Incise tear duct opening 68440 at SSM Health Saint Louis University Hospital
1201 S Grand Blvd, Saint Louis, MO · SSM Health · · NPI 1942685920
$179.16
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.
$325.74
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.
$117.32 with BCBS vs $4,616.00 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 | $117.32 | ↓ -35% |
| BCBS | Anthem Blue Preferred HMO/POS | $119.82 | ↓ -33% |
| BCBS | Anthem Blue Access Choice All Commercial Plans | $119.82 | ↓ -33% |
| BCBS | Anthem Blue Access PPO | $129.16 | ↓ -28% |
| BCBS | Anthem Medicare Managed Care Plan | $311.56 | ↑ +74% |
| Aetna | Medicare Managed Care Plan | $317.92 | ↑ +77% |
| Centene | Wellcare Medicare Managed Care - PPO | $321.10 | ↑ +79% |
| Humana | Medicare Managed Care Plan | $323.32 | ↑ +80% |
| Aetna | Advantra Medicare Managed Care Plan | $324.28 | ↑ +81% |
| Essence | Medicare Managed Care Plan | $327.46 | ↑ +83% |
| Oscar | Exchange | $381.50 | ↑ +113% |
| UnitedHealthCare | Employee | $537.00 | ↑ +200% |
| UnitedHealthCare | Non-PPO Other Commercial Plan | $760.00 | ↑ +324% |
| UnitedHealthCare | Options PPO | $961.00 | ↑ +436% |
| Aetna | Carelink All Commercial Plans | $1,234.00 | ↑ +589% |
| Cigna | All Commercial Plans | $1,373.00 | ↑ +666% |
| Aetna | All Commercial Plans | $1,907.00 | ↑ +964% |
| Healthlink | HMO | $3,085.00 | ↑ +1622% |
| Centene | Ambetter Exchange | $3,148.00 | ↑ +1657% |
| Healthlink | PPO | $4,616.00 | ↑ +2476% |
Visitor-reported prices
Comments
Incise tear duct opening 68440 at other Missouri hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health Cardinal Glennon Children's Hospital | Saint Louis | not published | $99.81 – $3,886.00 |
| Mercy Orthopedic Hospital Springfield | Ozark | $549.25 | $67.49 – $3,772.00 |
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis | not published | $102.17 – $2,302.00 |
| SSM Health DePaul Hospital - St. Louis | Bridgeton | not published | $102.17 – $2,302.00 |
| SSM Health St. Joseph Hospital- Wentzville | Wentzville | not published | $102.17 – $3,886.00 |
| SSM Health St. Joseph Hospital - St. Charles | Saint Charles | not published | $102.17 – $2,302.00 |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights | not published | $102.17 – $2,302.00 |
| SSM Health St. Mary's Hospital - Jefferson City | Jefferson City | not published | $316.17 – $2,277.00 |