Drainage of mouth lesion at HSHS St. Mary's Hospital
1800 E. LAKE SHORE DRIVE, DECATUR, IL · Hshs · · NPI 1326041229
$3,199.68
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.
$4,444.00
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.
$1,244.32 with AMISH COMMUNITY vs $4,444.00 with HEALTHLINK — 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 |
|---|---|---|---|
| AMISH COMMUNITY | PLAIN CHURCH MEDICAL GROUP | $1,244.32 | ↓ -61% |
| AMISH COMMUNITY | AMISH COMMUNITY DISCOUNT | $1,244.32 | ↓ -61% |
| AETNA | ALL COMMERCIAL AETNA | $1,617.62 | ↓ -49% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $1,654.11 | ↓ -48% |
| COVENTRY | COVENTRY MEDICARE ADVANTRA | $1,662.71 | ↓ -48% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MEDICARE | $1,662.71 | ↓ -48% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV | $1,662.71 | ↓ -48% |
| HUMANA | HUMANA MEDICARE | $1,662.71 | ↓ -48% |
| CLEAR SPRING HEALTH OF ILLINOIS | CLEAR SPRING HEALTH MEDICARE ADV | $1,662.71 | ↓ -48% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $1,662.71 | ↓ -48% |
| AETNA | AETNA MEDICARE | $1,662.71 | ↓ -48% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MMAI | $1,662.71 | ↓ -48% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $1,732.88 | ↓ -46% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $1,745.85 | ↓ -45% |
| WELLFIRST | ALL COMMERCIAL WELLFIRST | $2,101.12 | ↓ -34% |
| AETNA | AETNA HSHS | $2,444.20 | ↓ -24% |
| CURRENT HEALTH SOLUTIONS | ALL COMMERCIAL CURRENT HEALTH SOLUTIONS | $2,666.40 | ↓ -17% |
| CIGNA | ALL COMMERCIAL CIGNA | $2,710.84 | ↓ -15% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $3,110.80 | ↓ -3% |
| CONSOCIATE GROUP | ALL COMMERCIAL CONSOCIATE GROUP | $3,110.80 | ↓ -3% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $3,284.12 | ↑ +3% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $3,400.00 | ↑ +6% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $3,400.00 | ↑ +6% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK - PPO | $3,510.76 | ↑ +10% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK | $3,510.76 | ↑ +10% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $3,555.20 | ↑ +11% |
| CIGNA | CIGNA BEHAVIORAL HEALTH | $3,555.20 | ↑ +11% |
| CELTIC INSURANCE COMPANY | ALL COMMERCIAL EXCHANGE AMBETTER | $3,657.95 | ↑ +14% |
| HEALTHCARE FINEST NETWORK (HFN) | ALL COMMERCIAL HFN | $3,777.40 | ↑ +18% |
| PROVIDER NETWORK OF AMERICA | ALL COMMERCIAL PROVIDER NETWORK OF AMERICA | $3,999.60 | ↑ +25% |
| CLAIM DOC | ALL COMMERCIAL CLAIM DOC | $4,156.76 | ↑ +30% |
| HOPETRUST | ALL COMMERCIAL HOPETRUST | $4,156.76 | ↑ +30% |
| UNITED HEALTHCARE | UHC MEDICAID | $4,444.00 | ↑ +39% |
| CITY OF SPRINGFIELD | CITY OF SPRINGFIELD WORKCOMP | $4,444.00 | ↑ +39% |
| HEALTHLINK | ST CLAIR COUNTY HOUSING AUTHORITY | $4,444.00 | ↑ +39% |
| HEALTHSCOPE | ALL COMMERCIAL HEALTHSCOPE | $4,444.00 | ↑ +39% |
| ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | $4,444.00 | ↑ +39% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $4,444.00 | ↑ +39% |
| UNITED HEALTHCARE | UNITED HEALTHCARE BEHAVIORAL HEALTH | $4,444.00 | ↑ +39% |
| WEXFORD | WEXFORD HEALTH SOURCES | $4,444.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE KINGERY | $4,444.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MARKET PLACE | $4,444.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MEDICARE | $4,444.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE PPO | $4,444.00 | ↑ +39% |
| HEALTHLINK | HEALTHLINK CASINO QUEEN | $4,444.00 | ↑ +39% |
| BLUE CROSS SIHCA | BLUE CROSS BLUE SHIELD IL HMO SIHCA | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS OF ILLINOIS PPO | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL BLUE CHOICE PLANS | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL HMO PHAI | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO 470 | not published by hospital | — |
Visitor-reported prices
Comments
Drainage of mouth lesion at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Trinity Moline | Rock Island | $1,265.60 | $364.95 – $1,152.38 |
| OSF Saint Anthony Medical Center | Rockford | $299.40 | $547.78 – $5,819.47 |
| HSHS St. Joseph's Hospital | HIGHLAND | $3,087.36 | $3,666.44 – $4,288.00 |
| HSHS St. Joseph's Hospital | Breese | $4,096.08 | $1,575.35 – $5,689.00 |
| HSHS St. John's Hospital | IL 62769|301 N. 8th St. | $3,458.16 | $1,575.35 – $4,803.00 |
| HSHS St. Anthony's Memorial Hospital | Mattoon | $2,941.92 | $1,654.11 – $4,086.00 |
| MercyOne Genesis Silvis Medical Center | Silvis | not published | $1,544.12 – $2,316.17 |
| MercyOne Genesis Aledo Medical Center | Aledo | not published | $900.00 – $5,158.41 |