Biopsy of lip 40490 at Houston Methodist Hospital
6565 Fannin, Houston, TX · Houstonmethodist · · NPI 1548387418
$2,398.50
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.
$4,797.00
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.
$116.98 with Bcbs vs $7,542.00 with Aetna — 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 |
|---|---|---|---|
| Bcbs | All Commercial Plans | $116.98 | ↓ -95% |
| Cigna | Local Plus/Surefit Hmo/Ppo | $211.00 | ↓ -91% |
| Cigna | Network C-24 Hmo/Ppo | $211.00 | ↓ -91% |
| Cigna | Pcp Optional/Pcp Required Benefit Plans Hmo | $222.00 | ↓ -91% |
| Bcbs | Medicare Managed Care - Hmo | $237.93 | ↓ -90% |
| Aetna | Medicare Managed Care - Hmo/Ppo | $241.50 | ↓ -90% |
| Unitedhealthcare | Medicare Managed Care - Hmo | $242.69 | ↓ -90% |
| Cigna | Texas Healthspring Medicare Managed Care - Hmo/Ppo | $245.07 | ↓ -90% |
| Molina Healthcare | Advantage Medicare Managed Care Plan | $249.83 | ↓ -90% |
| Community Health Choice | D-Snp Medicare Managed Care - Hmo | $254.58 | ↓ -89% |
| Procare Advantage | Medicare Managed Care - Hmo | $261.72 | ↓ -89% |
| Community Health Choice | Silver & Gold Exchange | $387.82 | ↓ -84% |
| Optum Health | Transplant Medicare Managed Care Plan | $463.96 | ↓ -81% |
| Molina Healthcare | Exchange | $513.93 | ↓ -79% |
| Uae | All Commercial Plans | $951.72 | ↓ -60% |
| Entrust | All Commercial Plans | $2,956.00 | ↑ +23% |
| Unitedhealthcare | All Commercial Plans | $4,582.00 | ↑ +91% |
| Aetna | New Business Discount Other Commercial Plan | $7,316.00 | ↑ +205% |
| Aetna | Hmo/Pos/Ppo | $7,542.00 | ↑ +214% |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $68.92 – $578.47 |
| HCA HOUSTON WEST | HOUSTON | not published | $62.95 – $578.47 |
| HCA HOUSTON TOMBALL | HOUSTON | not published | $64.23 – $578.47 |
| Houston Methodist Willowbrook Hospital | Houston | not published | $116.98 – $2,956.00 |
| Houston Methodist West Hospital | Houston | not published | $116.98 – $2,956.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $594.71 | $68.73 – $892.07 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $579.03 | $64.23 – $723.79 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $594.71 | $68.73 – $892.07 |