Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet 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

$6,748.04

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.

$19,280.10

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.

$179.05 with BCBS-TX vs $639.45 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
BCBS-TX Commercial|Exchange $179.05 ↓ -97%
BCBS-TX Commercial|Blue Premier $187.58 ↓ -97%
United Commercial|Exchange $204.63 ↓ -97%
Aetna-Kelsey Care Commercial|HMO $213.15 ↓ -97%
BCBS - TX Commercial|MyBlue Health Exchange $221.68 ↓ -97%
Bright Health Commercial|All Plans $221.68 ↓ -97%
BCBS-TX Commercial|HMO $230.21 ↓ -97%
United Commercial|Charter $238.73 ↓ -96%
Aetna Commercial|HMO $247.26 ↓ -96%
Aetna Commercial|PPO $247.26 ↓ -96%
Cigna Commercial|PPO $255.78 ↓ -96%
BCBS-TX Commercial|PPO $255.78 ↓ -96%
Cigna Commercial|HMO $255.78 ↓ -96%
Cigna Commercial|Surefit $255.78 ↓ -96%
United Commercial|PPO $264.31 ↓ -96%
United Commercial|HMO $264.31 ↓ -96%
Aetna Commercial|Transplant $315.47 ↓ -95%
Humana Commercial|PPO $358.10 ↓ -95%
Humana Commercial|HMO $358.10 ↓ -95%
Cigna Lifesource Commercial|Transplant $511.56 ↓ -92%
Coventry Commercial|PPO $554.19 ↓ -92%
First Health Commercial|All Plans $554.19 ↓ -92%
PHCS Commercial|All Plans $554.19 ↓ -92%
Healthsmart Commercial|PPO $596.82 ↓ -91%
Cigna Commercial|Transplant $596.82 ↓ -91%
MultiPlan Commercial|All Plans $639.45 ↓ -91%

Visitor-reported prices

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Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet at other Texas hospitals

Hospital City Cash price Negotiated range
Baylor St Luke's Medical Center Houston $1,396.50 $739.20 – $3,360.00
St. Joseph Health Madison Hospital Madisonville $13,389.43 $483.87 – $3,418.20
St. Luke's Health - Springwoods Village Hospital Spring $1,396.50 $739.20 – $3,360.00
St. Luke's Health - Sugar Land Hospital Sugar Land $1,396.50 $739.20 – $3,360.00
St. Joseph Health College Station Hospital College Station $13,389.43 $759.60 – $3,228.30
St. Luke's Health - Lakeside Hospital The Woodlands $1,396.50 $739.20 – $3,360.00
St. Joseph Health Grimes Hospital Navasota $13,389.43 $759.60 – $4,215.78
St. Luke's Health - The Vintage Hospital Houston $1,396.50 $739.20 – $3,360.00

All Texas hospitals for this procedure →