Coombs direct at LAFAYETTE REGIONAL HEALTH CENTER
1500 State St, Lexington, MO · Hcamidwest · · NPI 1679520258
not published by hospital
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.
not published by hospital
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.
$5.39 with United vs $88.48 with Anthem MissouriCare — 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 |
|---|---|---|---|
| United | AllPayerAppendix | $5.39 | — |
| United | KSMGMCD | $5.39 | — |
| HealthyBlue | MGMCD | $5.50 | — |
| Sunflower State Health Plan | MCD | $5.55 | — |
| Aetna Better Health | MCD | $5.61 | — |
| Unicare | MGMCD | $5.61 | — |
| Home State Health Plan | MCD | $5.61 | — |
| Amerigroup | MGMCD | $5.61 | — |
| United | MOMGMCD | $5.93 | — |
| CorVel Corporation | KSWC | $11.45 | — |
| OHA Network | KansasWCOMP | $11.56 | — |
| Ambetter | Commercial-Exchange | $16.46 | — |
| NHC Advantage | MGMCR | $16.81 | — |
| NHC Advantage | MGMCD | $16.81 | — |
| United | OptionsPPO | $22.21 | — |
| Universal Healthcare | MCR | $23.00 | — |
| Humana | HMO | $29.91 | — |
| Humana | ASO | $29.91 | — |
| Humana | EPO | $29.91 | — |
| BCBS | Blue-Care(HMO) | $33.62 | — |
| BCBS | BlueAccess | $33.62 | — |
| BCBS | FreedomNetworkSelect | $33.62 | — |
| BCBS | Preferred-CareBlue(PPO) | $33.62 | — |
| BCBS | FreedomNetwork | $36.28 | — |
| College Park Family Care Center | COMM | $38.05 | — |
| Humana | PPO | $38.05 | — |
| BCBS | PC | $38.05 | — |
| Humana | POS | $38.05 | — |
| United | GlobalBenefitPlan | $39.82 | — |
| Aetna | IVLHIX | $42.03 | — |
| OHA Network | MissouriWCOMP | $44.24 | — |
| Oscar | HIX | $44.24 | — |
| Aetna | KCCarePlus | $46.63 | — |
| Cigna | LocalKC | $50.54 | — |
| Aetna Coventry | FamilyHealthPlanMCD | $51.86 | — |
| BCBS | Participating | $56.63 | — |
| BCBS | Traditional | $56.63 | — |
| Aetna | Local | $59.28 | — |
| Cigna | SureFit/LocalPlus | $63.13 | — |
| Cigna | Comm | $63.17 | — |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $66.36 | — |
| Aetna | NAP | $67.07 | — |
| Aetna | National | $67.78 | — |
| Multiplan | PrimaryNetwork | $69.01 | — |
| Coventry KC MO | WCOMP | $70.61 | — |
| Coventry | WCOMP | $70.61 | — |
| CorVel Corporation | MOWC | $75.21 | — |
| CCO, Inc. | WORKERSCOMPPPO | $75.21 | — |
| CCO, Inc. | COMM | $75.21 | — |
| Aetna | FHMedicalRental | $77.42 | — |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $79.63 | — |
| Anthem MissouriCare | MissouriCareMGMCD | $88.48 | — |
Visitor-reported prices
Comments
Coombs direct at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $45.10 | $5.39 – $70.91 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $45.10 | $5.39 – $70.91 |
| SSM Health Saint Louis University Hospital | Saint Louis | $62.70 | $5.39 – $70.91 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $45.10 | $5.39 – $22.21 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $45.10 | $5.39 – $70.91 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $45.10 | $5.39 – $70.91 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $114.40 | $4.85 – $106.36 |
| Mercy Hospital Aurora | Aurora | $65.65 | $5.39 – $77.97 |