Revita, per sq cm at BAYLOR UNIVERSITY MEDICAL CENTER

3500 Gaston Ave., Dallas, TX · Baylor Scott & White Health · · NPI 1447250253

Source: hospital's published price file ↗ · Published Jun 29, 2026 · Ingested Aug 12, 2026

$389.83

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$649.72

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$67.21 with WellPoint (fka Amerigroup) vs $296.54 with HealthSmart — 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 →

Payer
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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
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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
WellPoint (fka Amerigroup) CHIP/Medicaid $67.21 ↓ -83%
Superior Health Plan Medicaid $67.21 ↓ -83%
United Healthcare Medicaid/CHIP $71.92 ↓ -82%
Baylor Scott & White Health Plan Medicare Advantage $118.76 ↓ -70%
CORVEL Worker's Compensation $121.26 ↓ -69%
Humana Medicare $125.01 ↓ -68%
TriWest Community Care Network $125.01 ↓ -68%
Aetna Medicare Advantage $125.01 ↓ -68%
WellPoint (fka Amerigroup) Medicare $128.76 ↓ -67%
HealthSpring Medicare Advantage $131.26 ↓ -66%
American Health Plan Medicare Advantage $131.26 ↓ -66%
ProCare Advantage Medicare Advantage $131.26 ↓ -66%
Molina Medicare Advantage $131.26 ↓ -66%
Superior Health Plan Medicare $131.26 ↓ -66%
Blue Cross Blue Shield Medicare Advantage $131.26 ↓ -66%
Blue Cross Blue Shield Blue Advantage $138.38 ↓ -65%
United Healthcare Medicare Advantage $140.01 ↓ -64%
Texas Workforce Commission Workers Compensation $142.34 ↓ -63%
Baylor Scott & White Health Plan BSW Premier - Small Group $150.01 ↓ -62%
Baylor Scott & White Health Plan BSW Premier - Individual $156.89 ↓ -60%
Prime Health Services Worker's Compensation $157.64 ↓ -60%
Employers Health Network BSWQA Direct/EHN Rental $185.83 ↓ -52%
Sedgwick Preferred Network $186.89 ↓ -52%
Cigna Local Plus $194.92 ↓ -50%
Baylor Scott & White Health Plan BSW Plus - Small Group $206.27 ↓ -47%
Employers Health Network EHN Network $217.46 ↓ -44%
QuikTrip Employee Benefit Plan $217.46 ↓ -44%
Aetna Commercial $217.46 ↓ -44%
Cigna HMO/PPO $229.32 ↓ -41%
Imagine Health Commercial $229.32 ↓ -41%
University of Mary Hardin-Baylor Commercial $229.32 ↓ -41%
Baylor Scott & White Health Plan BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee $235.25 ↓ -40%
United Healthcare Charter $245.89 ↓ -37%
United Healthcare Nexus $245.89 ↓ -37%
Curative Commercial $257.00 ↓ -34%
Blue Cross Blue Shield City of Dallas $264.90 ↓ -32%
Superior Ambetter Ambetter Exchange $268.77 ↓ -31%
United Healthcare Commercial Broad $273.21 ↓ -30%
Optum Commercial $276.77 ↓ -29%
Humana Commercial PPO $276.77 ↓ -29%
Baylor Scott & White Health Plan BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) $276.77 ↓ -29%
Blue Cross Blue Shield Blue Essentials (HMO) $276.77 ↓ -29%
First Health PPO $276.77 ↓ -29%
HealthSmart Accel Network $276.77 ↓ -29%
Blue Cross Blue Shield BlueChoice (PPO) $292.58 ↓ -25%
Blue Cross Blue Shield Blue Premier/High Performance Network/My BlueHealth $292.58 ↓ -25%
Private Health Care System PHCS Network $296.54 ↓ -24%
HealthSmart Preferred Network $296.54 ↓ -24%

Visitor-reported prices

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Revita, per sq cm at other Texas hospitals

Hospital City Cash price Negotiated range
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $389.83 $48.83 – $355.84
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $389.83 $47.45 – $296.54
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $389.83 $63.26 – $296.54
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $389.83 $76.15 – $355.84
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $389.83 $122.57 – $355.84
BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK Cedar Park $389.83 $79.08 – $355.84
BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH Fort Worth $389.83 $63.26 – $296.54
BAYLOR SCOTT & WHITE MEDICAL CENTER - GRAPEVINE Grapevine $389.83 $59.31 – $296.54

All Texas hospitals for this procedure →