Biopsy of salivary gland 42400 at UnityPoint Health - St. Lukes Downtown
2720 Stone Park Blvd, Sioux City, IA · UnityPoint Health · · NPI 1962594622
$1,083.92
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.
$1,354.89
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.
$48.12 with Aetna vs $783.13 with Medica Exchange Insure — 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 | $48.12 | ↓ -96% |
| Molina | Medicare Advantage | $49.08 | ↓ -95% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $49.08 | ↓ -95% |
| United Healthcare | Medicare Advantage | $50.53 | ↓ -95% |
| Humana | Medicare Advantage | $50.53 | ↓ -95% |
| Amerivantage | Medicare Advantage | $50.53 | ↓ -95% |
| Avera Health Plan | Commercial | $72.18 | ↓ -93% |
| Nebraska Total Care | Managed Medicaid | $82.68 | ↓ -92% |
| Wellmark UPH Self-Funded | Commercial | $102.00 | ↓ -91% |
| Wellmark Blue Cross and Blue Shield | HMO | $102.00 | ↓ -91% |
| Health Partners Open Network | Commercial | $105.49 | ↓ -90% |
| Wellmark Blue Cross and Blue Shield | PPO | $120.00 | ↓ -89% |
| Aetna | HMO | $123.30 | ↓ -89% |
| Cigna/Midlands | Commercial | $127.89 | ↓ -88% |
| Aetna | PPO | $150.11 | ↓ -86% |
| United Healthcare | PPO | $167.52 | ↓ -85% |
| United Healthcare | HMO | $167.52 | ↓ -85% |
| Iowa Total Care | Managed Medicaid | $623.11 | ↓ -43% |
| Amerigroup | Managed Medicaid | $623.11 | ↓ -43% |
| Medica Exchange Inspire | Commercial | $699.12 | ↓ -36% |
| Medica Exchange Insure | Commercial | $783.13 | ↓ -28% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $651.00 | not published |
| MercyOne Des Moines Medical Center | Des Moines | $4,526.60 | $668.39 – $6,964.00 |
| MercyOne North Iowa Medical Center | Mason City | $1,870.05 | $685.18 – $2,877.00 |
| MercyOne Genesis Davenport Medical Center | Davenport | $752.40 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $210.00 | $255.50 – $2,679.00 |
| MercyOne Waterloo Medical Center | Waterloo | $1,320.15 | $477.29 – $3,576.15 |
| UnityPoint Health - Allen Hospital | Waterloo | $682.40 | $48.12 – $583.19 |
| UnityPoint Health - Finley Hospital | Dubuque | $1,237.60 | $48.12 – $1,237.59 |