Observation direct referral from physician office for admission at Houston Methodist Baytown Hospital
4401 Garth Road, Baytown, TX · Houstonmethodist · · NPI 1891789772
$291.00
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.
$582.00
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.
$396.93 with Bcbs vs $1,196.49 with Molina Healthcare — 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 | All Commercial Plans | $396.93 | ↑ +36% |
| Bcbs | Medicare Managed Care - Hmo | $598.24 | ↑ +106% |
| Aetna | Medicare Managed Care - Hmo/Ppo | $607.22 | ↑ +109% |
| Unitedhealthcare | Medicare Managed Care - Hmo | $610.21 | ↑ +110% |
| Cigna | Texas Healthspring Medicare Managed Care - Hmo/Ppo | $616.19 | ↑ +112% |
| Molina Healthcare | Advantage Medicare Managed Care Plan | $628.16 | ↑ +116% |
| Community Health Choice | D-Snp Medicare Managed Care - Hmo | $640.12 | ↑ +120% |
| Procare Advantage | Medicare Managed Care - Hmo | $658.07 | ↑ +126% |
| Community Health Choice | Silver & Gold Exchange | $975.14 | ↑ +235% |
| Optum Health | Transplant Medicare Managed Care Plan | $1,166.58 | ↑ +301% |
| Molina Healthcare | Exchange | $1,196.49 | ↑ +311% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $162.54 | $489.80 – $489.80 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $554.33 | $157.06 – $1,591.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $527.99 | $71.00 – $1,591.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $602.45 | $71.00 – $1,591.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $554.33 | $147.82 – $1,591.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $527.99 | $169.48 – $1,591.17 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $527.99 | $272.79 – $1,591.17 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $602.45 | $71.00 – $1,591.17 |