Ot evaluation moderate complexity patient/family 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.
$55.76 with United vs $1,090.47 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 | KSMGMCD | $55.76 | — |
| HealthyBlue | MGMCD | $56.88 | — |
| Sunflower State Health Plan | MCD | $57.43 | — |
| Amerigroup | MGMCD | $57.99 | — |
| Aetna Better Health | MCD | $57.99 | — |
| Unicare | MGMCD | $57.99 | — |
| Home State Health Plan | MCD | $57.99 | — |
| United | MOMGMCD | $61.34 | — |
| CorVel Corporation | KSWC | $119.48 | — |
| OHA Network | KansasWCOMP | $120.70 | — |
| Ambetter | Commercial-Exchange | $202.83 | — |
| NHC Advantage | MGMCR | $207.19 | — |
| NHC Advantage | MGMCD | $207.19 | — |
| United | OptionsPPO | $273.71 | — |
| Aetna Coventry | FamilyHealthPlanMCD | $283.52 | — |
| Universal Healthcare | MCR | $283.52 | — |
| Humana | EPO | $368.58 | — |
| Humana | ASO | $368.58 | — |
| Humana | HMO | $368.58 | — |
| BCBS | Blue-Care(HMO) | $414.38 | — |
| BCBS | BlueAccess | $414.38 | — |
| BCBS | FreedomNetworkSelect | $414.38 | — |
| BCBS | Preferred-CareBlue(PPO) | $414.38 | — |
| BCBS | FreedomNetwork | $447.09 | — |
| BCBS | PC | $468.90 | — |
| College Park Family Care Center | COMM | $468.90 | — |
| Humana | POS | $468.90 | — |
| Humana | PPO | $468.90 | — |
| United | GlobalBenefitPlan | $490.71 | — |
| Aetna | IVLHIX | $517.97 | — |
| OHA Network | MissouriWCOMP | $545.24 | — |
| Oscar | HIX | $545.24 | — |
| Aetna | KCCarePlus | $574.68 | — |
| Cigna | LocalKC | $622.88 | — |
| BCBS | Participating | $697.90 | — |
| BCBS | Traditional | $697.90 | — |
| Aetna | Local | $730.61 | — |
| Cigna | SureFit/LocalPlus | $778.05 | — |
| Cigna | Comm | $778.60 | — |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $817.85 | — |
| Aetna | NAP | $826.58 | — |
| Aetna | National | $835.30 | — |
| Multiplan | PrimaryNetwork | $850.57 | — |
| Coventry KC MO | WCOMP | $870.20 | — |
| Coventry | WCOMP | $870.20 | — |
| CorVel Corporation | MOWC | $926.90 | — |
| CCO, Inc. | WORKERSCOMPPPO | $926.90 | — |
| CCO, Inc. | COMM | $926.90 | — |
| Aetna | FHMedicalRental | $954.16 | — |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $981.42 | — |
| Anthem MissouriCare | MissouriCareMGMCD | $1,090.47 | — |
Visitor-reported prices
Comments
Ot evaluation moderate complexity patient/family at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $223.85 | $81.51 – $117.84 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $223.85 | $81.51 – $117.84 |
| SSM Health Saint Louis University Hospital | Saint Louis | $214.50 | $93.59 – $117.84 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $223.85 | $81.51 – $81.51 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $223.85 | $81.51 – $117.84 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $223.85 | $81.51 – $117.84 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $189.71 | $97.66 – $176.76 |
| Mercy Hospital Aurora | Aurora | $489.45 | $55.76 – $136.12 |