Ghs intermed repair 12.6 - 20.0 cm-12035 at St. Joseph Health Burleson Hospital
1101 Woodson Drive, Caldwell, TX · CommonSpirit Health · · NPI 1750377289
$151.38
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.
$865.00
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.
$150.52 with SUPERIOR vs $3,346.00 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 |
|---|---|---|---|
| SUPERIOR | Medicaid|CHIP | $150.52 | ↓ -1% |
| UNITED | Medicaid|All Other Plans | $153.53 | ↑ +1% |
| UNITED | Medicaid|STARKIDS | $153.53 | ↑ +1% |
| BCBS | Medicaid|STARKIDS | $158.05 | ↑ +4% |
| SUPERIOR | Medicaid|All Other Plans | $158.05 | ↑ +4% |
| United | Commercial|All Other Plans | $188.00 | ↑ +24% |
| SUPERIOR | Medicaid|STAR | $189.66 | ↑ +25% |
| BCBS | Medicare|All Plans | $190.30 | ↑ +26% |
| UNITED | Medicare|All Plans | $194.11 | ↑ +28% |
| AMERIVANTAGE | Medicare|All Plans | $196.01 | ↑ +29% |
| SCANHealth | Medicare|All Plans | $203.63 | ↑ +35% |
| AETNA | Medicare|All Plans | $216.25 | ↑ +43% |
| Wellpoint | Medicaid|All Other Plans | $254.31 | ↑ +68% |
| Ambetter | Commercial|All Plans | $275.94 | ↑ +82% |
| Wellpoint | Commercial|Exchange | $285.45 | ↑ +89% |
| Wellpoint | Medicaid|STAR | $305.18 | ↑ +102% |
| Bright Health | Commercial|All Plans | $338.74 | ↑ +124% |
| SUPERIOR | Medicaid|STARPLUS | $350.71 | ↑ +132% |
| UNITED | Medicaid|STARPLUS | $358.24 | ↑ +137% |
| Entrust | Commercial|All Plans | $415.20 | ↑ +174% |
| BCBS-TX | Commercial|Blue Premier | $447.31 | ↑ +195% |
| BCBS-TX | Commercial|Blue Advantage HMO | $450.51 | ↑ +198% |
| Health Smart | Commercial|All Plans | $475.75 | ↑ +214% |
| BCBS-TX | Commercial|HMO | $479.27 | ↑ +217% |
| First Health | Commercial|All Plans | $519.00 | ↑ +243% |
| BCBS-TX | Commercial|PPO | $527.19 | ↑ +248% |
| Humana | Commercial|All Plans | $527.65 | ↑ +249% |
| Aetna | Commercial|All Plans | $553.60 | ↑ +266% |
| Cigna | Commercial|All Other Plans | $553.60 | ↑ +266% |
| Ellwood | Commercial|All Plans | $570.90 | ↑ +277% |
| PHCS | Commercial|All Plans | $735.25 | ↑ +386% |
| Multiplan | Commercial|All Plans | $778.50 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $865.00 | ↑ +471% |
| United | Commercial|Exchange | $1,508.00 | ↑ +896% |
| Cigna | Commercial|Local Plus | $3,346.00 | ↑ +2110% |
Visitor-reported prices
Comments
Ghs intermed repair 12.6 - 20.0 cm-12035 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,084.85 | $143.08 – $1,356.07 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $1,176.86 | $71.00 – $1,765.30 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,599.65 | $71.00 – $1,999.57 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,084.85 | $143.08 – $1,356.07 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $1,176.86 | $85.00 – $1,765.30 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $1,176.86 | $143.08 – $1,765.30 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,599.65 | $71.00 – $2,399.48 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $1,084.85 | $143.08 – $1,356.07 |