Ortho elbow without jnt cstm w/fit&adj 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.
$318.22 with Oscar vs $2,497.63 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 | $318.22 | — |
| WellMed | MGMCR | $323.09 | — |
| Cigna HealthSpring | MCRHMO | $324.71 | — |
| Cigna HealthSpring | MCRPPO | $324.71 | — |
| Cigna HealthSpring | MCRSNP | $324.71 | — |
| Humana | MedicareAdvantagePPOPFFS | $324.71 | — |
| Renaissance IPA Radiology | COMM | $324.71 | — |
| TriWest Healthcare Alliance | Veterans | $324.71 | — |
| Renaissance IPA Radiology | MCR | $324.71 | — |
| Cigna HealthSpring | PFFS | $324.71 | — |
| Devoted Health | MGMCR | $324.71 | — |
| Humana | MedicareAdvantageHMO | $324.71 | — |
| Amerigroup | DualEligible | $324.71 | — |
| BCBS | MCRPPO | $324.71 | — |
| TriWest Health Alliance | TRCR | $324.71 | — |
| Cigna HealthSpring | MMP | $324.71 | — |
| Kelsey Seybold | MGMCR | $324.71 | — |
| Christus (USFHP) | TRICARE | $324.71 | — |
| CHC Harris Health | Indigent | $324.71 | — |
| BCBS | MedicareAdvantageHMO | $324.71 | — |
| Aetna | MCR | $327.47 | — |
| Van Lang IPA | MCR | $327.96 | — |
| United | MCR | $331.20 | — |
| WellCare | PFFS | $334.45 | — |
| WellCare | PPO | $334.45 | — |
| WellCare | SNP | $334.45 | — |
| WellCare | POS | $334.45 | — |
| WellCare | MCRHMO | $334.45 | — |
| Integranet Amerigroup IPA | MCR | $334.45 | — |
| ProCare Advantage | MGMCR | $340.95 | — |
| Superior Health Plan | PFFS | $340.95 | — |
| Superior Health Plan | MCRSNP | $340.95 | — |
| Superior Health Plan | MCRPPO | $340.95 | — |
| Superior Health Plan | MCRPOS | $340.95 | — |
| Superior Health Plan | MCRHMO | $340.95 | — |
| Superior Health Plan | DualEligible | $340.95 | — |
| American Health Plan | MGMCR | $340.95 | — |
| Shared Health | MGMCR | $340.95 | — |
| Provider Partners Health Plan of Texas | PPO | $344.19 | — |
| Provider Partners Health Plan of Texas | PFFS | $344.19 | — |
| Provider Partners Health Plan of Texas | MCRHMO | $344.19 | — |
| Provider Partners Health Plan of Texas | POS | $344.19 | — |
| Provider Partners Health Plan of Texas | SNP | $344.19 | — |
| Molina | MGMCR | $353.93 | — |
| Universal Healthcare Group | MCR | $389.65 | — |
| Verda Health Plan | MCR | $422.12 | — |
| Superior | ValueHMO | $470.83 | — |
| Community Health Choice | HIX | $470.83 | — |
| Superior | EPO | $503.30 | — |
| Superior | HMO | $503.30 | — |
| Corvel Corporation | WORKERSCOMP | $642.93 | — |
| OMNI Healthcare | WORKERSCOMP | $681.89 | — |
| Molina Healthcare | HIX | $698.13 | — |
| Humana | PPO | $2,497.63 | — |
| Humana | HMO | $2,497.63 | — |
Visitor-reported prices
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Ortho elbow without jnt cstm w/fit&adj at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON TOMBALL | HOUSTON | $496.00 | $318.22 – $698.13 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $318.22 – $698.13 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $278.40 | $57.30 – $417.60 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $278.40 | $55.68 – $371.20 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $278.40 | $89.37 – $417.60 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $278.40 | $143.84 – $417.60 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $278.40 | $92.80 – $417.60 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $278.40 | $55.68 – $371.20 |