Exome re-evaluation at MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
not published by hospital
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.
not published by hospital
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.
$192.00 with Cook Childrens Health Plan vs $2,879.46 with Humana — 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 |
|---|---|---|---|
| Cook Childrens Health Plan | CHIP | $192.00 | — |
| Cook Childrens Health Plan | STAR | $192.00 | — |
| WellMed | MGMCR | $318.40 | — |
| Devoted Health | POS | $320.00 | — |
| Devoted Health | MCR | $320.00 | — |
| Devoted Health | MME | $320.00 | — |
| Devoted Health | PPO | $320.00 | — |
| Mutual of Omaha | MGMCR | $320.00 | — |
| BCBS | MCRPPO | $320.00 | — |
| Humana | MGMCR | $320.00 | — |
| BCBS | MGMCRHMO | $320.00 | — |
| Amerigroup | DualEligible | $320.00 | — |
| TriWest Health Alliance | FEDERAL | $320.00 | — |
| United | AllPayerAppendix | $320.00 | — |
| Devoted Health | SNP | $320.00 | — |
| Devoted Health | HMO | $320.00 | — |
| United | SmallGroup | $320.00 | — |
| United | NarrowNetworkIndivExchange | $320.00 | — |
| United | MGMCR | $321.60 | — |
| Aetna | MCR | $322.72 | — |
| Care N Care | MGMCR | $323.20 | — |
| Cigna Healthspring | MGMCR | $326.40 | — |
| WellCare | MGMCR | $329.60 | — |
| Integranet | MGMCR | $329.60 | — |
| Humana | Tricare | $335.95 | — |
| Superior Health Plan | MGMCRPPO | $336.00 | — |
| Superior Health Plan | MGMCRHMO | $336.00 | — |
| Superior Health Plan | MGMCRPFFS | $336.00 | — |
| Superior Health Plan | MGMCRPOS | $336.00 | — |
| Superior Health Plan | MGMCRSNP | $336.00 | — |
| Superior Health Plan | MGMCRDualEligible | $336.00 | — |
| American Health Plan of Texas, Inc. | MGMCR | $336.00 | — |
| ProCare Advantge | MCR | $336.00 | — |
| Provider Partners Health Plan | MCR | $339.20 | — |
| Texas Independent Health Plan | MGMCR | $339.20 | — |
| Molina | MCR | $348.80 | — |
| Molina | MME | $348.80 | — |
| Molina | MMP | $348.80 | — |
| Imperial Insurance Company | MCR | $352.00 | — |
| Universal Healthcare Group | MCR | $384.00 | — |
| Aetna | QHPHIX | $407.04 | — |
| Verda Health Plan | MGMCR | $416.00 | — |
| Bravo Health | MCRPFFS | $480.00 | — |
| Bravo Health | MCRHMO | $480.00 | — |
| Bravo Health | MCRPOS | $480.00 | — |
| Bravo Health | MCRPPO | $480.00 | — |
| Bravo Health | MCRSNP | $480.00 | — |
| BCBS | BluePremier | $544.00 | — |
| BCBS | BlueAdvantageHMO | $560.00 | — |
| BCBS | MyBlueHealth | $560.00 | — |
| Aetna | NewBusiness | $560.64 | — |
| Superior | ValueHMO | $572.80 | — |
| Aetna | Meritain | $597.12 | — |
| Aetna | COMM | $597.12 | — |
| USA Managed Care | WORKERSCOMP | $608.00 | — |
| Corvel Corporation | WORKERSCOMP | $633.60 | — |
| Aetna | OON | $702.72 | — |
| Superior | HMO | $716.80 | — |
| Superior | EPO | $716.80 | — |
| BCBS | BlueEssentialsAccess | $790.40 | — |
| BCBS | BlueEssentials | $790.40 | — |
| BCBS | EPOSOA | $828.80 | — |
| Oscar | HIX | $832.00 | — |
| Molina Healthcare | HIX | $838.40 | — |
| BCBS | PPO | $867.20 | — |
| Cigna | LocalPlus | $1,218.94 | — |
| Cigna | NewBusiness | $1,220.16 | — |
| Cigna | HMO | $1,361.47 | — |
| Cigna | OpenAccessPlus | $1,361.47 | — |
| Cigna | NetworkBenefit | $1,361.47 | — |
| Cigna | AllOther | $1,723.11 | — |
| Humana | COMM | $2,879.46 | — |
| Curative Administrators | COMM | not published by hospital | — |
Visitor-reported prices
Comments
Exome re-evaluation at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | not published | $288.00 – $1,232.00 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | not published | $313.60 – $1,315.89 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $313.60 – $1,315.89 |
| Covenant Children's Hospital | Lubbock | not published | $698.88 – $1,395.20 |
| HCA HOUSTON CONROE | CONROE | not published | $313.60 – $1,315.89 |
| HCA HOUSTON KINGWOOD | HUMBLE | not published | $313.60 – $1,315.89 |
| HCA HOUSTON NORTHWEST | SPRING | not published | $313.60 – $1,315.89 |
| HCA HOUSTON PEARLAND | Pearland | not published | $313.60 – $1,315.89 |