Control oropharyngeal hemorr/simp 42960 at UnityPoint Health - St. Luke's Hospital
1026 A Avenue N.E, Cedar Rapids, IA · UnityPoint Health · · NPI 1083708226
$409.60
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.
$512.00
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.
$137.76 with Medica Exchange Inspire vs $511.86 with United 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 |
|---|---|---|---|
| Medica Exchange Inspire | Commercial | $137.76 | ↓ -66% |
| Aetna | Medicare Advantage | $146.24 | ↓ -64% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $149.16 | ↓ -64% |
| Molina | Medicare Advantage | $149.16 | ↓ -64% |
| Amerivantage | Medicare Advantage | $153.55 | ↓ -63% |
| Humana | Medicare Advantage | $153.55 | ↓ -63% |
| United Healthcare | Medicare Advantage | $153.55 | ↓ -63% |
| Medica Exchange Insure | Commercial | $154.67 | ↓ -62% |
| Cigna/Midlands | Commercial | $226.03 | ↓ -45% |
| Wellmark UHP Self-Funded | Commercial | $314.50 | ↓ -23% |
| Wellmark Blue Cross and Blue Shield | HMO | $314.50 | ↓ -23% |
| Health Partners Open Network | Commercial | $321.11 | ↓ -22% |
| Wellmark Blue Cross and Blue Shield | PPO | $370.00 | ↓ -10% |
| Aetna | HMO | $381.98 | ↓ -7% |
| Iowa Total Care | Managed Medicaid | $447.92 | ↑ +9% |
| Amerigroup | Managed Medicaid | $447.92 | ↑ +9% |
| Aetna | PPO | $465.08 | ↑ +14% |
| United Healthcare | HMO | $511.86 | ↑ +25% |
| United Healthcare | PPO | $511.86 | ↑ +25% |
Visitor-reported prices
Comments
Control oropharyngeal hemorr/simp 42960 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $318.00 | not published |
| MercyOne Genesis Davenport Medical Center | Davenport | $334.20 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $334.20 | $406.61 – $2,679.00 |
| UnityPoint Health - Allen Hospital | Waterloo | $409.60 | $83.61 – $422.11 |
| UnityPoint Health - Finley Hospital | Dubuque | $922.95 | $146.24 – $922.94 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $409.60 | $146.24 – $506.69 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $409.76 | $134.19 – $490.64 |
| UnityPoint Health - Jones Regional Medical Center | Anamosa | $409.60 | $146.24 – $389.55 |