Removal of adenoids <12yrs 42835 at SSM Health St. Anthony Hospital - Oklahoma City
1000 North Lee Avenue, Oklahoma City, OK · SSM Health · · NPI 1366545311
$6,493.85
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.
$11,807.00
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.
$302.88 with Medica vs $7,971.77 with Community Care — 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 |
|---|---|---|---|
| Medica | Exchange | $302.88 | ↓ -95% |
| PHCS | Multiplan All Commercial Plans | $1,594.00 | ↓ -75% |
| BCBS | Medicare Managed Care Plan | $3,188.71 | ↓ -51% |
| UnitedHealthCare | Medicare Managed Care Plan | $3,235.90 | ↓ -50% |
| Humana | Medicare Managed Care Plan | $3,242.92 | ↓ -50% |
| BCBS | Native Blue HMO | $3,284.37 | ↓ -49% |
| Cigna | All Commercial Plans | $3,359.00 | ↓ -48% |
| Oscar | All Commercial Plans | $4,194.75 | ↓ -35% |
| UnitedHealthCare | All Commercial Plans | $4,232.60 | ↓ -35% |
| Ambetter Health | Exchange | $4,304.76 | ↓ -34% |
| Healthchoice | All Commercial Plans | $5,837.53 | ↓ -10% |
| Community Care | Select HMO | $5,899.11 | ↓ -9% |
| Kempton | All Commercial Plans | $6,217.98 | ↓ -4% |
| Global Health | All Commercial Plans | $6,823.84 | ↑ +5% |
| Community Care | HMO | $7,971.77 | ↑ +23% |
Visitor-reported prices
Comments
Removal of adenoids <12yrs 42835 at other Oklahoma hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Anthony Hospital - Midwest | Midwest City | not published | $302.88 – $6,823.84 |
| SSM Health St. Anthony Hospital - Shawnee | Shawnee | not published | $302.88 – $6,217.98 |
| Ascension St. John Medical Center (St. John Medical Center, Inc.) | Tulsa | not published | $199.94 – $364.62 |
| Ascension St. John Broken Arrow (St. John Broken Arrow, Inc.) | Jenks | not published | $199.94 – $204.29 |
| Ascension St. John Owasso (Owasso Medical Facility, Inc.) | Owasso | not published | $199.94 – $422.96 |
| Ascension St. John Jane Phillips (Jane Phillips Memorial Medical Center, Inc.) | Bartlesville | not published | $199.94 – $418.10 |
| Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.) | Nowata | not published | $199.94 – $418.10 |
| Ascension St. John Sapulpa (St. John Sapulpa, Inc.) | Sapulpa | not published | $199.94 – $364.62 |