Aco cont gluc mnt phys/qhp eqp 95250aco at SSM Health St. Clare Hospital - Fenton
1015 Bowles, Fenton, MO · SSM Health · · NPI 1851496152
$200.75
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.
$365.00
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.
$133.35 with Aetna vs $177.25 with BCBS — 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 Managed Care Plan | $133.35 | ↓ -34% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $134.68 | ↓ -33% |
| UnitedHealthCare | Medicare Managed Care Plan | $135.32 | ↓ -33% |
| BCBS | Anthem Medicare Managed Care Plan | $135.35 | ↓ -33% |
| Humana | Medicare Managed Care Plan | $135.62 | ↓ -32% |
| Aetna | Advantra Medicare Managed Care Plan | $138.02 | ↓ -31% |
| BCBS | Anthem Pathway Exchange | $159.17 | ↓ -21% |
| Oscar | Exchange | $160.02 | ↓ -20% |
| BCBS | Anthem Blue Access Choice PPO | $163.56 | ↓ -19% |
| BCBS | Anthem Blue Preferred HMO/POS | $164.34 | ↓ -18% |
| BCBS | Anthem Blue Access PPO | $177.25 | ↓ -12% |
Visitor-reported prices
Comments
Aco cont gluc mnt phys/qhp eqp 95250aco at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $200.75 | $133.35 – $160.02 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $200.75 | $133.35 – $160.02 |
| SSM Health Saint Louis University Hospital | Saint Louis | $285.12 | $130.68 – $160.02 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $200.75 | $159.17 – $159.17 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $200.75 | $133.35 – $160.02 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $200.75 | $133.35 – $160.02 |
| Mercy Hospital Lincoln | Troy | $248.30 | $153.80 – $517.06 |
| Mercy Hospital Southeast | Cape Girardeau | $248.30 | $88.01 – $855.54 |