Removal of breast lesion at Mercy Primary Care - Bernie
810 N Walnut St, Bernie, MO · Mercy · · NPI 1679820286
$1,158.00
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.
$1,544.00
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.
$301.16 with MERIDIAN MEDICAID CONTRACTED [320430] vs $1,389.60 with WORKERS COMP [20426] — 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 |
|---|---|---|---|
| MERIDIAN MEDICAID CONTRACTED [320430] | PB MERIDIAN IL MCD HEALTH PLANS | $301.16 | ↓ -74% |
| MEDICAID [20240] | PB SPRG/JOPL/CAPE/STOD MEDICAID MO | $394.12 | ↓ -66% |
| BLUE CROSS AND BLUE SHIELD [20053] | PB STOD ANTHEM BLUE ACCESS CHOICE - BLUE PREF - PATHWAYS | $439.48 | ↓ -62% |
| MC ANTHEM [20455] | PB STOD ANTHEM BLUE ACCESS CHOICE - BLUE PREF - PATHWAYS | $439.48 | ↓ -62% |
| BLUE CROSS AND BLUE SHIELD [20053] | PB CAPE/STOD ANTHEM BLUE TRADITIONAL | $512.94 | ↓ -56% |
| MEDICARE [20244] | PB SPRG/JOPL/CAPE/STOD MEDICARE MO 99 | $528.71 | ↓ -54% |
| AETNA MEDICARE ADVANTAGE [20010] | PB SPRG/JOPL/CAPE/STOD MEDICARE MO 99 | $528.71 | ↓ -54% |
| HUMANA MEDICARE ADVANTAGE [20194] | PB IL HUMANA MCR-MCD DSNP | $598.68 | ↓ -48% |
| HUMANA MEDICARE ADVANTAGE CONTRACTED [320194] | PB IL HUMANA MCR-MCD DSNP | $598.68 | ↓ -48% |
| UNITED HEALTHCARE CONTRACTED [320396] | PB STL UHC CORE | $650.00 | ↓ -44% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | PB STL DEC EMPLOYER BENEFIT ALLIANCE (EBA) | $681.10 | ↓ -41% |
| CIGNA HEALTHCARE CONTRACTED [320071] | PB CAPE/STOD CIGNA | $711.49 | ↓ -39% |
| CENTIVO CONTRACTED [320505] | PB PCMH CAPE STOD CENTIVO | $713.76 | ↓ -38% |
| UNITED HEALTHCARE CONTRACTED [320396] | PB CAPE STOD UHC EXCHANGE - IFP | $760.05 | ↓ -34% |
| ADMINISTRATIVE PAYOR [20005] | PB MERCY AMISH/MENNONITE | $849.20 | ↓ -27% |
| ADMINISTRATIVE PAYOR CONTRACTED [320005] | PB MERCY AMISH/MENNONITE | $849.20 | ↓ -27% |
| 90 DEGREE BENEFITS CONTRACTED [320436] | PB CAPE STOD DEC COASTAL ENERGY | $872.37 | ↓ -25% |
| EBMS CONTRACTED [320493] | PB CAPE STOD DEC CRADER DISTRIBUTING | $872.37 | ↓ -25% |
| REFLECT HEALTH [20492] | PB CAPE STOD DEC WW WOOD PRODUCTS | $957.77 | ↓ -17% |
| REFLECT HEALTH CONTRACTED [320492] | PB CAPE STOD DEC WW WOOD PRODUCTS | $957.77 | ↓ -17% |
| UNITED HEALTHCARE CONTRACTED [320396] | PB CAPE-STOD UHC CORE | $973.97 | ↓ -16% |
| IMAGINE 360 CONTRACTED [320494] | PB CAPE STOD DEC ROBINSON CONSTRUCTION | $1,064.19 | ↓ -8% |
| MERCY BENEFIT ADMIN CONTRACTED [320251] | PB CAPE STOD DEC CITY OF JACKSON | $1,064.19 | ↓ -8% |
| MULTIPLAN CONTRACTED [320270] | PB CAPE / STOD MULTIPLAN COMM 75% | $1,158.00 | ↑ +0% |
| MULTIPLAN [20270] | PB CAPE / STOD MULTIPLAN COMM 75% | $1,158.00 | ↑ +0% |
| HOPE TRUST CONTRACTED [320488] | PB CAPE STOD DEC HOPE TRUST AREA 99 | $1,176.21 | ↑ +2% |
| AUXIANT CONTRACTED [320462] | PB CAPE STOD DEC BUCHHEIT | $1,260.23 | ↑ +9% |
| AUXIANT [20462] | PB CAPE STOD DEC BUCHHEIT | $1,260.23 | ↑ +9% |
| WORKERS COMP [20426] | PB CAPE/ STOD MULTIPLAN WORK COMP 85% | $1,312.40 | ↑ +13% |
| WORKERS COMP [20426] | PB CAPE/ STOD MULTIPLAN AUTO MEDICAL 90% | $1,389.60 | ↑ +20% |
Visitor-reported prices
Comments
Removal of breast lesion at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mercy Hospital Aurora | Aurora | $1,088.75 | $359.70 – $1,330.69 |
| Mercy Hospital Lincoln | Troy | $3,428.75 | $378.16 – $636.04 |
| Mercy Hospital Carthage | Carthage | $1,077.70 | $394.12 – $8,000.48 |
| Mercy Hospital Southeast | Cape Girardeau | $3,428.75 | $365.37 – $940.71 |