Incision of breast lesion at St. Luke's Health - Sugar Land Hospital
1317 Lake Pointe Parkway, Sugar Land, TX · CommonSpirit Health · · NPI 1659559573
$1,358.35
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.
$3,881.00
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.
$486.45 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 →
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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 |
|---|---|---|---|
| TCHP | Medicaid|STARKIDS | $486.45 | ↓ -64% |
| Wellpoint | Medicaid|STARKIDS | $486.45 | ↓ -64% |
| Wellpoint | Medicaid|CHIP | $486.45 | ↓ -64% |
| Wellpoint | Medicaid|All Other Plans | $486.45 | ↓ -64% |
| TCHP | Medicaid|All Other Plans | $486.45 | ↓ -64% |
| UHC | Medicaid|CHIP | $496.18 | ↓ -63% |
| UHC | Medicaid|STARKIDS | $496.18 | ↓ -63% |
| UNITED | Medicaid|All Other Plans | $496.18 | ↓ -63% |
| BCBS | Medicaid|All Plans | $510.77 | ↓ -62% |
| CHC | Medicaid|All Other Plans | $559.42 | ↓ -59% |
| TCHP | Medicaid|STAR | $651.84 | ↓ -52% |
| Wellpoint | Medicaid|STAR | $651.84 | ↓ -52% |
| UNITED | Medicaid|STAR | $666.44 | ↓ -51% |
| CHC | Medicaid|STAR | $749.13 | ↓ -45% |
| BCBS-TX | Commercial|Exchange | $1,029.45 | ↓ -24% |
| OPTUM | Medicare|All Plans | $1,047.87 | ↓ -23% |
| Aetna-Kelsey Care | Commercial|HMO | $1,076.00 | ↓ -21% |
| Renaissance | Commercial|All Plans | $1,168.46 | ↓ -14% |
| Healthsmart | Commercial|AP3-PPO | $1,285.00 | ↓ -5% |
| Aetna | Commercial|HMO | $1,298.00 | ↓ -4% |
| BCBS-TX | Commercial|MyBlue Health Exchange | $1,317.70 | ↓ -3% |
| KELSEY | Medicare|All Plans | $1,325.38 | ↓ -2% |
| TCHPCHIP | Medicaid|HMO | $1,358.35 | ↑ +0% |
| KelseyCare | Commercial|All Other Plans | $1,361.70 | ↑ +0% |
| OPTUM | Medicaid|STAR | $1,404.15 | ↑ +3% |
| UNITED | Medicaid|STARPLUS | $1,517.72 | ↑ +12% |
| UHC | Medicaid|STARPLUS | $1,517.72 | ↑ +12% |
| CIGNA HEALTHSPRING | Medicare|HMO | $1,622.86 | ↑ +19% |
| SELECTCARE | Medicare|All Plans | $1,622.86 | ↑ +19% |
| HUMANA | Medicare|All Other Plans | $1,622.86 | ↑ +19% |
| HUMANA | Medicare|TRANSPLANT | $1,622.86 | ↑ +19% |
| BCBS | Medicare|All Plans | $1,622.86 | ↑ +19% |
| CIGNA HEALTHSPRING | Medicare|PPO | $1,639.09 | ↑ +21% |
| AETNA | Medicare|All Plans | $1,655.32 | ↑ +22% |
| UHC-SecureHorizons | Medicare|All Plans | $1,655.32 | ↑ +22% |
| Amerivantage | Medicare|All Plans | $1,671.55 | ↑ +23% |
| Independent Med System | Commercial|All Plans | $1,675.00 | ↑ +23% |
| DEVOTED | Medicare|All Plans | $1,736.46 | ↑ +28% |
| SCANHealth | Medicare|All Plans | $1,736.46 | ↑ +28% |
| Humana | Commercial|HMO | $1,782.00 | ↑ +31% |
| Humana | Commercial|PPO | $1,782.00 | ↑ +31% |
| KINDRED | Medicare|All Plans | $1,785.15 | ↑ +31% |
| United | Commercial|Optum | $1,824.07 | ↑ +34% |
| BCBS-TX | Commercial|Blue Premier | $1,990.27 | ↑ +47% |
| CHC | Medicaid|HMO | $2,134.55 | ↑ +57% |
| CHC | Medicaid|CHIP | $2,134.55 | ↑ +57% |
| TEXASTRUECHOICE | Medicaid|CHIP | $2,134.55 | ↑ +57% |
| KelseyCare | Commercial|Exchange | $2,190.86 | ↑ +61% |
| Cigna Lifesource | Commercial|Transplant | $2,328.60 | ↑ +71% |
| Bright Health | Commercial|All Plans | $2,352.97 | ↑ +73% |
| BCBS-TX | Commercial|HMO | $2,360.87 | ↑ +74% |
| Superior Health Plan | Commercial|All Plans | $2,434.29 | ↑ +79% |
| Wellpoint | Commercial|Exchange | $2,434.29 | ↑ +79% |
| Community Health Choice | Commercial|All Other Plans | $2,434.29 | ↑ +79% |
| Community Health Choice | Commercial|Exchange | $2,434.29 | ↑ +79% |
| Aetna | Commercial|Exchange | $2,499.20 | ↑ +84% |
| First Health | Commercial|All Plans | $2,522.65 | ↑ +86% |
| Coventry | Commercial|PPO | $2,522.65 | ↑ +86% |
| Humana | Commercial|Transplant | $2,522.65 | ↑ +86% |
| Cigna | Commercial|Surefit | $2,609.00 | ↑ +92% |
| BCBS-TX | Commercial|PPO | $2,635.39 | ↑ +94% |
| Aetna | Commercial|PPO | $2,639.08 | ↑ +94% |
| Healthsmart | Commercial|PPO | $2,716.70 | ↑ +100% |
| Interlink | Commercial|Transplant | $2,716.70 | ↑ +100% |
| Cigna | Commercial|Transplant | $2,716.70 | ↑ +100% |
| Cigna | Commercial|HMO | $2,875.00 | ↑ +112% |
| MultiPlan | Commercial|All Plans | $2,910.75 | ↑ +114% |
| Aetna | Commercial|Transplant | $2,949.56 | ↑ +117% |
| United | Commercial|Exchange | $3,137.00 | ↑ +131% |
| OPTUM | Medicaid|STARPLUS | $3,206.49 | ↑ +136% |
| USA Health Network | Commercial|All Plans | $3,298.85 | ↑ +143% |
| MHealth Network | Commercial|PPO | $3,881.00 | ↑ +186% |
| United | Commercial|Charter | $4,631.00 | ↑ +241% |
| United | Commercial|HMO | $5,145.00 | ↑ +279% |
| United | Commercial|PPO | $5,145.00 | ↑ +279% |
| PHCS Savility | Commercial|PPO | $5,185.00 | ↑ +282% |
| PHCS | Commercial|All Plans | $5,185.00 | ↑ +282% |
| NX Health | Commercial|PPO | $5,274.30 | ↑ +288% |
| Cigna | Commercial|PPO | $7,221.00 | ↑ +432% |
Visitor-reported prices
Comments
Incision of breast lesion at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $3,030.26 | $486.45 – $4,016.35 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $3,041.19 | $71.00 – $4,561.78 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,207.17 | $71.00 – $4,016.35 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $3,030.26 | $486.45 – $4,016.35 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $3,041.19 | $85.00 – $4,561.78 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $3,041.19 | $486.45 – $4,561.78 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,207.17 | $71.00 – $4,810.75 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $3,030.26 | $486.45 – $4,016.35 |