Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im 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.
$105.93 with Ambetter vs $512.55 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 |
|---|---|---|---|
| Ambetter | Commercial-Exchange | $105.93 | — |
| United | KSMGMCD | $133.47 | — |
| HealthyBlue | MGMCD | $136.14 | — |
| Sunflower State Health Plan | MCD | $137.47 | — |
| Aetna Better Health | MCD | $138.81 | — |
| Amerigroup | MGMCD | $138.81 | — |
| Home State Health Plan | MCD | $138.81 | — |
| Unicare | MGMCD | $138.81 | — |
| United | OptionsPPO | $142.94 | — |
| United | MOMGMCD | $146.82 | — |
| Aetna Coventry | FamilyHealthPlanMCD | $148.07 | — |
| Humana | ASO | $192.49 | — |
| Humana | EPO | $192.49 | — |
| Humana | HMO | $192.49 | — |
| BCBS | BlueAccess | $216.41 | — |
| BCBS | FreedomNetworkSelect | $216.41 | — |
| BCBS | Blue-Care(HMO) | $216.41 | — |
| BCBS | Preferred-CareBlue(PPO) | $216.41 | — |
| United | AllPayerAppendix | $220.23 | — |
| BCBS | FreedomNetwork | $233.50 | — |
| Humana | POS | $244.88 | — |
| Humana | PPO | $244.88 | — |
| BCBS | PC | $244.88 | — |
| United | GlobalBenefitPlan | $256.27 | — |
| Aetna | IVLHIX | $270.51 | — |
| Oscar | HIX | $284.75 | — |
| OHA Network | MissouriWCOMP | $284.75 | — |
| Aetna | KCCarePlus | $300.13 | — |
| Cigna | LocalKC | $325.30 | — |
| BCBS | Traditional | $364.48 | — |
| BCBS | Participating | $364.48 | — |
| Aetna | Local | $381.56 | — |
| Cigna | SureFit/LocalPlus | $406.34 | — |
| Cigna | Comm | $406.62 | — |
| WPPA ProviDrs Care Network | UnifiedHealthPlan | $427.13 | — |
| Aetna | NAP | $431.68 | — |
| Aetna | National | $436.24 | — |
| Multiplan | PrimaryNetwork | $444.21 | — |
| Coventry KC MO | WCOMP | $454.46 | — |
| Coventry | WCOMP | $454.46 | — |
| CCO, Inc. | WORKERSCOMPPPO | $484.07 | — |
| CorVel Corporation | MOWC | $484.07 | — |
| CCO, Inc. | COMM | $484.07 | — |
| Aetna | FHMedicalRental | $498.31 | — |
| FOCUS Healthcare Mgmt, Inc | WORKERSCOMP | $512.55 | — |
| Pyramid Life | MCR | not published by hospital | — |
| United | MGMCR | not published by hospital | — |
| United | VACCN | not published by hospital | — |
| Coventry | MedicareAdvantage | not published by hospital | — |
| Wellcare | MCR | not published by hospital | — |
| Devoted Health | MGMCR | not published by hospital | — |
| Celtic | MCR | not published by hospital | — |
| Humana | PFFS | not published by hospital | — |
| Humana | MCRPPO | not published by hospital | — |
| Humana | MCRHMO | not published by hospital | — |
| BCBS | MCRPPO | not published by hospital | — |
| Cigna | HealthspringMGMCR | not published by hospital | — |
| BCBS | MCRHMO | not published by hospital | — |
| Universal Healthcare | MCR | not published by hospital | — |
Visitor-reported prices
Comments
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $225.06 | $141.48 – $141.48 |
| Mercy Hospital Carthage | Carthage | $494.67 | $124.97 – $194.87 |
| Mercy Hospital Southeast | Cape Girardeau | $380.52 | $126.45 – $467.15 |
| Mercy Primary Care - Bernie | Bernie | $29.25 | $39.00 – $39.00 |
| RESEARCH PSYCHIATRIC CENTER | Kansas City | $127.29 | $133.47 – $193.53 |
| CENTERPOINT MEDICAL CENTER | Independence | $223.00 | $133.47 – $140.14 |
| RESEARCH MEDICAL CENTER | Kansas City | $225.58 | $133.47 – $161.50 |
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | not published | $155.49 – $220.23 |