Dextran 40 infusion 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

$882.80

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.

$882.80

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.

$61.80 with Superior Health Plan vs $882.80 with Independent Medical Systems — 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 MCDSTAR $61.80 ↓ -93%
Superior Health Plan STARPLUS $61.80 ↓ -93%
Superior Health Plan STARKids $61.80 ↓ -93%
Superior Health Plan STARHealth $61.80 ↓ -93%
Superior Health Plan CHIP $61.80 ↓ -93%
BCBS MyBlueHealth $91.53 ↓ -90%
BCBS BlueAdvantageHMO $91.53 ↓ -90%
BCBS BluePremier $108.24 ↓ -88%
Cigna IFP $119.18 ↓ -86%
Aetna QHPHIX $119.18 ↓ -86%
Cigna QHP $123.59 ↓ -86%
BCBS BlueEssentials $133.98 ↓ -85%
BCBS BlueEssentialsAccess $133.98 ↓ -85%
BCBS EPOSOA $140.61 ↓ -84%
BCBS PPO $147.24 ↓ -83%
Humana COMM $166.04 ↓ -81%
United OptionsPPO $175.68 ↓ -80%
Aetna NewBusiness $175.68 ↓ -80%
Aetna COMM $188.04 ↓ -79%
Aetna Meritain $188.04 ↓ -79%
Unicare CHIP $211.87 ↓ -76%
Aetna OON $221.58 ↓ -75%
Healthcare Highways CityofPlano $298.39 ↓ -66%
BCBS Traditional $391.96 ↓ -56%
City of McKinney COMM $397.26 ↓ -55%
Cigna LocalPlus $410.80 ↓ -53%
Cigna NewBusiness $411.21 ↓ -53%
National ChoiceCare WCOMP $441.40 ↓ -50%
Cigna NetworkBenefit $458.94 ↓ -48%
Cigna OpenAccessPlus $458.94 ↓ -48%
Cigna HMO $458.94 ↓ -48%
Aetna ASA $465.24 ↓ -47%
Rockport Health Group WORKERSCOMP $485.54 ↓ -45%
Aetna WCOMP $485.54 ↓ -45%
PC Texas Partners WCOMP $485.54 ↓ -45%
Physicians Coop of TX MGMCR $485.54 ↓ -45%
Averde Health, Inc PPO $512.02 ↓ -42%
USC Health Services COMM $529.68 ↓ -40%
Cigna AllOther $580.60 ↓ -34%
Mega Life MGMCRPPO $617.96 ↓ -30%
Jostens WCOMP $617.96 ↓ -30%
Coastal Comp Health Networks WCOMP $617.96 ↓ -30%
United NarrowNetworkIndivExchange $628.63 ↓ -29%
United SmallGroup $628.63 ↓ -29%
United AllPayerAppendix $628.63 ↓ -29%
Aetna Coventry First Health COMM $641.80 ↓ -27%
HealthSmart Preferred Care PPO $662.10 ↓ -25%
LEWISVILLE ISD/DLS CONSULTING COMMPPO $662.10 ↓ -25%
USA Managed Care COMM $706.24 ↓ -20%
Galaxy Health Network PPO $750.38 ↓ -15%
Unicare MCD $882.80 ↑ +0%
National Healthcare Solutions COMM $882.80 ↑ +0%
Independent Medical Systems COMM $882.80 ↑ +0%

Visitor-reported prices

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Dextran 40 infusion at other Texas hospitals

Hospital City Cash price Negotiated range
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $151.20 $42.84 – $214.20
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $151.20 $31.12 – $226.80
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $151.20 $30.24 – $189.00
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $151.20 $40.32 – $214.20
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $151.20 $48.54 – $226.80
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $151.20 $78.12 – $226.80
BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK Cedar Park $151.20 $50.40 – $226.80
BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH Fort Worth $151.20 $40.32 – $214.20

All Texas hospitals for this procedure →