Removal of breast lesion at SSM Health St. Joseph Hospital - St. Charles
300 1St Capitol Dr, Saint Charles, MO · SSM Health · · NPI 1467521146
$3,502.40
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.
$6,368.00
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.
$437.91 with BCBS vs $4,059.02 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 |
|---|---|---|---|
| BCBS | Anthem Pathway Exchange | $437.91 | ↓ -87% |
| BCBS | Anthem Blue Access Choice PPO | $449.98 | ↓ -87% |
| BCBS | Anthem Blue Preferred HMO/POS | $452.12 | ↓ -87% |
| BCBS | Anthem Blue Access PPO | $487.64 | ↓ -86% |
| Healthlink | Employers Choice All Commercial Plans | $1,865.00 | ↓ -47% |
| Ambetter | Exchange | $2,167.00 | ↓ -38% |
| Aetna | Carelink Other Commercial Plan | $2,224.00 | ↓ -37% |
| UnitedHealthCare | St. Louis University Employee | $2,727.00 | ↓ -22% |
| UnitedHealthCare | All Commercial Plans | $3,018.00 | ↓ -14% |
| Cigna | OAP Other Commercial Plan | $3,071.00 | ↓ -12% |
| Healthlink | HMO | $3,102.00 | ↓ -11% |
| Aetna | NBD Other Commercial Plan | $3,262.00 | ↓ -7% |
| UnitedHealthCare | Options PPO | $3,532.00 | ↑ +1% |
| Aetna | All Commercial Plans | $3,697.00 | ↑ +6% |
| Oscar | Exchange | $3,886.00 | ↑ +11% |
| Aetna | Medicare Managed Care Plan | $3,921.76 | ↑ +12% |
| Aetna | Gold Advantage Medicare Managed Care Plan | $3,960.97 | ↑ +13% |
| UnitedHealthCare | Medicare Managed Care Plan | $3,979.80 | ↑ +14% |
| BCBS | Anthem Medicare Managed Care Plan | $3,980.58 | ↑ +14% |
| Humana | Medicare Managed Care Plan | $3,988.43 | ↑ +14% |
| Aetna | Advantra Medicare Managed Care Plan | $4,059.02 | ↑ +16% |
Visitor-reported prices
Comments
Removal of breast lesion at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | $3,502.40 | $437.91 – $3,988.43 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | $3,502.40 | $437.91 – $3,988.43 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | $3,502.40 | $437.91 – $3,886.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | $3,502.40 | $437.91 – $3,988.43 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | $3,912.70 | $2,034.00 – $7,059.16 |
| Mercy Hospital Aurora | Aurora | $1,088.75 | $359.70 – $1,330.69 |
| Mercy Hospital Lincoln | Troy | $3,428.75 | $378.16 – $636.04 |
| Mercy Hospital Carthage | Carthage | $1,077.70 | $394.12 – $8,000.48 |