Injection of sinus tract at SSM Health St. Joseph Hospital - Lake Saint Louis
100 Medical Plaza, Lake Saint Louis, MO · SSM Health · · NPI 1871665380
$1,310.65
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.
$2,383.00
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.
$89.97 with BCBS vs $3,829.00 with Healthlink — 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 | $89.97 | ↓ -93% |
| BCBS | Anthem Blue Access Choice PPO | $92.45 | ↓ -93% |
| BCBS | Anthem Blue Preferred HMO/POS | $92.89 | ↓ -93% |
| BCBS | Anthem Blue Access PPO | $100.18 | ↓ -92% |
| Cigna | OAP Other Commercial Plan | $279.00 | ↓ -79% |
| Aetna | Carelink Other Commercial Plan | $1,444.00 | ↑ +10% |
| Aetna | Medicare Managed Care Plan | $1,554.09 | ↑ +19% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $1,569.63 | ↑ +20% |
| UnitedHealthCare | Medicare Managed Care Plan | $1,577.09 | ↑ +20% |
| BCBS | Anthem Medicare Managed Care Plan | $1,577.40 | ↑ +20% |
| Humana | Medicare Managed Care Plan | $1,580.51 | ↑ +21% |
| Aetna | Advantra Medicare Managed Care Plan | $1,608.48 | ↑ +23% |
| Oscar | Exchange | $1,864.91 | ↑ +42% |
| Aetna | NBD Other Commercial Plan | $2,131.00 | ↑ +63% |
| Ambetter | Exchange | $2,167.00 | ↑ +65% |
| Healthlink | Employers Choice All Commercial Plans | $2,302.00 | ↑ +76% |
| UnitedHealthCare | All Commercial Plans | $2,363.00 | ↑ +80% |
| UnitedHealthCare | St. Louis University Employee | $2,371.00 | ↑ +81% |
| Aetna | All Commercial Plans | $2,414.00 | ↑ +84% |
| UnitedHealthCare | Options PPO | $2,783.00 | ↑ +112% |
| Healthlink | HMO | $3,829.00 | ↑ +192% |
Visitor-reported prices
Comments
Injection of sinus tract at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $1,310.65 | $89.97 – $2,302.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $1,310.65 | $89.97 – $2,363.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $1,310.65 | $89.97 – $2,302.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $1,310.65 | $89.97 – $2,302.00 |
| Mercy Orthopedic Hospital Springfield | Ozark | $1,152.45 | not published |
| SSM Health St. Clare Hospital - Fenton | Fenton | $1,310.65 | $89.97 – $2,302.00 |
| SSM Health Cardinal Glennon Children's Hospital | Saint Louis | $1,419.99 | $87.88 – $3,868.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | not published | $103.30 – $3,085.00 |