Screening mammogram prices by hospital in Austin
Sorted by published cash price. “Typical insured rate” is the median of all commercial plan rates each hospital lists for CPT 77067; Medicaid and Medicare Advantage are shown separately below.
| Hospital | Published cash price | Typical insured rate | Lowest insured rate |
|---|---|---|---|
| Ascension Seton Cedar ParkAscension Seton · file Jan 2026 | $92–$444Cash ÷ typical 0.3× | $36515 plans | $99.47 |
| Ascension Seton SmithvilleAscension Seton · file Jan 2026 | $122–$244Cash ÷ typical 0.4× | $34816 plans | $99.47 |
| Ascension Seton HaysAscension Seton · file Jan 2026 | $122–$244Cash ÷ typical 0.4× | $32721 plans | $83.82 |
| Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026 | $135–$174Cash ÷ typical 0.4× | $36515 plans | $99.47 |
| Ascension Seton NorthwestAscension Seton · file Jan 2026 | $135–$193Cash ÷ typical 0.4× | $32721 plans | $83.82 |
| Ascension Seton Medical Center AustinAscension Seton · file Jan 2026 | $135–$193Cash ÷ typical 0.4× | $32723 plans | $83.82 |
| Ascension Seton SouthwestAscension Seton · file Jan 2026 | $135–$193Cash ÷ typical 0.4× | $32721 plans | $83.82 |
| Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026 | $224Cash ÷ typical 0.7× | $33018 plans | $93.68 |
| Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026 | $238Cash ÷ typical 0.9× | $25822 plans | $144 |
| Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026 | $238Cash ÷ typical 0.9× | $25823 plans | $144 |
| Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026 | $238Cash ÷ typical 1.0× | $24826 plans | $95.26 |
| Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026 | $238Cash ÷ typical 1.0× | $24418 plans | $144 |
| Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026 | $238Cash ÷ typical 1.0× | $24418 plans | $144 |
| Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026 | $238Cash ÷ typical 0.9× | $25822 plans | $144 |
| CHRISTUS Santa Rosa Hospital – San MarcosCHRISTUS Health · file Jan 2026 | — | $3779 plans | $189 |
| Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026 | $237–$474Cash ÷ typical 0.6× | $36515 plans | $99.47 |
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Negotiated rates by insurer
If you have a high deductible, you usually pay the rate your insurer negotiated until you meet it. Ranges cover every plan of that insurer in the file; open a hospital to see plan by plan.
| Hospital | Blue Cross Blue Shield | Aetna | Cigna | UnitedHealthcare | Humana | Ambetter | Medicaid / CHIP | Medicare Advantage |
|---|---|---|---|---|---|---|---|---|
| Ascension Seton Cedar Park | $99–$403 | $563–$920 | $327 | — | — | — | — | — |
| Ascension Seton Smithville | $99–$403 | $563–$920 | $327 | — | — | — | — | — |
| Ascension Seton Hays | $99–$403 | $563–$920 | $327 | — | — | $152 | — | $82.98–$88.90 |
| Dell Seton Medical Center at The University of Texas | $99–$403 | $563–$920 | $327 | — | — | — | — | — |
| Ascension Seton Northwest | $99–$403 | $563–$920 | $327 | — | — | $152 | — | $82.98–$88.90 |
| Ascension Seton Medical Center Austin | $99–$403 | $563–$920 | $327 | $84.67 | — | $152 | — | $82.98–$88.90 |
| Ascension Seton Southwest | $99–$403 | $563–$920 | $327 | — | — | $152 | — | $82.98–$88.90 |
| Ascension Seton Edgar B. Davis | $99–$403 | $563–$920 | $327 | — | — | $93.68 | — | $93.68–$94.83 |
| Baylor Scott & White Medical Center – Lakeway | $334–$407 | $218 | $184–$215 | $170 | $258–$278 | — | $79.38–$84.94 | $238 |
| Baylor Scott & White Medical Center – Round Rock | $334–$407 | $218 | $199–$234 | $170 | $258–$278 | — | $79.38–$84.94 | — |
| Baylor Scott & White Medical Center – Taylor | $334–$407 | $218 | $199–$234 | $170 | $258–$278 | — | $95.97 | $75.41–$87.52 |
| Baylor Scott & White Medical Center – Austin | $334–$407 | $218 | $184–$215 | $170 | $258–$278 | — | $75.41–$80.69 | — |
| Baylor Scott & White Medical Center – Buda | $334–$407 | $218 | $184–$215 | $170 | $258–$278 | — | $47.63–$50.96 | — |
| Baylor Scott & White Medical Center – Pflugerville | $334–$407 | $218 | $184–$215 | $170 | $258–$278 | — | $43.66–$46.72 | — |
| CHRISTUS Santa Rosa Hospital – San Marcos | $340–$418 | — | $203–$256 | $471 | $553 | — | — | — |
| Dell Children's Medical Center | $99–$403 | $563–$920 | $327 | — | — | — | — | — |
Ascension Seton Cedar Park: all 18 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Ascension Seton Smithville: all 19 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $148 | OTHER |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Ascension Seton Hays: all 59 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $82.98 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $82.98 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $83.82 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $83.82 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $84.67 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $84.67 | OTHER |
| UTMB | 4677_UTMB PRISONS (HAY) IP 20251001 | Public program | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $84.67 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $84.67 | OTHER |
| UTMB | 4125_UTMB PRISONS (HAY) OP 20250101 | Public program | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $84.67 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $86.36 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $86.36 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $87.21 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $87.21 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $88.90 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $88.90 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $119 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $119 | OTHER |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $148 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $148 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $152 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $152 | OTHER |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Dell Seton Medical Center at The University of Texas: all 18 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Ascension Seton Northwest: all 56 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $82.98 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $82.98 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $83.82 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $83.82 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $84.67 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $84.67 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $86.36 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $86.36 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $87.21 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $87.21 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $88.90 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $88.90 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $119 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $119 | OTHER |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $148 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $148 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $152 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $152 | OTHER |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Ascension Seton Medical Center Austin: all 59 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $82.98 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $82.98 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $83.82 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $83.82 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $84.67 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $84.67 | OTHER |
| UHCPCIP | 4678_UNITED HEALTHCARE PCIP (AUS) IP 20251001 | Commercial | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $84.67 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $84.67 | OTHER |
| UHCPCIP | 4126_UNITED HEALTHCARE PCIP (AUS) OP 20250101 | Commercial | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $84.67 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $86.36 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $86.36 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $87.21 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $87.21 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $88.90 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $88.90 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $119 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $119 | OTHER |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $148 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $148 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $152 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $152 | OTHER |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Ascension Seton Southwest: all 57 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $82.98 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $82.98 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $83.82 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $83.82 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $84.67 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $84.67 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $84.67 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $84.67 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $84.67 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $84.67 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $84.67 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $84.67 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $86.36 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $86.36 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $87.21 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $87.21 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $88.90 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $88.90 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $88.90 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $119 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $119 | OTHER |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $148 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $148 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $152 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $152 | OTHER |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Ascension Seton Edgar B. Davis: all 30 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| AETNA MCR REPLACEMENT | 4277_MEDICARE ADVANTAGE AETNA (EBD) 20250219 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| CONNECTED SENIOR CARE | 4278_MEDICARE ADVANTAGE CONNECTED SENIOR CARE (EBD) 20250219 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| DEVOTED HEALTH MCR REPLACEMENT | 4414_MEDICARE ADVANTAGE DEVOTED HEALTH (EBD) 20250101 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| HUMANA MCR REPLACEMENT | 4280_MEDICARE ADVANTAGE HUMANA (EBD) 20250219 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| PPHP MCR ADVANTAGE | 4281_MEDICARE ADVANTAGE PPHP (EBD) 20250219 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| SENDERO CHAP | 4285_SENDERO CHAP (EBD) 20250219 | Commercial | $93.68 | FEE SCHEDULE |
| SENDERO IDEALCARE | 4286_SENDERO IDEALCARE (EBD) 20250219 | Commercial | $93.68 | FEE SCHEDULE |
| SUPERIOR ALLWELL | 4422_MEDICARE ADVANTAGE SUPERIOR ALLWELL (EBD) 20250101 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 4289_SUPERIOR AMBETTER (EBD) 20250219 | Commercial | $93.68 | FEE SCHEDULE |
| UHC MCR REPLACEMENT | 4282_MEDICARE ADVANTAGE UNITED HEALTHCARE (EBD) 20250219 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| WELMED MEDICARE | 4283_MEDICARE ADVANTAGE WELMED (EBD) 20250219 | Medicare Advantage | $93.68 | FEE SCHEDULE |
| WELLCARE MED ADVANTAGE | 4410_MEDICARE ADVANTAGE WELLCARE (EBD) 20250101 | Medicare Advantage | $94.83 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
Baylor Scott & White Medical Center – Lakeway: all 27 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $79.38 | percent of total billed charges |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $84.94 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $144 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $170 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $170 | per diem |
| Cigna | Local Plus | Commercial | $184 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $215 | percent of total billed charges |
| Aetna | Commercial | Commercial | $218 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $218 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $218 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $230 | percent of total billed charges |
| Aetna | Medicare Advantage | Medicare Advantage | $238 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $238 | percent of total billed charges |
| Curative | Commercial | Commercial | $258 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $258 | percent of total billed charges |
| First Health | PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $278 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $298 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $298 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $298 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $334 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $337 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $338 | fee schedule |
| Three Rivers | Three Rivers Provider Network | Commercial | $357 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $387 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $407 | fee schedule |
Baylor Scott & White Medical Center – Round Rock: all 27 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $79.38 | percent of total billed charges |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $84.94 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $144 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $170 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $170 | per diem |
| Cigna | Local Plus | Commercial | $199 | percent of total billed charges |
| Aetna | Commercial | Commercial | $218 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $218 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $218 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $230 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $234 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $238 | percent of total billed charges |
| Curative | Commercial | Commercial | $258 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $258 | percent of total billed charges |
| First Health | PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $278 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $278 | percent of total billed charges |
| BlueBell Creameries | Self Insured | Commercial | $298 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $298 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $298 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $298 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $334 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $337 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $338 | fee schedule |
| Three Rivers | Three Rivers Provider Network | Commercial | $357 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $387 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $407 | fee schedule |
Baylor Scott & White Medical Center – Taylor: all 39 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $75.41 | percent of total billed charges |
| American Health Plan | Medicare Advantage | Medicare Advantage | $79.38 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $79.38 | percent of total billed charges |
| CORVEL | Worker's Compensation | Workers' comp | $83.15 | percent of total billed charges |
| Prime Health Services | Worker's Compensation | Workers' comp | $83.15 | percent of total billed charges |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $83.35 | percent of total billed charges |
| HealthSpring | Medicare Advantage | Medicare Advantage | $83.35 | percent of total billed charges |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $83.35 | percent of total billed charges |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $87.52 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $95.26 | percent of total billed charges |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $95.97 | percent of total billed charges |
| CareWorks fka Rockport | Worker's Compensation | Workers' comp | $98.59 | percent of total billed charges |
| Injury Management Organization | Med Select Network | Workers' comp | $98.59 | percent of total billed charges |
| Sedgwick | Preferred Network | Workers' comp | $98.59 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $99.62 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $143 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $144 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $170 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $170 | per diem |
| Cigna | Local Plus | Commercial | $199 | percent of total billed charges |
| Aetna | Commercial | Commercial | $218 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $218 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $218 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $230 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $234 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $238 | percent of total billed charges |
| Curative | Commercial | Commercial | $258 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $258 | percent of total billed charges |
| First Health | PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $278 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $298 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $298 | percent of total billed charges |
| BlueBell Creameries | Self Insured | Commercial | $318 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $318 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $334 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $338 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $387 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $407 | fee schedule |
Baylor Scott & White Medical Center – Austin: all 21 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $75.41 | percent of total billed charges |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $80.69 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $144 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $170 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $170 | per diem |
| Cigna | Local Plus | Commercial | $184 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $215 | percent of total billed charges |
| Aetna | Commercial | Commercial | $218 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $218 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $218 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $230 | percent of total billed charges |
| Curative | Commercial | Commercial | $258 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $258 | percent of total billed charges |
| First Health | PPO | Commercial | $278 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $278 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $298 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $298 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $334 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $338 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $387 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $407 | fee schedule |
Baylor Scott & White Medical Center – Buda: all 21 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $47.63 | percent of total billed charges |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $50.96 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $144 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $170 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $170 | per diem |
| Cigna | Local Plus | Commercial | $184 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $215 | percent of total billed charges |
| Aetna | Commercial | Commercial | $218 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $218 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $218 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $230 | percent of total billed charges |
| Curative | Commercial | Commercial | $258 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $258 | percent of total billed charges |
| First Health | PPO | Commercial | $278 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $278 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $298 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $298 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $334 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $338 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $387 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $407 | fee schedule |
Baylor Scott & White Medical Center – Pflugerville: all 26 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $43.66 | percent of total billed charges |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $46.72 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $144 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $170 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $170 | per diem |
| Cigna | Local Plus | Commercial | $184 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $215 | percent of total billed charges |
| Aetna | Commercial | Commercial | $218 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $218 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $218 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $230 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $238 | percent of total billed charges |
| Curative | Commercial | Commercial | $258 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $258 | percent of total billed charges |
| First Health | PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $278 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $278 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $298 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $298 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $298 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $334 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $337 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $338 | fee schedule |
| Three Rivers | Three Rivers Provider Network | Commercial | $357 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $387 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $407 | fee schedule |
CHRISTUS Santa Rosa Hospital – San Marcos: all 9 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Five Point Credit Union | PPO | Commercial | $189 | fee schedule |
| Cigna | New Business | Commercial | $203 | fee schedule |
| Cigna | PPO | Commercial | $256 | fee schedule |
| Blue Cross Blue Shield Of Texas | Blue Advantage HMO | Commercial | $340 | fee schedule |
| Blue Cross Blue Shield Of Texas | HEB | Commercial | $377 | fee schedule |
| Blue Cross Blue Shield Of Texas | HMO | Commercial | $382 | fee schedule |
| Blue Cross Blue Shield Of Texas | PPO | Commercial | $418 | fee schedule |
| United Healthcare | All Payer | Commercial | $471 | fee schedule |
| Humana | Choicecare | Commercial | $553 | fee schedule |
Dell Children's Medical Center: all 18 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $44.79 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $99.47 | FEE SCHEDULE |
| COMMUNITY HEALTH SERVICES | 2281_COMMUNITY HEALTH SERVICES Q32 20220901 | Commercial | $102 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $104 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $133 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $169 | OTHER |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $327 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $327 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $330 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $365 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $403 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $563 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $616 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $736 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $920 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $920 | OTHER |
What this price covers
These are hospital charges for CPT code 77067 (Screening mammogram (both breasts)). A hospital price file covers the hospital's own charges. Doctors who are not hospital employees — for imaging, usually the radiologist who reads the scan — can bill you separately, and extra services on the same day (contrast, an injection, a consultation) have their own codes.
How to ask for a lower price without insurance
- Ask the hospital for a Good Faith Estimate. If you are uninsured or not using insurance, federal law entitles you to a written estimate on request, and automatically when you schedule at least three business days ahead (CMS: No Surprises Act).
- Ask whether the hospital has an uninsured discount or a financial assistance policy, and how to apply.
- Compare with an independent imaging center or lab: they are not covered by the hospital price rule and often quote lower cash prices.