Closed tx humerus fx with manip 23605 at St. Luke's Health - Sugar Land Hospital
1317 Lake Pointe Parkway, Sugar Land, TX · CommonSpirit Health · · NPI 1659559573
$603.40
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.
$1,724.00
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.
$465.48 with OPTUM 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 →
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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 |
|---|---|---|---|
| OPTUM | Medicare|All Plans | $465.48 | ↓ -23% |
| Wellpoint | Medicaid|All Other Plans | $593.04 | ↓ -2% |
| TCHP | Medicaid|STARKIDS | $593.04 | ↓ -2% |
| TCHP | Medicaid|All Other Plans | $593.04 | ↓ -2% |
| Wellpoint | Medicaid|STARKIDS | $593.04 | ↓ -2% |
| Wellpoint | Medicaid|CHIP | $593.04 | ↓ -2% |
| TCHPCHIP | Medicaid|HMO | $603.40 | ↑ +0% |
| UHC | Medicaid|CHIP | $604.90 | ↑ +0% |
| UHC | Medicaid|STARKIDS | $604.90 | ↑ +0% |
| UNITED | Medicaid|All Other Plans | $604.90 | ↑ +0% |
| BCBS | Medicaid|All Plans | $622.69 | ↑ +3% |
| OPTUM | Medicaid|STAR | $623.75 | ↑ +3% |
| CHC | Medicaid|All Other Plans | $682.00 | ↑ +13% |
| TCHP | Medicaid|STAR | $794.67 | ↑ +32% |
| Wellpoint | Medicaid|STAR | $794.67 | ↑ +32% |
| United | Commercial|Optum | $810.28 | ↑ +34% |
| UNITED | Medicaid|STAR | $812.46 | ↑ +35% |
| CHC | Medicaid|STAR | $913.28 | ↑ +51% |
| TEXASTRUECHOICE | Medicaid|CHIP | $948.20 | ↑ +57% |
| CHC | Medicaid|CHIP | $948.20 | ↑ +57% |
| CHC | Medicaid|HMO | $948.20 | ↑ +57% |
| BCBS-TX | Commercial|Exchange | $1,016.54 | ↑ +68% |
| Cigna Lifesource | Commercial|Transplant | $1,034.40 | ↑ +71% |
| Aetna-Kelsey Care | Commercial|HMO | $1,076.00 | ↑ +78% |
| Humana | Commercial|Transplant | $1,120.60 | ↑ +86% |
| First Health | Commercial|All Plans | $1,120.60 | ↑ +86% |
| Coventry | Commercial|PPO | $1,120.60 | ↑ +86% |
| Renaissance | Commercial|All Plans | $1,154.16 | ↑ +91% |
| Aetna | Commercial|PPO | $1,172.32 | ↑ +94% |
| Healthsmart | Commercial|PPO | $1,206.80 | ↑ +100% |
| Interlink | Commercial|Transplant | $1,206.80 | ↑ +100% |
| Cigna | Commercial|Transplant | $1,206.80 | ↑ +100% |
| Healthsmart | Commercial|AP3-PPO | $1,285.00 | ↑ +113% |
| MultiPlan | Commercial|All Plans | $1,293.00 | ↑ +114% |
| Aetna | Commercial|HMO | $1,298.00 | ↑ +115% |
| BCBS-TX | Commercial|MyBlue Health Exchange | $1,301.17 | ↑ +116% |
| Aetna | Commercial|Transplant | $1,310.24 | ↑ +117% |
| KELSEY | Medicare|All Plans | $1,327.26 | ↑ +120% |
| OPTUM | Medicaid|STARPLUS | $1,424.37 | ↑ +136% |
| USA Health Network | Commercial|All Plans | $1,465.40 | ↑ +143% |
| HUMANA | Medicare|All Other Plans | $1,603.00 | ↑ +166% |
| CIGNA HEALTHSPRING | Medicare|HMO | $1,603.00 | ↑ +166% |
| BCBS | Medicare|All Plans | $1,603.00 | ↑ +166% |
| HUMANA | Medicare|TRANSPLANT | $1,603.00 | ↑ +166% |
| SELECTCARE | Medicare|All Plans | $1,603.00 | ↑ +166% |
| CIGNA HEALTHSPRING | Medicare|PPO | $1,619.03 | ↑ +168% |
| AETNA | Medicare|All Plans | $1,635.06 | ↑ +171% |
| UHC-SecureHorizons | Medicare|All Plans | $1,635.06 | ↑ +171% |
| Amerivantage | Medicare|All Plans | $1,651.09 | ↑ +174% |
| Independent Med System | Commercial|All Plans | $1,675.00 | ↑ +178% |
| DEVOTED | Medicare|All Plans | $1,715.21 | ↑ +184% |
| SCANHealth | Medicare|All Plans | $1,715.21 | ↑ +184% |
| MHealth Network | Commercial|PPO | $1,724.00 | ↑ +186% |
| KINDRED | Medicare|All Plans | $1,763.30 | ↑ +192% |
| UNITED | Medicaid|STARPLUS | $1,850.28 | ↑ +207% |
| UHC | Medicaid|STARPLUS | $1,850.28 | ↑ +207% |
| BCBS-TX | Commercial|Blue Premier | $1,965.32 | ↑ +226% |
| KelseyCare | Commercial|Exchange | $2,164.05 | ↑ +259% |
| Bright Health | Commercial|All Plans | $2,329.26 | ↑ +286% |
| BCBS-TX | Commercial|HMO | $2,331.27 | ↑ +286% |
| Community Health Choice | Commercial|All Other Plans | $2,404.50 | ↑ +298% |
| Superior Health Plan | Commercial|All Plans | $2,404.50 | ↑ +298% |
| Wellpoint | Commercial|Exchange | $2,404.50 | ↑ +298% |
| Community Health Choice | Commercial|Exchange | $2,404.50 | ↑ +298% |
| KelseyCare | Commercial|All Other Plans | $2,404.80 | ↑ +299% |
| Aetna | Commercial|Exchange | $2,468.62 | ↑ +309% |
| BCBS-TX | Commercial|PPO | $2,602.35 | ↑ +331% |
| Cigna | Commercial|Surefit | $2,609.00 | ↑ +332% |
| Cigna | Commercial|HMO | $2,875.00 | ↑ +376% |
| United | Commercial|Exchange | $3,137.00 | ↑ +420% |
| Humana | Commercial|HMO | $4,000.00 | ↑ +563% |
| Humana | Commercial|PPO | $4,000.00 | ↑ +563% |
| United | Commercial|Charter | $4,631.00 | ↑ +667% |
| United | Commercial|HMO | $5,145.00 | ↑ +753% |
| United | Commercial|PPO | $5,145.00 | ↑ +753% |
| PHCS | Commercial|All Plans | $5,185.00 | ↑ +759% |
| PHCS Savility | Commercial|PPO | $5,185.00 | ↑ +759% |
| NX Health | Commercial|PPO | $5,209.75 | ↑ +763% |
| Cigna | Commercial|PPO | $7,221.00 | ↑ +1097% |
Visitor-reported prices
Comments
Closed tx humerus fx with manip 23605 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $2,855.92 | $593.04 – $3,981.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $1,991.98 | $71.00 – $3,981.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,691.17 | $71.00 – $3,981.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $2,855.92 | $593.04 – $3,981.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $1,991.98 | $85.00 – $3,981.46 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $1,991.98 | $593.04 – $3,981.46 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,691.17 | $71.00 – $3,981.46 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $2,855.92 | $593.04 – $3,981.46 |