Biopsy of salivary gland 42400 at St. Luke's Health - Lakeside Hospital
17400 St Lukes Way, The Woodlands, TX · CommonSpirit Health · · NPI 1184868879
$348.25
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.
$995.00
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.
$56.30 with BCBS-TX vs $5,160.00 with Cigna — 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 |
|---|---|---|---|
| BCBS-TX | Commercial|Exchange | $56.30 | ↓ -84% |
| Wellpoint | Medicaid|All Other Plans | $57.58 | ↓ -83% |
| TCHP | Medicaid|STARKIDS | $57.58 | ↓ -83% |
| TCHP | Medicaid|Lakeside | $57.58 | ↓ -83% |
| Wellpoint | Medicaid|STARKIDS | $57.58 | ↓ -83% |
| Wellpoint | Medicaid|CHIP | $57.58 | ↓ -83% |
| UNITED | Medicaid|All Other Plans | $58.73 | ↓ -83% |
| UHC | Medicaid|CHIP | $58.73 | ↓ -83% |
| UHC | Medicaid|STARKIDS | $58.73 | ↓ -83% |
| BCBS | Medicaid|All Plans | $60.46 | ↓ -83% |
| CHC | Medicaid|All Other Plans | $66.22 | ↓ -81% |
| BCBS - TX | Commercial|MyBlue Health Exchange | $72.07 | ↓ -79% |
| Wellpoint | Medicaid|STAR | $77.16 | ↓ -78% |
| TCHP | Medicaid|STAR | $77.16 | ↓ -78% |
| UNITED | Medicaid|STAR | $78.88 | ↓ -77% |
| CHC | Medicaid|STAR | $88.67 | ↓ -75% |
| BCBS-TX | Commercial|Blue Premier | $108.85 | ↓ -69% |
| BCBS-TX | Commercial|HMO | $129.12 | ↓ -63% |
| BCBS-TX | Commercial|PPO | $144.13 | ↓ -59% |
| UNITED | Medicaid|STARPLUS | $179.65 | ↓ -48% |
| UHC | Medicaid|STARPLUS | $179.65 | ↓ -48% |
| OPTUM | Medicare|All Plans | $268.65 | ↓ -23% |
| TCHPCHIP | Medicaid|HMO | $348.25 | ↑ +0% |
| OPTUM | Medicaid|STAR | $360.00 | ↑ +3% |
| United | Commercial|Optum | $467.65 | ↑ +34% |
| Renaissance | Commercial|All Plans | $507.41 | ↑ +46% |
| TEXASTRUECHOICE | Medicaid|CHIP | $547.25 | ↑ +57% |
| CHC | Medicaid|CHIP | $547.25 | ↑ +57% |
| CHC | Medicaid|HMO | $547.25 | ↑ +57% |
| Independent Med System | Commercial|All Plans | $597.00 | ↑ +71% |
| Cigna Lifesource | Commercial|Transplant | $597.00 | ↑ +71% |
| First Health | Commercial|All Plans | $646.75 | ↑ +86% |
| PHCS Savility | Commercial|PPO | $646.75 | ↑ +86% |
| PHCS | Commercial|All Plans | $646.75 | ↑ +86% |
| Humana | Commercial|Transplant | $646.75 | ↑ +86% |
| Coventry | Commercial|PPO | $646.75 | ↑ +86% |
| Aetna | Commercial|PPO | $676.60 | ↑ +94% |
| Interlink | Commercial|Transplant | $696.50 | ↑ +100% |
| Cigna | Commercial|Transplant | $696.50 | ↑ +100% |
| Healthsmart | Commercial|PPO | $696.50 | ↑ +100% |
| HUMANA | Medicare|TRANSPLANT | $704.73 | ↑ +102% |
| BCBS | Medicare|All Plans | $704.73 | ↑ +102% |
| CIGNA HEALTHSPRING | Medicare|HMO | $704.73 | ↑ +102% |
| HUMANA | Medicare|All Other Plans | $704.73 | ↑ +102% |
| KELSEY | Medicare|All Plans | $704.73 | ↑ +102% |
| SELECTCARE | Medicare|All Plans | $704.73 | ↑ +102% |
| CIGNA HEALTHSPRING | Medicare|PPO | $711.78 | ↑ +104% |
| UHC-SecureHorizons | Medicare|All Plans | $718.82 | ↑ +106% |
| AETNA | Medicare|All Plans | $718.82 | ↑ +106% |
| Amerivantage | Medicare|All Plans | $725.87 | ↑ +108% |
| MultiPlan | Commercial|All Plans | $746.25 | ↑ +114% |
| DEVOTED | Medicare|All Plans | $754.06 | ↑ +117% |
| SCANHealth | Medicare|All Plans | $754.06 | ↑ +117% |
| Aetna | Commercial|Transplant | $756.20 | ↑ +117% |
| KINDRED | Medicare|All Plans | $775.20 | ↑ +123% |
| Aetna-Kelsey Care | Commercial|HMO | $807.00 | ↑ +132% |
| OPTUM | Medicaid|STARPLUS | $822.07 | ↑ +136% |
| USA Health Network | Commercial|All Plans | $845.75 | ↑ +143% |
| KelseyCare | Commercial|All Other Plans | $942.30 | ↑ +171% |
| KelseyCare | Commercial|Exchange | $951.39 | ↑ +173% |
| Aetna | Commercial|HMO | $972.00 | ↑ +179% |
| MHealth Network | Commercial|PPO | $995.00 | ↑ +186% |
| Bright Health | Commercial|All Plans | $1,040.66 | ↑ +199% |
| Community Health Choice | Commercial|Exchange | $1,057.10 | ↑ +204% |
| Wellpoint | Commercial|Exchange | $1,057.10 | ↑ +204% |
| Ambetter | Commercial|All Plans | $1,057.10 | ↑ +204% |
| Harris Health | Commercial|ERS | $1,057.10 | ↑ +204% |
| Community Health Choice | Commercial|All Other Plans | $1,057.10 | ↑ +204% |
| Aetna | Commercial|Exchange | $1,085.28 | ↑ +212% |
| United | Commercial|Exchange | $1,676.00 | ↑ +381% |
| Cigna | Commercial|Surefit | $1,864.00 | ↑ +435% |
| Cigna | Commercial|HMO | $2,054.00 | ↑ +490% |
| NX Health | Commercial|PPO | $2,290.37 | ↑ +558% |
| Humana | Commercial|PPO | $2,430.00 | ↑ +598% |
| Humana | Commercial|HMO | $2,430.00 | ↑ +598% |
| United | Commercial|Charter | $2,474.00 | ↑ +610% |
| United | Commercial|PPO | $2,749.00 | ↑ +689% |
| United | Commercial|HMO | $2,749.00 | ↑ +689% |
| Cigna | Commercial|PPO | $5,160.00 | ↑ +1382% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,145.90 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $997.05 | $61.61 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,387.07 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,145.90 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $997.05 | $61.61 – $1,742.94 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $997.05 | $57.58 – $1,742.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,387.07 | $57.58 – $2,080.61 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $1,145.90 | $57.58 – $1,742.94 |