Analysis tumor at SSM Health St. Clare Hospital - Fenton
1015 Bowles, Fenton, MO · SSM Health · · NPI 1851496152
not published by hospital
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.
not published by hospital
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.
$39.09 with BCBS vs $204.77 with Oscar — 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 |
|---|---|---|---|
| BCBS | Anthem Pathway Exchange | $39.09 | — |
| BCBS | Anthem Blue Access Choice PPO | $40.17 | — |
| BCBS | Anthem Blue Preferred HMO/POS | $40.36 | — |
| BCBS | Anthem Blue Access PPO | $43.53 | — |
| UnitedHealthCare | All Commercial Plans | $149.16 | — |
| UnitedHealthCare | St. Louis University Employee | $149.16 | — |
| UnitedHealthCare | Options PPO | $149.16 | — |
| Healthlink | Employers Choice All Commercial Plans | $153.47 | — |
| Healthlink | HMO | $153.47 | — |
| Cigna | OAP Other Commercial Plan | $154.91 | — |
| Aetna | Medicare Managed Care Plan | $170.64 | — |
| Aetna | Gold Advantage Medicare Managed Care Plan | $172.35 | — |
| UnitedHealthCare | Medicare Managed Care Plan | $173.17 | — |
| BCBS | Anthem Medicare Managed Care Plan | $173.20 | — |
| Humana | Medicare Managed Care Plan | $173.55 | — |
| Aetna | Advantra Medicare Managed Care Plan | $176.62 | — |
| Oscar | Exchange | $204.77 | — |
Visitor-reported prices
Comments
Analysis tumor at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $275.55 | $62.23 – $307.16 |
| Mercy Hospital Lincoln | Troy | $174.85 | $30.65 – $224.98 |
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | not published | $39.09 – $204.77 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | not published | $39.09 – $204.77 |
| SSM Health Saint Louis University Hospital | Saint Louis | not published | $44.88 – $204.77 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | not published | $39.09 – $154.91 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | not published | $39.09 – $204.77 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | not published | $39.09 – $204.77 |