Aco cmplx chron care without pt visit, 60 min 99487aco at St. Luke's Health - Sugar Land Hospital
1317 Lake Pointe Parkway, Sugar Land, TX · CommonSpirit Health · · NPI 1659559573
$131.60
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.
$376.00
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.
$70.73 with KELSEY vs $523.02 with NX Health — 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 |
|---|---|---|---|
| KELSEY | Medicare|All Plans | $70.73 | ↓ -46% |
| United | Commercial|Exchange | $74.00 | ↓ -44% |
| BCBS-TX | Commercial|MyBlue Health Exchange | $77.35 | ↓ -41% |
| BCBS-TX | Commercial|Exchange | $89.54 | ↓ -32% |
| OPTUM | Medicare|All Plans | $101.52 | ↓ -23% |
| United | Commercial|Charter | $109.00 | ↓ -17% |
| BCBS-TX | Commercial|Blue Premier | $112.32 | ↓ -15% |
| Renaissance | Commercial|All Plans | $115.87 | ↓ -12% |
| United | Commercial|HMO | $122.00 | ↓ -7% |
| United | Commercial|PPO | $122.00 | ↓ -7% |
| TCHPCHIP | Medicaid|HMO | $131.60 | ↑ +0% |
| OPTUM | Medicaid|STAR | $136.04 | ↑ +3% |
| BCBS-TX | Commercial|HMO | $148.34 | ↑ +13% |
| CIGNA HEALTHSPRING | Medicare|HMO | $160.93 | ↑ +22% |
| HUMANA | Medicare|All Other Plans | $160.93 | ↑ +22% |
| BCBS | Medicare|All Plans | $160.93 | ↑ +22% |
| SELECTCARE | Medicare|All Plans | $160.93 | ↑ +22% |
| HUMANA | Medicare|TRANSPLANT | $160.93 | ↑ +22% |
| CIGNA HEALTHSPRING | Medicare|PPO | $162.54 | ↑ +24% |
| AETNA | Medicare|All Plans | $164.15 | ↑ +25% |
| UHC-SecureHorizons | Medicare|All Plans | $164.15 | ↑ +25% |
| Amerivantage | Medicare|All Plans | $165.76 | ↑ +26% |
| BCBS-TX | Commercial|PPO | $168.48 | ↑ +28% |
| SCANHealth | Medicare|All Plans | $172.20 | ↑ +31% |
| DEVOTED | Medicare|All Plans | $172.20 | ↑ +31% |
| United | Commercial|Optum | $176.72 | ↑ +34% |
| KINDRED | Medicare|All Plans | $177.02 | ↑ +35% |
| CHC | Medicaid|HMO | $206.80 | ↑ +57% |
| CHC | Medicaid|CHIP | $206.80 | ↑ +57% |
| TEXASTRUECHOICE | Medicaid|CHIP | $206.80 | ↑ +57% |
| KelseyCare | Commercial|Exchange | $217.26 | ↑ +65% |
| Bright Health | Commercial|All Plans | $223.76 | ↑ +70% |
| Cigna Lifesource | Commercial|Transplant | $225.60 | ↑ +71% |
| Superior Health Plan | Commercial|All Plans | $241.40 | ↑ +83% |
| Community Health Choice | Commercial|Exchange | $241.40 | ↑ +83% |
| Community Health Choice | Commercial|All Other Plans | $241.40 | ↑ +83% |
| Wellpoint | Commercial|Exchange | $241.40 | ↑ +83% |
| First Health | Commercial|All Plans | $244.40 | ↑ +86% |
| Humana | Commercial|Transplant | $244.40 | ↑ +86% |
| Coventry | Commercial|PPO | $244.40 | ↑ +86% |
| Aetna | Commercial|Exchange | $247.83 | ↑ +88% |
| Interlink | Commercial|Transplant | $263.20 | ↑ +100% |
| Cigna | Commercial|Transplant | $263.20 | ↑ +100% |
| Healthsmart | Commercial|PPO | $263.20 | ↑ +100% |
| MultiPlan | Commercial|All Plans | $282.00 | ↑ +114% |
| OPTUM | Medicaid|STARPLUS | $310.66 | ↑ +136% |
| USA Health Network | Commercial|All Plans | $319.60 | ↑ +143% |
| MHealth Network | Commercial|PPO | $376.00 | ↑ +186% |
| NX Health | Commercial|PPO | $523.02 | ↑ +297% |
Visitor-reported prices
Comments
Aco cmplx chron care without pt visit, 60 min 99487aco at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $103.84 | $29.42 – $394.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $122.12 | $25.14 – $394.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $95.17 | $19.03 – $394.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $103.84 | $27.69 – $394.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $122.12 | $39.20 – $394.97 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $122.12 | $63.09 – $394.97 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $95.17 | $31.72 – $394.97 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $103.84 | $27.69 – $394.97 |