Close lac/mouth vest/2.5 cm or < 40830 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

$231.21

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.

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What you pay up front if you don't use insurance.

$660.60

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.

$83.20 with TCHP vs $2,749.00 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 →

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 $83.20 ↓ -64%
CHC Medicaid|All Plans $83.20 ↓ -64%
Wellpoint Medicaid|All Plans $87.58 ↓ -62%
UNITED Medicaid|All Other Plans $89.33 ↓ -61%
UNITED Medicaid|STAR $119.98 ↓ -48%
Cigna Commercial|Surefit $140.00 ↓ -39%
BCBS-TX Commercial|Exchange $152.73 ↓ -34%
Cigna Commercial|HMO $154.00 ↓ -33%
BCBS - TX Commercial|MyBlue Health Exchange $195.49 ↓ -15%
BCBS Medicare|All Plans $232.60 ↑ +1%
KELSEY Medicare|All Plans $232.60 ↑ +1%
CIGNA-HEALTHSPRING Medicare|All Plans $232.60 ↑ +1%
HUMANA Medicare|All Plans $232.60 ↑ +1%
AETNA Medicare|All Plans $237.25 ↑ +3%
UNITED Medicare|All Plans $237.25 ↑ +3%
AMERIVANTAGE Medicare|All Plans $239.58 ↑ +4%
DEVOTED Medicare|All Plans $248.88 ↑ +8%
SCANHealth Medicare|All Plans $248.88 ↑ +8%
UNITED Medicaid|STARPLUS $273.25 ↑ +18%
BCBS-TX Commercial|Blue Premier $295.28 ↑ +28%
Wellpoint Commercial|Exchange $348.90 ↑ +51%
Ambetter Commercial|All Plans $348.90 ↑ +51%
Community Health Choice Commercial|Exchange $348.90 ↑ +51%
BCBS-TX Commercial|HMO $350.26 ↑ +51%
Bright Health Commercial|All Plans $353.79 ↑ +53%
Cigna Commercial|PPO $387.00 ↑ +67%
BCBS-TX Commercial|PPO $390.99 ↑ +69%
Cigna Lifesource Commercial|Transplant $396.36 ↑ +71%
Coventry Commercial|PPO $429.39 ↑ +86%
First Health Commercial|All Plans $429.39 ↑ +86%
PHCS Commercial|All Plans $429.39 ↑ +86%
Aetna Commercial|PPO $449.21 ↑ +94%
Cigna Commercial|Transplant $462.42 ↑ +100%
Healthsmart Commercial|PPO $462.42 ↑ +100%
MultiPlan Commercial|All Plans $495.45 ↑ +114%
Aetna Commercial|Transplant $502.06 ↑ +117%
United Commercial|Exchange $1,676.00 ↑ +625%
Humana Commercial|PPO $2,430.00 ↑ +951%
Humana Commercial|HMO $2,430.00 ↑ +951%
United Commercial|Charter $2,474.00 ↑ +970%
United Commercial|PPO $2,749.00 ↑ +1089%
United Commercial|HMO $2,749.00 ↑ +1089%

Visitor-reported prices

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Close lac/mouth vest/2.5 cm or < 40830 at other Texas hospitals

Hospital City Cash price Negotiated range
HCA HOUSTON SOUTHEAST PASADENA not published $85.83 – $354.33
Adventhealth Rollins Brook Lampasas $1,350.29 $254.55 – $4,826.69
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $523.20 $87.58 – $654.00
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $553.04 $71.00 – $829.56
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $487.69 $71.00 – $609.61
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $523.20 $87.58 – $654.00
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $553.04 $85.00 – $829.56
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $553.04 $87.58 – $829.56

All Texas hospitals for this procedure →