Closed tx/talus fracture without manip 28430 at BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST
100 Hillcrest Medical Blvd., Waco, TX · Baylor Scott & White Health · · NPI 1891882833
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.
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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.
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The hospital's undiscounted list price — almost no one pays this.
$85.00 with Cigna vs $1,132.00 with United Healthcare — 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 |
|---|---|---|---|
| Cigna | Local Plus | $85.00 | — |
| Superior Health Plan | Medicaid | $85.32 | — |
| United Healthcare | Medicaid/CHIP | $91.29 | — |
| Cigna | HMO/PPO | $100.00 | — |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $171.07 | — |
| Blue Cross Blue Shield | Blue Advantage | $173.25 | — |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $198.31 | — |
| Blue Cross Blue Shield | BlueChoice (PPO) | $209.20 | — |
| Baylor Scott & White Health Plan | Medicare Advantage | $235.40 | — |
| CORVEL | Worker's Compensation | $240.36 | — |
| Humana | Medicare | $247.79 | — |
| TriWest | Community Care Network | $247.79 | — |
| Blue Cross Blue Shield | Medicare Advantage | $260.18 | — |
| American Health Plan | Medicare Advantage | $260.18 | — |
| ProCare Advantage | Medicare Advantage | $260.18 | — |
| United Healthcare | Medicare Advantage | $277.52 | — |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $297.35 | — |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $310.98 | — |
| Prime Health Services | Worker's Compensation | $312.46 | — |
| Sedgwick | Preferred Network | $370.45 | — |
| Injury Management Organization | Med Select Network | $370.45 | — |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $408.85 | — |
| Mark Cuban | Commercial | $584.19 | — |
| Humana | Commercial HMO | $856.00 | — |
| United Healthcare | Charter | $1,019.00 | — |
| United Healthcare | Nexus | $1,019.00 | — |
| United Healthcare | Commercial Broad | $1,132.00 | — |
| University of Mary Hardin-Baylor | Commercial | not published by hospital | — |
| Humana Military | TRICARE | not published by hospital | — |
| Imagine Health | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Closed tx/talus fracture without manip 28430 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Providence | Waco | $170.19 | $85.32 – $352.65 |
| Covenant Children's Hospital | Lubbock | $291.90 | $109.34 – $2,444.00 |
| St. Luke's Health - Patients Medical Center | Pasadena | $86.94 | $149.04 – $186.30 |
| St. Joseph Health Madison Hospital | Madisonville | $48.65 | $35.42 – $278.00 |
| St. Joseph Health College Station Hospital | College Station | $48.65 | $136.22 – $278.00 |
| St. Joseph Health Grimes Hospital | Navasota | $48.65 | $100.81 – $308.58 |
| Covenant Medical Center | Lubbock | $291.90 | $111.18 – $261.42 |
| St. Joseph Health Burleson Hospital | Caldwell | $48.65 | $61.16 – $278.00 |