Pt evaluation moderate complexity patient/family at SSM Health St. Anthony Hospital - Shawnee
1102 W Macarthur, Shawnee, OK · SSM Health · · NPI 1134123193
$147.40
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.
$268.00
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.
$92.86 with BCBS vs $181.08 with Kempton — 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 | Medicare Managed Care Plan | $92.86 | ↓ -37% |
| UnitedHealthCare | Medicare Managed Care Plan | $94.23 | ↓ -36% |
| Humana | Medicare Managed Care Plan | $94.44 | ↓ -36% |
| BCBS | Native Blue HMO | $95.65 | ↓ -35% |
| Oscar | All Commercial Plans | $122.16 | ↓ -17% |
| Ambetter Health | Exchange | $125.36 | ↓ -15% |
| Medica | Exchange | $153.10 | ↑ +4% |
| Healthchoice | All Commercial Plans | $154.55 | ↑ +5% |
| Kempton | All Commercial Plans | $181.08 | ↑ +23% |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Oklahoma hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| SSM Health St. Anthony Hospital - Oklahoma City | Oklahoma City | $233.75 | $92.86 – $198.72 |
| Love County Health Center | Marietta | $601.00 | $88.72 – $158.37 |
| Mercy Hospital Ardmore | Northwest Ardmore | $341.25 | $88.72 – $205.99 |
| Mercy Hospital Healdton | Healdton | $390.65 | $88.72 – $158.37 |
| Mercy Hospital Kingfisher | Kingfisher | $394.55 | $88.72 – $158.37 |
| SSM Health St. Anthony Hospital - Midwest | Midwest City | $303.88 | $92.86 – $198.72 |
| Mercy Hospital Logan County | Guthrie | $394.55 | $88.72 – $158.37 |
| Mercy Hospital Oklahoma City | Oklahoma City | $438.10 | $86.88 – $205.99 |