MRI breast c-+ w/cad uni at St. Luke's Health - Sugar Land Hospital
1317 Lake Pointe Parkway, Sugar Land, TX · CommonSpirit Health · · NPI 1659559573
$372.40
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.
$1,064.00
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.
$287.28 with OPTUM vs $2,812.00 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 | $287.28 | ↓ -23% |
| TCHPCHIP | Medicaid|HMO | $372.40 | ↑ +0% |
| OPTUM | Medicaid|STAR | $384.96 | ↑ +3% |
| BCBS-TX | Commercial|MyBlue Health Exchange | $429.88 | ↑ +15% |
| United | Commercial|Optum | $500.08 | ↑ +34% |
| BCBS-TX | Commercial|Exchange | $500.55 | ↑ +34% |
| TEXASTRUECHOICE | Medicaid|CHIP | $585.20 | ↑ +57% |
| CHC | Medicaid|CHIP | $585.20 | ↑ +57% |
| CHC | Medicaid|HMO | $585.20 | ↑ +57% |
| Aetna-Kelsey Care | Commercial|HMO | $627.76 | ↑ +69% |
| Cigna Lifesource | Commercial|Transplant | $638.40 | ↑ +71% |
| First Health | Commercial|All Plans | $691.60 | ↑ +86% |
| Humana | Commercial|Transplant | $691.60 | ↑ +86% |
| Coventry | Commercial|PPO | $691.60 | ↑ +86% |
| Aetna | Commercial|HMO | $723.52 | ↑ +94% |
| Cigna | Commercial|Transplant | $744.80 | ↑ +100% |
| Healthsmart | Commercial|PPO | $744.80 | ↑ +100% |
| Interlink | Commercial|Transplant | $744.80 | ↑ +100% |
| MultiPlan | Commercial|All Plans | $798.00 | ↑ +114% |
| OPTUM | Medicaid|STARPLUS | $879.08 | ↑ +136% |
| USA Health Network | Commercial|All Plans | $904.40 | ↑ +143% |
| BCBS-TX | Commercial|Blue Premier | $912.76 | ↑ +145% |
| Cigna | Commercial|Surefit | $1,015.00 | ↑ +173% |
| Aetna | Commercial|Transplant | $1,023.00 | ↑ +175% |
| Humana | Commercial|HMO | $1,050.00 | ↑ +182% |
| Humana | Commercial|PPO | $1,050.00 | ↑ +182% |
| BCBS-TX | Commercial|PPO | $1,064.00 | ↑ +186% |
| BCBS-TX | Commercial|HMO | $1,064.00 | ↑ +186% |
| MHealth Network | Commercial|PPO | $1,064.00 | ↑ +186% |
| Healthsmart | Commercial|AP3-PPO | $1,100.00 | ↑ +195% |
| Cigna | Commercial|HMO | $1,119.00 | ↑ +200% |
| Aetna | Commercial|PPO | $1,145.00 | ↑ +207% |
| KelseyCare | Commercial|All Other Plans | $1,398.60 | ↑ +276% |
| United | Commercial|Exchange | $1,535.00 | ↑ +312% |
| United | Commercial|Charter | $2,266.00 | ↑ +508% |
| United | Commercial|PPO | $2,518.00 | ↑ +576% |
| United | Commercial|HMO | $2,518.00 | ↑ +576% |
| Cigna | Commercial|PPO | $2,812.00 | ↑ +655% |
Visitor-reported prices
Comments
MRI breast c-+ w/cad uni at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $2,003.54 | $567.67 – $2,838.35 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $346.24 | $71.27 – $2,149.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,645.45 | $329.09 – $2,149.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $2,003.54 | $534.28 – $2,838.35 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $346.24 | $111.14 – $2,149.00 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $346.24 | $178.89 – $2,700.00 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,645.45 | $548.48 – $2,468.17 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $2,003.54 | $534.28 – $2,838.35 |