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Tonsillectomy (age 12+) at BAYLOR UNIVERSITY MEDICAL CENTER
3500 Gaston Ave., Dallas, TX · Baylor Scott & White Health · · NPI 1447250253
not published by hospital
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.
not published by hospital
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.
$886.62 with WellPoint (fka Amerigroup) vs $9,350.87 with Blue Cross Blue Shield — 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 |
|---|---|---|---|
| WellPoint (fka Amerigroup) | CHIP/Medicaid | $886.62 | — |
| Superior Health Plan | Medicaid | $886.62 | — |
| United Healthcare | Medicaid/CHIP | $948.68 | — |
| Baylor Scott & White Health Plan | Medicare Advantage | $3,164.04 | — |
| CORVEL | Worker's Compensation | $3,230.65 | — |
| Humana | Medicare | $3,330.57 | — |
| Aetna | Medicare Advantage | $3,330.57 | — |
| TriWest | Community Care Network | $3,330.57 | — |
| WellPoint (fka Amerigroup) | Medicare | $3,430.49 | — |
| Blue Cross Blue Shield | Medicare Advantage | $3,497.10 | — |
| ProCare Advantage | Medicare Advantage | $3,497.10 | — |
| Molina | Medicare Advantage | $3,497.10 | — |
| HealthSpring | Medicare Advantage | $3,497.10 | — |
| American Health Plan | Medicare Advantage | $3,497.10 | — |
| Superior Health Plan | Medicare | $3,497.10 | — |
| United Healthcare | Medicare Advantage | $3,730.24 | — |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $3,996.68 | — |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $4,179.87 | — |
| Prime Health Services | Worker's Compensation | $4,199.85 | — |
| United Healthcare | Charter | $4,302.00 | — |
| United Healthcare | Nexus | $4,302.00 | — |
| Blue Cross Blue Shield | Blue Advantage | $4,426.60 | — |
| United Healthcare | Commercial Broad | $4,780.00 | — |
| Sedgwick | Preferred Network | $4,979.20 | — |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $5,495.44 | — |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $6,260.10 | — |
| HealthSmart | Accel Network | $6,304.00 | — |
| Cigna | Local Plus | $6,703.00 | — |
| Superior Ambetter | Ambetter Exchange | $7,160.73 | — |
| Cigna | HMO/PPO | $7,886.00 | — |
| Mark Cuban | Commercial | $7,975.81 | — |
| Blue Cross Blue Shield | City of Dallas | $8,407.92 | — |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $8,879.39 | — |
| Blue Cross Blue Shield | BlueChoice (PPO) | $9,350.87 | — |
| University of Mary Hardin-Baylor | Commercial | not published by hospital | — |
| Imagine Health | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $2,735.53 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $4,424.11 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $2,735.53 | $85.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $2,735.53 | $886.62 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $2,735.53 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $4,424.11 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $4,424.11 | $71.00 – $7,975.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR | Taylor | $4,424.11 | $71.00 – $7,975.81 |