Excision of rectal lesion at BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE
2600 E. Pflugerville Parkway, Suite 100, TX · Baylor Scott & White Health · · NPI 1346729159
$2,526.60
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.
$4,211.00
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.
$939.93 with Superior Health Plan vs $6,955.62 with Mark Cuban — 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 |
|---|---|---|---|
| Superior Health Plan | Medicaid | $939.93 | ↓ -63% |
| United Healthcare | Medicaid/CHIP | $1,005.73 | ↓ -60% |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | $1,660.82 | ↓ -34% |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | $1,953.90 | ↓ -23% |
| Aetna | Commercial | $2,316.05 | ↓ -8% |
| MidCoast | Commercial | $2,316.05 | ↓ -8% |
| QuikTrip | Employee Benefit Plan | $2,316.05 | ↓ -8% |
| HealthSmart | Accel Network | $2,416.00 | ↓ -4% |
| Independent Medical System | Commercial PPO | $2,526.60 | ↑ +0% |
| Baylor Scott & White Health Plan | Medicare Advantage | $2,648.89 | ↑ +5% |
| CORVEL | Worker's Compensation | $2,704.66 | ↑ +7% |
| Curative | Commercial | $2,737.15 | ↑ +8% |
| Superior Health Plan | Medicare HMO/Medicare PPO | $2,788.31 | ↑ +10% |
| Humana | Medicare | $2,788.31 | ↑ +10% |
| TriWest | Community Care Network | $2,788.31 | ↑ +10% |
| ProCare Advantage | Medicare Advantage | $2,927.73 | ↑ +16% |
| HealthSpring | Medicare Advantage | $2,927.73 | ↑ +16% |
| American Health Plan | Medicare Advantage | $2,927.73 | ↑ +16% |
| First Health | PPO | $2,947.70 | ↑ +17% |
| Humana | Commercial PPO | $2,947.70 | ↑ +17% |
| United Healthcare | Medicare Advantage | $3,122.91 | ↑ +24% |
| Private Health Care System | PHCS Network | $3,158.25 | ↑ +25% |
| HealthSmart | Preferred Network | $3,158.25 | ↑ +25% |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $3,345.97 | ↑ +32% |
| Cigna | Local Plus | $3,421.00 | ↑ +35% |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $3,499.33 | ↑ +38% |
| Prime Health Services | Worker's Compensation | $3,516.06 | ↑ +39% |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $3,680.36 | ↑ +46% |
| Blue Cross Blue Shield | Blue Advantage | $3,727.25 | ↑ +48% |
| Three Rivers | Three Rivers Provider Network | $3,789.90 | ↑ +50% |
| Cigna | HMO/PPO | $4,025.00 | ↑ +59% |
| Sedgwick | Preferred Network | $4,168.52 | ↑ +65% |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $4,266.41 | ↑ +69% |
| Blue Cross Blue Shield | BlueChoice (PPO) | $4,500.83 | ↑ +78% |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $4,600.71 | ↑ +82% |
| Humana | Commercial HMO | $5,266.00 | ↑ +108% |
| United Healthcare | Commercial | $6,555.00 | ↑ +159% |
| Mark Cuban | Commercial | $6,955.62 | ↑ +175% |
| University of Mary Hardin-Baylor | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Excision of rectal lesion at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $2,526.60 | $520.06 – $6,955.62 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $2,526.60 | $939.93 – $6,955.62 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $2,526.60 | $1,005.73 – $6,955.62 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $2,526.60 | $939.93 – $6,955.62 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $2,526.60 | $939.93 – $6,955.62 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $2,526.60 | $939.93 – $6,955.62 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $2,526.60 | $939.93 – $6,955.62 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR | Taylor | $2,526.60 | $800.09 – $6,955.62 |