Acyclovir 400 mg tablet at St. Luke's Health - Lakeside Hospital
17400 St Lukes Way, The Woodlands, TX · CommonSpirit Health · · NPI 1184868879
$654.96
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.
$1,871.31
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.
$411.69 with Aetna-Kelsey Care vs $1,871.31 with MHealth Network — 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 |
|---|---|---|---|
| Aetna-Kelsey Care | Commercial|HMO | $411.69 | ↓ -37% |
| United | Commercial|Exchange | $486.55 | ↓ -26% |
| Aetna | Commercial|PPO | $486.55 | ↓ -26% |
| Aetna | Commercial|HMO | $486.55 | ↓ -26% |
| OPTUM | Medicare|All Plans | $505.26 | ↓ -23% |
| Aetna | Commercial|Transplant | $598.82 | ↓ -9% |
| Bright Health | Commercial|All Plans | $617.54 | ↓ -6% |
| United | Commercial|Charter | $636.25 | ↓ -3% |
| TCHPCHIP | Medicaid|HMO | $654.96 | ↑ +0% |
| Cigna | Commercial|HMO | $673.68 | ↑ +3% |
| Cigna | Commercial|PPO | $673.68 | ↑ +3% |
| Cigna | Commercial|Surefit | $673.68 | ↑ +3% |
| OPTUM | Medicaid|STAR | $677.04 | ↑ +3% |
| United | Commercial|HMO | $711.10 | ↑ +9% |
| United | Commercial|PPO | $711.10 | ↑ +9% |
| United | Commercial|Optum | $879.52 | ↑ +34% |
| Humana | Commercial|HMO | $898.23 | ↑ +37% |
| Humana | Commercial|PPO | $898.23 | ↑ +37% |
| KelseyCare | Commercial|All Other Plans | $916.95 | ↑ +40% |
| CHC | Medicaid|CHIP | $1,029.23 | ↑ +57% |
| CHC | Medicaid|HMO | $1,029.23 | ↑ +57% |
| TEXASTRUECHOICE | Medicaid|CHIP | $1,029.23 | ↑ +57% |
| Cigna Lifesource | Commercial|Transplant | $1,122.79 | ↑ +71% |
| Independent Med System | Commercial|All Plans | $1,122.79 | ↑ +71% |
| First Health | Commercial|All Plans | $1,216.36 | ↑ +86% |
| Coventry | Commercial|PPO | $1,216.36 | ↑ +86% |
| Humana | Commercial|Transplant | $1,216.36 | ↑ +86% |
| PHCS | Commercial|All Plans | $1,309.92 | ↑ +100% |
| PHCS Savility | Commercial|PPO | $1,309.92 | ↑ +100% |
| Interlink | Commercial|Transplant | $1,309.92 | ↑ +100% |
| Healthsmart | Commercial|PPO | $1,309.92 | ↑ +100% |
| Cigna | Commercial|Transplant | $1,309.92 | ↑ +100% |
| MultiPlan | Commercial|All Plans | $1,403.49 | ↑ +114% |
| OPTUM | Medicaid|STARPLUS | $1,546.08 | ↑ +136% |
| USA Health Network | Commercial|All Plans | $1,590.62 | ↑ +143% |
| MHealth Network | Commercial|PPO | $1,871.31 | ↑ +186% |
Visitor-reported prices
Comments
Acyclovir 400 mg tablet at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Baylor St Luke's Medical Center | Houston | $654.96 | $411.69 – $1,871.31 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $654.96 | $411.69 – $1,871.31 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $654.96 | $411.69 – $1,871.31 |
| St. Luke's Health - Brazosport Hospital | Lake Jackson | $467.94 | $14.27 – $61.84 |
| St. Luke's Health - The Vintage Hospital | Houston | $654.96 | $411.69 – $1,871.31 |