Pulse ox multiple at LAFAYETTE REGIONAL HEALTH CENTER
1500 State St, Lexington, MO · Hcamidwest · · NPI 1679520258
$39.48
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.
$39.48
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.
$7.34 with Ambetter vs $39.48 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 |
|---|---|---|---|
| Ambetter | Commercial-Exchange | $7.34 | ↓ -81% |
| NHC Advantage | MGMCD | $7.50 | ↓ -81% |
| NHC Advantage | MGMCR | $7.50 | ↓ -81% |
| United | OptionsPPO | $9.91 | ↓ -75% |
| Aetna Coventry | FamilyHealthPlanMCD | $10.26 | ↓ -74% |
| Universal Healthcare | MCR | $10.26 | ↓ -74% |
| Humana | HMO | $13.34 | ↓ -66% |
| Humana | ASO | $13.34 | ↓ -66% |
| Humana | EPO | $13.34 | ↓ -66% |
| BCBS | Preferred-CareBlue(PPO) | $15.00 | ↓ -62% |
| BCBS | Blue-Care(HMO) | $15.00 | ↓ -62% |
| BCBS | BlueAccess | $15.00 | ↓ -62% |
| BCBS | FreedomNetworkSelect | $15.00 | ↓ -62% |
| United | KSMGMCD | $15.60 | ↓ -60% |
| HealthyBlue | MGMCD | $15.91 | ↓ -60% |
| Sunflower State Health Plan | MCD | $16.07 | ↓ -59% |
| BCBS | FreedomNetwork | $16.19 | ↓ -59% |
| Home State Health Plan | MCD | $16.22 | ↓ -59% |
| Unicare | MGMCD | $16.22 | ↓ -59% |
| Amerigroup | MGMCD | $16.22 | ↓ -59% |
| Aetna Better Health | MCD | $16.22 | ↓ -59% |
| Humana | POS | $16.98 | ↓ -57% |
| BCBS | PC | $16.98 | ↓ -57% |
| Humana | PPO | $16.98 | ↓ -57% |
| College Park Family Care Center | COMM | $16.98 | ↓ -57% |
| United | MOMGMCD | $17.16 | ↓ -57% |
| United | GlobalBenefitPlan | $17.77 | ↓ -55% |
| Aetna | IVLHIX | $18.75 | ↓ -53% |
| OHA Network | MissouriWCOMP | $19.74 | ↓ -50% |
| Oscar | HIX | $19.74 | ↓ -50% |
| Aetna | KCCarePlus | $20.81 | ↓ -47% |
| Cigna | LocalKC | $22.55 | ↓ -43% |
| BCBS | Participating | $25.27 | ↓ -36% |
| BCBS | Traditional | $25.27 | ↓ -36% |
| Aetna | Local | $26.45 | ↓ -33% |
| Cigna | SureFit/LocalPlus | $28.17 | ↓ -29% |
| Cigna | Comm | $28.19 | ↓ -29% |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $29.61 | ↓ -25% |
| Aetna | NAP | $29.93 | ↓ -24% |
| Aetna | National | $30.24 | ↓ -23% |
| Multiplan | PrimaryNetwork | $30.79 | ↓ -22% |
| Coventry | WCOMP | $31.51 | ↓ -20% |
| Coventry KC MO | WCOMP | $31.51 | ↓ -20% |
| CCO, Inc. | WORKERSCOMPPPO | $33.56 | ↓ -15% |
| CCO, Inc. | COMM | $33.56 | ↓ -15% |
| CorVel Corporation | MOWC | $33.56 | ↓ -15% |
| Aetna | FHMedicalRental | $34.54 | ↓ -13% |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $35.53 | ↓ -10% |
| Anthem MissouriCare | MissouriCareMGMCD | $39.48 | ↑ +0% |
Visitor-reported prices
Comments
Pulse ox multiple at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $272.25 | $5.04 – $5.04 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $272.25 | $5.04 – $5.04 |
| SSM Health Saint Louis University Hospital | Saint Louis | $134.20 | $5.79 – $10.69 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $272.25 | $5.04 – $5.04 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | $272.25 | $5.04 – $5.04 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $272.25 | $5.04 – $5.04 |
| Mercy Hospital Aurora | Aurora | $163.15 | $15.60 – $28.00 |
| Mercy Hospital Carthage | Carthage | $156.00 | $3.31 – $15.60 |