anthem | Medicare|Imperial | $543.88 | ↓ -43% |
| Aetna | Commercial|HMO | $560.77 | ↓ -42% |
| Aetna | Commercial|PPO | $560.77 | ↓ -42% |
| Aetna | Commercial|All Other Plans | $560.77 | ↓ -42% |
| BrightHealth | Commercial|All Plans | $580.84 | ↓ -40% |
| Partnership Health Plan | Medicaid|All Plans | $763.64 | ↓ -21% |
| Prison Healthcare | Medicaid|All Plans | $792.06 | ↓ -18% |
| United | Commercial|HMO | $848.52 | ↓ -12% |
| United | Commercial|All Other Plans | $848.52 | ↓ -12% |
| United | Commercial|Non-Options PPO | $848.52 | ↓ -12% |
| Cigna | Commercial|LocalPlus | $1,523.13 | ↑ +58% |
| Western Health Advantage | Commercial|All Plans | $1,544.90 | ↑ +61% |
| BCBS - Anthem | Commercial|Connection EPO | $1,809.55 | ↑ +88% |
| Kaiser | Medicaid|All Plans | $1,809.74 | ↑ +88% |
| Cigna | Commercial|All Other Plans | $2,030.99 | ↑ +111% |
| BCBS - Anthem | Commercial|All Other Plans | $2,260.99 | ↑ +135% |
| Healthsmart | Commercial|All Plans | $3,178.08 | ↑ +230% |
| BCBS - Anthem | Commercial|MCS | $3,277.67 | ↑ +241% |
| First Health | Commercial|All Plans | $3,310.50 | ↑ +244% |
| Kaiser | Commercial|All Plans | $3,487.06 | ↑ +262% |
| Sutter Health | Commercial|All Plans | $3,531.20 | ↑ +267% |
| MultiPlan | Commercial|All Plans | $3,531.20 | ↑ +267% |
Visitor-reported prices
Comments
Quant diff pulm perf w/imaging at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $1,271.24 | $165.44 – $3,663.62 |
| Arroyo Grande Hospital | Santa Maria | $1,588.31 | $177.59 – $3,463.32 |
| Mark Twain Medical Center | San Andreas | $3,372.63 | $177.59 – $4,848.06 |
| French Hospital | San Luis Obispo | $1,267.73 | $177.59 – $2,083.30 |
| Mercy Hospitals – Bakersfield | Bakersfield | $279.00 | $177.59 – $1,976.45 |
| Bakersfield Memorial Hospital | Bakersfield | $275.99 | $177.59 – $1,976.45 |
| St. Joseph's Medical Center Stockton | Stockton | $207.86 | $111.51 – $531.00 |
| Providence Mission Hospital - Mission Viejo | Mission Viejo | $987.84 | $437.05 – $951.22 |