Biopsy of salivary gland 42400 at St. Luke's Health Memorial San Augustine
511 E. Hospital Street, San Augustine, TX · CommonSpirit Health · · NPI 1578547345
$366.75
Cash price 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.
$2,445.00
Gross charge 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.
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The hospital's undiscounted list price — almost no one pays this.
$49.55 with BCBS-TX vs $2,542.80 with Entrust — 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 →
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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 ?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 ?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|Blue Advantage HMO | $49.55 | ↓ -86% |
| Wellpoint | Medicaid|All Other Plans | $57.58 | ↓ -84% |
| SUPERIOR | Medicaid|All Other Plans | $57.58 | ↓ -84% |
| TCHP | Medicaid|All Plans | $57.58 | ↓ -84% |
| UNITED | Medicaid|All Other Plans | $57.58 | ↓ -84% |
| UNITED | Medicaid|STAR | $57.58 | ↓ -84% |
| SUPERIOR | Medicaid|STARPLUS | $57.58 | ↓ -84% |
| UNITED | Medicaid|STARKIDS | $57.58 | ↓ -84% |
| CIGNA HEALTHSPRING | Medicaid|STARPLUS | $58.73 | ↓ -84% |
| Wellpoint | Medicaid|STARPLUS | $59.31 | ↓ -84% |
| BCBS | Medicaid|All Plans | $60.46 | ↓ -84% |
| SUPERIOR | Medicaid|STAR | $90.40 | ↓ -75% |
| Wellpoint | Medicaid|STAR | $90.40 | ↓ -75% |
| UNITED | Medicaid|STARPLUS | $103.07 | ↓ -72% |
| BCBS-TX | Commercial|Blue Premier | $110.35 | ↓ -70% |
| BCBS-TX | Commercial|HMO | $112.61 | ↓ -69% |
| BCBS-TX | Commercial|PPO | $123.87 | ↓ -66% |
| United | Commercial|Exchange | $440.10 | ↑ +20% |
| United | Commercial|All Other Plans | $562.35 | ↑ +53% |
| Aetna | Commercial|All Plans | $611.25 | ↑ +67% |
| AETNA | Medicare|All Plans | $620.40 | ↑ +69% |
| HUMANA | Medicare|All Plans | $620.40 | ↑ +69% |
| Wellpoint | Medicare|All Plans | $639.01 | ↑ +74% |
| CIGNA HEALTHSPRING | Medicare|All Other Plans | $651.42 | ↑ +78% |
| CIGNA HEALTHSPRING | Medicare|PPO | $657.62 | ↑ +79% |
| BCBS | Medicare|All Plans | $698.30 | ↑ +90% |
| UNITED | Medicare|All Plans | $698.30 | ↑ +90% |
| SCANHealth | Medicare|All Plans | $711.60 | ↑ +94% |
| MD Save | Commercial|All Plans | $775.50 | ↑ +111% |
| Wellpoint | Commercial|Exchange | $1,047.45 | ↑ +186% |
| PHCS | Commercial|All Plans | $1,662.60 | ↑ +353% |
| Angelina County | Commercial|All Plans | $1,693.69 | ↑ +362% |
| Humana | Commercial|All Plans | $1,711.50 | ↑ +367% |
| Multiplan | Commercial|All Plans | $1,711.50 | ↑ +367% |
| Brookshire Brothers | Commercial|All Plans | $1,861.20 | ↑ +407% |
| Cigna | Commercial|All Plans | $2,016.00 | ↑ +450% |
| Galaxy | Commercial|All Plans | $2,200.50 | ↑ +500% |
| Entrust | Commercial|All Plans | $2,542.80 | ↑ +593% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,145.90 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $997.05 | $61.61 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,387.07 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,145.90 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $997.05 | $61.61 – $1,742.94 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $997.05 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,387.07 | $57.58 – $2,080.61 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $1,145.90 | $57.58 – $1,742.94 |