Ot evaluation high complexity patient/family 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.
$86.87 with Oscar vs $1,922.40 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 |
|---|---|---|---|
| Oscar | MGMCR | $86.87 | — |
| WellMed | MGMCR | $88.20 | — |
| TriWest Healthcare Alliance | Veterans | $88.64 | — |
| Amerigroup | DualEligible | $88.64 | — |
| Humana | MedicareAdvantageHMO | $88.64 | — |
| Humana | MedicareAdvantagePPOPFFS | $88.64 | — |
| Cigna HealthSpring | MCRHMO | $88.64 | — |
| CHC Harris Health | Indigent | $88.64 | — |
| Renaissance IPA Radiology | MCR | $88.64 | — |
| BCBS | MedicareAdvantageHMO | $88.64 | — |
| BCBS | MCRPPO | $88.64 | — |
| Cigna HealthSpring | MMP | $88.64 | — |
| Devoted Health | MGMCR | $88.64 | — |
| Renaissance IPA Radiology | COMM | $88.64 | — |
| Cigna HealthSpring | PFFS | $88.64 | — |
| Cigna HealthSpring | MCRSNP | $88.64 | — |
| Kelsey Seybold | MGMCR | $88.64 | — |
| Cigna HealthSpring | MCRPPO | $88.64 | — |
| Aetna | MCR | $89.40 | — |
| Van Lang IPA | MCR | $89.53 | — |
| United | MCR | $90.41 | — |
| Integranet Amerigroup IPA | MCR | $91.30 | — |
| WellCare | POS | $91.30 | — |
| WellCare | PPO | $91.30 | — |
| WellCare | PFFS | $91.30 | — |
| WellCare | MCRHMO | $91.30 | — |
| WellCare | SNP | $91.30 | — |
| American Health Plan | MGMCR | $93.07 | — |
| Superior Health Plan | MCRPOS | $93.07 | — |
| Shared Health | MGMCR | $93.07 | — |
| Superior Health Plan | MCRPPO | $93.07 | — |
| Superior Health Plan | MCRSNP | $93.07 | — |
| ProCare Advantage | MGMCR | $93.07 | — |
| Superior Health Plan | DualEligible | $93.07 | — |
| Superior Health Plan | MCRHMO | $93.07 | — |
| Superior Health Plan | PFFS | $93.07 | — |
| Provider Partners Health Plan of Texas | MCRHMO | $93.96 | — |
| Provider Partners Health Plan of Texas | SNP | $93.96 | — |
| Provider Partners Health Plan of Texas | PFFS | $93.96 | — |
| Provider Partners Health Plan of Texas | PPO | $93.96 | — |
| Provider Partners Health Plan of Texas | POS | $93.96 | — |
| Molina | MGMCR | $96.62 | — |
| Christus (USFHP) | TRICARE | $100.74 | — |
| TriWest Health Alliance | TRCR | $100.74 | — |
| Universal Healthcare Group | MCR | $106.37 | — |
| Verda Health Plan | MCR | $115.23 | — |
| Superior Health Plan | STARKids | $128.16 | — |
| Superior Health Plan | CHIP | $128.16 | — |
| Superior Health Plan | CHPFC | $128.16 | — |
| Superior Health Plan | STAR | $128.16 | — |
| Superior Health Plan | STARPLUS | $128.16 | — |
| Superior | ValueHMO | $128.53 | — |
| Community Health Choice | HIX | $128.53 | — |
| Superior | HMO | $137.40 | — |
| Superior | EPO | $137.40 | — |
| Corvel Corporation | WORKERSCOMP | $175.51 | — |
| OMNI Healthcare | WORKERSCOMP | $186.15 | — |
| Molina Healthcare | HIX | $190.58 | — |
| BCBS | MyBlueHealth | $217.57 | — |
| BCBS | BAV | $239.89 | — |
| Community Health Choice MCD | CHIP | $277.68 | — |
| Community Health Choice MCD | CHIPPerinatal | $277.68 | — |
| Community Health Choice MCD | STAR | $277.68 | — |
| Community Health Choice MCD | STAR+PLUS | $277.68 | — |
| Amerigroup | MGMCD | $299.04 | — |
| Amerigroup | MCDCHIPBH | $299.04 | — |
| Texas Athletic Network | Premier | $300.00 | — |
| Aetna | QHPExchange | $300.10 | — |
| BCBS | HMO | $300.33 | — |
| BCBS | EPOSOA | $337.52 | — |
| Texas Childrens Health Plans | CHIP | $354.58 | — |
| United | OptionsPPO | $358.85 | — |
| BCBS | PPO | $373.78 | — |
| Aetna | NBPPO | $398.65 | — |
| Aetna | NBHMO | $398.65 | — |
| Aetna | NBPOS | $398.65 | — |
| Oscar | HIX | $416.52 | — |
| Aetna | COMMPPO | $422.81 | — |
| Aetna | COMMHMO | $422.81 | — |
| Aetna | COMMPOS | $422.81 | — |
| Aetna | OONPOS | $498.47 | — |
| Aetna | OONHMO | $498.47 | — |
| Aetna | OONPPO | $498.47 | — |
| Texas Athletic Network | PremierPlus | $500.00 | — |
| Texas Childrens Health Plans | STAR | $506.23 | — |
| Texas Childrens Health Plans | STARKIDS | $506.23 | — |
| Texas Workforce Commission | WCOMP | $512.64 | — |
| Aetna | ASAPOS | $537.89 | — |
| Aetna | ASAHMO | $537.89 | — |
| Aetna | ASAPPO | $537.89 | — |
| Texas Athletic Network | TexasCustomUC | $600.00 | — |
| BCBS | Traditional | $747.60 | — |
| Humana | HMO | $868.91 | — |
| Humana | PPO | $868.91 | — |
| HealthSmart Preferred Care | ACCEL | $918.48 | — |
| United | GlobalAppendix | $961.20 | — |
| Fidelis SecureCare of TX | MGMCR | $961.20 | — |
| Coventry National First Health | COMM | $1,138.49 | — |
| Physicians Cooperative of Texas | WC | $1,174.80 | — |
| Rockport Workers Comp | COMM | $1,174.80 | — |
| Triumph | COMM | $1,281.60 | — |
| National Healthcare Solutions | COMM | $1,281.60 | — |
| SouthWest Medical | WORKERSCOMP | $1,281.60 | — |
| Independent Medical System | COMM | $1,281.60 | — |
| Coastal Comp | COMM | $1,388.40 | — |
| Multiplan | PHCSPrimaryNetwork | $1,602.00 | — |
| Cigna Behavioral Health | COMMBH | $1,708.80 | — |
| HealthSmart Preferred Care | PPO | $1,751.52 | — |
| Physicians, INC | COMM | $1,815.60 | — |
| HealthSmart Preferred Care | ACCOUNTABLEPPO | $1,815.60 | — |
| Multiplan | ComplementaryNetwork | $1,815.60 | — |
| Affiliated PPO | COMM | $1,922.40 | — |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON MEDICAL CENTER | Houston | $1,543.45 | $86.87 – $300.10 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $86.87 – $190.58 |
| Adventhealth Rollins Brook | Lampasas | $333.87 | $357.97 – $357.97 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $374.12 | $106.00 – $530.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $419.98 | $86.45 – $629.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $405.44 | $81.09 – $506.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $374.12 | $99.76 – $530.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $419.98 | $108.00 – $629.97 |