Biliary endo perq dx w/speci at SSM Health St. Clare Hospital - Fenton
1015 Bowles, Fenton, MO · SSM Health · · NPI 1851496152
$2,085.05
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.
$3,791.00
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.
$339.05 with BCBS vs $6,711.22 with Aetna — 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 | $339.05 | ↓ -84% |
| BCBS | Anthem Blue Access Choice PPO | $348.40 | ↓ -83% |
| BCBS | Anthem Blue Preferred HMO/POS | $350.06 | ↓ -83% |
| BCBS | Anthem Blue Access PPO | $377.56 | ↓ -82% |
| Healthlink | Employers Choice All Commercial Plans | $1,628.00 | ↓ -22% |
| Aetna | Carelink Other Commercial Plan | $1,944.00 | ↓ -7% |
| Ambetter | Exchange | $2,167.00 | ↑ +4% |
| Cigna | OAP Other Commercial Plan | $2,680.00 | ↑ +29% |
| Healthlink | HMO | $2,709.00 | ↑ +30% |
| Aetna | NBD Other Commercial Plan | $2,835.00 | ↑ +36% |
| Aetna | All Commercial Plans | $3,213.00 | ↑ +54% |
| UnitedHealthCare | St. Louis University Employee | $3,379.00 | ↑ +62% |
| Oscar | Exchange | $3,886.00 | ↑ +86% |
| UnitedHealthCare | All Commercial Plans | $4,114.00 | ↑ +97% |
| UnitedHealthCare | Options PPO | $4,553.00 | ↑ +118% |
| Aetna | Medicare Managed Care Plan | $6,484.27 | ↑ +211% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $6,549.12 | ↑ +214% |
| UnitedHealthCare | Medicare Managed Care Plan | $6,580.24 | ↑ +216% |
| BCBS | Anthem Medicare Managed Care Plan | $6,581.54 | ↑ +216% |
| Humana | Medicare Managed Care Plan | $6,594.51 | ↑ +216% |
| Aetna | Advantra Medicare Managed Care Plan | $6,711.22 | ↑ +222% |
Visitor-reported prices
Comments
Biliary endo perq dx w/speci at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $2,085.05 | $339.05 – $6,594.51 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $2,085.05 | $339.05 – $6,594.51 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $2,085.05 | $339.05 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $2,085.05 | $339.05 – $6,594.51 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $2,085.05 | $339.05 – $6,594.51 |
| SSM Health Cardinal Glennon Children's Hospital | Saint Louis | $2,510.20 | $331.20 – $3,935.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | not published | $389.31 – $6,678.80 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | not published | $1,778.00 – $11,671.69 |