Ex palate/uvula lesion without closure 42104 at Virginia Mason Medical Center
1100 9th Ave., Seattle, WA · Vmfh · · NPI 1801851258
$3,610.80
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.
$7,080.00
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.
$2.99 with aetna vs $5,227.87 with cigna — 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 |
|---|---|---|---|
| aetna | medicare advantage hmo | $2.99 | ↓ -100% |
| aetna | medicare advantage | $5.99 | ↓ -100% |
| first choice | commercial | $6.44 | ↓ -100% |
| united healthcare | commercial | $145.76 | ↓ -96% |
| humana | medicare advantage | $149.51 | ↓ -96% |
| optum care network | medicare advantage | $149.51 | ↓ -96% |
| kaiser foundation | hp medicare | $149.51 | ↓ -96% |
| humana | choicecare medicare advantage | $149.51 | ↓ -96% |
| united healthcare | medicare advantage | $149.51 | ↓ -96% |
| signal health | medicare advantage | $152.92 | ↓ -96% |
| multiplan | medicare advantage | $152.92 | ↓ -96% |
| premera | medicare advantage hmo/ppo | $152.92 | ↓ -96% |
| regence | medicare advantage | $157.26 | ↓ -96% |
| confluence health | medicare advantage | $228.33 | ↓ -94% |
| regence | uniform medical plan | $252.66 | ↓ -93% |
| premera | commercial | $299.00 | ↓ -92% |
| cigna | commercial | $481.28 | ↓ -87% |
| coventry - first health | commercial | $532.59 | ↓ -85% |
| regence | commercial | $544.48 | ↓ -85% |
| kaiser health plan | commercial | $578.50 | ↓ -84% |
| aetna | medicare advantage ppo | $3,638.59 | ↑ +1% |
| aetna | commercial | $4,460.40 | ↑ +24% |
| cigna | local plus | $5,227.87 | ↑ +45% |
Visitor-reported prices
Comments
Ex palate/uvula lesion without closure 42104 at other Washington hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Swedish Medical Center - First Hill Campus | Seattle | not published | $3,839.27 – $12,755.94 |
| Swedish Medical Center Cherry Hill | Seattle | not published | $3,839.27 – $12,284.47 |
| Central Medical Center | Seattle | not published | not published |
| Providence St Luke's Rehabilitation Medical Center | Spokane | not published | $3,694.56 – $4,064.02 |
| Providence Sacred Heart Medical Center and Children's Hospital | Spokane | not published | $3,694.56 – $9,402.66 |
| Swedish Issaquah | Issaquah | not published | $3,850.04 – $12,755.94 |
| Providence Centralia Hospital | Centralia | not published | $3,839.27 – $15,322.85 |
| Swedish Edmonds Hospital | Edmonds | not published | $2,225.00 – $12,677.36 |