Best Hospitals in San Antonio (2026)
San Antonio is the seventh-largest city in America, but its hospital landscape tells a different story. Unlike Houston or Dallas, no San Antonio hospital currently holds a 4 or 5-star CMS rating. E...
San Antonio is the seventh-largest city in America, but its hospital landscape tells a different story. Unlike Houston or Dallas, no San Antonio hospital currently holds a 4 or 5-star CMS rating. Every rated hospital in the metro earns 3 stars, placing the city solidly in the middle tier of quality.
That doesn't mean all options are equal. This guide digs into the data — CMS ratings, cost-to-charge ratios, and price transparency — to help you find the best care available in San Antonio.
Top 5 Hospitals in San Antonio
| Hospital | CMS Rating | Cost-to-Charge | Priced Procedures |
|---|---|---|---|
| Methodist Hospital | ⭐⭐⭐ | N/A | 229 |
| Baptist Medical Center | ⭐⭐⭐ | 0.07 | 229 |
| CHRISTUS Santa Rosa Hospital - Medical Center | ⭐⭐⭐ | N/A | 140 |
| Foundation Surgical Hospital of San Antonio | ⭐⭐⭐ | 0.15 | 219 |
| CHRISTUS Santa Rosa Hospital - Westover Hills | ⭐⭐⭐ | N/A | 126 |
Understanding the Rankings
CMS Star Ratings
Every rated San Antonio hospital earns exactly 3 stars. This puts the city's hospital quality at the national average. The Methodist system, Baptist Health, and CHRISTUS Santa Rosa all sit at this level. For San Antonians seeking 4 or 5-star care, the nearest options are in Austin or Houston.
Cost-to-Charge Ratio
Baptist Medical Center's cost-to-charge ratio of 0.07 is strikingly low — meaning it charges roughly 14x its actual costs. This is among the highest markup rates we track nationally. Foundation Surgical Hospital at 0.15 offers significantly better value. Most Methodist facilities don't have published cost-to-charge data.
Price Transparency
San Antonio hospitals generally do well on transparency. Methodist Healthcare facilities publish 229 priced procedures each — consistent across the system. Foundation Surgical Hospital publishes 219. CHRISTUS Santa Rosa varies significantly by campus (77 to 140 procedures).
Best Value Hospitals in San Antonio
- Best transparency: Methodist Hospital — 229 priced procedures at 3-star quality
- Best value ratio: Foundation Surgical Hospital — 0.15 cost-to-charge with 219 procedures
- Most priced procedures (tie): Baptist Medical Center and Methodist facilities at 229 each
- Best CHRISTUS option: CHRISTUS Santa Rosa Medical Center — 140 published prices
Price Comparison: Common Procedures in San Antonio
- Lab work (CBC, metabolic panel): $12–$180 depending on facility
- CT scans: $200–$2,800 in the San Antonio metro
- MRI: $250–$3,200+ — freestanding imaging centers are typically 40–60% cheaper
- ER visits: Facility fees from $500 at urgent care to $1,800+ at hospital ERs
Compare real negotiated rates at Taven's price comparison tool.
San Antonio Hospital System Overview
- Methodist Healthcare (HCA) — For-profit system with Methodist Hospital as flagship, plus specialty facilities (Transplant, Texsan, Stone Oak), children's hospital, and multiple freestanding ERs throughout the metro. All rated 3 stars.
- Baptist Health System (Tenet) — Baptist Medical Center as flagship. Known cost-to-charge ratio of 0.07 indicates high markups despite 3-star quality.
- CHRISTUS Santa Rosa — Catholic system with locations at Medical Center, Alamo Heights, Westover Hills, and freestanding emergency centers. Transparency varies by campus.
- University Health — County/teaching hospital system affiliated with UT Health San Antonio. Typically most affordable for uninsured.
- Foundation Surgical Hospital — Specialty surgical center with the best cost-to-charge ratio (0.15) and strong transparency (219 procedures).
San Antonio's Quality Gap
San Antonio's lack of any 4 or 5-star hospital is notable for a city of its size. Houston has 11 five-star facilities; Dallas has one. San Antonio has zero. This represents an opportunity for the city's health systems to improve — and a reason for patients to carefully compare quality metrics before choosing a facility.
Tips for Choosing a Hospital in San Antonio
- All 3-star hospitals aren't equal. Look at cost-to-charge ratios and transparency scores to differentiate within the 3-star tier.
- Foundation Surgical Hospital offers the best value for planned surgical procedures — 0.15 ratio with 219 published prices.
- Watch out for freestanding ERs. San Antonio has many freestanding emergency rooms that charge full ER facility fees. Use urgent care for non-emergencies.
- Compare prices before scheduled procedures. Use Taven's comparison tool with real San Antonio data.
- University Health may be most affordable for uninsured. As the county system, it typically offers the lowest prices and strongest financial assistance.
- Ask about charity care — especially at nonprofit CHRISTUS facilities.
- Get a Good Faith Estimate before any planned procedure.
- Review your bill. Use our free bill review tool — high markups make billing errors especially costly in San Antonio.
How We Rank Hospitals
Our rankings use CMS Overall Hospital Quality Star Ratings, cost-to-charge ratios from CMS cost reports, and price transparency compliance data. We don't accept advertising from hospitals. Learn more about our methodology.