Biopsy of lip 40490 at St. Francis Hospital
34515 Ninth Avenue South, Federal Way, WA · Vmfh · · NPI 1093713091
not published by hospital
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.
not published by hospital
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.
$258.47 with SoundPath vs $1,183.09 with First Choice — 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 |
|---|---|---|---|
| SoundPath | Medicare|All Plans | $258.47 | — |
| Kaiser | Medicare|All Plans | $258.47 | — |
| Optum | Medicare|All Plans | $261.05 | — |
| Aetna | Medicare|All Plans | $266.22 | — |
| BCBS - Regence | Medicare|All Plans | $266.22 | — |
| BCBS - Premera | Medicare|All Plans | $266.22 | — |
| Humana | Medicare|All Plans | $276.56 | — |
| United | Medicare|All Plans | $279.15 | — |
| Molina | Medicare|All Plans | $279.15 | — |
| Amerigroup | Medicare|All Plans | $281.73 | — |
| CHPW | Medicare|All Plans | $297.24 | — |
| Seattle Medical Group | Medicare|All Plans | $297.24 | — |
| Sound Family Medicine | Commercial|All Plans | $491.09 | — |
| Molina | Commercial|Marketplace Exchange | $496.26 | — |
| Coordinated Care | Commercial|Ambetter Exchange | $511.77 | — |
| BCBS - Premera | Commercial|LifeWise Primary Exchange | $565.44 | — |
| Kaiser | Commercial|HMO | $565.48 | — |
| Uniform Medical Plan | Commercial|All Plans | $603.68 | — |
| Kaiser | Commercial|PPO | $622.08 | — |
| BCBS - Regence | Commercial|All Plans | $692.21 | — |
| BCBS - Premera | Commercial|All Other Plans | $817.40 | — |
| United | Commercial|Navigate | $830.56 | — |
| United | Commercial|Cascade Care | $874.29 | — |
| United | Commercial|All Other Plans | $874.29 | — |
| Aetna | Commercial|AWH | $984.41 | — |
| Aetna | Commercial|All Other Plans | $1,158.12 | — |
| First Choice | Commercial|All Plans | $1,183.09 | — |
| MultiPlan | Commercial|All Plans | not published by hospital | — |
| Cigna | Commercial|All Plans | not published by hospital | — |
| Aetna | Commercial|Rental | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other Washington hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Swedish Medical Center - First Hill Campus | Seattle | $636.48 | $274.27 – $957.11 |
| Swedish Medical Center Cherry Hill | Seattle | $636.48 | $274.27 – $926.56 |
| Swedish Issaquah | Issaquah | $636.48 | $275.04 – $957.11 |
| Virginia Mason Medical Center | Seattle | $380.97 | $3.69 – $337.01 |
| Providence St Luke's Rehabilitation Medical Center | Spokane | not published | $263.93 – $290.33 |
| Providence Sacred Heart Medical Center and Children's Hospital | Spokane | not published | $263.93 – $671.71 |
| Central Medical Center | Seattle | not published | not published |
| Providence Centralia Hospital | Centralia | not published | $274.27 – $1,191.29 |