Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$521.90
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.
$2,394.00
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.
$84.69 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 | $84.69 | ↓ -84% |
| United | Medicaid|< 21 | $237.90 | ↓ -54% |
| United | Medicaid|> 21 | $237.90 | ↓ -54% |
| Hill Physicians | Medicaid|All Plans | $261.69 | ↓ -50% |
| Hill Physicians | Medicare|All Plans | $282.31 | ↓ -46% |
| Molina | Medicaid|All Plans | $447.25 | ↓ -14% |
| BCBS - Anthem | Medicaid|All Plans | $452.45 | ↓ -13% |
| Health Net | Medicaid|All Plans | $551.93 | ↑ +6% |
| California Health & Wellness | Medicaid|All Plans | $551.93 | ↑ +6% |
| Western Health Advantage | Commercial|All Plans | $634.90 | ↑ +22% |
| Kaiser | Medicaid|All Plans | $743.74 | ↑ +43% |
| BCBS - Anthem | Medicare|All Other Plans | $858.17 | ↑ +64% |
| United | Medicare|All Plans | $910.04 | ↑ +74% |
| Molina | Medicare|All Plans | $910.04 | ↑ +74% |
| Blue Shield CA | Medicare|PPO | $910.04 | ↑ +74% |
| Humana | Commercial|All Plans | $910.04 | ↑ +74% |
| Kaiser | Medicare|All Plans | $910.04 | ↑ +74% |
| Aetna | Medicare|All Plans | $910.04 | ↑ +74% |
| Blue Shield CA | Medicare|HMO | $910.04 | ↑ +74% |
| BCBS - Anthem | Medicare|Imperial | $937.34 | ↑ +80% |
| BrightHealth | Commercial|All Plans | $1,001.04 | ↑ +92% |
| Partnership Health Plan | Medicaid|All Plans | $1,022.97 | ↑ +96% |
| Healthsmart | Commercial|All Plans | $1,306.08 | ↑ +150% |
| First Health | Commercial|All Plans | $1,360.50 | ↑ +161% |
| Prison Healthcare | Medicaid|All Plans | $1,365.06 | ↑ +162% |
| Kaiser | Commercial|All Plans | $1,433.06 | ↑ +175% |
| MultiPlan | Commercial|All Plans | $1,451.20 | ↑ +178% |
| Sutter Health | Commercial|All Plans | $1,451.20 | ↑ +178% |
| United | Commercial|Non-Options PPO | $1,814.00 | ↑ +248% |
| Health Net | Commercial|EPPO | $3,312.00 | ↑ +535% |
| BCBS - Anthem | Commercial|Connection EPO | $3,631.00 | ↑ +596% |
| BCBS - Anthem | Commercial|All Other Plans | $4,539.00 | ↑ +770% |
| Aetna | Commercial|HMO | $5,002.00 | ↑ +858% |
| Aetna | Commercial|PPO | $5,002.00 | ↑ +858% |
| Aetna | Commercial|All Other Plans | $5,002.00 | ↑ +858% |
| Health Net | Commercial|FFS | $6,108.00 | ↑ +1070% |
| BCBS - Anthem | Commercial|MCS | $6,582.00 | ↑ +1161% |
Visitor-reported prices
Comments
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $689.48 | $84.69 – $1,505.62 |
| St. John's Camarillo Hospital | Camarillo | $790.59 | $359.92 – $1,617.30 |
| Banner Lassen Medical Center | Susanville | $601.34 | $138.50 – $1,117.44 |
| Petaluma Valley Hospital | Petaluma | $1,391.79 | $951.25 – $2,695.00 |
| Arroyo Grande Hospital | Santa Maria | $851.30 | $237.90 – $1,766.94 |
| Mark Twain Medical Center | San Andreas | $1,204.13 | $237.90 – $1,771.84 |
| French Hospital | San Luis Obispo | $757.74 | $237.90 – $1,821.82 |
| Mercy Hospitals – Bakersfield | Bakersfield | $745.34 | $237.90 – $1,607.20 |