Established Patient Office Visit (level 5) at St. Joseph Health Burleson Hospital
1101 Woodson Drive, Caldwell, TX · CommonSpirit Health · · NPI 1750377289
$113.58
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.
$649.00
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.
$52.58 with BCBS vs $343.20 with UNITED — 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|All Plans | $52.58 | ↓ -54% |
| UNITED | Medicare|All Plans | $53.64 | ↓ -53% |
| AMERIVANTAGE | Medicare|All Plans | $54.16 | ↓ -52% |
| SCANHealth | Medicare|All Plans | $56.27 | ↓ -50% |
| AETNA | Medicare|All Plans | $59.75 | ↓ -47% |
| Wellpoint | Medicaid|All Other Plans | $70.27 | ↓ -38% |
| Ambetter | Commercial|All Plans | $76.25 | ↓ -33% |
| United | Commercial|Exchange | $77.00 | ↓ -32% |
| Wellpoint | Commercial|Exchange | $78.87 | ↓ -31% |
| Wellpoint | Medicaid|STAR | $84.32 | ↓ -26% |
| Bright Health | Commercial|All Plans | $93.60 | ↓ -18% |
| Entrust | Commercial|All Plans | $114.72 | ↑ +1% |
| Health Smart | Commercial|All Plans | $131.45 | ↑ +16% |
| First Health | Commercial|All Plans | $143.40 | ↑ +26% |
| SUPERIOR | Medicaid|CHIP | $144.20 | ↑ +27% |
| Humana | Commercial|All Plans | $145.79 | ↑ +28% |
| UNITED | Medicaid|STARKIDS | $147.09 | ↑ +30% |
| UNITED | Medicaid|All Other Plans | $147.09 | ↑ +30% |
| SUPERIOR | Medicaid|All Other Plans | $151.41 | ↑ +33% |
| BCBS | Medicaid|STARKIDS | $151.41 | ↑ +33% |
| Cigna | Commercial|All Other Plans | $152.96 | ↑ +35% |
| Aetna | Commercial|All Plans | $152.96 | ↑ +35% |
| Ellwood | Commercial|All Plans | $157.74 | ↑ +39% |
| SUPERIOR | Medicaid|STAR | $181.70 | ↑ +60% |
| United | Commercial|All Other Plans | $186.42 | ↑ +64% |
| PHCS | Commercial|All Plans | $203.15 | ↑ +79% |
| Multiplan | Commercial|All Plans | $215.10 | ↑ +89% |
| BCBS-TX | Commercial|Blue Advantage HMO | $224.47 | ↑ +98% |
| BCBS-TX | Commercial|Blue Premier | $239.00 | ↑ +110% |
| BCBS-TX | Commercial|PPO | $239.00 | ↑ +110% |
| BCBS-TX | Commercial|HMO | $239.00 | ↑ +110% |
| BCBS-TX | Commercial|Ref Lab | $239.00 | ↑ +110% |
| Cigna | Commercial|Local Plus | $252.35 | ↑ +122% |
| SUPERIOR | Medicaid|STARPLUS | $335.99 | ↑ +196% |
| UNITED | Medicaid|STARPLUS | $343.20 | ↑ +202% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $450.00 | $434.28 – $434.28 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | $884.58 | $263.95 – $315.77 |
| HCA HOUSTON MEDICAL CENTER | Houston | $1,971.10 | $263.95 – $315.77 |
| Baylor St Luke's Medical Center | Houston | $174.65 | $82.00 – $499.00 |
| St. Joseph Health Madison Hospital | Madisonville | $113.58 | $30.45 – $224.47 |
| St. Luke's Health Memorial Lufkin | Lufkin | $253.49 | $83.24 – $499.40 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $174.65 | $74.00 – $499.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $174.65 | $74.00 – $499.00 |