healthcosts.net
Repair nose to lip fistula at UnityPoint Health - Marshalltown
55 UnityPoint Way, Marshalltown, IA · UnityPoint Health · · NPI 1629503057
$2,055.20
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.
$2,569.00
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.
$606.58 with Aetna vs $5,756.50 with Iowa Total Care — 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 |
|---|---|---|---|
| Aetna | Medicare Advantage | $606.58 | ↓ -70% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $618.71 | ↓ -70% |
| Molina | Medicare Advantage | $618.71 | ↓ -70% |
| Humana | Medicare Advantage | $636.91 | ↓ -69% |
| Amerivantage | Medicare Advantage | $636.91 | ↓ -69% |
| United Healthcare | Medicare Advantage | $636.91 | ↓ -69% |
| Wellmark Blue Cross and Blue Shield | HMO | $1,302.80 | ↓ -37% |
| Wellmark UPH Self-Funded | Commercial | $1,302.80 | ↓ -37% |
| Health Partners Open Network | Commercial | $1,347.92 | ↓ -34% |
| Wellmark Blue Cross and Blue Shield | PPO | $1,532.70 | ↓ -25% |
| Aetna | HMO | $1,620.41 | ↓ -21% |
| Aetna | PPO | $1,620.41 | ↓ -21% |
| Cigna/Midlands | Commercial | $1,622.86 | ↓ -21% |
| United Healthcare | PPO | $2,055.23 | ↑ +0% |
| United Healthcare | HMO | $2,055.23 | ↑ +0% |
| Amerigroup | Managed Medicaid | $5,756.50 | ↑ +180% |
| Iowa Total Care | Managed Medicaid | $5,756.50 | ↑ +180% |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
| Medica Exchange Insure | Commercial | not published by hospital | — |
Visitor-reported prices
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Repair nose to lip fistula at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Allen Hospital | Waterloo | $2,055.20 | $606.58 – $4,903.34 |
| UnityPoint Health - Finley Hospital | Dubuque | $2,055.20 | $606.58 – $5,201.22 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $2,055.20 | $606.58 – $5,885.87 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $2,055.20 | $606.58 – $5,699.45 |
| UnityPoint Health - Jones Regional Medical Center | Anamosa | $2,055.20 | $606.58 – $1,622.86 |
| UnityPoint Health - St. Lukes Downtown | Sioux City | $2,055.20 | $606.58 – $5,239.04 |
| UnityPoint Health - Trinity Bettendorf | Bettendorf | $2,055.20 | $606.58 – $5,090.43 |
| UnityPoint Health - Trinity Muscatine | Muscatine | $2,055.20 | $606.58 – $5,109.01 |