Biopsy of salivary gland 42400 at Baylor St Luke's Medical Center
1101 Bates Avenue, Houston, TX · CommonSpirit Health · · NPI 1184622847
$348.25
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.
$995.00
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.
$60.57 with Wellpoint vs $5,160.00 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 |
|---|---|---|---|
| Wellpoint | Medicaid|All Other Plans | $60.57 | ↓ -83% |
| TCHP | Medicaid|STARKIDS | $60.57 | ↓ -83% |
| TCHP | Medicaid|All Other Plans | $60.57 | ↓ -83% |
| Wellpoint | Medicaid|STARKIDS | $60.57 | ↓ -83% |
| Wellpoint | Medicaid|CHIP | $60.57 | ↓ -83% |
| UNITED | Medicaid|All Other Plans | $61.78 | ↓ -82% |
| UHC | Medicaid|CHIP | $61.78 | ↓ -82% |
| UHC | Medicaid|STARKIDS | $61.78 | ↓ -82% |
| BCBS | Medicaid|All Plans | $63.60 | ↓ -82% |
| BCBS - TX | Commercial|MyBlue Health Exchange | $69.06 | ↓ -80% |
| CHC | Medicaid|All Other Plans | $69.66 | ↓ -80% |
| BCBS - TX | Commercial|Blue Advantage Exchange | $81.08 | ↓ -77% |
| Wellpoint | Medicaid|STAR | $81.16 | ↓ -77% |
| TCHP | Medicaid|STAR | $81.16 | ↓ -77% |
| UNITED | Medicaid|STAR | $82.98 | ↓ -76% |
| CHC | Medicaid|STAR | $93.28 | ↓ -73% |
| BCBS - TX | Commercial|Transplant | $118.67 | ↓ -66% |
| BCBS - TX | Commercial|Premier | $125.37 | ↓ -64% |
| BCBS - TX | Commercial|HMO | $161.40 | ↓ -54% |
| BCBS - TX | Commercial|PPO Trad | $171.91 | ↓ -51% |
| UHC | Medicaid|STARPLUS | $188.98 | ↓ -46% |
| UNITED | Medicaid|STARPLUS | $188.98 | ↓ -46% |
| OPTUM | Medicare|All Plans | $268.65 | ↓ -23% |
| OPTUM | Medicaid|STAR | $360.00 | ↑ +3% |
| TCHPCHIP | Medicaid|HMO | $407.95 | ↑ +17% |
| TCH | Commercial|Transplant | $447.75 | ↑ +29% |
| United | Commercial|Optum | $467.65 | ↑ +34% |
| Shell | Commercial|All Plans | $497.50 | ↑ +43% |
| Renaissance | Commercial|All Plans | $507.41 | ↑ +46% |
| TEXASTRUECHOICE | Medicaid|CHIP | $547.25 | ↑ +57% |
| CHC | Medicaid|HMO | $547.25 | ↑ +57% |
| CHC | Medicaid|CHIP | $547.25 | ↑ +57% |
| Independent Med System | Commercial|All Plans | $597.00 | ↑ +71% |
| Cigna Lifesource | Commercial|Transplant | $597.00 | ↑ +71% |
| PHCS | Commercial|PPO | $646.75 | ↑ +86% |
| Coventry | Commercial|PPO | $646.75 | ↑ +86% |
| Humana | Commercial|Transplant | $646.75 | ↑ +86% |
| First Health | Commercial|All Plans | $646.75 | ↑ +86% |
| PHCS Savility | Commercial|PPO | $646.75 | ↑ +86% |
| Healthsmart | Commercial|PPO | $696.50 | ↑ +100% |
| Cigna | Commercial|Transplant | $696.50 | ↑ +100% |
| Aetna | Commercial|PPO | $696.50 | ↑ +100% |
| Interlink | Commercial|Transplant | $696.50 | ↑ +100% |
| Humana | Medicare|All Other Plans | $704.73 | ↑ +102% |
| CIGNA HEALTHSPRING | Medicare|HMO | $704.73 | ↑ +102% |
| KELSEY | Medicare|All Plans | $704.73 | ↑ +102% |
| Humana | Medicare|TRANSPLANT | $704.73 | ↑ +102% |
| BCBS | Medicare|All Plans | $704.73 | ↑ +102% |
| AETNA | Medicare|TRANSPLANT | $704.73 | ↑ +102% |
| CIGNA HEALTHSPRING | Medicare|PPO | $711.78 | ↑ +104% |
| AETNA | Medicare|All Other Plans | $718.82 | ↑ +106% |
| UHC-SecureHorizons | Medicare|All Plans | $718.82 | ↑ +106% |
| Amerivantage | Medicare|All Plans | $725.87 | ↑ +108% |
| SELECTCARE | Medicare|All Plans | $739.97 | ↑ +112% |
| MultiPlan | Commercial|All Plans | $746.25 | ↑ +114% |
| SCANHealth | Medicare|All Plans | $754.06 | ↑ +117% |
| DEVOTED | Medicare|All Plans | $754.06 | ↑ +117% |
| Aetna | Commercial|Transplant | $756.20 | ↑ +117% |
| OPTUM | Medicaid|STARPLUS | $822.07 | ↑ +136% |
| KINDRED | Medicare|All Plans | $845.68 | ↑ +143% |
| USA Health Network | Commercial|All Plans | $845.75 | ↑ +143% |
| Aetna | Commercial|KelseyCare | $896.00 | ↑ +157% |
| KelseyCare | Commercial|All Other Plans | $942.30 | ↑ +171% |
| KelseyCare | Commercial|Exchange | $951.39 | ↑ +173% |
| Employer Direct | Commercial|PPO | $986.62 | ↑ +183% |
| MHealth Network | Commercial|PPO | $995.00 | ↑ +186% |
| Bright Health | Commercial|All Plans | $1,040.66 | ↑ +199% |
| Superior Health Plan | Commercial|All Plans | $1,057.10 | ↑ +204% |
| Community Health Choice | Commercial|Exchange | $1,057.10 | ↑ +204% |
| Harris Health | Commercial|ERS | $1,057.10 | ↑ +204% |
| Community Health Choice | Commercial|All Other Plans | $1,057.10 | ↑ +204% |
| Wellpoint | Commercial|Exchange | $1,057.10 | ↑ +204% |
| Aetna | Commercial|HMO | $1,079.00 | ↑ +210% |
| Aetna | Commercial|Exchange | $1,085.28 | ↑ +212% |
| United | Commercial|Exchange | $1,452.00 | ↑ +317% |
| Cigna | Commercial|Surefit | $1,864.00 | ↑ +435% |
| United | Commercial|Charter | $1,955.00 | ↑ +461% |
| Cigna | Commercial|HMO | $2,054.00 | ↑ +490% |
| United | Commercial|HMO | $2,172.00 | ↑ +524% |
| United | Commercial|PPO | $2,172.00 | ↑ +524% |
| NX Health | Commercial|PPO | $2,290.37 | ↑ +558% |
| Humana | Commercial|PPO | $2,700.00 | ↑ +675% |
| Humana | Commercial|HMO | $2,700.00 | ↑ +675% |
| Cigna | Commercial|PPO | $5,160.00 | ↑ +1382% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. Luke's Health - The Vintage Hospital | Houston | $348.25 | $268.65 – $995.00 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $61.78 – $542.01 |
| HCA HOUSTON WEST | HOUSTON | not published | $56.43 – $714.92 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $57.58 – $542.01 |
| 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 |