Mastectomy form at MEDICAL CITY DALLAS HOSPITAL

7777 Forest Lane, Dallas, TX · Medicalcityhealthcare · · NPI 1689628984

Source: hospital's published price file ↗ · Published Mar 1, 2026 · Ingested Sep 16, 2026

not published by hospital

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

not published by hospital

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$269.80 with Humana vs $1,571.45 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 →

Payer
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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
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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
Humana Tricare $269.80
BCBS MCRPPO $272.69
BCBS MGMCRHMO $272.69
WellMed MGMCR $276.75
Devoted Health MCR $278.14
Devoted Health MME $278.14
Triwest Veterans FEDERAL $278.14
Devoted Health SNP $278.14
Devoted Health PPO $278.14
Humana MGMCR $278.14
Devoted Health POS $278.14
Amerigroup DualEligible $278.14
Mutual of Omaha MGMCR $278.14
TriWest Health Alliance TRCR $278.14
Devoted Health HMO $278.14
United MGMCR $279.53
Aetna MCR $280.50
Care N Care MGMCR $280.92
Cigna Healthspring MGMCR $283.70
WellCare MGMCR $286.48
Integranet MGMCR $286.48
Superior Health Plan MGMCRPPO $292.05
Superior Health Plan MGMCRPFFS $292.05
Superior Health Plan MGMCRDualEligible $292.05
Superior Health Plan MGMCRPOS $292.05
Superior Health Plan MGMCRSNP $292.05
ProCare Advantge MCR $292.05
American Health Plan of Texas, Inc. MGMCR $292.05
Superior Health Plan MGMCRHMO $292.05
Texas Independent Health Plan MGMCR $294.83
Provider Partners Health Plan MCR $294.83
Molina MME $303.17
Molina MMP $303.17
Molina MCR $303.17
Imperial Insurance Company MCR $305.95
Universal Healthcare Group MCR $333.77
Verda Health Plan MGMCR $361.58
Bravo Health MCRPPO $417.21
Bravo Health MCRPFFS $417.21
Bravo Health MCRSNP $417.21
Bravo Health MCRHMO $417.21
Bravo Health MCRPOS $417.21
Superior ValueHMO $497.87
USA Managed Care WORKERSCOMP $528.47
Corvel Corporation WORKERSCOMP $550.72
Superior EPO $623.03
Superior HMO $623.03
Molina Healthcare HIX $728.73
Humana COMM $1,571.45

Visitor-reported prices

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Mastectomy form at other Texas hospitals

Hospital City Cash price Negotiated range
MEDICAL CITY GREEN OAKS HOSPITAL DALLAS not published $278.14 – $728.73
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $224.40 $4.99 – $36.39
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $224.40 $4.85 – $32.34
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $224.40 $7.79 – $36.39
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $224.40 $12.53 – $36.39
BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK Cedar Park $224.40 $8.09 – $36.39
BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST Waco $224.40 $4.85 – $32.34
BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER Temple $224.40 $6.06 – $36.39

All Texas hospitals for this procedure →