Exc mal+marg tal 3.1-4 cm 11604 at SSM Health St. Joseph Hospital - Lake Saint Louis
100 Medical Plaza, Lake Saint Louis, MO · SSM Health · · NPI 1871665380
$249.88
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.
$454.32
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.
$227.75 with BCBS vs $3,213.00 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 | $227.75 | ↓ -9% |
| BCBS | Anthem Blue Access Choice PPO | $234.03 | ↓ -6% |
| BCBS | Anthem Blue Preferred HMO/POS | $235.14 | ↓ -6% |
| BCBS | Anthem Blue Access PPO | $253.62 | ↑ +1% |
| Aetna | Medicare Managed Care Plan | $709.28 | ↑ +184% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $716.37 | ↑ +187% |
| UnitedHealthCare | Medicare Managed Care Plan | $719.77 | ↑ +188% |
| BCBS | Anthem Medicare Managed Care Plan | $719.91 | ↑ +188% |
| Humana | Medicare Managed Care Plan | $721.33 | ↑ +189% |
| Aetna | Advantra Medicare Managed Care Plan | $734.10 | ↑ +194% |
| Oscar | Exchange | $851.13 | ↑ +241% |
| Healthlink | Employers Choice All Commercial Plans | $1,628.00 | ↑ +552% |
| UnitedHealthCare | All Commercial Plans | $1,775.00 | ↑ +610% |
| UnitedHealthCare | St. Louis University Employee | $1,781.00 | ↑ +613% |
| Aetna | Carelink Other Commercial Plan | $1,944.00 | ↑ +678% |
| UnitedHealthCare | Options PPO | $2,087.00 | ↑ +735% |
| Ambetter | Exchange | $2,167.00 | ↑ +767% |
| Cigna | OAP Other Commercial Plan | $2,680.00 | ↑ +973% |
| Healthlink | HMO | $2,709.00 | ↑ +984% |
| Aetna | NBD Other Commercial Plan | $2,835.00 | ↑ +1035% |
| Aetna | All Commercial Plans | $3,213.00 | ↑ +1186% |
Visitor-reported prices
Comments
Exc mal+marg tal 3.1-4 cm 11604 at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $249.88 | $227.75 – $2,680.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | $249.88 | $261.51 – $2,187.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $249.88 | $227.75 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $249.88 | $227.75 – $2,680.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $249.88 | $227.75 – $2,680.00 |
| Mercy Hospital Aurora | Aurora | $650.65 | $234.17 – $923.69 |
| Mercy Hospital Lincoln | Troy | $634.40 | $599.80 – $923.69 |
| Mercy Hospital Southeast | Cape Girardeau | $168.35 | $168.53 – $4,550.61 |