Ammonia 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

$122.50

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.

$350.00

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.

$11.63 with TCHP vs $262.50 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
TCHP Medicaid|All Plans $11.63 ↓ -91%
CHC Medicaid|All Plans $11.63 ↓ -91%
Wellpoint Medicaid|All Plans $12.24 ↓ -90%
UNITED Medicaid|All Other Plans $12.48 ↓ -90%
KELSEY Medicare|All Plans $14.57 ↓ -88%
CIGNA-HEALTHSPRING Medicare|All Plans $14.57 ↓ -88%
BCBS Medicare|All Plans $14.57 ↓ -88%
HUMANA Medicare|All Plans $14.57 ↓ -88%
UNITED Medicare|All Plans $14.86 ↓ -88%
AETNA Medicare|All Plans $14.86 ↓ -88%
AMERIVANTAGE Medicare|All Plans $15.01 ↓ -88%
SCANHealth Medicare|All Plans $15.59 ↓ -87%
DEVOTED Medicare|All Plans $15.59 ↓ -87%
UNITED Medicaid|STAR $16.77 ↓ -86%
BCBS - TX Commercial|MyBlue Health Exchange $21.27 ↓ -83%
Wellpoint Commercial|Exchange $21.86 ↓ -82%
Ambetter Commercial|All Plans $21.86 ↓ -82%
Community Health Choice Commercial|Exchange $21.86 ↓ -82%
Bright Health Commercial|All Plans $24.04 ↓ -80%
United Commercial|Charter $26.99 ↓ -78%
United Commercial|HMO $26.99 ↓ -78%
United Commercial|Exchange $26.99 ↓ -78%
United Commercial|PPO $26.99 ↓ -78%
BCBS-TX Commercial|Exchange $27.68 ↓ -77%
Cigna Commercial|Surefit $34.71 ↓ -72%
UNITED Medicaid|STARPLUS $38.19 ↓ -69%
Cigna Commercial|HMO $38.30 ↓ -69%
BCBS-TX Commercial|Blue Premier $47.50 ↓ -61%
Cigna Commercial|PPO $52.35 ↓ -57%
BCBS-TX Commercial|HMO $63.82 ↓ -48%
BCBS-TX Commercial|PPO $74.74 ↓ -39%
Cigna Lifesource Commercial|Transplant $210.00 ↑ +71%
First Health Commercial|All Plans $227.50 ↑ +86%
Coventry Commercial|PPO $227.50 ↑ +86%
Aetna Commercial|HMO $238.00 ↑ +94%
Healthsmart Commercial|PPO $245.00 ↑ +100%
Cigna Commercial|Transplant $245.00 ↑ +100%
MultiPlan Commercial|All Plans $262.50 ↑ +114%

Visitor-reported prices

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Ammonia at other Texas hospitals

Hospital City Cash price Negotiated range
HCA HOUSTON SOUTHEAST PASADENA $1,199.83 $12.00 – $59.93
Adventhealth Rollins Brook Lampasas $232.94 $13.11 – $56.09
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $145.94 $10.00 – $182.42
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $142.06 $12.00 – $213.08
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $145.94 $12.00 – $182.42
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $145.94 $10.00 – $182.42
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $142.06 $12.00 – $213.08
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $142.06 $8.00 – $213.08

All Texas hospitals for this procedure →