Biopsy of upper nose/throat at St. Joseph Health Burleson Hospital
1101 Woodson Drive, Caldwell, TX · CommonSpirit Health · · NPI 1750377289
$15.05
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.
?
What you pay up front if you don't use insurance.
$86.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$18.92 with BCBS vs $4,321.83 with BCBS-TX — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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|All Plans | $18.92 | ↑ +26% |
| UNITED | Medicare|All Plans | $19.30 | ↑ +28% |
| AMERIVANTAGE | Medicare|All Plans | $19.49 | ↑ +30% |
| SCANHealth | Medicare|All Plans | $20.25 | ↑ +35% |
| AETNA | Medicare|All Plans | $21.50 | ↑ +43% |
| Wellpoint | Medicaid|All Other Plans | $25.29 | ↑ +68% |
| Ambetter | Commercial|All Plans | $27.44 | ↑ +82% |
| Wellpoint | Commercial|Exchange | $28.38 | ↑ +89% |
| Wellpoint | Medicaid|STAR | $30.35 | ↑ +102% |
| Bright Health | Commercial|All Plans | $33.68 | ↑ +124% |
| Entrust | Commercial|All Plans | $41.28 | ↑ +174% |
| Health Smart | Commercial|All Plans | $47.30 | ↑ +214% |
| First Health | Commercial|All Plans | $51.60 | ↑ +243% |
| Humana | Commercial|All Plans | $52.46 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $55.04 | ↑ +266% |
| Aetna | Commercial|All Plans | $55.04 | ↑ +266% |
| Ellwood | Commercial|All Plans | $56.76 | ↑ +277% |
| United | Commercial|All Other Plans | $67.08 | ↑ +346% |
| PHCS | Commercial|All Plans | $73.10 | ↑ +386% |
| Multiplan | Commercial|All Plans | $77.40 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $86.00 | ↑ +471% |
| SUPERIOR | Medicaid|CHIP | $932.72 | ↑ +6097% |
| UNITED | Medicaid|All Other Plans | $951.37 | ↑ +6221% |
| UNITED | Medicaid|STARKIDS | $951.37 | ↑ +6221% |
| SUPERIOR | Medicaid|All Other Plans | $979.36 | ↑ +6407% |
| BCBS | Medicaid|STARKIDS | $979.36 | ↑ +6407% |
| SUPERIOR | Medicaid|STAR | $1,175.23 | ↑ +7709% |
| United | Commercial|Exchange | $2,124.00 | ↑ +14013% |
| SUPERIOR | Medicaid|STARPLUS | $2,173.24 | ↑ +14340% |
| UNITED | Medicaid|STARPLUS | $2,219.87 | ↑ +14650% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +19089% |
| BCBS-TX | Commercial|Blue Premier | $3,667.01 | ↑ +24266% |
| BCBS-TX | Commercial|Blue Advantage HMO | $3,693.20 | ↑ +24440% |
| BCBS-TX | Commercial|HMO | $3,928.94 | ↑ +26006% |
| BCBS-TX | Commercial|PPO | $4,321.83 | ↑ +28616% |
Visitor-reported prices
Comments
Biopsy of upper nose/throat at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $2,463.14 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $2,463.14 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $2,463.14 | $85.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $2,463.14 | $886.62 – $7,975.81 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $2,463.14 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $2,463.14 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $2,463.14 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $2,463.14 | $71.00 – $7,975.81 |