Observation per hour 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.
$5.30 with HealthyBlue vs $107.42 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 |
|---|---|---|---|
| HealthyBlue | MGMCD | $5.30 | — |
| Sunflower State Health Plan | MCD | $5.36 | — |
| Amerigroup | MGMCD | $5.41 | — |
| Aetna Better Health | MCD | $5.41 | — |
| Home State Health Plan | MCD | $5.41 | — |
| Unicare | MGMCD | $5.41 | — |
| United | MOMGMCD | $5.72 | — |
| Ambetter | Commercial-Exchange | $22.20 | — |
| United | OptionsPPO | $29.96 | — |
| Aetna Coventry | FamilyHealthPlanMCD | $31.03 | — |
| Universal Healthcare | MCR | $31.03 | — |
| Humana | ASO | $40.34 | — |
| Humana | EPO | $40.34 | — |
| Humana | HMO | $40.34 | — |
| BCBS | Blue-Care(HMO) | $45.36 | — |
| BCBS | BlueAccess | $45.36 | — |
| BCBS | Preferred-CareBlue(PPO) | $45.36 | — |
| BCBS | FreedomNetworkSelect | $45.36 | — |
| BCBS | FreedomNetwork | $48.94 | — |
| Humana | PPO | $51.32 | — |
| Humana | POS | $51.32 | — |
| BCBS | PC | $51.32 | — |
| United | GlobalBenefitPlan | $53.71 | — |
| Oscar | HIX | $59.68 | — |
| OHA Network | MissouriWCOMP | $59.68 | — |
| Cigna | LocalKC | $68.18 | — |
| BCBS | Traditional | $76.39 | — |
| BCBS | Participating | $76.39 | — |
| Cigna | SureFit/LocalPlus | $85.16 | — |
| Cigna | Comm | $85.22 | — |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $89.52 | — |
| Multiplan | PrimaryNetwork | $93.10 | — |
| Coventry KC MO | WCOMP | $95.25 | — |
| Coventry | WCOMP | $95.25 | — |
| CorVel Corporation | MOWC | $101.46 | — |
| CCO, Inc. | WORKERSCOMPPPO | $101.46 | — |
| CCO, Inc. | COMM | $101.46 | — |
| Aetna | FHMedicalRental | $104.44 | — |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $107.42 | — |
Visitor-reported prices
Comments
Observation per hour at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mercy Hospital Aurora | Aurora | $59.80 | $5.20 – $86.90 |
| Mercy Hospital Lincoln | Troy | $72.15 | $79.00 – $86.90 |
| Mercy Hospital Carthage | Carthage | $74.10 | $5.20 – $86.90 |
| Mercy Hospital Southeast | Cape Girardeau | $55.25 | $56.43 – $101.57 |
| Mercy Hospital Stoddard | Dexter | $52.65 | $56.43 – $84.65 |
| Mercy Orthopedic Hospital Springfield | Ozark | $74.10 | $5.20 – $95.93 |
| LEE'S SUMMIT MEDICAL CENTER | Lee's Summit | not published | $5.30 – $6.50 |
| RESEARCH PSYCHIATRIC CENTER | Kansas City | not published | $5.30 – $7.54 |