Biopsy abdominal mass at SSM Health St. Clare Hospital - Fenton
1015 Bowles, Fenton, MO · SSM Health · · NPI 1851496152
$2,890.80
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.
$5,256.00
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.
$92.96 with BCBS vs $2,783.00 with UnitedHealthCare — 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 | $92.96 | ↓ -97% |
| BCBS | Anthem Blue Access Choice PPO | $95.53 | ↓ -97% |
| BCBS | Anthem Blue Preferred HMO/POS | $95.98 | ↓ -97% |
| BCBS | Anthem Blue Access PPO | $103.52 | ↓ -96% |
| Healthlink | Employers Choice All Commercial Plans | $1,216.00 | ↓ -58% |
| Aetna | Carelink Other Commercial Plan | $1,444.00 | ↓ -50% |
| Aetna | Medicare Managed Care Plan | $1,654.26 | ↓ -43% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $1,670.81 | ↓ -42% |
| UnitedHealthCare | Medicare Managed Care Plan | $1,678.75 | ↓ -42% |
| BCBS | Anthem Medicare Managed Care Plan | $1,679.08 | ↓ -42% |
| Humana | Medicare Managed Care Plan | $1,682.39 | ↓ -42% |
| Aetna | Advantra Medicare Managed Care Plan | $1,712.16 | ↓ -41% |
| Oscar | Exchange | $1,985.12 | ↓ -31% |
| Cigna | OAP Other Commercial Plan | $2,004.00 | ↓ -31% |
| Healthlink | HMO | $2,024.00 | ↓ -30% |
| Aetna | NBD Other Commercial Plan | $2,131.00 | ↓ -26% |
| Ambetter | Exchange | $2,167.00 | ↓ -25% |
| UnitedHealthCare | All Commercial Plans | $2,363.00 | ↓ -18% |
| UnitedHealthCare | St. Louis University Employee | $2,371.00 | ↓ -18% |
| Aetna | All Commercial Plans | $2,414.00 | ↓ -16% |
| UnitedHealthCare | Options PPO | $2,783.00 | ↓ -4% |
Visitor-reported prices
Comments
Biopsy abdominal mass at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $2,890.80 | $92.96 – $2,167.00 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $2,890.80 | $92.96 – $2,167.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | $4,164.60 | $106.74 – $2,544.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $2,890.80 | $92.96 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $2,890.80 | $92.96 – $2,167.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $2,890.80 | $92.96 – $2,167.00 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $1,710.72 | $1,325.00 – $2,977.67 |
| Mercy Hospital Southeast | Cape Girardeau | $5,334.80 | $68.46 – $10,613.58 |