Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm at HCA HOUSTON WEST

12141 RICHMOND AVENUE, HOUSTON, TX · HCA Houston Healthcare · · NPI 1275580938

Source: hospital's published price file ↗ · Published May 14, 2026 · Ingested Sep 10, 2026

not published by hospital

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

not published by hospital

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$119.82 with Superior Health Plan vs $1,797.30 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 →

Payer
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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
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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 $119.82
Superior Health Plan STARKids $119.82
Superior Health Plan STARPLUS $119.82
Superior Health Plan STAR $119.82
Superior Health Plan CHPFC $119.82
Aetna MCR $132.40
United NarrowNetworkIndivExchange $209.78
United SmallGroup $209.78
United AllPayerAppendix $209.78
Community Health Choice MCD CHIPPerinatal $259.61
Community Health Choice MCD STAR+PLUS $259.61
Community Health Choice MCD CHIP $259.61
Community Health Choice MCD STAR $259.61
Amerigroup MGMCD $279.58
Amerigroup MCDCHIPBH $279.58
BCBS MyBlueHealth $325.51
Cigna CSN $329.56
Texas Childrens Health Plans CHIP $331.50
United OptionsPPO $335.50
Superior EPO $349.48
Superior HMO $349.48
Cigna OpenAccessPlus $356.79
BCBS BAV $359.46
Superior ValueHMO $395.41
Cigna PPO $424.88
BCBS HMO $449.32
BCBS EPOSOA $459.31
BCBS PPO $467.30
Texas Childrens Health Plans STAR $473.29
Texas Childrens Health Plans STARKIDS $473.29
Texas Workforce Commission WCOMP $479.28
Molina Healthcare HIX $539.19
CHC Harris Health Indigent $599.10
BCBS Traditional $698.95
Christus (USFHP) TRICARE $798.80
HealthSmart Preferred Care ACCEL $858.71
United GlobalAppendix $898.65
Coventry National First Health COMM $1,064.40
Rockport Workers Comp COMM $1,098.35
Physicians Cooperative of Texas WC $1,098.35
Triumph COMM $1,198.20
Independent Medical System COMM $1,198.20
National Healthcare Solutions COMM $1,198.20
SouthWest Medical WORKERSCOMP $1,198.20
Humana HMO $1,283.63
Humana PPO $1,283.63
Coastal Comp COMM $1,298.05
Multiplan PHCSPrimaryNetwork $1,497.75
Cigna Behavioral Health COMMBH $1,597.60
HealthSmart Preferred Care PPO $1,637.54
HealthSmart Preferred Care ACCOUNTABLEPPO $1,697.45
Multiplan ComplementaryNetwork $1,697.45
Physicians, INC COMM $1,697.45
Affiliated PPO COMM $1,797.30

Visitor-reported prices

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Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm at other Texas hospitals

Hospital City Cash price Negotiated range
HCA HOUSTON MEDICAL CENTER Houston $6,023.00 $136.37 – $1,283.63
HCA HOUSTON TOMBALL HOUSTON not published $136.37 – $1,283.63
HCA HOUSTON CLEAR LAKE FRIENDSWOOD $820.00 $136.37 – $1,283.63
Covenant Children's Hospital Lubbock $17,161.20 $476.62 – $518.02
HCA HOUSTON KINGWOOD HUMBLE $6,031.00 $209.78 – $1,283.63
St. Luke's Health - Patients Medical Center Pasadena $4,325.48 $87.98 – $314.22
St. Joseph Health Madison Hospital Madisonville $2,177.70 $138.75 – $3,321.90
St. Joseph Health College Station Hospital College Station $2,177.70 $138.75 – $5,587.40

All Texas hospitals for this procedure →