Biopsy of salivary glnd;incisional 42405 at UnityPoint Health - Trinity Muscatine
1518 Mulberry, Muscatine, IA · UnityPoint Health · · NPI 1861444333
$742.40
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.
$928.00
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.
$205.65 with Blue Cross and Blue Shield vs $1,279.30 with Amerigroup — 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 |
|---|---|---|---|
| Blue Cross and Blue Shield | Medicare Advantage | $205.65 | ↓ -72% |
| Ambetter | HMO | $205.65 | ↓ -72% |
| Health Alliance | Medicare Advantage | $205.65 | ↓ -72% |
| Aetna | Medicare Advantage | $205.65 | ↓ -72% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $209.76 | ↓ -72% |
| Meridian Health Plan | Medicare Advantage | $215.93 | ↓ -71% |
| Humana | Medicare Advantage | $215.93 | ↓ -71% |
| United Healthcare | Medicare Advantage | $215.93 | ↓ -71% |
| BC Illinois Community | PPO | $393.99 | ↓ -47% |
| Health Partners Open Network | Commercial | $427.86 | ↓ -42% |
| BC Illinois Community | Blue Choice | $435.71 | ↓ -41% |
| Wellmark Blue Cross and Blue Shield | HMO | $442.20 | ↓ -40% |
| Wellmark UPH Self-Funded | Commercial | $442.20 | ↓ -40% |
| Aetna | HMO | $507.97 | ↓ -32% |
| Wellmark Blue Cross and Blue Shield | PPO | $520.20 | ↓ -30% |
| Cigna/Midlands | Commercial | $550.09 | ↓ -26% |
| Aetna | PPO | $619.19 | ↓ -17% |
| United Healthcare | PPO | $700.87 | ↓ -6% |
| United Healthcare | HMO | $700.87 | ↓ -6% |
| Iowa Total Care | Managed Medicaid | $1,279.30 | ↑ +72% |
| Amerigroup | Managed Medicaid | $1,279.30 | ↑ +72% |
| Medica Exchange Insure | Commercial | not published by hospital | — |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
Visitor-reported prices
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Biopsy of salivary glnd;incisional 42405 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $556.20 | not published |
| MercyOne Genesis Davenport Medical Center | Davenport | $583.80 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $583.80 | $710.29 – $2,679.00 |
| UnityPoint Health - Allen Hospital | Waterloo | $742.40 | $205.65 – $1,227.80 |
| UnityPoint Health - Finley Hospital | Dubuque | $742.40 | $205.65 – $1,302.39 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $742.40 | $205.65 – $1,473.83 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $742.40 | $205.65 – $1,427.15 |
| UnityPoint Health - Jones Regional Medical Center | Anamosa | $742.40 | $205.65 – $550.09 |