Clsd tx metatarsal fracture w/manip 28475 at BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST
100 Hillcrest Medical Blvd., Waco, TX · Baylor Scott & White Health · · NPI 1891882833
$522.78
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.
$871.30
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.
$71.00 with Blue Cross Blue Shield vs $856.00 with Humana — 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 |
|---|---|---|---|
| Blue Cross Blue Shield | Blue Advantage | $71.00 | ↓ -86% |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $75.00 | ↓ -86% |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $81.00 | ↓ -85% |
| Cigna | Local Plus | $85.00 | ↓ -84% |
| Blue Cross Blue Shield | BlueChoice (PPO) | $85.00 | ↓ -84% |
| Superior Health Plan | Medicaid | $85.32 | ↓ -84% |
| United Healthcare | Medicaid/CHIP | $91.29 | ↓ -83% |
| Cigna | HMO/PPO | $100.00 | ↓ -81% |
| Baylor Scott & White Health Plan | Medicare Advantage | $235.40 | ↓ -55% |
| CORVEL | Worker's Compensation | $240.36 | ↓ -54% |
| TriWest | Community Care Network | $247.79 | ↓ -53% |
| Humana | Medicare | $247.79 | ↓ -53% |
| ProCare Advantage | Medicare Advantage | $260.18 | ↓ -50% |
| Blue Cross Blue Shield | Medicare Advantage | $260.18 | ↓ -50% |
| American Health Plan | Medicare Advantage | $260.18 | ↓ -50% |
| United Healthcare | Medicare Advantage | $277.52 | ↓ -47% |
| Texas Workforce Commission | Workers Compensation | $287.53 | ↓ -45% |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $297.35 | ↓ -43% |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $310.98 | ↓ -41% |
| Prime Health Services | Worker's Compensation | $312.46 | ↓ -40% |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | $316.98 | ↓ -39% |
| Sedgwick | Preferred Network | $370.45 | ↓ -29% |
| Injury Management Organization | Med Select Network | $370.45 | ↓ -29% |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | $372.92 | ↓ -29% |
| United Healthcare | Charter | $386.60 | ↓ -26% |
| United Healthcare | Nexus | $386.60 | ↓ -26% |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $408.85 | ↓ -22% |
| High Plains Health Plans | Commercial | $426.85 | ↓ -18% |
| United Healthcare | Commercial Broad | $429.55 | ↓ -18% |
| QuikTrip | Employee Benefit Plan | $479.21 | ↓ -8% |
| MidCoast | Commercial | $479.21 | ↓ -8% |
| Aetna | Commercial | $479.21 | ↓ -8% |
| University of Mary Hardin-Baylor | Commercial | $505.35 | ↓ -3% |
| Imagine Health | Commercial | $505.35 | ↓ -3% |
| Independent Medical System | Commercial PPO | $522.78 | ↑ +0% |
| Curative | Commercial | $566.35 | ↑ +8% |
| Mark Cuban | Commercial | $584.19 | ↑ +12% |
| Humana | Commercial PPO | $609.91 | ↑ +17% |
| HealthSmart | Accel Network | $609.91 | ↑ +17% |
| First Health | PPO | $609.91 | ↑ +17% |
| Private Health Care System | PHCS Network | $653.48 | ↑ +25% |
| HealthSmart | Preferred Network | $653.48 | ↑ +25% |
| Humana | Commercial HMO | $856.00 | ↑ +64% |
| Humana Military | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx metatarsal fracture w/manip 28475 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Providence | Waco | $111.96 | $85.32 – $352.65 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $580.30 | $85.32 – $725.37 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $522.78 | $71.00 – $784.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $484.06 | $71.00 – $605.07 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $580.30 | $85.32 – $725.37 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $522.78 | $85.00 – $784.17 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $522.78 | $85.32 – $784.17 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $484.06 | $71.00 – $726.08 |