Biopsy skin incisional single lesion at SSM Health St. Joseph Hospital - St. Charles
300 1St Capitol Dr, Saint Charles, MO · SSM Health · · NPI 1467521146
$1,192.40
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.
$2,168.00
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.
$740.27 with Aetna vs $2,414.00 with Aetna — 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 |
|---|---|---|---|
| Aetna | Medicare Managed Care Plan | $740.27 | ↓ -38% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $747.67 | ↓ -37% |
| UnitedHealthCare | Medicare Managed Care Plan | $751.22 | ↓ -37% |
| BCBS | Anthem Medicare Managed Care Plan | $751.37 | ↓ -37% |
| Humana | Medicare Managed Care Plan | $752.85 | ↓ -37% |
| Aetna | Advantra Medicare Managed Care Plan | $766.17 | ↓ -36% |
| BCBS | Anthem Pathway Exchange | $779.10 | ↓ -35% |
| BCBS | Anthem Blue Access Choice PPO | $800.59 | ↓ -33% |
| BCBS | Anthem Blue Preferred HMO/POS | $804.39 | ↓ -33% |
| BCBS | Anthem Blue Access PPO | $867.58 | ↓ -27% |
| Oscar | Exchange | $888.32 | ↓ -26% |
| Healthlink | Employers Choice All Commercial Plans | $1,216.00 | ↑ +2% |
| Aetna | Carelink Other Commercial Plan | $1,444.00 | ↑ +21% |
| UnitedHealthCare | All Commercial Plans | $1,775.00 | ↑ +49% |
| UnitedHealthCare | St. Louis University Employee | $1,781.00 | ↑ +49% |
| Cigna | OAP Other Commercial Plan | $2,004.00 | ↑ +68% |
| Healthlink | HMO | $2,024.00 | ↑ +70% |
| UnitedHealthCare | Options PPO | $2,087.00 | ↑ +75% |
| Aetna | NBD Other Commercial Plan | $2,131.00 | ↑ +79% |
| Ambetter | Exchange | $2,167.00 | ↑ +82% |
| Aetna | All Commercial Plans | $2,414.00 | ↑ +102% |
Visitor-reported prices
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Biopsy skin incisional single lesion at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $1,192.40 | $740.27 – $2,167.00 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $1,192.40 | $740.27 – $2,167.00 |
| SSM Health Saint Louis University Hospital | Saint Louis | $891.55 | $725.46 – $2,020.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $1,192.40 | $779.10 – $2,167.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $1,192.40 | $740.27 – $2,167.00 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $1,010.46 | $736.19 – $2,277.00 |
| Mercy Hospital Aurora | Aurora | $242.45 | $67.59 – $803.62 |
| Mercy Hospital Lincoln | Troy | $393.90 | $521.83 – $803.62 |