Biopsy of salivary glnd;incisional 42405 at Wellstar Spalding Regional Hospital
601 South 8Th Street, Griffin, GA · Wellstar Health System · · NPI 1972535318
$3,249.48
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.
$8,332.00
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.
$1,556.28 with Aetna vs $5,930.96 with Bcbs — 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 |
|---|---|---|---|
| Aetna | Medicare Managed Care Plan | $1,556.28 | ↓ -52% |
| Bcbs | Medicare Managed Care Plan | $1,587.40 | ↓ -51% |
| Cigna | Medicare Managed Care Plan | $1,634.09 | ↓ -50% |
| Clover | Medicare Managed Care Plan | $1,665.22 | ↓ -49% |
| Alliant Health Plan | Ppo | $1,694.00 | ↓ -48% |
| Oscar Healthplan | Exchange | $2,645.67 | ↓ -19% |
| Ambetter | Select Exchange | $2,739.05 | ↓ -16% |
| Peachstate | Ambetter Exchange | $2,879.11 | ↓ -11% |
| Caresource | Exchange | $3,050.30 | ↓ -6% |
| Cigna | Hmo | $3,437.00 | ↑ +6% |
| Bcbs | Shbp Other Commercial Plan | $4,681.30 | ↑ +44% |
| Aetna | Hmo/Pos/Ppo | $4,714.00 | ↑ +45% |
| Unitedhealthcare | All Commercial Plans | $5,272.00 | ↑ +62% |
| Bcbs | Hmo/Pos | $5,930.96 | ↑ +83% |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Georgia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Wellstar Cobb Hospital | Austell | $3,249.48 | $1,575.96 – $5,272.00 |
| Wellstar Douglas Hospital | Douglasville | $3,249.48 | $1,561.79 – $5,272.00 |
| Wellstar Kennestone Hospital | Marietta | $3,249.48 | $1,575.96 – $5,272.00 |
| Wellstar MCG Health | Augusta | $3,249.48 | $1,359.68 – $3,437.00 |
| Wellstar North Fulton Hospital | Roswell | $3,249.48 | $1,575.96 – $5,272.00 |
| Wellstar Paulding Hospital | Hiram | $3,249.48 | $1,575.96 – $5,272.00 |
| Wellstar Roosevelt Long Term Acute Care at Warm Springs | P O Box 280 | $3,249.48 | not published |
| Wellstar Sylvan Grove Hospital | Jackson | $3,249.48 | $1,694.00 – $5,272.00 |