X-ray mandible ltd <4 views at St. Luke's Health - The Vintage Hospital

20171 Chasewood Park Drive, Houston, TX · CommonSpirit Health · · NPI 1710314141

Source: hospital's published price file ↗ · Published Feb 28, 2026 · Ingested Sep 10, 2026

$455.35

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.

$1,301.00

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.

$38.76 with Wellpoint vs $1,301.00 with MHealth Network — 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 Medicaid|STARKIDS $38.76 ↓ -91%
Wellpoint Medicaid|CHIP $38.76 ↓ -91%
Wellpoint Medicaid|All Other Plans $39.09 ↓ -91%
UNITED Medicaid|All Other Plans $39.54 ↓ -91%
UHC Medicaid|CHIP $39.87 ↓ -91%
UHC Medicaid|STARKIDS $39.87 ↓ -91%
BCBS Medicaid|All Plans $41.04 ↓ -91%
CHC Medicaid|All Other Plans $44.57 ↓ -90%
Wellpoint Medicaid|STAR $51.94 ↓ -89%
UNITED Medicaid|STAR $53.10 ↓ -88%
CHC Medicaid|STAR $59.69 ↓ -87%
Renaissance Commercial|All Plans $63.50 ↓ -86%
HUMANA Medicare|TRANSPLANT $88.19 ↓ -81%
SELECTCARE Medicare|All Plans $88.19 ↓ -81%
KELSEY Medicare|All Plans $88.19 ↓ -81%
BCBS Medicare|All Plans $88.19 ↓ -81%
CIGNA HEALTHSPRING Medicare|HMO $88.19 ↓ -81%
HUMANA Medicare|All Other Plans $88.19 ↓ -81%
CIGNA HEALTHSPRING Medicare|PPO $89.07 ↓ -80%
AETNA Medicare|All Plans $89.95 ↓ -80%
UHC-SecureHorizons Medicare|All Plans $89.95 ↓ -80%
Amerivantage Medicare|All Plans $90.84 ↓ -80%
Cigna Commercial|Surefit $93.68 ↓ -79%
SCANHealth Medicare|All Plans $94.36 ↓ -79%
DEVOTED Medicare|All Plans $94.36 ↓ -79%
KINDRED Medicare|All Plans $97.01 ↓ -79%
Cigna Commercial|HMO $103.18 ↓ -77%
TCHP Medicaid|All Other Plans $104.08 ↓ -77%
TCHP Medicaid|STARKIDS $104.08 ↓ -77%
BCBS-TX Commercial|Exchange $112.53 ↓ -75%
BCBS-TX Commercial|MyBlue Health Exchange $116.52 ↓ -74%
KelseyCare Commercial|Exchange $119.06 ↓ -74%
UNITED Medicaid|STARPLUS $120.93 ↓ -73%
UHC Medicaid|STARPLUS $120.93 ↓ -73%
Employer Direct Commercial|PPO $123.47 ↓ -73%
Cigna Commercial|PPO $126.59 ↓ -72%
Wellpoint Commercial|Exchange $132.28 ↓ -71%
Community Health Choice Commercial|Exchange $132.28 ↓ -71%
Superior Health Plan Commercial|All Plans $132.28 ↓ -71%
Community Health Choice Commercial|All Other Plans $132.28 ↓ -71%
Bright Health Commercial|All Plans $135.27 ↓ -70%
Aetna Commercial|Exchange $135.81 ↓ -70%
TCHP Medicaid|STAR $139.47 ↓ -69%
United Commercial|Exchange $140.00 ↓ -69%
BCBS-TX Commercial|Blue Premier $204.31 ↓ -55%
United Commercial|Charter $209.00 ↓ -54%
United Commercial|PPO $230.00 ↓ -49%
United Commercial|HMO $230.00 ↓ -49%
BCBS-TX Commercial|HMO $239.43 ↓ -47%
BCBS-TX Commercial|PPO $268.96 ↓ -41%
NX Health Commercial|PPO $286.62 ↓ -37%
OPTUM Medicare|All Plans $351.27 ↓ -23%
TCHPCHIP Medicaid|HMO $455.35 ↑ +0%
OPTUM Medicaid|STAR $470.71 ↑ +3%
United Commercial|Optum $611.47 ↑ +34%
CHC Medicaid|HMO $715.55 ↑ +57%
CHC Medicaid|CHIP $715.55 ↑ +57%
TEXASTRUECHOICE Medicaid|CHIP $715.55 ↑ +57%
Aetna-Kelsey Care Commercial|HMO $767.59 ↑ +69%
Cigna Lifesource Commercial|Transplant $780.60 ↑ +71%
Coventry Commercial|PPO $845.65 ↑ +86%
Humana Commercial|Transplant $845.65 ↑ +86%
First Health Commercial|All Plans $845.65 ↑ +86%
Aetna Commercial|HMO $884.68 ↑ +94%
Cigna Commercial|Transplant $910.70 ↑ +100%
Healthsmart Commercial|PPO $910.70 ↑ +100%
Interlink Commercial|Transplant $910.70 ↑ +100%
MultiPlan Commercial|All Plans $975.75 ↑ +114%
OPTUM Medicaid|STARPLUS $1,074.89 ↑ +136%
USA Health Network Commercial|All Plans $1,105.85 ↑ +143%
MHealth Network Commercial|PPO $1,301.00 ↑ +186%

Visitor-reported prices

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X-ray mandible ltd <4 views at other Texas hospitals

Hospital City Cash price Negotiated range
Baylor St Luke's Medical Center Houston $455.35 $38.76 – $1,301.00
HCA HOUSTON MEDICAL CENTER Houston not published $38.76 – $177.00
HCA HOUSTON WEST HOUSTON not published $38.31 – $177.00
HCA HOUSTON TOMBALL HOUSTON not published $38.76 – $177.00
Adventhealth Rollins Brook Lampasas $426.98 $307.27 – $307.27
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $121.12 $39.09 – $225.11
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $261.13 $53.75 – $391.70
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $303.05 $39.09 – $378.81

All Texas hospitals for this procedure →