Endo knee-shin frct swg & st at HCA HOUSTON WEST
12141 RICHMOND AVENUE, HOUSTON, TX · HCA Houston Healthcare · · NPI 1275580938
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.
$722.91 with Oscar vs $5,674.23 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 |
|---|---|---|---|
| Oscar | MGMCR | $722.91 | — |
| WellMed | MGMCR | $733.97 | — |
| Cigna HealthSpring | MCRHMO | $737.66 | — |
| Cigna HealthSpring | MCRPPO | $737.66 | — |
| Cigna HealthSpring | MCRSNP | $737.66 | — |
| Humana | MedicareAdvantagePPOPFFS | $737.66 | — |
| Renaissance IPA Radiology | COMM | $737.66 | — |
| TriWest Healthcare Alliance | Veterans | $737.66 | — |
| Renaissance IPA Radiology | MCR | $737.66 | — |
| Cigna HealthSpring | PFFS | $737.66 | — |
| Devoted Health | MGMCR | $737.66 | — |
| Humana | MedicareAdvantageHMO | $737.66 | — |
| Amerigroup | DualEligible | $737.66 | — |
| BCBS | MCRPPO | $737.66 | — |
| TriWest Health Alliance | TRCR | $737.66 | — |
| Cigna HealthSpring | MMP | $737.66 | — |
| Kelsey Seybold | MGMCR | $737.66 | — |
| Christus (USFHP) | TRICARE | $737.66 | — |
| CHC Harris Health | Indigent | $737.66 | — |
| BCBS | MedicareAdvantageHMO | $737.66 | — |
| Aetna | MCR | $743.93 | — |
| Van Lang IPA | MCR | $745.04 | — |
| United | MCR | $752.41 | — |
| WellCare | PFFS | $759.79 | — |
| WellCare | PPO | $759.79 | — |
| WellCare | SNP | $759.79 | — |
| WellCare | POS | $759.79 | — |
| WellCare | MCRHMO | $759.79 | — |
| Integranet Amerigroup IPA | MCR | $759.79 | — |
| ProCare Advantage | MGMCR | $774.54 | — |
| Superior Health Plan | PFFS | $774.54 | — |
| Superior Health Plan | MCRSNP | $774.54 | — |
| Superior Health Plan | MCRPPO | $774.54 | — |
| Superior Health Plan | MCRPOS | $774.54 | — |
| Superior Health Plan | MCRHMO | $774.54 | — |
| Superior Health Plan | DualEligible | $774.54 | — |
| American Health Plan | MGMCR | $774.54 | — |
| Shared Health | MGMCR | $774.54 | — |
| Provider Partners Health Plan of Texas | PPO | $781.92 | — |
| Provider Partners Health Plan of Texas | PFFS | $781.92 | — |
| Provider Partners Health Plan of Texas | MCRHMO | $781.92 | — |
| Provider Partners Health Plan of Texas | POS | $781.92 | — |
| Provider Partners Health Plan of Texas | SNP | $781.92 | — |
| Molina | MGMCR | $804.05 | — |
| Universal Healthcare Group | MCR | $885.19 | — |
| Verda Health Plan | MCR | $958.96 | — |
| Superior | ValueHMO | $1,069.61 | — |
| Community Health Choice | HIX | $1,069.61 | — |
| Superior | EPO | $1,143.37 | — |
| Superior | HMO | $1,143.37 | — |
| Corvel Corporation | WORKERSCOMP | $1,460.57 | — |
| OMNI Healthcare | WORKERSCOMP | $1,549.09 | — |
| Molina Healthcare | HIX | $1,585.97 | — |
| Humana | PPO | $5,674.23 | — |
| Humana | HMO | $5,674.23 | — |
Visitor-reported prices
Comments
Endo knee-shin frct swg & st at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $722.91 – $1,585.97 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $722.91 – $1,585.97 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | not published | $722.91 – $1,585.97 |
| HCA HOUSTON CONROE | CONROE | not published | $722.91 – $1,585.97 |
| HCA HOUSTON KINGWOOD | HUMBLE | not published | $722.91 – $1,585.97 |
| HCA HOUSTON NORTHWEST | SPRING | not published | $722.91 – $1,585.97 |
| HCA HOUSTON PEARLAND | Pearland | not published | $722.91 – $1,585.97 |
| HCA HOUSTON SOUTHEAST | PASADENA | not published | $722.91 – $1,585.97 |