Aco annual medicare visit (awv), initial g0438aco at MEDICAL CITY FRISCO HOSPITAL
5500 Frisco Square Blvd, Frisco, TX · Medicalcityhealthcare · · NPI 1699726406
not published by hospital
Cash price 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.
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What you pay up front if you don't use insurance.
not published by hospital
Gross charge 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.
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The hospital's undiscounted list price — almost no one pays this.
$128.78 with Humana vs $1,209.33 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 →
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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 ?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 ?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 | $128.78 | — |
| TriWest Health Alliance | TRCR | $132.76 | — |
| BCBS | MCRPPO | $156.18 | — |
| BCBS | MGMCRHMO | $156.18 | — |
| WellMed | MGMCR | $168.78 | — |
| Devoted Health | MME | $169.63 | — |
| Humana | MGMCR | $169.63 | — |
| Triwest Veterans | FED | $169.63 | — |
| Devoted Health | SNP | $169.63 | — |
| Devoted Health | HMO | $169.63 | — |
| Devoted Health | POS | $169.63 | — |
| Devoted Health | MCR | $169.63 | — |
| Amerigroup | DualEligible | $169.63 | — |
| Mutual of Omaha | MGMCR | $169.63 | — |
| TriWest Veterans | FEDERAL | $169.63 | — |
| Devoted Health | PPO | $169.63 | — |
| United | MGMCR | $170.48 | — |
| Aetna | MCR | $171.07 | — |
| Care N Care | MGMCR | $171.33 | — |
| Cigna Healthspring | MGMCR | $173.02 | — |
| Integranet | MGMCR | $174.72 | — |
| WellCare | MGMCR | $174.72 | — |
| Superior Health Plan | MGMCRPOS | $178.11 | — |
| Superior Health Plan | MGMCRSNP | $178.11 | — |
| American Health Plan of Texas, Inc. | MGMCR | $178.11 | — |
| ProCare Advantge | MCR | $178.11 | — |
| Superior Health Plan | MGMCRHMO | $178.11 | — |
| Superior Health Plan | MGMCRPPO | $178.11 | — |
| Superior Health Plan | MGMCRDualEligible | $178.11 | — |
| Superior Health Plan | MGMCRPFFS | $178.11 | — |
| Texas Independent Health Plan | MGMCR | $179.81 | — |
| Provider Partners Health Plan | MCR | $179.81 | — |
| Molina | MMP | $184.90 | — |
| Molina | MCR | $184.90 | — |
| Molina | MME | $184.90 | — |
| Imperial Insurance Company | MCR | $186.59 | — |
| Universal Healthcare Group | MCR | $203.56 | — |
| Verda Health Plan | MGMCR | $220.52 | — |
| Bravo Health | MCRHMO | $254.44 | — |
| Bravo Health | MCRPPO | $254.44 | — |
| Bravo Health | MCRPFFS | $254.44 | — |
| Bravo Health | MCRSNP | $254.44 | — |
| Bravo Health | MCRPOS | $254.44 | — |
| Superior | ValueHMO | $303.64 | — |
| USA Managed Care | WORKERSCOMP | $322.30 | — |
| Corvel Corporation | WORKERSCOMP | $335.87 | — |
| Superior | EPO | $379.97 | — |
| Superior | HMO | $379.97 | — |
| Molina Healthcare | HIX | $444.43 | — |
| Humana | COMM | $1,209.33 | — |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), initial g0438aco at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. Joseph Health Madison Hospital | Madisonville | $41.30 | $30.07 – $236.00 |
| St. Joseph Health College Station Hospital | College Station | $41.30 | $77.00 – $507.58 |
| St. Joseph Health Grimes Hospital | Navasota | $41.30 | $77.00 – $261.96 |
| St. Joseph Health Burleson Hospital | Caldwell | $41.30 | $51.92 – $236.00 |
| Covenant Hospital Plainview | Plainview | $141.12 | $167.87 – $182.58 |
| Covenant Hospital Levelland | Levelland | $141.12 | $167.87 – $182.58 |
| MEDICAL CITY NORTH HILLS HOSPITAL | North Richland Hills | $152.00 | $132.51 – $453.94 |
| CHRISTUS Children's Hospital | San Antonio | not published | $452.33 – $452.33 |