Surgical pathology level 4 gross & microscopic examination 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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$38.04 with Superior Health Plan vs $570.60 with Affiliated PPO — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $38.04 | — |
| Superior Health Plan | STARPLUS | $38.04 | — |
| Superior Health Plan | STARKids | $38.04 | — |
| Superior Health Plan | STAR | $38.04 | — |
| Superior Health Plan | CHPFC | $38.04 | — |
| United | AllPayerAppendix | $49.76 | — |
| United | NarrowNetworkIndivExchange | $49.76 | — |
| United | SmallGroup | $49.76 | — |
| Community Health Choice MCD | STAR+PLUS | $82.42 | — |
| Community Health Choice MCD | CHIPPerinatal | $82.42 | — |
| Community Health Choice MCD | STAR | $82.42 | — |
| Community Health Choice MCD | CHIP | $82.42 | — |
| Amerigroup | MCDCHIPBH | $88.76 | — |
| Amerigroup | MGMCD | $88.76 | — |
| BCBS | MyBlueHealth | $99.93 | — |
| Texas Childrens Health Plans | CHIP | $105.24 | — |
| United | OptionsPPO | $106.51 | — |
| BCBS | BAV | $110.32 | — |
| Oscar | HIX | $123.63 | — |
| Aetna | QHPExchange | $130.28 | — |
| BCBS | HMO | $138.02 | — |
| Cigna | CSN | $144.71 | — |
| BCBS | EPOSOA | $147.92 | — |
| Texas Childrens Health Plans | STAR | $150.26 | — |
| Texas Childrens Health Plans | STARKIDS | $150.26 | — |
| Texas Workforce Commission | WCOMP | $152.16 | — |
| Cigna | OpenAccessPlus | $156.74 | — |
| BCBS | PPO | $157.81 | — |
| Healthcare Highways | NarrowNetwork | $161.67 | — |
| Evry Health | BroadNetwork | $173.08 | — |
| Aetna | NBPPO | $173.26 | — |
| Aetna | NBPOS | $173.26 | — |
| Aetna | NBHMO | $173.26 | — |
| Aetna | COMMHMO | $184.07 | — |
| Aetna | COMMPOS | $184.07 | — |
| Aetna | COMMPPO | $184.07 | — |
| Cigna | PPO | $186.48 | — |
| Aetna | OONHMO | $216.24 | — |
| Aetna | OONPOS | $216.24 | — |
| Aetna | OONPPO | $216.24 | — |
| BCBS | Traditional | $221.90 | — |
| Imagine Health | PPO | $221.90 | — |
| Aetna | ASAPOS | $233.81 | — |
| Aetna | ASAPPO | $233.81 | — |
| Aetna | ASAHMO | $233.81 | — |
| Christus (USFHP) | TRICARE | $253.60 | — |
| HealthSmart Preferred Care | ACCEL | $272.62 | — |
| United | GlobalAppendix | $285.30 | — |
| Averde Health | Commercial | $285.30 | — |
| Fidelis SecureCare of TX | MGMCR | $285.30 | — |
| Humana | HMO | $306.42 | — |
| Humana | PPO | $306.42 | — |
| Coventry National First Health | COMM | $337.92 | — |
| Rockport Workers Comp | COMM | $348.70 | — |
| Physicians Cooperative of Texas | WC | $348.70 | — |
| Triumph | COMM | $380.40 | — |
| Independent Medical System | COMM | $380.40 | — |
| National Healthcare Solutions | COMM | $380.40 | — |
| SouthWest Medical | WORKERSCOMP | $380.40 | — |
| Coastal Comp | COMM | $412.10 | — |
| Multiplan | PHCSPrimaryNetwork | $475.50 | — |
| Cigna Behavioral Health | COMMBH | $507.20 | — |
| HealthSmart Preferred Care | PPO | $519.88 | — |
| HealthSmart Preferred Care | ACCOUNTABLEPPO | $538.90 | — |
| Physicians, INC | COMM | $538.90 | — |
| Multiplan | ComplementaryNetwork | $538.90 | — |
| Affiliated PPO | COMM | $570.60 | — |
| Curative Administrators | COMM | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 4 gross & microscopic examination at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Baylor St Luke's Medical Center | Houston | $408.10 | $59.36 – $1,166.00 |
| St. Luke's Health - The Vintage Hospital | Houston | $408.10 | $67.05 – $1,166.00 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $49.76 – $306.42 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $49.76 – $306.42 |
| Adventhealth Rollins Brook | Lampasas | $1,149.92 | $190.46 – $190.46 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $474.00 | $35.00 – $371.42 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $474.00 | $36.00 – $473.26 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $474.00 | $36.00 – $272.36 |