Explore/drain eye socket at SSM Health St. Joseph Hospital - Lake Saint Louis
100 Medical Plaza, Lake Saint Louis, MO · SSM Health · · NPI 1871665380
$1,233.65
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.
$2,243.00
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.
$820.66 with BCBS vs $4,498.00 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 | $820.66 | ↓ -33% |
| BCBS | Anthem Blue Access Choice PPO | $843.30 | ↓ -32% |
| BCBS | Anthem Blue Preferred HMO/POS | $847.30 | ↓ -31% |
| BCBS | Anthem Blue Access PPO | $913.86 | ↓ -26% |
| Ambetter | Exchange | $2,167.00 | ↑ +76% |
| Healthlink | Employers Choice All Commercial Plans | $2,302.00 | ↑ +87% |
| Aetna | Medicare Managed Care Plan | $2,381.32 | ↑ +93% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $2,405.14 | ↑ +95% |
| UnitedHealthCare | Medicare Managed Care Plan | $2,416.57 | ↑ +96% |
| BCBS | Anthem Medicare Managed Care Plan | $2,417.04 | ↑ +96% |
| Humana | Medicare Managed Care Plan | $2,421.81 | ↑ +96% |
| Aetna | Advantra Medicare Managed Care Plan | $2,464.67 | ↑ +100% |
| Aetna | Carelink Other Commercial Plan | $2,666.00 | ↑ +116% |
| UnitedHealthCare | St. Louis University Employee | $2,727.00 | ↑ +121% |
| Oscar | Exchange | $2,857.59 | ↑ +132% |
| UnitedHealthCare | All Commercial Plans | $3,018.00 | ↑ +145% |
| UnitedHealthCare | Options PPO | $3,532.00 | ↑ +186% |
| Cigna | OAP Other Commercial Plan | $3,783.00 | ↑ +207% |
| Healthlink | HMO | $3,829.00 | ↑ +210% |
| Aetna | NBD Other Commercial Plan | $3,969.00 | ↑ +222% |
| Aetna | All Commercial Plans | $4,498.00 | ↑ +265% |
Visitor-reported prices
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Explore/drain eye socket at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $1,233.65 | $820.66 – $3,783.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $1,233.65 | $820.66 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $1,233.65 | $820.66 – $3,783.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $1,233.65 | $820.66 – $3,783.00 |
| Mercy Orthopedic Hospital Springfield | Ozark | $13,617.98 | $297.00 – $13,373.78 |
| SSM Health St. Clare Hospital - Fenton | Fenton | $1,233.65 | $820.66 – $3,783.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | not published | $942.31 – $3,241.00 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | not published | $2,277.00 – $4,286.38 |