Biopsy of toe joint lining at UnityPoint Health - Trinity Muscatine
1518 Mulberry, Muscatine, IA · UnityPoint Health · · NPI 1861444333
$1,872.00
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.
$2,340.00
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.
$217.66 with Ambetter vs $2,802.18 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 |
|---|---|---|---|
| Ambetter | HMO | $217.66 | ↓ -88% |
| Aetna | Medicare Advantage | $217.66 | ↓ -88% |
| Health Alliance | Medicare Advantage | $217.66 | ↓ -88% |
| Blue Cross and Blue Shield | Medicare Advantage | $217.66 | ↓ -88% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $222.01 | ↓ -88% |
| United Healthcare | Medicare Advantage | $228.54 | ↓ -88% |
| Humana | Medicare Advantage | $228.54 | ↓ -88% |
| Meridian Health Plan | Medicare Advantage | $228.54 | ↓ -88% |
| Health Partners Open Network | Commercial | $456.22 | ↓ -76% |
| Wellmark Blue Cross and Blue Shield | HMO | $460.10 | ↓ -75% |
| Wellmark UPH Self-Funded | Commercial | $460.10 | ↓ -75% |
| BC Illinois Community | PPO | $504.75 | ↓ -73% |
| Aetna | HMO | $524.03 | ↓ -72% |
| Wellmark Blue Cross and Blue Shield | PPO | $541.30 | ↓ -71% |
| Cigna/Midlands | Commercial | $577.97 | ↓ -69% |
| Aetna | PPO | $637.98 | ↓ -66% |
| BC Illinois Community | Blue Choice | $642.34 | ↓ -66% |
| United Healthcare | PPO | $742.37 | ↓ -60% |
| United Healthcare | HMO | $742.37 | ↓ -60% |
| Amerigroup | Managed Medicaid | $2,802.18 | ↑ +50% |
| Iowa Total Care | Managed Medicaid | $2,802.18 | ↑ +50% |
| 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 toe joint lining at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UnityPoint Health - Allen Hospital | Waterloo | $1,872.00 | $217.66 – $2,689.38 |
| UnityPoint Health - Finley Hospital | Dubuque | $1,872.00 | $217.66 – $2,852.76 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $1,872.00 | $217.66 – $3,228.27 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $1,872.00 | $217.66 – $3,126.02 |
| UnityPoint Health - Jones Regional Medical Center | Anamosa | $1,872.00 | $217.66 – $577.97 |
| UnityPoint Health - Marshalltown | Marshalltown | $1,872.00 | $217.66 – $3,157.32 |
| UnityPoint Health - St. Lukes Downtown | Sioux City | $1,872.00 | $217.66 – $2,873.50 |
| UnityPoint Health - Trinity Bettendorf | Bettendorf | $1,872.00 | $217.66 – $2,791.99 |