Biopsy of salivary glnd;incisional 42405 at Covenant Children's Hospital
4015 22nd Pl, Lubbock, TX · Providence · · NPI 1437171568
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.
$2,150.00 with Phcs vs $7,034.24 with Capstar — 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 |
|---|---|---|---|
| Phcs | All Commercial Plans | $2,150.00 | — |
| Scott And White | Individual Bsw Premier Exchange | $2,296.68 | — |
| Scott And White | Group Bsw Premier/Covenant Preferred Other Commercial Plan | $2,778.21 | — |
| Bcbs | Par Traditional | $2,874.09 | — |
| Bcbs | Blue Essentials Hmo | $2,874.09 | — |
| Bcbs | Ers Blue Essentials For Healthselect Members Hmo | $2,874.09 | — |
| Covenant Preferred | All Commercial Plans | $3,218.00 | — |
| Bcbs | Ppo | $3,400.34 | — |
| Scott And White | Group Bsw Plus All Commercial Plans | $4,012.38 | — |
| Aetna | New Business Tier 1 Other Commercial Plan | $4,524.00 | — |
| Aetna | Preferred Other Commercial Plan | $5,563.00 | — |
| Aetna | All Commercial Plans | $6,149.00 | — |
| Capstar | All Commercial Plans | $7,034.24 | — |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Medical Center | Lubbock | not published | $1,558.65 – $6,330.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $4,522.97 | $71.00 – $6,784.45 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,417.89 | $71.00 – $4,272.37 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $4,522.97 | $85.00 – $6,784.45 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $4,522.97 | $420.64 – $6,784.45 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,417.89 | $71.00 – $5,126.84 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $4,522.97 | $71.00 – $5,653.71 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $4,522.97 | $71.00 – $6,784.45 |