Surgical pathology level 4 gross & microscopic examination at HSHS St. Mary's Hospital
1800 E. LAKE SHORE DRIVE, DECATUR, IL · Hshs · · NPI 1326041229
$1,763.28
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.
$2,449.00
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.
$29.34 with MOLINA HEALTHCARE vs $675.00 with INTERPLAN — 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 HEALTHCARE | MOLINA MEDICAID | $29.34 | ↓ -98% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $30.74 | ↓ -98% |
| ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | $35.73 | ↓ -98% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK | $41.35 | ↓ -98% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK - PPO | $41.35 | ↓ -98% |
| HUMANA | HUMANA MEDICARE | $55.84 | ↓ -97% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV | $55.84 | ↓ -97% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $55.84 | ↓ -97% |
| AETNA | AETNA MEDICARE | $55.84 | ↓ -97% |
| CLEAR SPRING HEALTH OF ILLINOIS | CLEAR SPRING HEALTH MEDICARE ADV | $55.84 | ↓ -97% |
| COVENTRY | COVENTRY MEDICARE ADVANTRA | $55.84 | ↓ -97% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MEDICARE | $55.84 | ↓ -97% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MMAI | $55.84 | ↓ -97% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $58.63 | ↓ -97% |
| CIGNA | ALL COMMERCIAL CIGNA | $64.13 | ↓ -96% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $103.26 | ↓ -94% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $103.26 | ↓ -94% |
| CELTIC INSURANCE COMPANY | ALL COMMERCIAL EXCHANGE AMBETTER | $122.86 | ↓ -93% |
| HOPETRUST | ALL COMMERCIAL HOPETRUST | $139.61 | ↓ -92% |
| CLAIM DOC | ALL COMMERCIAL CLAIM DOC | $139.61 | ↓ -92% |
| AMISH COMMUNITY | AMISH COMMUNITY DISCOUNT | $189.00 | ↓ -89% |
| AMISH COMMUNITY | PLAIN CHURCH MEDICAL GROUP | $189.00 | ↓ -89% |
| AETNA | ALL COMMERCIAL AETNA | $245.70 | ↓ -86% |
| WELLFIRST | ALL COMMERCIAL WELLFIRST | $319.14 | ↓ -82% |
| AETNA | AETNA HSHS | $371.25 | ↓ -79% |
| CURRENT HEALTH SOLUTIONS | ALL COMMERCIAL CURRENT HEALTH SOLUTIONS | $405.00 | ↓ -77% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $472.50 | ↓ -73% |
| CONSOCIATE GROUP | ALL COMMERCIAL CONSOCIATE GROUP | $472.50 | ↓ -73% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $498.83 | ↓ -72% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $540.00 | ↓ -69% |
| CIGNA | CIGNA BEHAVIORAL HEALTH | $540.00 | ↓ -69% |
| HEALTHCARE FINEST NETWORK (HFN) | ALL COMMERCIAL HFN | $573.75 | ↓ -67% |
| PROVIDER NETWORK OF AMERICA | ALL COMMERCIAL PROVIDER NETWORK OF AMERICA | $607.50 | ↓ -66% |
| WEXFORD | WEXFORD HEALTH SOURCES | $675.00 | ↓ -62% |
| CITY OF SPRINGFIELD | CITY OF SPRINGFIELD WORKCOMP | $675.00 | ↓ -62% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE KINGERY | $675.00 | ↓ -62% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MARKET PLACE | $675.00 | ↓ -62% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MEDICARE | $675.00 | ↓ -62% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE PPO | $675.00 | ↓ -62% |
| UNITED HEALTHCARE | UHC MEDICAID | $675.00 | ↓ -62% |
| HEALTHLINK | HEALTHLINK CASINO QUEEN | $675.00 | ↓ -62% |
| HEALTHLINK | ST CLAIR COUNTY HOUSING AUTHORITY | $675.00 | ↓ -62% |
| HEALTHSCOPE | ALL COMMERCIAL HEALTHSCOPE | $675.00 | ↓ -62% |
| UNITED HEALTHCARE | UNITED HEALTHCARE BEHAVIORAL HEALTH | $675.00 | ↓ -62% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $675.00 | ↓ -62% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL BLUE CHOICE PLANS | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO 470 | 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 | not published by hospital | — |
| BLUE CROSS SIHCA | BLUE CROSS BLUE SHIELD IL HMO SIHCA | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS OF ILLINOIS PPO | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 4 gross & microscopic examination at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $88.20 | $32.05 – $98.44 |
| MercyOne Genesis Aledo Medical Center | Aledo | $64.20 | $21.62 – $59.37 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $116.25 | $28.37 – $90.47 |
| Advocate Christ Medical Center | Oak Lawn | $237.50 | $49.47 – $414.32 |
| Advocate Condell Medical Center | Libertyville | $237.50 | $49.47 – $380.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $237.50 | $49.47 – $424.32 |
| UnityPoint Health - Trinity Moline | Rock Island | $164.00 | $28.96 – $64.27 |
| Uchicago Medicine Adventhealth La Grange | La Grange | $116.25 | $27.25 – $90.47 |