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Fragmenting of kidney stone at BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE
2600 E. Pflugerville Parkway, Suite 100, TX · Baylor Scott & White Health · · NPI 1346729159
$13,092.17
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.
$21,820.28
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.
$71.00 with Blue Cross Blue Shield vs $15,811.00 with Humana — 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 |
|---|---|---|---|
| Blue Cross Blue Shield | Blue Advantage | $71.00 | ↓ -99% |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $75.00 | ↓ -99% |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $81.00 | ↓ -99% |
| Blue Cross Blue Shield | BlueChoice (PPO) | $85.00 | ↓ -99% |
| Superior Health Plan | Medicaid | $1,142.90 | ↓ -91% |
| United Healthcare | Medicaid/CHIP | $1,222.90 | ↓ -91% |
| MidCoast | Commercial | $3,300.00 | ↓ -75% |
| QuikTrip | Employee Benefit Plan | $3,300.00 | ↓ -75% |
| Aetna | Commercial | $3,300.00 | ↓ -75% |
| Baylor Scott & White Health Plan | Medicare Advantage | $3,363.99 | ↓ -74% |
| CORVEL | Worker's Compensation | $3,434.81 | ↓ -74% |
| Superior Health Plan | Medicare HMO/Medicare PPO | $3,541.04 | ↓ -73% |
| TriWest | Community Care Network | $3,541.04 | ↓ -73% |
| Humana | Medicare | $3,541.04 | ↓ -73% |
| Independent Medical System | Commercial PPO | $3,600.00 | ↓ -73% |
| HealthSpring | Medicare Advantage | $3,718.09 | ↓ -72% |
| American Health Plan | Medicare Advantage | $3,718.09 | ↓ -72% |
| ProCare Advantage | Medicare Advantage | $3,718.09 | ↓ -72% |
| Curative | Commercial | $3,900.00 | ↓ -70% |
| United Healthcare | Medicare Advantage | $3,965.96 | ↓ -70% |
| First Health | PPO | $4,200.00 | ↓ -68% |
| HealthSmart | Accel Network | $4,200.00 | ↓ -68% |
| Humana | Commercial PPO | $4,200.00 | ↓ -68% |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $4,249.25 | ↓ -68% |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $4,444.01 | ↓ -66% |
| Prime Health Services | Worker's Compensation | $4,465.25 | ↓ -66% |
| HealthSmart | Preferred Network | $4,500.00 | ↓ -66% |
| Private Health Care System | PHCS Network | $4,500.00 | ↓ -66% |
| Sedgwick | Preferred Network | $5,293.85 | ↓ -60% |
| Three Rivers | Three Rivers Provider Network | $5,400.00 | ↓ -59% |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $5,842.72 | ↓ -55% |
| Mark Cuban | Commercial | $8,636.11 | ↓ -34% |
| Cigna | Local Plus | $8,736.00 | ↓ -33% |
| United Healthcare | Commercial | $9,277.00 | ↓ -29% |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | $9,568.19 | ↓ -27% |
| Cigna | HMO/PPO | $10,278.00 | ↓ -21% |
| University of Mary Hardin-Baylor | Commercial | $10,982.00 | ↓ -16% |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | $11,256.69 | ↓ -14% |
| Humana | Commercial HMO | $15,811.00 | ↑ +21% |
Visitor-reported prices
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Fragmenting of kidney stone at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $13,091.90 | $1,142.90 – $10,982.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $12,835.46 | $71.00 – $12,407.61 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $13,092.17 | $71.00 – $10,982.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $13,091.90 | $1,142.90 – $12,306.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $12,835.46 | $85.00 – $12,407.61 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $12,835.46 | $1,142.90 – $10,696.22 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $13,092.17 | $71.00 – $10,982.00 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $13,091.90 | $1,142.90 – $12,306.00 |