Tib/per revasc stent & ather 37231 at Mercy General Hospital
4001 J St., Sacramento, CA · CommonSpirit Health · · NPI 1487694857
$8,310.60
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.
$38,122.00
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.
$646.31 with United vs $35,395.39 with Prison Healthcare — 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 |
|---|---|---|---|
| United | Medicaid|< 21 | $646.31 | ↓ -92% |
| United | Medicaid|> 21 | $646.31 | ↓ -92% |
| Hill Physicians | Commercial|All Plans | $695.88 | ↓ -92% |
| Hill Physicians | Medicaid|All Plans | $710.94 | ↓ -91% |
| Molina | Medicaid|All Plans | $1,215.06 | ↓ -85% |
| BCBS - Anthem | Medicaid|All Plans | $1,227.74 | ↓ -85% |
| Health Net | Medicaid|All Plans | $1,499.44 | ↓ -82% |
| California Health & Wellness | Medicaid|All Plans | $1,499.44 | ↓ -82% |
| Partnership Health Plan | Medicaid|All Plans | $2,779.13 | ↓ -67% |
| Western Health Advantage | Commercial|All Plans | $4,222.40 | ↓ -49% |
| Kaiser | Medicaid|All Plans | $4,946.24 | ↓ -40% |
| Healthsmart | Commercial|All Plans | $8,686.08 | ↑ +5% |
| First Health | Commercial|All Plans | $9,048.00 | ↑ +9% |
| Kaiser | Commercial|All Plans | $9,530.56 | ↑ +15% |
| MultiPlan | Commercial|All Plans | $9,651.20 | ↑ +16% |
| Sutter Health | Commercial|All Plans | $9,651.20 | ↑ +16% |
| Aetna | Commercial|All Other Plans | $10,007.00 | ↑ +20% |
| Aetna | Commercial|HMO | $10,007.00 | ↑ +20% |
| Aetna | Commercial|PPO | $10,007.00 | ↑ +20% |
| BCBS - Anthem | Medicare|All Other Plans | $11,376.36 | ↑ +37% |
| United | Commercial|Non-Options PPO | $12,064.00 | ↑ +45% |
| Molina | Medicare|All Plans | $12,064.00 | ↑ +45% |
| Humana | Commercial|All Plans | $12,064.00 | ↑ +45% |
| Blue Shield CA | Medicare|PPO | $12,064.00 | ↑ +45% |
| Aetna | Medicare|All Plans | $12,064.00 | ↑ +45% |
| Hill Physicians | Medicare|All Plans | $12,064.00 | ↑ +45% |
| Health Net | Commercial|EPPO | $12,309.00 | ↑ +48% |
| BCBS - Anthem | Medicare|Imperial | $12,425.92 | ↑ +50% |
| BrightHealth | Commercial|All Plans | $13,270.40 | ↑ +60% |
| BCBS - Anthem | Commercial|Connection EPO | $13,595.00 | ↑ +64% |
| BCBS - Anthem | Commercial|All Other Plans | $16,994.00 | ↑ +104% |
| Health Net | Commercial|FFS | $22,699.00 | ↑ +173% |
| Kaiser | Medicare|All Plans | $23,596.93 | ↑ +184% |
| Blue Shield CA | Medicare|HMO | $23,596.93 | ↑ +184% |
| United | Medicare|All Plans | $23,596.93 | ↑ +184% |
| BCBS - Anthem | Commercial|MCS | $24,641.00 | ↑ +197% |
| Prison Healthcare | Medicaid|All Plans | $35,395.39 | ↑ +326% |
Visitor-reported prices
Comments
Tib/per revasc stent & ather 37231 at other California hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Methodist Hospital of Sacramento | Sacramento | $10,979.14 | $646.31 – $12,064.00 |
| St. John's Camarillo Hospital | Camarillo | $21,131.75 | $977.80 – $43,115.78 |
| Arroyo Grande Hospital | Santa Maria | $25,795.99 | $646.18 – $59,065.58 |
| French Hospital | San Luis Obispo | $23,626.24 | $646.18 – $57,299.62 |
| Mercy Hospitals – Bakersfield | Bakersfield | $18,273.98 | $646.31 – $36,273.60 |
| Bakersfield Memorial Hospital | Bakersfield | $16,640.52 | $646.31 – $35,820.18 |
| Queen of The Valley Medical Center | Napa | $25,453.59 | $9,256.00 – $89,248.00 |
| St. Joseph's Medical Center Stockton | Stockton | $14,274.88 | $0.80 – $13,349.00 |