Baylor Scott & White the Heart Hospital Plano
BAYLOR SCOTT & WHITE THE HEART HOSPITAL PLANO in Plano, TX charges 6.1x the Medicare reimbursement rate across 52 analyzed procedures, representing a significant markup above the government benchmark.
Plano, TX 75093 · Acute Care Hospitals · CMS Rating: 5/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
D
High
Avg markup vs Medicare
6.09x
Charge / Medicare rate
Max markup
11.42x
Worst procedure
Procedures analyzed
52
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $43,354 | $21,677 | — | 11.4x |
| CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | 306 | $96,059 | $48,030 | — | 10.6x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $106,355 | $53,177 | — | 10.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $113,973 | $56,987 | — | 9.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $48,184 | $24,092 | — | 9.4x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $52,409 | $26,205 | — | 9.2x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC | 234 | $173,184 | $86,592 | — | 7.7x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $39,655 | $19,827 | — | 7.6x |
| HEART FAILURE AND SHOCK WITH CC | 292 | $33,267 | $16,633 | — | 7.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/ | 321 | $160,060 | $80,030 | — | 7.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $18,087 | $9,043 | — | 7.2x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $98,289 | $49,145 | — | 7x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $150,967 | $75,484 | — | 6.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $65,105 | $32,553 | — | 6.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $142,073 | $71,037 | — | 6.8x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $48,754 | $24,377 | — | 6.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $86,191 | $43,095 | — | 6.4x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | 244 | $74,875 | $37,437 | — | 6.4x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC | 273 | $145,187 | $72,594 | — | 6.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $22,580 | $11,290 | — | 6x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $188,516 | $94,258 | — | 5.9x |
| OTHER HEART ASSIST SYSTEM IMPLANT | 215 | $458,403 | $229,202 | — | 5.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $39,868 | $19,934 | — | 5.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $71,474 | $35,737 | — | 5.9x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | 236 | $136,808 | $68,404 | — | 5.7x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $88,681 | $44,340 | — | 5.7x |
| CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC | 226 | $249,523 | $124,761 | — | 5.6x |
| OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC | 229 | $119,723 | $59,861 | — | 5.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $40,945 | $20,473 | — | 5.5x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $33,166 | $16,583 | — | 5.4x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | 274 | $119,282 | $59,641 | — | 5.3x |
| AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | 269 | $143,538 | $71,769 | — | 5.2x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 220 | $169,375 | $84,687 | — | 5.2x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $40,906 | $20,453 | — | 5.2x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC | 235 | $172,122 | $86,061 | — | 5x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | 267 | $171,347 | $85,673 | — | 5x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $117,524 | $58,762 | — | 5x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WIT | 216 | $331,185 | $165,593 | — | 4.8x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | 271 | $109,708 | $54,854 | — | 4.8x |
| CAROTID ARTERY STENT PROCEDURES WITH CC | 035 | $65,478 | $32,739 | — | 4.8x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | 266 | $217,742 | $108,871 | — | 4.8x |
| HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC | 001 | $896,806 | $448,403 | — | 4.8x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $61,696 | $30,848 | — | 4.7x |
| ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC | 003 | $633,805 | $316,903 | — | 4.7x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | 233 | $215,794 | $107,897 | — | 4.6x |
| CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC | 036 | $53,047 | $26,524 | — | 4.5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $53,028 | $26,514 | — | 4.5x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | 270 | $184,768 | $92,384 | — | 4.3x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $74,413 | $37,207 | — | 4.3x |
| MAJOR CHEST PROCEDURES WITH MCC | 163 | $128,376 | $64,188 | — | 4.2x |
Showing 50 of 52 procedures
How BAYLOR SCOTT & WHITE THE HEART HOSPITAL PLANO compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use