Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr at St. Luke's Health - Patients Medical Center

4600 E. Sam Houston Parkway South, Pasadena, TX · CommonSpirit Health · · NPI 1407990088

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

$8.82

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.

$25.20

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.

$0.07 with United vs $18.90 with MultiPlan — 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
United Commercial|Exchange $0.07 ↓ -99%
Cigna Commercial|Surefit $0.09 ↓ -99%
Cigna Commercial|HMO $0.09 ↓ -99%
Cigna Commercial|PPO $0.09 ↓ -99%
United Commercial|Charter $0.11 ↓ -99%
United Commercial|PPO $0.11 ↓ -99%
United Commercial|HMO $0.11 ↓ -99%
BCBS - TX Commercial|MyBlue Health Exchange $0.13 ↓ -99%
BCBS-TX Commercial|Exchange $0.15 ↓ -98%
BCBS-TX Commercial|Blue Premier $0.25 ↓ -97%
BCBS-TX Commercial|HMO $0.32 ↓ -96%
BCBS-TX Commercial|PPO $0.39 ↓ -96%
Cigna Lifesource Commercial|Transplant $15.12 ↑ +71%
Coventry Commercial|PPO $16.38 ↑ +86%
First Health Commercial|All Plans $16.38 ↑ +86%
Cigna Commercial|Transplant $17.64 ↑ +100%
Healthsmart Commercial|PPO $17.64 ↑ +100%
MultiPlan Commercial|All Plans $18.90 ↑ +114%

Visitor-reported prices

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Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr at other Texas hospitals

Hospital City Cash price Negotiated range
HCA HOUSTON SOUTHEAST PASADENA not published $0.04 – $0.29
Adventhealth Rollins Brook Lampasas $50.85 $0.46 – $0.46
Baylor St Luke's Medical Center Houston $25.40 $0.09 – $54.79
St. Joseph Health Madison Hospital Madisonville $3.29 $0.03 – $2.72
St. Luke's Health Memorial Lufkin Lufkin $120.90 $0.03 – $370.18
St. Luke's Health - Springwoods Village Hospital Spring $25.40 $0.07 – $54.79
St. Luke's Health - Sugar Land Hospital Sugar Land $25.40 $0.07 – $54.79
St. Joseph Health College Station Hospital College Station $3.29 $0.03 – $2.57

All Texas hospitals for this procedure →