Tc-99m tilmanocept diag at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$795.70
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.
$3,650.00
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.
$684.95 with BCBS - Anthem vs $3,650.00 with United — 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 |
|---|---|---|---|
| BCBS - Anthem | Commercial|Connection EPO | $684.95 | ↓ -14% |
| BCBS - Anthem | Commercial|All Other Plans | $856.20 | ↑ +8% |
| BCBS - Anthem | Medicaid|All Plans | $1,174.71 | ↑ +48% |
| BCBS - Anthem | Commercial|MCS | $1,242.21 | ↑ +56% |
| Western Health Advantage | Commercial|All Plans | $1,277.50 | ↑ +61% |
| Kaiser | Medicaid|All Plans | $1,496.50 | ↑ +88% |
| Cigna | Commercial|LocalPlus | $1,569.61 | ↑ +97% |
| California Health & Wellness | Medicaid|All Plans | $1,825.00 | ↑ +129% |
| Health Net | Medicaid|All Plans | $1,825.00 | ↑ +129% |
| Cigna | Commercial|All Other Plans | $2,093.26 | ↑ +163% |
| Healthsmart | Commercial|All Plans | $2,628.00 | ↑ +230% |
| First Health | Commercial|All Plans | $2,737.50 | ↑ +244% |
| Kaiser | Commercial|All Plans | $2,883.50 | ↑ +262% |
| MultiPlan | Commercial|All Plans | $2,920.00 | ↑ +267% |
| Sutter Health | Commercial|All Plans | $2,920.00 | ↑ +267% |
| United | Commercial|Non-Options PPO | $3,650.00 | ↑ +359% |
Visitor-reported prices
Comments
Tc-99m tilmanocept diag at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $1,051.20 | $1,174.71 – $3,613.50 |
| St. John's Camarillo Hospital | Camarillo | $800.23 | $321.90 – $1,425.06 |
| Banner Lassen Medical Center | Susanville | $1,672.45 | $983.79 – $2,327.51 |
| Arroyo Grande Hospital | Santa Maria | $1,344.78 | $533.83 – $3,079.16 |
| French Hospital | San Luis Obispo | $1,231.67 | $848.34 – $3,079.16 |
| Mercy Hospitals – Bakersfield | Bakersfield | $368.78 | $497.00 – $795.20 |
| Bakersfield Memorial Hospital | Bakersfield | $364.80 | $481.09 – $984.06 |
| St. Joseph's Medical Center Stockton | Stockton | $292.24 | $208.74 – $2,228.22 |