Biopsy of lip 40490 at UnityPoint Health - St. Lukes Downtown
2720 Stone Park Blvd, Sioux City, IA · UnityPoint Health · · NPI 1962594622
$308.80
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.
$386.00
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.
$62.94 with Aetna vs $223.41 with United Healthcare — 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 | $62.94 | ↓ -80% |
| Molina | Medicare Advantage | $64.20 | ↓ -79% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $64.20 | ↓ -79% |
| United Healthcare | Medicare Advantage | $66.09 | ↓ -79% |
| Humana | Medicare Advantage | $66.09 | ↓ -79% |
| Amerivantage | Medicare Advantage | $66.09 | ↓ -79% |
| Avera Health Plan | Commercial | $94.41 | ↓ -69% |
| Nebraska Total Care | Managed Medicaid | $100.36 | ↓ -68% |
| Wellmark UPH Self-Funded | Commercial | $133.50 | ↓ -57% |
| Wellmark Blue Cross and Blue Shield | HMO | $133.50 | ↓ -57% |
| Health Partners Open Network | Commercial | $137.39 | ↓ -56% |
| Wellmark Blue Cross and Blue Shield | PPO | $157.00 | ↓ -49% |
| Aetna | HMO | $163.51 | ↓ -47% |
| Cigna/Midlands | Commercial | $167.27 | ↓ -46% |
| Aetna | PPO | $198.35 | ↓ -36% |
| Iowa Total Care | Managed Medicaid | $205.66 | ↓ -33% |
| Amerigroup | Managed Medicaid | $205.66 | ↓ -33% |
| United Healthcare | HMO | $223.41 | ↓ -28% |
| United Healthcare | PPO | $223.41 | ↓ -28% |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
| Medica Exchange Insure | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $235.80 | not published |
| MercyOne Clinton Medical Center | Clinton | $141.05 | $61.41 – $506.85 |
| MercyOne North Iowa Medical Center | Mason City | $328.50 | $11.04 – $513.13 |
| MercyOne Genesis Davenport Medical Center | Davenport | $247.80 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $247.80 | $301.49 – $2,679.00 |
| MercyOne Waterloo Medical Center | Waterloo | $386.10 | $11.04 – $457.66 |
| UnityPoint Health - Allen Hospital | Waterloo | $308.80 | $62.94 – $192.48 |
| UnityPoint Health - Finley Hospital | Dubuque | $308.80 | $62.94 – $355.12 |