Observation direct referral from physician office for admission at SSM Health St. Joseph Hospital - Lake Saint Louis
100 Medical Plaza, Lake Saint Louis, MO · SSM Health · · NPI 1871665380
$437.80
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.
$796.00
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.
$596.49 with Aetna vs $715.79 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 |
|---|---|---|---|
| Aetna | Medicare Managed Care Plan | $596.49 | ↑ +36% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $602.46 | ↑ +38% |
| UnitedHealthCare | Medicare Managed Care Plan | $605.32 | ↑ +38% |
| BCBS | Anthem Medicare Managed Care Plan | $605.44 | ↑ +38% |
| Humana | Medicare Managed Care Plan | $606.63 | ↑ +39% |
| Aetna | Advantra Medicare Managed Care Plan | $617.37 | ↑ +41% |
| Oscar | Exchange | $715.79 | ↑ +63% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $437.80 | $596.49 – $715.79 |
| SSM Health Saint Louis University Hospital | Saint Louis | $453.20 | $584.56 – $715.79 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $437.80 | not published |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $437.80 | $596.49 – $715.79 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $437.80 | $596.49 – $715.79 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $160.93 | $593.21 – $1,073.69 |
| Mercy Hospital Aurora | Aurora | $362.05 | $614.98 – $614.98 |
| Mercy Hospital Carthage | Carthage | $421.85 | $614.98 – $614.98 |