Established Patient Office Visit (level 5) 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.
$54.30 with Superior Health Plan vs $814.50 with Affiliated PPO — 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 | $54.30 | — |
| Superior Health Plan | STARPLUS | $54.30 | — |
| Superior Health Plan | STARKids | $54.30 | — |
| Superior Health Plan | STAR | $54.30 | — |
| Superior Health Plan | CHPFC | $54.30 | — |
| Aetna | MCR | $60.00 | — |
| Community Health Choice MCD | CHIPPerinatal | $117.65 | — |
| Community Health Choice MCD | STAR | $117.65 | — |
| Community Health Choice MCD | CHIP | $117.65 | — |
| Community Health Choice MCD | STAR+PLUS | $117.65 | — |
| Amerigroup | MGMCD | $126.70 | — |
| Amerigroup | MCDCHIPBH | $126.70 | — |
| Texas Childrens Health Plans | CHIP | $150.23 | — |
| United | OptionsPPO | $152.04 | — |
| Superior | HMO | $158.38 | — |
| Superior | EPO | $158.38 | — |
| Superior | ValueHMO | $179.19 | — |
| Texas Childrens Health Plans | STAR | $214.49 | — |
| Texas Childrens Health Plans | STARKIDS | $214.49 | — |
| Texas Workforce Commission | WCOMP | $217.20 | — |
| Healthcare Highways | NarrowNetwork | $230.78 | — |
| Molina Healthcare | HIX | $244.35 | — |
| Evry Health | BroadNetwork | $247.06 | — |
| BCBS | MyBlueHealth | $263.95 | — |
| CHC Harris Health | Indigent | $271.50 | — |
| Aetna | NBHMO | $290.50 | — |
| Aetna | NBPPO | $290.50 | — |
| Aetna | NBPOS | $290.50 | — |
| BCBS | BAV | $291.02 | — |
| Texas Athletic Network | Premier | $300.00 | — |
| Aetna | COMMPPO | $309.51 | — |
| Aetna | COMMPOS | $309.51 | — |
| Aetna | COMMHMO | $309.51 | — |
| Humana | HMO | $315.77 | — |
| Humana | PPO | $315.77 | — |
| Imagine Health | PPO | $316.75 | — |
| BCBS | Traditional | $316.75 | — |
| Christus (USFHP) | TRICARE | $362.00 | — |
| Curative Administrators | COMM | $362.00 | — |
| Aetna | OONHMO | $362.90 | — |
| Aetna | OONPPO | $362.90 | — |
| Aetna | OONPOS | $362.90 | — |
| BCBS | HMO | $364.34 | — |
| HealthSmart Preferred Care | ACCEL | $389.15 | — |
| Aetna | ASAPPO | $391.87 | — |
| Aetna | ASAPOS | $391.87 | — |
| Aetna | ASAHMO | $391.87 | — |
| Averde Health | Commercial | $407.25 | — |
| United | GlobalAppendix | $407.25 | — |
| Fidelis SecureCare of TX | MGMCR | $407.25 | — |
| BCBS | EPOSOA | $409.46 | — |
| BCBS | PPO | $453.46 | — |
| Coventry National First Health | COMM | $482.37 | — |
| Rockport Workers Comp | COMM | $497.75 | — |
| Physicians Cooperative of Texas | WC | $497.75 | — |
| Texas Athletic Network | PremierPlus | $500.00 | — |
| Triumph | COMM | $543.00 | — |
| National Healthcare Solutions | COMM | $543.00 | — |
| SouthWest Medical | WORKERSCOMP | $543.00 | — |
| Independent Medical System | COMM | $543.00 | — |
| Coastal Comp | COMM | $588.25 | — |
| Texas Athletic Network | TexasCustomUC | $600.00 | — |
| Multiplan | PHCSPrimaryNetwork | $678.75 | — |
| Cigna Behavioral Health | COMMBH | $724.00 | — |
| HealthSmart Preferred Care | PPO | $742.10 | — |
| Physicians, INC | COMM | $769.25 | — |
| HealthSmart Preferred Care | ACCOUNTABLEPPO | $769.25 | — |
| Multiplan | ComplementaryNetwork | $769.25 | — |
| Affiliated PPO | COMM | $814.50 | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON MEDICAL CENTER | Houston | $1,971.10 | $263.95 – $315.77 |
| Baylor St Luke's Medical Center | Houston | $174.65 | $82.00 – $499.00 |
| St. Luke's Health - The Vintage Hospital | Houston | $174.65 | $74.00 – $499.00 |
| Adventhealth Rollins Brook | Lampasas | $450.00 | $434.28 – $434.28 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | $884.58 | $263.95 – $315.77 |
| St. Joseph Health Madison Hospital | Madisonville | $113.58 | $30.45 – $224.47 |
| St. Luke's Health Memorial Lufkin | Lufkin | $253.49 | $83.24 – $499.40 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $174.65 | $74.00 – $499.00 |