Exc tmr sft tiss shldr subq <3cm at LAFAYETTE REGIONAL HEALTH CENTER
1500 State St, Lexington, MO · Hcamidwest · · NPI 1679520258
$1,095.00
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.
$1,095.00
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.
$203.67 with Ambetter vs $3,041.00 with United — 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 |
|---|---|---|---|
| Ambetter | Commercial-Exchange | $203.67 | ↓ -81% |
| United | OptionsPPO | $274.85 | ↓ -75% |
| Aetna Coventry | FamilyHealthPlanMCD | $284.70 | ↓ -74% |
| Universal Healthcare | MCR | $284.70 | ↓ -74% |
| Humana | HMO | $370.11 | ↓ -66% |
| Humana | ASO | $370.11 | ↓ -66% |
| Humana | EPO | $370.11 | ↓ -66% |
| BCBS | Blue-Care(HMO) | $416.10 | ↓ -62% |
| BCBS | Preferred-CareBlue(PPO) | $416.10 | ↓ -62% |
| BCBS | FreedomNetworkSelect | $416.10 | ↓ -62% |
| BCBS | BlueAccess | $416.10 | ↓ -62% |
| BCBS | FreedomNetwork | $448.95 | ↓ -59% |
| BCBS | PC | $470.85 | ↓ -57% |
| Humana | POS | $470.85 | ↓ -57% |
| College Park Family Care Center | COMM | $470.85 | ↓ -57% |
| Humana | PPO | $470.85 | ↓ -57% |
| United | GlobalBenefitPlan | $492.75 | ↓ -55% |
| Aetna | IVLHIX | $520.13 | ↓ -52% |
| United | KSMGMCD | $525.22 | ↓ -52% |
| HealthyBlue | MGMCD | $535.72 | ↓ -51% |
| Sunflower State Health Plan | MCD | $540.98 | ↓ -51% |
| Amerigroup | MGMCD | $546.23 | ↓ -50% |
| Aetna Better Health | MCD | $546.23 | ↓ -50% |
| Unicare | MGMCD | $546.23 | ↓ -50% |
| Home State Health Plan | MCD | $546.23 | ↓ -50% |
| Oscar | HIX | $547.50 | ↓ -50% |
| OHA Network | MissouriWCOMP | $547.50 | ↓ -50% |
| Aetna | KCCarePlus | $577.07 | ↓ -47% |
| United | MOMGMCD | $577.74 | ↓ -47% |
| Cigna | LocalKC | $625.46 | ↓ -43% |
| BCBS | Traditional | $700.80 | ↓ -36% |
| BCBS | Participating | $700.80 | ↓ -36% |
| Aetna | Local | $733.65 | ↓ -33% |
| Cigna | SureFit/LocalPlus | $781.28 | ↓ -29% |
| Cigna | Comm | $781.83 | ↓ -29% |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $821.25 | ↓ -25% |
| Aetna | NAP | $830.01 | ↓ -24% |
| Aetna | National | $838.77 | ↓ -23% |
| Multiplan | PrimaryNetwork | $854.10 | ↓ -22% |
| Coventry KC MO | WCOMP | $873.81 | ↓ -20% |
| Coventry | WCOMP | $873.81 | ↓ -20% |
| CCO, Inc. | COMM | $930.75 | ↓ -15% |
| CCO, Inc. | WORKERSCOMPPPO | $930.75 | ↓ -15% |
| CorVel Corporation | MOWC | $930.75 | ↓ -15% |
| Aetna | FHMedicalRental | $958.13 | ↓ -12% |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $985.50 | ↓ -10% |
| Anthem MissouriCare | MissouriCareMGMCD | $1,095.00 | ↑ +0% |
| NHC Advantage | MGMCD | $2,550.00 | ↑ +133% |
| NHC Advantage | MGMCR | $2,550.00 | ↑ +133% |
| CorVel Corporation | KSWC | $2,641.96 | ↑ +141% |
| OHA Network | KansasWCOMP | $2,668.92 | ↑ +144% |
| United | AllPayerAppendix | $3,041.00 | ↑ +178% |
Visitor-reported prices
Comments
Exc tmr sft tiss shldr subq <3cm at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mercy Primary Care - Bernie | Bernie | $384.00 | $234.99 – $512.00 |
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | not published | $345.32 – $2,680.00 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | not published | $345.32 – $2,680.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | not published | $396.51 – $2,544.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | not published | $345.32 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | not published | $345.32 – $2,680.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | not published | $345.32 – $2,680.00 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | not published | $1,645.17 – $2,977.67 |