healthcosts.net
Treatment of mouth lesion physical 40820 at UnityPoint Health - Trinity Muscatine
1518 Mulberry, Muscatine, IA · UnityPoint Health · · NPI 1861444333
$638.40
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.
$798.00
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.
$148.33 with Health Alliance vs $2,800.85 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 |
|---|---|---|---|
| Health Alliance | Medicare Advantage | $148.33 | ↓ -77% |
| Blue Cross and Blue Shield | Medicare Advantage | $148.33 | ↓ -77% |
| Ambetter | HMO | $148.33 | ↓ -77% |
| Aetna | Medicare Advantage | $148.33 | ↓ -77% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $151.30 | ↓ -76% |
| Humana | Medicare Advantage | $155.75 | ↓ -76% |
| United Healthcare | Medicare Advantage | $155.75 | ↓ -76% |
| Meridian Health Plan | Medicare Advantage | $155.75 | ↓ -76% |
| BC Illinois Community | PPO | $276.56 | ↓ -57% |
| Wellmark UPH Self-Funded | Commercial | $318.90 | ↓ -50% |
| Wellmark Blue Cross and Blue Shield | HMO | $318.90 | ↓ -50% |
| Health Partners Open Network | Commercial | $321.97 | ↓ -50% |
| BC Illinois Community | Blue Choice | $356.24 | ↓ -44% |
| Wellmark Blue Cross and Blue Shield | PPO | $375.20 | ↓ -41% |
| Aetna | HMO | $390.02 | ↓ -39% |
| Cigna/Midlands | Commercial | $401.48 | ↓ -37% |
| Aetna | PPO | $474.47 | ↓ -26% |
| United Healthcare | PPO | $516.62 | ↓ -19% |
| United Healthcare | HMO | $516.62 | ↓ -19% |
| Amerigroup | Managed Medicaid | $2,800.85 | ↑ +339% |
| Iowa Total Care | Managed Medicaid | $2,800.85 | ↑ +339% |
| Medica Exchange Insure | Commercial | not published by hospital | — |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of mouth lesion physical 40820 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $489.00 | not published |
| MercyOne New Hampton Medical Center | New Hampton | $6,324.50 | $141.40 – $612.00 |
| MercyOne Des Moines Medical Center | Des Moines | $642.67 | $14.39 – $612.00 |
| MercyOne Genesis Davenport Medical Center | Davenport | $513.60 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $513.60 | $624.88 – $2,679.00 |
| UnityPoint Health - Allen Hospital | Waterloo | $638.40 | $148.33 – $2,688.10 |
| UnityPoint Health - Finley Hospital | Dubuque | $638.40 | $148.33 – $2,851.40 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $638.40 | $148.33 – $3,226.74 |