Fitting of diaphragm/cap 57170 at BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA
5330 Overpass Road, Suite 110, TX · Baylor Scott & White Health · · NPI 1144781501
$168.73
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.
$281.22
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.
$35.71 with Superior Health Plan vs $493.64 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 | $35.71 | ↓ -79% |
| United Healthcare | Medicaid/CHIP | $38.21 | ↓ -77% |
| Blue Cross Blue Shield | Blue Advantage | $71.00 | ↓ -58% |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $75.00 | ↓ -56% |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $81.00 | ↓ -52% |
| Blue Cross Blue Shield | BlueChoice (PPO) | $85.00 | ↓ -50% |
| Cigna | Local Plus | $85.00 | ↓ -50% |
| Cigna | HMO/PPO | $100.00 | ↓ -41% |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | $102.31 | ↓ -39% |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | $120.36 | ↓ -29% |
| United Healthcare | Commercial | $138.64 | ↓ -18% |
| QuikTrip | Employee Benefit Plan | $154.67 | ↓ -8% |
| MidCoast | Commercial | $154.67 | ↓ -8% |
| Aetna | Commercial | $154.67 | ↓ -8% |
| University of Mary Hardin-Baylor | Commercial | $163.11 | ↓ -3% |
| Curative | Commercial | $182.79 | ↑ +8% |
| Baylor Scott & White Health Plan | Medicare Advantage | $192.94 | ↑ +14% |
| Humana | Commercial PPO | $196.85 | ↑ +17% |
| First Health | PPO | $196.85 | ↑ +17% |
| Superior Health Plan | Medicare HMO/Medicare PPO | $203.09 | ↑ +20% |
| TriWest | Community Care Network | $203.09 | ↑ +20% |
| Humana | Medicare | $203.09 | ↑ +20% |
| Private Health Care System | PHCS Network | $210.91 | ↑ +25% |
| Blue Cross Blue Shield | Medicare Advantage | $213.24 | ↑ +26% |
| ProCare Advantage | Medicare Advantage | $213.24 | ↑ +26% |
| HealthSpring | Medicare Advantage | $213.24 | ↑ +26% |
| American Health Plan | Medicare Advantage | $213.24 | ↑ +26% |
| United Healthcare | Medicare Advantage | $227.46 | ↑ +35% |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $243.71 | ↑ +44% |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $254.88 | ↑ +51% |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $335.10 | ↑ +99% |
| Humana | Commercial HMO | $442.00 | ↑ +162% |
| Mark Cuban | Commercial | $493.64 | ↑ +193% |
| Humana Military | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Fitting of diaphragm/cap 57170 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $29.63 | $6.10 – $493.64 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $29.63 | $17.96 – $493.64 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $29.63 | $24.69 – $493.64 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $168.73 | $35.71 – $493.64 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $29.63 | $16.30 – $493.64 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $29.63 | $17.28 – $493.64 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $168.73 | $35.71 – $493.64 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR | Taylor | $168.73 | $38.21 – $493.64 |