Oropharyngeal biopsy 42800 at St. Joseph Health Grimes Hospital
210 South Judson Street, Navasota, TX · CommonSpirit Health · · NPI 1154317774
$35.53
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.
$203.00
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.
$73.61 with PGT vs $2,960.00 with United — 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 |
|---|---|---|---|
| PGT | Medicare|All Plans | $73.61 | ↑ +107% |
| AETNA | Medicare|All Plans | $75.11 | ↑ +111% |
| BCBS | Medicare|All Plans | $75.11 | ↑ +111% |
| UNITED | Medicare|All Plans | $76.62 | ↑ +116% |
| AMERIVANTAGE | Medicare|All Plans | $77.37 | ↑ +118% |
| SCANHealth | Medicare|All Plans | $80.37 | ↑ +126% |
| SUPERIOR | Medicaid|CHIP | $89.99 | ↑ +153% |
| UNITED | Medicaid|All Other Plans | $91.79 | ↑ +158% |
| UNITED | Medicaid|STARKIDS | $91.79 | ↑ +158% |
| BCBS | Medicaid|STARKIDS | $94.49 | ↑ +166% |
| SUPERIOR | Medicaid|All Other Plans | $94.49 | ↑ +166% |
| Wellpoint | Medicaid|All Other Plans | $95.92 | ↑ +170% |
| Ambetter | Commercial|All Plans | $108.91 | ↑ +207% |
| Health Smart | Commercial|All Plans | $111.65 | ↑ +214% |
| SUPERIOR | Medicaid|STAR | $112.49 | ↑ +217% |
| Wellpoint | Commercial|Exchange | $112.67 | ↑ +217% |
| Aetna | Commercial|All Plans | $113.68 | ↑ +220% |
| Wellpoint | Medicaid|STAR | $114.19 | ↑ +221% |
| Humana | Commercial|All Plans | $123.83 | ↑ +249% |
| Entrust | Commercial|All Plans | $142.10 | ↑ +300% |
| BCBS-TX | Commercial|Blue Premier | $144.51 | ↑ +307% |
| BCBS-TX | Commercial|Blue Advantage HMO | $145.54 | ↑ +310% |
| BCBS-TX | Commercial|HMO | $154.83 | ↑ +336% |
| Bright Health | Commercial|All Plans | $155.38 | ↑ +337% |
| BCBS-TX | Commercial|PPO | $170.31 | ↑ +379% |
| Multiplan | Commercial|All Plans | $172.55 | ↑ +386% |
| BCBS-TX | Commercial|Ref Lab | $203.00 | ↑ +471% |
| Ellwood | Commercial|All Plans | $225.33 | ↑ +534% |
| SUPERIOR | Medicaid|STARPLUS | $240.27 | ↑ +576% |
| UNITED | Medicaid|STARPLUS | $244.77 | ↑ +589% |
| United | Commercial|Exchange | $1,508.00 | ↑ +4144% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +8231% |
Visitor-reported prices
Comments
Oropharyngeal biopsy 42800 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,698.19 | $85.54 – $3,777.93 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $3,490.19 | $71.00 – $5,235.29 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,047.33 | $71.00 – $3,809.16 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,698.19 | $85.54 – $3,777.93 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $3,490.19 | $85.00 – $5,235.29 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $3,490.19 | $85.54 – $5,235.29 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,047.33 | $71.00 – $4,570.99 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $1,698.19 | $85.54 – $3,777.93 |