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Tonsillectomy (child under 12) at BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE
2600 E. Pflugerville Parkway, Suite 100, TX · Baylor Scott & White Health · · NPI 1346729159
$4,555.73
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.
$7,592.89
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 $14,507.25 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 |
|---|---|---|---|
| Blue Cross Blue Shield | Blue Advantage | $71.00 | ↓ -98% |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $75.00 | ↓ -98% |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $81.00 | ↓ -98% |
| Blue Cross Blue Shield | BlueChoice (PPO) | $85.00 | ↓ -98% |
| Superior Health Plan | Medicaid | $1,954.22 | ↓ -57% |
| United Healthcare | Medicaid/CHIP | $2,091.02 | ↓ -54% |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | $2,762.29 | ↓ -39% |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | $3,249.76 | ↓ -29% |
| United Healthcare | Commercial | $3,743.29 | ↓ -18% |
| QuikTrip | Employee Benefit Plan | $4,176.09 | ↓ -8% |
| Aetna | Commercial | $4,176.09 | ↓ -8% |
| MidCoast | Commercial | $4,176.09 | ↓ -8% |
| University of Mary Hardin-Baylor | Commercial | $4,403.88 | ↓ -3% |
| Independent Medical System | Commercial PPO | $4,555.73 | ↑ +0% |
| Curative | Commercial | $4,935.38 | ↑ +8% |
| Cigna | Local Plus | $5,132.00 | ↑ +13% |
| Humana | Commercial PPO | $5,315.02 | ↑ +17% |
| First Health | PPO | $5,315.02 | ↑ +17% |
| Baylor Scott & White Health Plan | Medicare Advantage | $5,649.47 | ↑ +24% |
| HealthSmart | Preferred Network | $5,694.67 | ↑ +25% |
| Private Health Care System | PHCS Network | $5,694.67 | ↑ +25% |
| CORVEL | Worker's Compensation | $5,768.41 | ↑ +27% |
| Humana | Medicare | $5,946.81 | ↑ +31% |
| TriWest | Community Care Network | $5,946.81 | ↑ +31% |
| Superior Health Plan | Medicare HMO/Medicare PPO | $5,946.81 | ↑ +31% |
| Cigna | HMO/PPO | $6,038.00 | ↑ +33% |
| ProCare Advantage | Medicare Advantage | $6,244.15 | ↑ +37% |
| HealthSpring | Medicare Advantage | $6,244.15 | ↑ +37% |
| American Health Plan | Medicare Advantage | $6,244.15 | ↑ +37% |
| HealthSmart | Accel Network | $6,304.00 | ↑ +38% |
| United Healthcare | Medicare Advantage | $6,660.43 | ↑ +46% |
| Three Rivers | Three Rivers Provider Network | $6,833.60 | ↑ +50% |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $7,136.17 | ↑ +57% |
| Humana | Commercial HMO | $7,441.00 | ↑ +63% |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $7,463.25 | ↑ +64% |
| Prime Health Services | Worker's Compensation | $7,498.93 | ↑ +65% |
| Sedgwick | Preferred Network | $8,890.48 | ↑ +95% |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $9,812.24 | ↑ +115% |
| Mark Cuban | Commercial | $14,507.25 | ↑ +218% |
Visitor-reported prices
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Tonsillectomy (child under 12) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $4,182.80 | $71.00 – $14,507.25 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $4,555.73 | $71.00 – $14,507.25 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $4,182.80 | $85.00 – $14,507.25 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $4,182.80 | $1,954.22 – $14,507.25 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $4,182.80 | $71.00 – $14,507.25 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $4,555.73 | $71.00 – $14,507.25 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR | Taylor | $4,555.73 | $71.00 – $14,507.25 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $4,182.80 | $71.00 – $14,507.25 |