Allograft 160mg placental salera mini membrane 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

$516.00

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.

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What you pay up front if you don't use insurance.

$516.00

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.

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The hospital's undiscounted list price — almost no one pays this.

$36.12 with Superior Health Plan vs $516.00 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
Superior Health Plan CHIP $36.12 ↓ -93%
Superior Health Plan STARHealth $36.12 ↓ -93%
Superior Health Plan MCDSTAR $36.12 ↓ -93%
Superior Health Plan STARPLUS $36.12 ↓ -93%
Superior Health Plan STARKids $36.12 ↓ -93%
Cigna IFP $69.66 ↓ -87%
Aetna QHPHIX $69.66 ↓ -87%
Cigna QHP $72.24 ↓ -86%
United OptionsPPO $102.68 ↓ -80%
Aetna NewBusiness $102.68 ↓ -80%
Cigna LocalPlus $103.17 ↓ -80%
Cigna NewBusiness $103.27 ↓ -80%
Aetna COMM $109.91 ↓ -79%
Aetna Meritain $109.91 ↓ -79%
Cigna NetworkBenefit $115.26 ↓ -78%
Cigna HMO $115.26 ↓ -78%
Cigna OpenAccessPlus $115.26 ↓ -78%
Unicare CHIP $123.84 ↓ -76%
BCBS BlueAdvantageHMO $127.45 ↓ -75%
BCBS MyBlueHealth $127.45 ↓ -75%
Aetna OON $129.52 ↓ -75%
Cigna AllOther $145.81 ↓ -72%
BCBS BluePremier $150.67 ↓ -71%
BCBS BlueEssentialsAccess $164.60 ↓ -68%
BCBS BlueEssentials $164.60 ↓ -68%
BCBS EPOSOA $172.86 ↓ -67%
Healthcare Highways CityofPlano $174.41 ↓ -66%
BCBS PPO $180.60 ↓ -65%
BCBS Traditional $229.10 ↓ -56%
City of McKinney COMM $232.20 ↓ -55%
National ChoiceCare WCOMP $258.00 ↓ -50%
Aetna ASA $271.93 ↓ -47%
Physicians Coop of TX MGMCR $283.80 ↓ -45%
Aetna WCOMP $283.80 ↓ -45%
Rockport Health Group WORKERSCOMP $283.80 ↓ -45%
PC Texas Partners WCOMP $283.80 ↓ -45%
Averde Health, Inc PPO $299.28 ↓ -42%
USC Health Services COMM $309.60 ↓ -40%
Jostens WCOMP $361.20 ↓ -30%
Coastal Comp Health Networks WCOMP $361.20 ↓ -30%
Mega Life MGMCRPPO $361.20 ↓ -30%
Aetna Coventry First Health COMM $375.13 ↓ -27%
LEWISVILLE ISD/DLS CONSULTING COMMPPO $387.00 ↓ -25%
HealthSmart Preferred Care PPO $387.00 ↓ -25%
USA Managed Care COMM $412.80 ↓ -20%
Galaxy Health Network PPO $438.60 ↓ -15%
Independent Medical Systems COMM $516.00 ↑ +0%
National Healthcare Solutions COMM $516.00 ↑ +0%
Unicare MCD $516.00 ↑ +0%

Visitor-reported prices

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Allograft 160mg placental salera mini membrane at other Texas hospitals

Hospital City Cash price Negotiated range
MEDICAL CITY ARGYLE HOSPITAL Argyle $456.00 $103.17 – $103.17
HCA HOUSTON CLEAR LAKE FRIENDSWOOD not published $41.26 – $41.26
HCA HOUSTON MEDICAL CENTER Houston not published $41.26 – $41.26
HCA HOUSTON CONROE CONROE not published $41.26 – $41.26
HCA HOUSTON KINGWOOD HUMBLE not published $41.26 – $41.26
HCA HOUSTON NORTHWEST SPRING not published $41.26 – $41.26
HCA HOUSTON PEARLAND Pearland not published $41.26 – $41.26
HCA HOUSTON SOUTHEAST PASADENA not published $41.26 – $41.26

All Texas hospitals for this procedure →