Clip phn wireless f/baha4 proc at Baylor St Luke's Medical Center
1101 Bates Avenue, Houston, TX · CommonSpirit Health · · NPI 1184622847
$0.35
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.
$1.00
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.
$0.27 with OPTUM vs $51,840.00 with BCBS - TX — 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 |
|---|---|---|---|
| OPTUM | Medicare|All Plans | $0.27 | ↓ -23% |
| OPTUM | Medicaid|STAR | $0.37 | ↑ +6% |
| KelseyCare | Commercial|All Other Plans | $0.41 | ↑ +17% |
| TCHPCHIP | Medicaid|HMO | $0.41 | ↑ +17% |
| TCH | Commercial|Transplant | $0.45 | ↑ +29% |
| United | Commercial|Optum | $0.47 | ↑ +34% |
| Shell | Commercial|All Plans | $0.50 | ↑ +43% |
| TEXASTRUECHOICE | Medicaid|CHIP | $0.55 | ↑ +57% |
| CHC | Medicaid|CHIP | $0.55 | ↑ +57% |
| CHC | Medicaid|HMO | $0.55 | ↑ +57% |
| Cigna Lifesource | Commercial|Transplant | $0.60 | ↑ +71% |
| Interlink | Commercial|Transplant | $0.60 | ↑ +71% |
| Independent Med System | Commercial|All Plans | $0.60 | ↑ +71% |
| Coventry | Commercial|PPO | $0.65 | ↑ +86% |
| First Health | Commercial|All Plans | $0.65 | ↑ +86% |
| Humana | Commercial|Transplant | $0.65 | ↑ +86% |
| Healthsmart | Commercial|PPO | $0.70 | ↑ +100% |
| Cigna | Commercial|Transplant | $0.70 | ↑ +100% |
| Healthsmart | Commercial|AP3 | $0.72 | ↑ +106% |
| MultiPlan | Commercial|All Plans | $0.75 | ↑ +114% |
| OPTUM | Medicaid|STARPLUS | $0.83 | ↑ +137% |
| USA Health Network | Commercial|All Plans | $0.85 | ↑ +143% |
| Cigna | Commercial|HMO | $1.00 | ↑ +186% |
| Cigna | Commercial|Surefit | $1.00 | ↑ +186% |
| Bright Health | Commercial|All Plans | $1.00 | ↑ +186% |
| MHealth Network | Commercial|PPO | $1.00 | ↑ +186% |
| Cigna | Commercial|PPO | $1.00 | ↑ +186% |
| BCBS - TX | Commercial|MyBlue Health Exchange | $19,766.00 | ↑ +5647329% |
| BCBS - TX | Commercial|Transplant | $33,600.00 | ↑ +9599900% |
| BCBS - TX | Commercial|Premier | $35,727.00 | ↑ +10207614% |
| BCBS - TX | Commercial|Blue Advantage Exchange | $40,285.00 | ↑ +11509900% |
| BCBS - TX | Commercial|HMO | $51,840.00 | ↑ +14811329% |
| BCBS - TX | Commercial|PPO Trad | $51,840.00 | ↑ +14811329% |