Biopsy vestibule of mouth 40808 at OSF Saint Anthony Medical Center
5666 East State Street, Rockford, IL · Osfhealthcare · · NPI 1790739977
$799.20
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.
$1,332.00
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.
$195.24 with Humana vs $2,022.84 with The Alliance — 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 |
|---|---|---|---|
| Humana | All Commercial Plans | $195.24 | ↓ -76% |
| Health Alliance Plan | Medicare Managed Care Plan | $577.95 | ↓ -28% |
| Aetna | Medicare Managed Care Plan | $583.73 | ↓ -27% |
| BCBS | Medicare Managed Care Plan | $589.51 | ↓ -26% |
| Zing | Medicare Managed Care Plan | $606.85 | ↓ -24% |
| UnitedHealthCare | All Commercial Plans | $693.00 | ↓ -13% |
| Caterpillar | All Commercial Plans | $1,468.00 | ↑ +84% |
| The Alliance | All Commercial Plans | $2,022.84 | ↑ +153% |
Visitor-reported prices
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Biopsy vestibule of mouth 40808 at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $262.80 | $402.96 – $1,235.24 |
| MercyOne Genesis Aledo Medical Center | Aledo | $262.80 | $2,970.16 – $2,970.16 |
| UnityPoint Health - Trinity Moline | Rock Island | $392.00 | $81.66 – $396.18 |
| Northwestern Medicine Central DuPage Hospital | IL 60190 | $1,097.60 | not published |
| Northwestern Medicine Delnor Hospital | Geneva | $1,097.60 | not published |
| Northwestern Medicine Palos Hospital | Palos Heights | $1,097.60 | not published |
| Northwestern Medicine Marianjoy Rehabilitation Hospital | Wheaton | $1,097.60 | not published |
| Northwestern Lake Forest Hospital DBA Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital | Lake Forest | $1,097.60 | not published |