Revasc lithotrip tibi/perone 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.

$3,956.51 with Superior Health Plan vs $56,521.60 with Unicare — 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
Superior Health Plan STARHealth $3,956.51
Superior Health Plan MCDSTAR $3,956.51
Superior Health Plan STARPLUS $3,956.51
Superior Health Plan STARKids $3,956.51
Superior Health Plan CHIP $3,956.51
TEXAS HEALTH NETWORK MCD $4,678.99
Amerigroup MGMCD $4,750.24
Parkland Community Health Plan MCD $4,750.24
Cook Childrens Health Plan STAR $4,750.24
United CHIP $4,750.24
Cook Childrens Health Plan CHIP $4,750.24
United STAR $4,750.24
United STARKids $4,750.24
United STARPLUS $4,750.24
United STARPerinate $4,750.24
Amerigroup CHIP $4,750.24
Cigna Healthspring MGMCD $4,987.75
Aetna Better Health MCD $5,130.26
Aetna Better Health CHIP $5,130.26
Molina MCDSTAR $5,225.26
Molina STARKIDS $5,225.26
Molina CHIP $5,225.26
Molina STAR+PLUS $5,225.26
Humana MGMCD $5,937.80
Optum Health MCD $6,217.38
Cigna IFP $7,630.42
Cigna QHP $7,913.02
Aetna QHPHIX $9,213.02
Curative Administrators COMM $9,875.00
Religious Order of Jehovah Witness LOGOV $11,304.32
Oscar HIX $11,756.49
United OptionsPPO $12,152.14
BCBS BluePremier $13,055.82
Aetna NewBusiness $13,452.14
Unicare CHIP $13,565.18
Healthcare Highways NarrowNetwork $13,847.79
Aetna COMM $14,469.53
Aetna Meritain $14,469.53
Evry Health COMM $14,582.57
Aetna OON $16,956.48
United NarrowNetworkIndivExchange $17,031.00
Humana COMM $17,516.04
United SmallGroup $17,864.00
Cigna LocalPlus $18,151.00
Cigna NewBusiness $18,169.00
Healthcare Highways CityofPlano $19,104.30
Healthcare Highways NTX CityofPlanoEmployeeBenefitPlan $19,782.56
BCBS BlueAdvantageHMO $19,885.02
BCBS MyBlueHealth $19,885.02
Cigna HMO $20,280.00
Cigna OpenAccessPlus $20,280.00
Cigna NetworkBenefit $20,280.00
BCBS BlueEssentials $22,596.62
BCBS BlueEssentialsAccess $22,596.62
Prominence Health Plan HIX $22,608.64
BCBS EPOSOA $23,701.34
BCBS PPO $24,806.06
BCBS Traditional $25,095.59
Fidelis SecureCare MGMCR $25,434.72
City of McKinney COMM $25,434.72
Cigna AllOther $25,655.00
United AllPayerAppendix $25,750.00
Emerging Therapy Solutions MCR $27,695.58
National ChoiceCare WCOMP $28,260.80
Aetna ASA $29,786.88
PC Texas Partners WCOMP $31,086.88
Aetna WCOMP $31,086.88
Cigna Lifesource COMM $31,086.88
Rockport Health Group WORKERSCOMP $31,086.88
Physicians Coop of TX MGMCR $31,086.88
TEXAS INSTRUMENTS EmployeesHealthBenefitPlan $31,652.10
Averde Health, Inc PPO $32,782.53
Aetna Coventry First Health EXCLUSIVE $33,291.22
Aetna Coventry First Health NONEXCLUSIVE $33,291.22
Emerging Therapy Solutions COMM $37,869.47
Multiplan PHCS PrimaryNetwork $39,565.12
Mega Life MGMCRPPO $39,565.12
Coastal Comp Health Networks WCOMP $39,565.12
HealthSmart Preferred Care PPO $40,130.34
LEWISVILLE ISD/DLS CONSULTING COMMPPO $42,391.20
USA Managed Care COMM $45,217.28
USC Health Services COMM $45,217.28
Galaxy Health Network PPO $48,043.36
Optum Health (URN) COMM $50,304.22
National Healthcare Solutions COMM $56,521.60
Independent Medical Systems COMM $56,521.60
Unicare MCD $56,521.60

Visitor-reported prices

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Revasc lithotrip tibi/perone at other Texas hospitals

Hospital City Cash price Negotiated range
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $14,653.34 $4,750.24 – $27,252.71
Texas Health Presbyterian Hospital Dallas Dallas $18,808.65 $4,750.24 – $5,130.26
Methodist Charlton Medical Center Dallas $11,399.50 $4,750.24 – $30,625.42
Methodist Dallas Medical Center Dallas $11,399.50 $4,750.24 – $31,311.35
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $14,653.35 $3,016.15 – $27,252.71
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $13,321.23 $4,750.24 – $27,252.71
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $14,653.34 $4,750.24 – $27,252.71
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $14,653.35 $5,082.76 – $27,252.71

All Texas hospitals for this procedure →