Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber at SSM Health St. Clare Hospital - Fenton
1015 Bowles, Fenton, MO · SSM Health · · NPI 1851496152
$17,333.80
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.
$31,516.00
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.
$996.59 with BCBS vs $37,727.45 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 | $996.59 | ↓ -94% |
| BCBS | Anthem Blue Access Choice PPO | $1,024.07 | ↓ -94% |
| BCBS | Anthem Blue Preferred HMO/POS | $1,028.94 | ↓ -94% |
| BCBS | Anthem Blue Access PPO | $1,109.77 | ↓ -94% |
| Ambetter | Exchange | $2,167.00 | ↓ -87% |
| Cigna | OAP Other Commercial Plan | $3,071.00 | ↓ -82% |
| Aetna | Carelink Other Commercial Plan | $5,786.00 | ↓ -67% |
| Aetna | NBD Other Commercial Plan | $7,120.00 | ↓ -59% |
| UnitedHealthCare | St. Louis University Employee | $7,717.00 | ↓ -55% |
| Aetna | All Commercial Plans | $8,068.00 | ↓ -53% |
| UnitedHealthCare | All Commercial Plans | $8,542.00 | ↓ -51% |
| Healthlink | Employers Choice All Commercial Plans | $9,535.00 | ↓ -45% |
| UnitedHealthCare | Options PPO | $9,729.00 | ↓ -44% |
| Healthlink | HMO | $15,860.00 | ↓ -9% |
| Healthlink | PPO | $27,535.00 | ↑ +59% |
| Aetna | Medicare Managed Care Plan | $31,439.54 | ↑ +81% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $31,753.94 | ↑ +83% |
| UnitedHealthCare | Medicare Managed Care Plan | $31,904.85 | ↑ +84% |
| BCBS | Anthem Medicare Managed Care Plan | $31,911.13 | ↑ +84% |
| Humana | Medicare Managed Care Plan | $31,974.01 | ↑ +84% |
| Aetna | Advantra Medicare Managed Care Plan | $32,539.93 | ↑ +88% |
| Oscar | Exchange | $37,727.45 | ↑ +118% |
Visitor-reported prices
Comments
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $17,333.80 | $996.59 – $37,727.45 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $17,333.80 | $996.59 – $37,727.45 |
| SSM Health Saint Louis University Hospital | Saint Louis | $43,450.00 | $1,144.31 – $75,368.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $17,333.80 | $996.59 – $9,535.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $17,333.80 | $996.59 – $37,727.45 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $17,333.80 | $996.59 – $37,727.45 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $24,665.66 | $2,277.00 – $56,591.17 |
| Mercy Hospital Southeast | Cape Girardeau | $63,856.93 | $753.14 – $201,712.19 |