Biliary endo perq dx w/speci at Texas Health Presbyterian Hospital Kaufman
850 Ed Hall, Kaufman, TX · Texashealth · · NPI 1457382798
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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1,151.54 with United Healthcare vs $25,981.65 with Blue Cross Blue Shield — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| United Healthcare | Managed Medicaid | $1,151.54 | — |
| Parkland | Managed Medicaid | $1,151.54 | — |
| Blue Cross Blue Shield | Managed Medicaid | $1,151.54 | — |
| Amerigroup | Managed Medicaid | $1,151.54 | — |
| Superior Wellcare | Managed Medicaid | $1,209.12 | — |
| Molina | Managed Medicaid | $1,243.66 | — |
| Blue Cross Blue Shield | Exchange | $6,218.68 | — |
| Blue Cross Blue Shield | Medicare Advantage | $6,503.32 | — |
| American Health | Medicare Advantage | $6,503.32 | — |
| HealthSpring | Medicare Advantage | $6,633.39 | — |
| Humana | Medicare Advantage | $6,763.45 | — |
| Amerigroup | Medicare Advantage | $6,828.49 | — |
| Molina | Medicare Advantage | $6,828.49 | — |
| Superior Wellcare | Medicare Advantage HMO | $6,828.49 | — |
| Superior Wellcare | Medicare Advantage MMP | $7,153.65 | — |
| United Healthcare | Medicare Advantage PPO | $7,218.69 | — |
| Blue Cross Blue Shield | HMO | $7,306.95 | — |
| United Healthcare | Medicare Advantage HMO | $7,348.75 | — |
| Fort Worth Firefighters | Commercial | $7,612.00 | — |
| Blue Cross Blue Shield | PPO | $8,118.49 | — |
| United Healthcare | All Payer | $9,560.00 | — |
| United Healthcare Options | PPO | $12,345.00 | — |
| Blue Cross Blue Shield | Traditional | $25,981.65 | — |
Visitor-reported prices
Comments
Biliary endo perq dx w/speci at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON KINGWOOD | HUMBLE | $4,262.78 | $1,128.51 – $6,535.84 |
| St. Luke's Health - Patients Medical Center | Pasadena | $1,414.67 | $2,425.14 – $3,031.43 |
| Baylor St Luke's Medical Center | Houston | $6,238.05 | $1,285.00 – $17,823.00 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $6,238.05 | $1,285.00 – $17,823.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $6,238.05 | $1,285.00 – $17,823.00 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $6,238.05 | $4,812.21 – $17,823.00 |
| Texas Health Presbyterian Hospital Allen | Allen | $4,498.20 | $1,151.54 – $1,243.66 |
| Texas Health Harris Methodist Hospital Alliance | Fort Worth | $4,498.20 | $1,151.54 – $1,266.69 |