Optx clavicular fx w/int fix at UnityPoint Health - Allen Hospital
1825 Logan Avenue, Waterloo, IA · UnityPoint Health · · NPI 1336231091
$3,540.80
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.
$4,426.00
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.
$652.06 with Aetna vs $5,921.26 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 | $652.06 | ↓ -82% |
| Molina | Medicare Advantage | $665.10 | ↓ -81% |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $665.10 | ↓ -81% |
| United Healthcare | Medicare Advantage | $684.66 | ↓ -81% |
| Humana | Medicare Advantage | $684.66 | ↓ -81% |
| Amerivantage | Medicare Advantage | $684.66 | ↓ -81% |
| Health Partners Open Network | Commercial | $1,332.61 | ↓ -62% |
| Wellmark Blue Cross and Blue Shield | HMO | $1,418.90 | ↓ -60% |
| Wellmark UPH Self-Funded | Commercial | $1,418.90 | ↓ -60% |
| Aetna | HMO | $1,632.30 | ↓ -54% |
| Wellmark Blue Cross and Blue Shield | PPO | $1,669.30 | ↓ -53% |
| Cigna/Midlands | Commercial | $1,734.13 | ↓ -51% |
| Aetna | PPO | $1,947.43 | ↓ -45% |
| United Healthcare | PPO | $2,212.37 | ↓ -38% |
| United Healthcare | HMO | $2,212.37 | ↓ -38% |
| Amerigroup | Managed Medicaid | $5,921.26 | ↑ +67% |
| Iowa Total Care | Managed Medicaid | $5,921.26 | ↑ +67% |
| Medica Exchange Insure | Commercial | not published by hospital | — |
| Medica Exchange Inspire | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Optx clavicular fx w/int fix at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Waterloo Medical Center | Waterloo | $49,725.05 | $0.96 – $14,021.15 |
| MercyOne Dubuque Medical Center | Dubuque | $30,200.40 | $0.96 – $14,498.57 |
| MercyOne Clinton Medical Center | Clinton | $2,489.00 | $26.91 – $258.72 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $51,205.93 | $15.69 – $14,021.15 |
| MercyOne West Des Moines Medical Center | West Des Moines | $36,226.68 | $9.09 – $14,087.30 |
| MercyOne Des Moines Medical Center | Des Moines | $39,084.35 | $3.84 – $14,087.30 |
| UnityPoint Health - Finley Hospital | Dubuque | $3,540.80 | $652.06 – $6,280.98 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $3,540.80 | $652.06 – $7,107.76 |