Exc tendon sheath or cap lesion 26160 at UnityPoint Health - St. Lukes Downtown
2720 Stone Park Blvd, Sioux City, IA · UnityPoint Health · · NPI 1962594622
$1,396.00
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.
$1,745.00
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.
$290.91 with Aetna vs $1,417.36 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 |
|---|---|---|---|
| Aetna | Medicare Advantage | $290.91 | ↓ -79% |
| Molina | Medicare Advantage | $296.73 | ↓ -79% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $296.73 | ↓ -79% |
| United Healthcare | Medicare Advantage | $305.46 | ↓ -78% |
| Humana | Medicare Advantage | $305.46 | ↓ -78% |
| Amerivantage | Medicare Advantage | $305.46 | ↓ -78% |
| Avera Health Plan | Commercial | $436.37 | ↓ -69% |
| Nebraska Total Care | Managed Medicaid | $453.70 | ↓ -68% |
| Health Partners Open Network | Commercial | $611.49 | ↓ -56% |
| Wellmark UPH Self-Funded | Commercial | $631.50 | ↓ -55% |
| Wellmark Blue Cross and Blue Shield | HMO | $631.50 | ↓ -55% |
| Aetna | HMO | $735.81 | ↓ -47% |
| Wellmark Blue Cross and Blue Shield | PPO | $742.90 | ↓ -47% |
| Cigna/Midlands | Commercial | $771.68 | ↓ -45% |
| Aetna | PPO | $895.30 | ↓ -36% |
| United Healthcare | HMO | $966.53 | ↓ -31% |
| United Healthcare | PPO | $966.53 | ↓ -31% |
| Amerigroup | Managed Medicaid | $1,417.36 | ↑ +2% |
| Iowa Total Care | Managed Medicaid | $1,417.36 | ↑ +2% |
| Medica Exchange Insure | Commercial | not published by hospital | — |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Exc tendon sheath or cap lesion 26160 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $1,031.40 | not published |
| MercyOne Clinton Medical Center | Clinton | $1,103.00 | $7.75 – $116.32 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $17,479.03 | $2.28 – $4,604.83 |
| MercyOne Newton Medical Center | Newton | $6,699.50 | $74.48 – $3,121.78 |
| MercyOne North Iowa Medical Center | Mason City | $22,540.18 | $1,555.89 – $3,483.68 |
| MercyOne Genesis Davenport Medical Center | Davenport | $2,309.40 | $1,531.94 – $2,144.72 |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $1,083.00 | $928.00 – $2,679.00 |
| MercyOne Waterloo Medical Center | Waterloo | $18,380.15 | $0.96 – $4,604.83 |