Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr at MEDICAL CITY LEWISVILLE HOSPITAL

1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533

Source: hospital's published price file ↗ · Published Mar 1, 2026 · Ingested Sep 16, 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.

$0.04 with Humana vs $218.68 with Unicare — 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
Humana Tricare $0.04
Cigna LocalPlus $0.18
Cigna NewBusiness $0.18
United SmallGroup $0.20
Cigna HMO $0.20
Cigna OpenAccessPlus $0.20
United AllPayerAppendix $0.20
Cigna NetworkBenefit $0.20
United NarrowNetworkIndivExchange $0.20
Humana COMM $0.21
Cigna AllOther $0.26
BCBS MyBlueHealth $0.41
BCBS BlueAdvantageHMO $0.41
BCBS BluePremier $0.49
BCBS BlueEssentials $0.61
BCBS BlueEssentialsAccess $0.61
BCBS EPOSOA $0.64
BCBS PPO $0.67
Superior Health Plan MCDSTAR $15.31
Superior Health Plan CHIP $15.31
Superior Health Plan STARKids $15.31
Superior Health Plan STARPLUS $15.31
Superior Health Plan STARHealth $15.31
Aetna QHPHIX $29.52
Cigna IFP $29.52
Cigna QHP $30.62
United OptionsPPO $43.52
Aetna NewBusiness $43.52
Aetna COMM $46.58
Aetna Meritain $46.58
Unicare CHIP $52.48
Aetna OON $54.89
Healthcare Highways CityofPlano $73.91
BCBS Traditional $97.09
City of McKinney COMM $98.41
National ChoiceCare WCOMP $109.34
Aetna ASA $115.24
PC Texas Partners WCOMP $120.27
Rockport Health Group WORKERSCOMP $120.27
Physicians Coop of TX MGMCR $120.27
Aetna WCOMP $120.27
Averde Health, Inc PPO $126.83
USC Health Services COMM $131.21
Coastal Comp Health Networks WCOMP $153.08
Jostens WCOMP $153.08
Mega Life MGMCRPPO $153.08
Aetna Coventry First Health COMM $158.98
HealthSmart Preferred Care PPO $164.01
LEWISVILLE ISD/DLS CONSULTING COMMPPO $164.01
USA Managed Care COMM $174.94
Galaxy Health Network PPO $185.88
National Healthcare Solutions COMM $218.68
Independent Medical Systems COMM $218.68
Unicare MCD $218.68

Visitor-reported prices

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Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr at other Texas hospitals

Hospital City Cash price Negotiated range
Adventhealth Rollins Brook Lampasas $50.85 $0.46 – $0.46
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $129.00 $0.02 – $61.62
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $129.00 $0.02 – $65.25
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $129.00 $0.02 – $54.38
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $129.00 $0.02 – $61.62
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $129.00 $0.02 – $65.25
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $129.00 $0.02 – $65.25
BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK Cedar Park $129.00 $0.02 – $65.25

All Texas hospitals for this procedure →