healthcosts.net
Total Knee Replacement at BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE
2600 E. Pflugerville Parkway, Suite 100, TX · Baylor Scott & White Health · · NPI 1346729159
not published by hospital
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.
?
What you pay up front if you don't use insurance.
not published by hospital
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.
?
The hospital's undiscounted list price — almost no one pays this.
$5,388.00 with Cigna vs $32,603.53 with Mark Cuban — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Cigna | Local Plus | $5,388.00 | — |
| Cigna | HMO/PPO | $6,339.00 | — |
| Baylor Scott & White Health Plan | Medicare Advantage | $12,252.33 | — |
| CORVEL | Worker's Compensation | $12,510.27 | — |
| Humana | Medicare | $12,897.19 | — |
| Superior Health Plan | Medicare HMO/Medicare PPO | $12,897.19 | — |
| TriWest | Community Care Network | $12,897.19 | — |
| American Health Plan | Medicare Advantage | $13,542.05 | — |
| HealthSpring | Medicare Advantage | $13,542.05 | — |
| ProCare Advantage | Medicare Advantage | $13,542.05 | — |
| United Healthcare | Medicare Advantage | $14,444.85 | — |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $15,476.63 | — |
| Humana | Commercial HMO | $15,811.00 | — |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $16,185.97 | — |
| Prime Health Services | Worker's Compensation | $16,263.36 | — |
| United Healthcare | Commercial | $17,641.00 | — |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $18,684.11 | — |
| Blue Cross Blue Shield | Blue Advantage | $18,922.13 | — |
| Sedgwick | Preferred Network | $19,281.30 | — |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $21,280.36 | — |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $21,659.29 | — |
| Blue Cross Blue Shield | BlueChoice (PPO) | $22,849.36 | — |
| Mark Cuban | Commercial | $32,603.53 | — |
| University of Mary Hardin-Baylor | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Total Knee Replacement at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | not published | $7,038.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | not published | $5,388.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | not published | $7,038.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | not published | $5,388.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | not published | $7,038.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - GRAPEVINE | Grapevine | not published | $7,038.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | not published | $5,388.00 – $32,603.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - LAKE POINTE | Rowlett | not published | $7,038.00 – $32,603.53 |