Established Patient Office Visit (level 1) at MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
$329.04
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.
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What you pay up front if you don't use insurance.
$329.04
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.
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The hospital's undiscounted list price — almost no one pays this.
$23.03 with Superior Health Plan vs $329.04 with National Healthcare Solutions — 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 →
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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 ?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 |
|---|---|---|---|
| Superior Health Plan | CHIP | $23.03 | ↓ -93% |
| Superior Health Plan | STARHealth | $23.03 | ↓ -93% |
| Superior Health Plan | MCDSTAR | $23.03 | ↓ -93% |
| Superior Health Plan | STARPLUS | $23.03 | ↓ -93% |
| Superior Health Plan | STARKids | $23.03 | ↓ -93% |
| BCBS | BlueAdvantageHMO | $25.77 | ↓ -92% |
| BCBS | MyBlueHealth | $25.77 | ↓ -92% |
| Aetna | QHPHIX | $44.42 | ↓ -87% |
| Cigna | IFP | $44.42 | ↓ -87% |
| BCBS | BlueEssentials | $45.63 | ↓ -86% |
| BCBS | BlueEssentialsAccess | $45.63 | ↓ -86% |
| Cigna | QHP | $46.07 | ↓ -86% |
| BCBS | EPOSOA | $47.88 | ↓ -85% |
| BCBS | PPO | $50.13 | ↓ -85% |
| Imperial Insurance Company | MCR | $62.52 | ↓ -81% |
| United | OptionsPPO | $65.48 | ↓ -80% |
| Aetna | NewBusiness | $65.48 | ↓ -80% |
| Aetna | COMM | $70.09 | ↓ -79% |
| Aetna | Meritain | $70.09 | ↓ -79% |
| Unicare | CHIP | $78.97 | ↓ -76% |
| Healthcare Highways | NarrowNetwork | $80.61 | ↓ -76% |
| Aetna | OON | $82.59 | ↓ -75% |
| Humana | COMM | $84.56 | ↓ -74% |
| Evry Health | COMM | $84.89 | ↓ -74% |
| Healthcare Highways | CityofPlano | $111.22 | ↓ -66% |
| Curative Administrators | COMM | $131.62 | ↓ -60% |
| BCBS | Traditional | $146.09 | ↓ -56% |
| Fidelis SecureCare | MGMCR | $148.07 | ↓ -55% |
| City of McKinney | COMM | $148.07 | ↓ -55% |
| National ChoiceCare | WCOMP | $164.52 | ↓ -50% |
| Aetna | ASA | $173.40 | ↓ -47% |
| Aetna | WCOMP | $180.97 | ↓ -45% |
| Rockport Health Group | WORKERSCOMP | $180.97 | ↓ -45% |
| Physicians Coop of TX | MGMCR | $180.97 | ↓ -45% |
| PC Texas Partners | WCOMP | $180.97 | ↓ -45% |
| Averde Health, Inc | PPO | $190.84 | ↓ -42% |
| USC Health Services | COMM | $197.42 | ↓ -40% |
| Coastal Comp Health Networks | WCOMP | $230.33 | ↓ -30% |
| Multiplan PHCS | PrimaryNetwork | $230.33 | ↓ -30% |
| Jostens | WCOMP | $230.33 | ↓ -30% |
| Mega Life | MGMCRPPO | $230.33 | ↓ -30% |
| Aetna Coventry First Health | COMM | $239.21 | ↓ -27% |
| HealthSmart Preferred Care | PPO | $246.78 | ↓ -25% |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $246.78 | ↓ -25% |
| USA Managed Care | COMM | $263.23 | ↓ -20% |
| Galaxy Health Network | PPO | $279.68 | ↓ -15% |
| Unicare | MCD | $329.04 | ↑ +0% |
| Independent Medical Systems | COMM | $329.04 | ↑ +0% |
| National Healthcare Solutions | COMM | $329.04 | ↑ +0% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $256.64 | $36.07 – $36.07 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $134.02 | $15.44 – $112.50 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $96.94 | $15.00 – $93.75 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $134.02 | $24.07 – $112.50 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $134.02 | $38.75 – $112.50 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $96.94 | $25.00 – $112.50 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $134.02 | $15.00 – $106.25 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $134.02 | $8.82 – $112.50 |