Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at HCA HOUSTON TOMBALL
5003 CYPRESS CREEK PKWY, HOUSTON, TX · HCA Houston Healthcare · · NPI 1750819025
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.
$13.45 with Superior Health Plan vs $460.02 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 |
|---|---|---|---|
| Superior Health Plan | CHIP | $13.45 | — |
| Superior Health Plan | CHPFC | $13.45 | — |
| Superior Health Plan | STAR | $13.45 | — |
| Superior Health Plan | STARKids | $13.45 | — |
| Superior Health Plan | STARPLUS | $13.45 | — |
| Community Health Choice MCD | STAR | $29.14 | — |
| Community Health Choice MCD | CHIP | $29.14 | — |
| Community Health Choice MCD | CHIPPerinatal | $29.14 | — |
| Community Health Choice MCD | STAR+PLUS | $29.14 | — |
| United | OptionsPPO | $37.66 | — |
| Oscar | MGMCR | $43.22 | — |
| Oscar | HIX | $43.71 | — |
| Humana | MedicareAdvantagePPOPFFS | $44.11 | — |
| BCBS | MedicareAdvantageHMO | $44.11 | — |
| BCBS | MCRPPO | $44.11 | — |
| Cigna HealthSpring | MMP | $44.11 | — |
| Cigna HealthSpring | PFFS | $44.11 | — |
| Cigna HealthSpring | MCRSNP | $44.11 | — |
| Cigna HealthSpring | MCRPPO | $44.11 | — |
| Cigna HealthSpring | MCRHMO | $44.11 | — |
| TriWest Healthcare Alliance | Veterans | $44.11 | — |
| Devoted Health | MGMCR | $44.11 | — |
| Humana | MedicareAdvantageHMO | $44.11 | — |
| CHC Harris Health | Indigent | $44.11 | — |
| WellMed | MGMCR | $44.33 | — |
| Aetna | MCR | $44.48 | — |
| Van Lang IPA | MCR | $44.55 | — |
| United | MCR | $44.99 | — |
| WellCare | PFFS | $45.43 | — |
| Integranet Amerigroup IPA | MCR | $45.43 | — |
| WellCare | PPO | $45.43 | — |
| WellCare | MCRHMO | $45.43 | — |
| WellCare | POS | $45.43 | — |
| WellCare | SNP | $45.43 | — |
| Superior Health Plan | MCRHMO | $46.31 | — |
| American Health Plan | MGMCR | $46.31 | — |
| Superior Health Plan | DualEligible | $46.31 | — |
| Superior Health Plan | MCRPOS | $46.31 | — |
| Superior Health Plan | MCRPPO | $46.31 | — |
| Superior Health Plan | MCRSNP | $46.31 | — |
| Superior Health Plan | PFFS | $46.31 | — |
| ProCare Advantage | MGMCR | $46.31 | — |
| Shared Health | MGMCR | $46.31 | — |
| Provider Partners Health Plan of Texas | POS | $46.75 | — |
| Provider Partners Health Plan of Texas | PPO | $46.75 | — |
| Provider Partners Health Plan of Texas | PFFS | $46.75 | — |
| Provider Partners Health Plan of Texas | MCRHMO | $46.75 | — |
| Provider Partners Health Plan of Texas | SNP | $46.75 | — |
| Molina | MGMCR | $48.08 | — |
| Christus (USFHP) | TRICARE | $50.59 | — |
| TriWest Health Alliance | TRCR | $50.59 | — |
| Verda Health Plan | MCR | $57.34 | — |
| Community Health Choice | HIX | $63.95 | — |
| Superior | ValueHMO | $63.95 | — |
| Superior | HMO | $68.36 | — |
| Superior | EPO | $68.36 | — |
| BCBS | Traditional | $78.46 | — |
| Coventry National First Health | COMM | $81.60 | — |
| Molina Healthcare | HIX | $94.83 | — |
| United | GlobalAppendix | $100.88 | — |
| BCBS | MyBlueHealth | $120.60 | — |
| BCBS | BAV | $132.97 | — |
| BCBS | HMO | $166.47 | — |
| BCBS | EPOSOA | $169.57 | — |
| BCBS | PPO | $172.66 | — |
| Aetna | QHPExchange | $233.78 | — |
| Aetna | NBPPO | $310.55 | — |
| Aetna | NBPOS | $310.55 | — |
| Aetna | NBHMO | $310.55 | — |
| Aetna | COMMHMO | $329.37 | — |
| Aetna | COMMPPO | $329.37 | — |
| Aetna | COMMPOS | $329.37 | — |
| Aetna | OONPPO | $388.32 | — |
| Aetna | OONHMO | $388.32 | — |
| Aetna | OONPOS | $388.32 | — |
| Aetna | ASAPOS | $419.02 | — |
| Aetna | ASAPPO | $419.02 | — |
| Aetna | ASAHMO | $419.02 | — |
| Humana | PPO | $460.02 | — |
| Humana | HMO | $460.02 | — |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Baylor St Luke's Medical Center | Houston | $129.15 | $60.82 – $369.00 |
| St. Luke's Health - The Vintage Hospital | Houston | $129.15 | $75.25 – $369.00 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $43.22 – $233.78 |
| HCA HOUSTON WEST | HOUSTON | not published | $43.22 – $94.83 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $124.35 | $35.23 – $176.16 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $135.00 | $27.79 – $202.50 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $118.67 | $23.73 – $155.65 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $124.35 | $33.16 – $176.16 |