Observation direct referral from physician office for admission at SSM Health St. Mary's Hospital - Centralia
400 North Pleasant Avenue, Centralia, IL · SSM Health · · NPI 1083617245
$572.00
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.
$1,040.00
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.
$638.18 with Molina vs $670.09 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 | $638.18 | ↑ +12% |
| UnitedHealthCare | Medicare Managed Care Plan | $663.71 | ↑ +16% |
| Essence Healthcare | Medicare Managed Care Plan | $670.09 | ↑ +17% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $146.40 | $78.08 – $4,283.45 |
| MercyOne Genesis Aledo Medical Center | Aledo | $137.40 | $105.34 – $703.79 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $193.00 | $624.78 – $1,033.86 |
| Advocate Christ Medical Center | Oak Lawn | $207.50 | $163.51 – $11,037.00 |
| Advocate Condell Medical Center | Libertyville | $207.50 | $163.51 – $8,058.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $207.50 | $163.51 – $11,037.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $127.13 | $32.74 – $7,845.34 |
| Uchicago Medicine Adventhealth La Grange | La Grange | $193.00 | $624.78 – $1,033.86 |