Treatment of mouth lesion physical 40820 at St. Joseph Health Burleson Hospital
1101 Woodson Drive, Caldwell, TX · CommonSpirit Health · · NPI 1750377289
$59.50
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.
$340.00
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.
$74.80 with BCBS vs $2,888.00 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 |
|---|---|---|---|
| BCBS | Medicare|All Plans | $74.80 | ↑ +26% |
| UNITED | Medicare|All Plans | $76.30 | ↑ +28% |
| AMERIVANTAGE | Medicare|All Plans | $77.05 | ↑ +29% |
| SCANHealth | Medicare|All Plans | $80.04 | ↑ +35% |
| AETNA | Medicare|All Plans | $85.00 | ↑ +43% |
| Wellpoint | Medicaid|All Other Plans | $99.96 | ↑ +68% |
| Ambetter | Commercial|All Plans | $108.46 | ↑ +82% |
| Wellpoint | Commercial|Exchange | $112.20 | ↑ +89% |
| Wellpoint | Medicaid|STAR | $119.96 | ↑ +102% |
| Bright Health | Commercial|All Plans | $133.15 | ↑ +124% |
| Entrust | Commercial|All Plans | $163.20 | ↑ +174% |
| Health Smart | Commercial|All Plans | $187.00 | ↑ +214% |
| SUPERIOR | Medicaid|CHIP | $187.56 | ↑ +215% |
| UNITED | Medicaid|All Other Plans | $191.31 | ↑ +222% |
| UNITED | Medicaid|STARKIDS | $191.31 | ↑ +222% |
| BCBS | Medicaid|STARKIDS | $196.94 | ↑ +231% |
| SUPERIOR | Medicaid|All Other Plans | $196.94 | ↑ +231% |
| First Health | Commercial|All Plans | $204.00 | ↑ +243% |
| Humana | Commercial|All Plans | $207.40 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $217.60 | ↑ +266% |
| Aetna | Commercial|All Plans | $217.60 | ↑ +266% |
| Ellwood | Commercial|All Plans | $224.40 | ↑ +277% |
| SUPERIOR | Medicaid|STAR | $236.33 | ↑ +297% |
| United | Commercial|All Other Plans | $265.20 | ↑ +346% |
| PHCS | Commercial|All Plans | $289.00 | ↑ +386% |
| BCBS-TX | Commercial|Blue Premier | $300.62 | ↑ +405% |
| BCBS-TX | Commercial|Blue Advantage HMO | $302.77 | ↑ +409% |
| Multiplan | Commercial|All Plans | $306.00 | ↑ +414% |
| BCBS-TX | Commercial|HMO | $322.10 | ↑ +441% |
| BCBS-TX | Commercial|Ref Lab | $340.00 | ↑ +471% |
| BCBS-TX | Commercial|PPO | $354.30 | ↑ +495% |
| SUPERIOR | Medicaid|STARPLUS | $437.01 | ↑ +634% |
| UNITED | Medicaid|STARPLUS | $446.39 | ↑ +650% |
| United | Commercial|Exchange | $2,124.00 | ↑ +3470% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +4754% |
Visitor-reported prices
Comments
Treatment of mouth lesion physical 40820 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $2,641.78 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $2,641.78 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $2,641.78 | $85.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $2,641.78 | $178.29 – $7,975.81 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $2,641.78 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $2,641.78 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $2,641.78 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $2,641.78 | $71.00 – $7,975.81 |