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Shoulder Arthroscopy (Rotator Cuff Repair) at UnityPoint Health - Marshalltown
55 UnityPoint Way, Marshalltown, IA · UnityPoint Health · · NPI 1629503057
$5,272.00
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.
$6,590.00
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.
$958.10 with Aetna vs $6,951.54 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 | $958.10 | ↓ -82% |
| Molina | Medicare Advantage | $977.26 | ↓ -81% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $977.26 | ↓ -81% |
| Amerivantage | Medicare Advantage | $1,006.01 | ↓ -81% |
| Humana | Medicare Advantage | $1,006.01 | ↓ -81% |
| United Healthcare | Medicare Advantage | $1,006.01 | ↓ -81% |
| Health Partners Open Network | Commercial | $1,992.48 | ↓ -62% |
| Wellmark Blue Cross and Blue Shield | HMO | $2,083.80 | ↓ -60% |
| Wellmark UPH Self-Funded | Commercial | $2,083.80 | ↓ -60% |
| Aetna | HMO | $2,342.81 | ↓ -56% |
| Aetna | PPO | $2,342.81 | ↓ -56% |
| Wellmark Blue Cross and Blue Shield | PPO | $2,451.50 | ↓ -53% |
| Cigna/Midlands | Commercial | $2,551.95 | ↓ -52% |
| United Healthcare | HMO | $3,294.92 | ↓ -38% |
| United Healthcare | PPO | $3,294.92 | ↓ -38% |
| Amerigroup | Managed Medicaid | $6,951.54 | ↑ +32% |
| Iowa Total Care | Managed Medicaid | $6,951.54 | ↑ +32% |
| Medica Exchange Insure | Commercial | not published by hospital | — |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
Visitor-reported prices
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Shoulder Arthroscopy (Rotator Cuff Repair) at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $5,272.00 | $958.10 – $6,882.64 |
| UnityPoint Health - Allen Hospital | Waterloo | $5,272.00 | $958.10 – $5,921.26 |
| MercyOne Dubuque Medical Center | Dubuque | $24,101.99 | $0.96 – $14,498.57 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $38,326.67 | $2.28 – $14,021.15 |
| MercyOne West Des Moines Medical Center | West Des Moines | $27,109.23 | $0.96 – $14,087.30 |
| MercyOne Centerville Medical Center | Centerville | $3,671.00 | $37.48 – $2,306.00 |
| MercyOne Newton Medical Center | Newton | $29,101.52 | $0.36 – $14,087.30 |
| MercyOne Waterloo Medical Center | Waterloo | $40,635.41 | $2.28 – $14,021.15 |