Biopsy of salivary gland 42400 at Texas Health Harris Methodist Hospital Cleburne
201 Walls Drive, Cleburne, TX · Texashealth · · NPI 1396778064
$888.75
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.
$1,481.25
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.
$57.58 with Amerigroup vs $3,076.00 with United Healthcare Options — 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 |
|---|---|---|---|
| Amerigroup | Managed Medicaid | $57.58 | ↓ -94% |
| Cook Childrens | Managed Medicaid | $57.58 | ↓ -94% |
| United Healthcare | Managed Medicaid | $57.58 | ↓ -94% |
| Blue Cross Blue Shield | Managed Medicaid | $57.58 | ↓ -94% |
| Superior Wellcare | Managed Medicaid | $60.46 | ↓ -93% |
| Molina | Managed Medicaid | $62.19 | ↓ -93% |
| Aetna | Managed Medicaid | $63.34 | ↓ -93% |
| Blue Cross Blue Shield | Exchange | $150.14 | ↓ -83% |
| Blue Cross Blue Shield | HMO | $176.41 | ↓ -80% |
| Blue Cross Blue Shield | PPO | $196.01 | ↓ -78% |
| Aetna | Whole Health | $572.06 | ↓ -36% |
| Blue Cross Blue Shield | Traditional | $627.28 | ↓ -29% |
| Blue Cross Blue Shield | Medicare Advantage | $671.04 | ↓ -24% |
| American Health | Medicare Advantage | $671.04 | ↓ -24% |
| HealthSpring | Medicare Advantage | $684.46 | ↓ -23% |
| City of Fort Worth | Commercial | $696.19 | ↓ -22% |
| Humana | Medicare Advantage | $697.88 | ↓ -21% |
| Superior Wellcare | Medicare Advantage HMO | $704.59 | ↓ -21% |
| Molina | Medicare Advantage | $704.59 | ↓ -21% |
| Amerigroup | Medicare Advantage | $704.59 | ↓ -21% |
| Superior Wellcare | Medicare Advantage MMP | $738.15 | ↓ -17% |
| United Healthcare | Medicare Advantage PPO | $744.86 | ↓ -16% |
| United Healthcare | Medicare Advantage HMO | $758.28 | ↓ -15% |
| Aetna | Commercial | $762.84 | ↓ -14% |
| Cigna | OAP/HMO | $818.84 | ↓ -8% |
| Fort Worth Firefighters | Commercial | $904.30 | ↑ +2% |
| Cigna | PPO | $1,032.43 | ↑ +16% |
| Aetna | Coventry | $1,038.36 | ↑ +17% |
| Aetna | ASA | $1,038.36 | ↑ +17% |
| Quick Trip | Commercial | $1,051.69 | ↑ +18% |
| PHCS | PPO | $1,238.33 | ↑ +39% |
| Multiplan | Commercial | $1,288.69 | ↑ +45% |
| Healthsmart | Commercial | $1,288.69 | ↑ +45% |
| Galaxy | Commercial | $1,303.50 | ↑ +47% |
| USA | MCO | $1,303.50 | ↑ +47% |
| Cigna | Indemnity | $1,393.86 | ↑ +57% |
| United Healthcare | All Payer | $2,380.00 | ↑ +168% |
| United Healthcare Options | PPO | $3,076.00 | ↑ +246% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,145.90 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $997.05 | $61.61 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,387.07 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,145.90 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $997.05 | $61.61 – $1,742.94 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $997.05 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,387.07 | $57.58 – $2,080.61 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $1,145.90 | $57.58 – $1,742.94 |