Ghs intermed repair 12.6 - 20.0 cm-12035 at SSM Health St. Mary's Hospital - Centralia
400 North Pleasant Avenue, Centralia, IL · SSM Health · · NPI 1083617245
$642.95
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.
$1,169.00
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.
$435.63 with Molina vs $457.41 with Essence 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 |
|---|---|---|---|
| Molina | Dual Eligible Medicare/Medicaid | $435.63 | ↓ -32% |
| UnitedHealthCare | Medicare Managed Care Plan | $453.05 | ↓ -30% |
| Essence Healthcare | Medicare Managed Care Plan | $457.41 | ↓ -29% |
Visitor-reported prices
Comments
Ghs intermed repair 12.6 - 20.0 cm-12035 at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $715.80 | $182.08 – $624.72 |
| MercyOne Genesis Aledo Medical Center | Aledo | $715.80 | $261.74 – $436.91 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $187.50 | $426.48 – $705.72 |
| Advocate Christ Medical Center | Oak Lawn | $800.00 | $603.89 – $1,280.00 |
| Advocate Condell Medical Center | Libertyville | $800.00 | $603.89 – $1,280.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $800.00 | $603.89 – $1,280.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $943.20 | $216.14 – $444.46 |
| Uchicago Medicine Adventhealth La Grange | La Grange | $187.50 | $426.48 – $705.72 |