Surgical pathology level 5 gross & microscopic examination at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$574.00
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.
$2,633.00
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.
$87.64 with Partnership Health Plan vs $2,106.40 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 |
|---|---|---|---|
| Partnership Health Plan | Medicaid|All Plans | $87.64 | ↓ -85% |
| United | Medicaid|< 21 | $125.71 | ↓ -78% |
| United | Medicaid|> 21 | $125.71 | ↓ -78% |
| Hill Physicians | Medicaid|All Plans | $138.28 | ↓ -76% |
| Molina | Medicaid|All Plans | $164.76 | ↓ -71% |
| Hill Physicians | Commercial|All Plans | $232.18 | ↓ -60% |
| BCBS - Anthem | Medicaid|All Plans | $238.85 | ↓ -58% |
| BCBS - Anthem | Commercial|Connection EPO | $284.10 | ↓ -51% |
| California Health & Wellness | Medicaid|All Plans | $291.65 | ↓ -49% |
| Health Net | Medicaid|All Plans | $291.65 | ↓ -49% |
| Hill Physicians | Medicare|All Plans | $309.51 | ↓ -46% |
| United | Commercial|All Other Plans | $349.51 | ↓ -39% |
| United | Commercial|HMO | $349.51 | ↓ -39% |
| United | Commercial|Non-Options PPO | $349.51 | ↓ -39% |
| BCBS - Anthem | Commercial|All Other Plans | $354.98 | ↓ -38% |
| Aetna | Commercial|HMO | $410.33 | ↓ -29% |
| Aetna | Commercial|All Other Plans | $410.33 | ↓ -29% |
| Aetna | Commercial|PPO | $410.33 | ↓ -29% |
| BCBS - Anthem | Medicare|All Other Plans | $445.77 | ↓ -22% |
| Cigna | Commercial|LocalPlus | $461.34 | ↓ -20% |
| Molina | Medicare|All Plans | $472.71 | ↓ -18% |
| United | Medicare|All Plans | $472.71 | ↓ -18% |
| Aetna | Medicare|All Plans | $472.71 | ↓ -18% |
| Kaiser | Medicare|All Plans | $472.71 | ↓ -18% |
| Blue Shield CA | Medicare|HMO | $472.71 | ↓ -18% |
| Blue Shield CA | Medicare|PPO | $472.71 | ↓ -18% |
| Humana | Commercial|All Plans | $472.71 | ↓ -18% |
| BCBS - Anthem | Medicare|Imperial | $486.89 | ↓ -15% |
| BCBS - Anthem | Commercial|MCS | $514.60 | ↓ -10% |
| BrightHealth | Commercial|All Plans | $519.98 | ↓ -9% |
| Cigna | Commercial|All Other Plans | $615.17 | ↑ +7% |
| Prison Healthcare | Medicaid|All Plans | $709.07 | ↑ +24% |
| Western Health Advantage | Commercial|All Plans | $921.55 | ↑ +61% |
| Kaiser | Medicaid|All Plans | $1,079.53 | ↑ +88% |
| Healthsmart | Commercial|All Plans | $1,895.76 | ↑ +230% |
| First Health | Commercial|All Plans | $1,974.75 | ↑ +244% |
| Kaiser | Commercial|All Plans | $2,080.07 | ↑ +262% |
| Sutter Health | Commercial|All Plans | $2,106.40 | ↑ +267% |
| MultiPlan | Commercial|All Plans | $2,106.40 | ↑ +267% |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $758.31 | $87.64 – $2,185.39 |
| St. John's Camarillo Hospital | Camarillo | $222.51 | $137.16 – $813.52 |
| Petaluma Valley Hospital | Petaluma | $653.82 | $163.66 – $566.82 |
| Arroyo Grande Hospital | Santa Maria | $141.24 | $109.34 – $536.77 |
| Mark Twain Medical Center | San Andreas | $291.05 | $56.81 – $215.18 |
| French Hospital | San Luis Obispo | $129.36 | $59.05 – $631.01 |
| Mercy Hospitals – Bakersfield | Bakersfield | $191.44 | $123.13 – $598.65 |
| Bakersfield Memorial Hospital | Bakersfield | $189.38 | $123.13 – $598.65 |