ER Visit (level 1, minor) at LAFAYETTE REGIONAL HEALTH CENTER
1500 State St, Lexington, MO · Hcamidwest · · NPI 1679520258
$503.93
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.
$503.93
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.
$75.00 with Sunflower State Health Plan vs $453.54 with FOCUS Healthcare Mgmt, Inc — 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 |
|---|---|---|---|
| Sunflower State Health Plan | MCD | $75.00 | ↓ -85% |
| Ambetter | Commercial-Exchange | $93.73 | ↓ -81% |
| United | KSMGMCD | $105.00 | ↓ -79% |
| HealthyBlue | MGMCD | $107.10 | ↓ -79% |
| Amerigroup | MGMCD | $109.20 | ↓ -78% |
| Aetna Better Health | MCD | $109.20 | ↓ -78% |
| Unicare | MGMCD | $109.20 | ↓ -78% |
| Home State Health Plan | MCD | $109.20 | ↓ -78% |
| United | MOMGMCD | $115.50 | ↓ -77% |
| United | OptionsPPO | $126.49 | ↓ -75% |
| Humana | HMO | $170.33 | ↓ -66% |
| Humana | EPO | $170.33 | ↓ -66% |
| Humana | ASO | $170.33 | ↓ -66% |
| BCBS | BlueAccess | $191.49 | ↓ -62% |
| BCBS | Preferred-CareBlue(PPO) | $191.49 | ↓ -62% |
| BCBS | FreedomNetworkSelect | $191.49 | ↓ -62% |
| BCBS | Blue-Care(HMO) | $191.49 | ↓ -62% |
| BCBS | FreedomNetwork | $206.61 | ↓ -59% |
| BCBS | PC | $216.69 | ↓ -57% |
| Humana | PPO | $216.69 | ↓ -57% |
| Humana | POS | $216.69 | ↓ -57% |
| United | GlobalBenefitPlan | $226.77 | ↓ -55% |
| Aetna | IVLHIX | $239.37 | ↓ -52% |
| Oscar | HIX | $251.97 | ↓ -50% |
| OHA Network | MissouriWCOMP | $251.97 | ↓ -50% |
| Aetna | KCCarePlus | $265.57 | ↓ -47% |
| Cigna | LocalKC | $287.84 | ↓ -43% |
| BCBS | Participating | $322.52 | ↓ -36% |
| BCBS | Traditional | $322.52 | ↓ -36% |
| Aetna | Local | $337.63 | ↓ -33% |
| Cigna | SureFit/LocalPlus | $359.55 | ↓ -29% |
| Cigna | Comm | $359.81 | ↓ -29% |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $377.95 | ↓ -25% |
| Aetna | NAP | $381.98 | ↓ -24% |
| Aetna | National | $386.01 | ↓ -23% |
| Multiplan | PrimaryNetwork | $393.07 | ↓ -22% |
| Coventry | WCOMP | $402.14 | ↓ -20% |
| Coventry KC MO | WCOMP | $402.14 | ↓ -20% |
| CCO, Inc. | WORKERSCOMPPPO | $428.34 | ↓ -15% |
| CorVel Corporation | MOWC | $428.34 | ↓ -15% |
| CCO, Inc. | COMM | $428.34 | ↓ -15% |
| United | AllPayerAppendix | $436.00 | ↓ -13% |
| Aetna | FHMedicalRental | $440.94 | ↓ -12% |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $453.54 | ↓ -10% |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $280.50 | $84.46 – $101.35 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $280.50 | $84.46 – $101.35 |
| SSM Health Saint Louis University Hospital | Saint Louis | $311.30 | $25.24 – $101.35 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $280.50 | not published |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $280.50 | $84.46 – $101.35 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $280.50 | $84.46 – $101.35 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $190.46 | $84.00 – $152.03 |
| Mercy Hospital Aurora | Aurora | $405.60 | $23.23 – $115.59 |