Biopsy of salivary glnd;incisional 42405 at SSM Health Saint Louis University Hospital
1201 S Grand Blvd, Saint Louis, MO · SSM Health · · NPI 1942685920
$244.18
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.
$443.97
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.
$278.72 with BCBS vs $3,406.00 with Healthlink — 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 | $278.72 | ↑ +14% |
| BCBS | Anthem Blue Preferred HMO/POS | $284.67 | ↑ +17% |
| BCBS | Anthem Blue Access Choice All Commercial Plans | $284.67 | ↑ +17% |
| BCBS | Anthem Blue Access PPO | $306.84 | ↑ +26% |
| BCBS | Anthem Medicare Managed Care Plan | $1,523.01 | ↑ +524% |
| Aetna | Medicare Managed Care Plan | $1,554.09 | ↑ +536% |
| Centene | Wellcare Medicare Managed Care - PPO | $1,569.63 | ↑ +543% |
| Humana | Medicare Managed Care Plan | $1,580.51 | ↑ +547% |
| Aetna | Advantra Medicare Managed Care Plan | $1,585.17 | ↑ +549% |
| Essence | Medicare Managed Care Plan | $1,600.71 | ↑ +556% |
| Aetna | Carelink All Commercial Plans | $1,642.00 | ↑ +572% |
| Cigna | All Commercial Plans | $1,719.00 | ↑ +604% |
| Oscar | Exchange | $1,864.91 | ↑ +664% |
| Healthlink | HMO | $2,187.00 | ↑ +796% |
| Aetna | All Commercial Plans | $2,535.00 | ↑ +938% |
| UnitedHealthCare | Non-PPO Other Commercial Plan | $2,544.00 | ↑ +942% |
| UnitedHealthCare | Employee | $2,595.00 | ↑ +963% |
| UnitedHealthCare | Options PPO | $2,831.00 | ↑ +1059% |
| Centene | Ambetter Exchange | $3,148.00 | ↑ +1189% |
| Healthlink | PPO | $3,406.00 | ↑ +1295% |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health Cardinal Glennon Children's Hospital | Saint Louis | not published | $237.11 – $3,935.00 |
| Mercy Orthopedic Hospital Springfield | Ozark | $17,264.74 | $188.24 – $3,200.22 |
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | not published | $242.74 – $2,680.00 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | not published | $242.74 – $2,680.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | not published | $242.74 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | not published | $242.74 – $2,680.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | not published | $242.74 – $2,680.00 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | not published | $1,545.54 – $2,797.36 |