X-ray mandible ltd <4 views 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.

$38.31 with Texas Health Network vs $1,647.90 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
Texas Health Network MCD $38.31
Community Health Choice MCD CHIPPerinatal $38.76
Community Health Choice MCD CHIP $38.76
Community Health Choice MCD STAR+PLUS $38.76
Community Health Choice MCD STAR $38.76
Amerigroup MCDCHIPBH $39.09
Amerigroup MGMCD $39.09
Texas Childrens Health Plans STARKIDS $39.09
Texas Childrens Health Plans STAR $39.09
United MGMCD $39.54
Aetna Better Health MGMCD $41.86
Molina Healthcare STARKIDS $43.00
Molina Healthcare CHIP $43.00
Molina Healthcare STAR $43.00
Molina Healthcare STARPLUS $43.00
Humana MCD $48.86
Cigna CSN $108.99
Superior Health Plan STARPLUS $109.86
Superior Health Plan CHIP $109.86
Superior Health Plan CHPFC $109.86
Superior Health Plan STAR $109.86
Superior Health Plan STARKids $109.86
Cigna OpenAccessPlus $117.95
Cigna PPO $140.21
BCBS MyBlueHealth $140.47
BCBS BAV $151.64
United NarrowNetworkIndivExchange $153.71
Aetna QHPExchange $177.00
United SmallGroup $182.03
United AllPayerAppendix $182.03
Aetna NBPOS $235.25
Aetna NBHMO $235.25
Aetna NBPPO $235.25
Aetna COMMPPO $250.25
Aetna COMMHMO $250.25
Aetna COMMPOS $250.25
BCBS HMO $271.35
BCBS EPOSOA $281.73
BCBS PPO $291.31
Aetna OONHMO $294.25
Aetna OONPOS $294.25
Aetna OONPPO $294.25
Texas Childrens Health Plans CHIP $303.95
United OptionsPPO $307.61
Aetna ASAHMO $318.00
Aetna ASAPOS $318.00
Aetna ASAPPO $318.00
Humana HMO $415.29
Humana PPO $415.29
Texas Workforce Commission WCOMP $439.44
Healthcare Highways NarrowNetwork $466.90
Evry Health BroadNetwork $499.86
Imagine Health PPO $640.85
BCBS Traditional $640.85
Christus (USFHP) TRICARE $732.40
Curative Administrators COMM $732.40
HealthSmart Preferred Care ACCEL $787.33
Averde Health Commercial $823.95
United GlobalAppendix $823.95
Fidelis SecureCare of TX MGMCR $823.95
Coventry National First Health COMM $975.92
Rockport Workers Comp COMM $1,007.05
Physicians Cooperative of Texas WC $1,007.05
SouthWest Medical WORKERSCOMP $1,098.60
Triumph COMM $1,098.60
National Healthcare Solutions COMM $1,098.60
Independent Medical System COMM $1,098.60
Coastal Comp COMM $1,190.15
Multiplan PHCSPrimaryNetwork $1,373.25
Cigna Behavioral Health COMMBH $1,464.80
HealthSmart Preferred Care PPO $1,501.42
Multiplan ComplementaryNetwork $1,556.35
Physicians, INC COMM $1,556.35
HealthSmart Preferred Care ACCOUNTABLEPPO $1,556.35
Affiliated PPO COMM $1,647.90

Visitor-reported prices

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X-ray mandible ltd <4 views at other Texas hospitals

Hospital City Cash price Negotiated range
Baylor St Luke's Medical Center Houston $455.35 $38.76 – $1,301.00
St. Luke's Health - The Vintage Hospital Houston $455.35 $38.76 – $1,301.00
HCA HOUSTON MEDICAL CENTER Houston not published $38.76 – $177.00
HCA HOUSTON TOMBALL HOUSTON not published $38.76 – $177.00
Adventhealth Rollins Brook Lampasas $426.98 $307.27 – $307.27
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $121.12 $39.09 – $225.11
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $261.13 $53.75 – $391.70
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $303.05 $39.09 – $378.81

All Texas hospitals for this procedure →