Shldr disar prosth tiss shap at HCA HOUSTON MEDICAL CENTER
1313 Hermann Dr, Houston, TX · HCA Houston Healthcare · · NPI 1073043592
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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$4,574.99 with Oscar vs $35,909.43 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Oscar | MGMCR | $4,574.99 | — |
| Devoted Health | MGMCR | $4,668.36 | — |
| Humana | MedicareAdvantageHMO | $4,668.36 | — |
| Humana | MedicareAdvantagePPOPFFS | $4,668.36 | — |
| Cigna HealthSpring | MCRHMO | $4,668.36 | — |
| Cigna HealthSpring | MCRPPO | $4,668.36 | — |
| Cigna HealthSpring | MCRSNP | $4,668.36 | — |
| Cigna HealthSpring | PFFS | $4,668.36 | — |
| Cigna HealthSpring | MMP | $4,668.36 | — |
| TriWest Health Alliance | TRCR | $4,668.36 | — |
| BCBS | MCRPPO | $4,668.36 | — |
| BCBS | MedicareAdvantageHMO | $4,668.36 | — |
| Christus (USFHP) | TRICARE | $4,668.36 | — |
| TriWest Healthcare Alliance | FED | $4,668.36 | — |
| WellMed | MGMCR | $4,691.70 | — |
| Van Lang IPA | MCR | $4,715.04 | — |
| United | MCR | $4,761.73 | — |
| WellCare | SNP | $4,808.41 | — |
| WellCare | PPO | $4,808.41 | — |
| Integranet Amerigroup IPA | MCR | $4,808.41 | — |
| WellCare | PFFS | $4,808.41 | — |
| WellCare | MCRHMO | $4,808.41 | — |
| WellCare | POS | $4,808.41 | — |
| Superior Health Plan | MCRHMO | $4,901.78 | — |
| Superior Health Plan | MCRPOS | $4,901.78 | — |
| Superior Health Plan | MCRPPO | $4,901.78 | — |
| Superior Health Plan | MCRSNP | $4,901.78 | — |
| Superior Health Plan | PFFS | $4,901.78 | — |
| ProCare Advantage | MGMCR | $4,901.78 | — |
| Shared Health | MGMCR | $4,901.78 | — |
| American Health Plan | MGMCR | $4,901.78 | — |
| Superior Health Plan | DualEligible | $4,901.78 | — |
| Provider Partners Health Plan of Texas | SNP | $4,948.46 | — |
| Provider Partners Health Plan of Texas | MCRHMO | $4,948.46 | — |
| Provider Partners Health Plan of Texas | PPO | $4,948.46 | — |
| Provider Partners Health Plan of Texas | POS | $4,948.46 | — |
| Provider Partners Health Plan of Texas | PFFS | $4,948.46 | — |
| Molina | MGMCR | $5,088.51 | — |
| Verda Health Plan | MCR | $6,068.87 | — |
| Superior | ValueHMO | $6,769.12 | — |
| Community Health Choice | HIX | $6,769.12 | — |
| Superior | EPO | $7,235.96 | — |
| Superior | HMO | $7,235.96 | — |
| Molina Healthcare | HIX | $10,036.97 | — |
| Humana | HMO | $35,909.43 | — |
| Humana | PPO | $35,909.43 | — |
Visitor-reported prices
Comments
Shldr disar prosth tiss shap at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON WEST | HOUSTON | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON CONROE | CONROE | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON KINGWOOD | HUMBLE | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON NORTHWEST | SPRING | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON PEARLAND | Pearland | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON SOUTHEAST | PASADENA | not published | $4,574.99 – $10,036.97 |