Ghs lac repair mouth.ant tong 2.5cm/less 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

$104.27

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.

$297.90

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.

$19.82 with TCHP vs $7,221.00 with Cigna — 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 $19.82 ↓ -81%
CHC Medicaid|All Plans $19.82 ↓ -81%
Wellpoint Medicaid|All Plans $20.86 ↓ -80%
UNITED Medicaid|All Other Plans $21.28 ↓ -80%
UNITED Medicaid|STAR $28.57 ↓ -73%
UNITED Medicaid|STARPLUS $65.07 ↓ -38%
BCBS-TX Commercial|Exchange $81.77 ↓ -22%
BCBS - TX Commercial|MyBlue Health Exchange $104.67 ↑ +0%
BCBS-TX Commercial|Blue Premier $158.09 ↑ +52%
Cigna Lifesource Commercial|Transplant $178.74 ↑ +71%
BCBS-TX Commercial|HMO $187.53 ↑ +80%
Coventry Commercial|PPO $193.64 ↑ +86%
First Health Commercial|All Plans $193.64 ↑ +86%
Aetna Commercial|PPO $202.58 ↑ +94%
Healthsmart Commercial|PPO $208.53 ↑ +100%
Cigna Commercial|Transplant $208.53 ↑ +100%
BCBS-TX Commercial|PPO $209.34 ↑ +101%
MultiPlan Commercial|All Plans $223.43 ↑ +114%
Aetna Commercial|Transplant $226.41 ↑ +117%
HUMANA Medicare|All Plans $399.69 ↑ +283%
CIGNA-HEALTHSPRING Medicare|All Plans $399.69 ↑ +283%
KELSEY Medicare|All Plans $399.69 ↑ +283%
BCBS Medicare|All Plans $399.69 ↑ +283%
UNITED Medicare|All Plans $407.68 ↑ +291%
AETNA Medicare|All Plans $407.68 ↑ +291%
AMERIVANTAGE Medicare|All Plans $411.68 ↑ +295%
DEVOTED Medicare|All Plans $427.67 ↑ +310%
SCANHealth Medicare|All Plans $427.67 ↑ +310%
Bright Health Commercial|All Plans $453.87 ↑ +335%
Ambetter Commercial|All Plans $599.53 ↑ +475%
Community Health Choice Commercial|Exchange $599.53 ↑ +475%
Wellpoint Commercial|Exchange $599.54 ↑ +475%
Aetna-Kelsey Care Commercial|HMO $1,076.00 ↑ +932%
Aetna Commercial|HMO $1,298.00 ↑ +1145%
United Commercial|Exchange $1,676.00 ↑ +1507%
Humana Commercial|PPO $1,782.00 ↑ +1609%
Humana Commercial|HMO $1,782.00 ↑ +1609%
United Commercial|Charter $2,474.00 ↑ +2273%
Cigna Commercial|Surefit $2,609.00 ↑ +2402%
United Commercial|PPO $2,749.00 ↑ +2536%
United Commercial|HMO $2,749.00 ↑ +2536%
Cigna Commercial|HMO $2,875.00 ↑ +2657%
PHCS Commercial|All Plans $5,185.00 ↑ +4873%
Cigna Commercial|PPO $7,221.00 ↑ +6825%

Visitor-reported prices

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Ghs lac repair mouth.ant tong 2.5cm/less at other Texas hospitals

Hospital City Cash price Negotiated range
HCA HOUSTON SOUTHEAST PASADENA not published $189.71 – $189.71
Adventhealth Rollins Brook Lampasas $816.85 $136.29 – $4,826.69
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $586.06 $166.05 – $987.04
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $489.67 $71.00 – $987.04
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $408.99 $71.00 – $987.04
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $586.06 $156.28 – $987.04
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $489.67 $85.00 – $987.04
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $489.67 $252.99 – $987.04

All Texas hospitals for this procedure →