Observation direct referral from physician office for admission 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.
$92.26 with Amerigroup vs $600.00 with Texas Athletic Network — 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 |
|---|---|---|---|
| Amerigroup | MCDCHIPBH | $92.26 | — |
| Texas Childrens Health Plans | CHIP | $109.39 | — |
| United | OptionsPPO | $110.71 | — |
| Texas Childrens Health Plans | STARKIDS | $156.18 | — |
| Texas Childrens Health Plans | STAR | $156.18 | — |
| Texas Workforce Commission | WCOMP | $158.16 | — |
| BCBS | Traditional | $230.65 | — |
| Christus (USFHP) | TRICARE | $263.60 | — |
| HealthSmart Preferred Care | ACCEL | $283.37 | — |
| United | GlobalAppendix | $296.55 | — |
| BCBS | MyBlueHealth | $297.69 | — |
| Texas Athletic Network | Premier | $300.00 | — |
| BCBS | BAV | $328.23 | — |
| Coventry National First Health | COMM | $351.25 | — |
| Rockport Workers Comp | COMM | $362.45 | — |
| Physicians Cooperative of Texas | WC | $362.45 | — |
| Triumph | COMM | $395.40 | — |
| Independent Medical System | COMM | $395.40 | — |
| National Healthcare Solutions | COMM | $395.40 | — |
| SouthWest Medical | WORKERSCOMP | $395.40 | — |
| BCBS | HMO | $410.92 | — |
| Coastal Comp | COMM | $428.35 | — |
| BCBS | EPOSOA | $461.81 | — |
| Multiplan | PHCSPrimaryNetwork | $494.25 | — |
| Texas Athletic Network | PremierPlus | $500.00 | — |
| BCBS | PPO | $511.42 | — |
| Cigna Behavioral Health | COMMBH | $527.20 | — |
| HealthSmart Preferred Care | PPO | $540.38 | — |
| HealthSmart Preferred Care | ACCOUNTABLEPPO | $560.15 | — |
| Physicians, INC | COMM | $560.15 | — |
| Multiplan | ComplementaryNetwork | $560.15 | — |
| Affiliated PPO | COMM | $593.10 | — |
| Texas Athletic Network | TexasCustomUC | $600.00 | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Baylor St Luke's Medical Center | Houston | $545.65 | $90.90 – $1,559.00 |
| St. Luke's Health - The Vintage Hospital | Houston | $545.65 | $90.00 – $1,559.00 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $297.69 – $297.69 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $297.69 – $297.69 |
| Adventhealth Rollins Brook | Lampasas | $162.54 | $489.80 – $489.80 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $554.33 | $157.06 – $1,591.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $527.99 | $71.00 – $1,591.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $602.45 | $71.00 – $1,591.17 |