Ot evaluation high complexity patient/family at MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
$867.94
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.
$867.94
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.
$60.76 with Superior Health Plan vs $867.94 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 | MCDSTAR | $60.76 | ↓ -93% |
| Superior Health Plan | STARPLUS | $60.76 | ↓ -93% |
| Superior Health Plan | STARKids | $60.76 | ↓ -93% |
| Superior Health Plan | STARHealth | $60.76 | ↓ -93% |
| Superior Health Plan | CHIP | $60.76 | ↓ -93% |
| WellMed | MGMCR | $85.83 | ↓ -90% |
| BCBS | MCRPPO | $86.06 | ↓ -90% |
| BCBS | MGMCRHMO | $86.06 | ↓ -90% |
| TriWest Health Alliance | FEDERAL | $86.26 | ↓ -90% |
| Devoted Health | SNP | $86.26 | ↓ -90% |
| Devoted Health | HMO | $86.26 | ↓ -90% |
| Devoted Health | POS | $86.26 | ↓ -90% |
| Devoted Health | MCR | $86.26 | ↓ -90% |
| Devoted Health | MME | $86.26 | ↓ -90% |
| Devoted Health | PPO | $86.26 | ↓ -90% |
| Humana | MGMCR | $86.26 | ↓ -90% |
| Mutual of Omaha | MGMCR | $86.26 | ↓ -90% |
| Amerigroup | DualEligible | $86.26 | ↓ -90% |
| United | MGMCR | $86.69 | ↓ -90% |
| Aetna | MCR | $86.99 | ↓ -90% |
| Care N Care | MGMCR | $87.12 | ↓ -90% |
| Cigna Healthspring | MGMCR | $87.98 | ↓ -90% |
| WellCare | MGMCR | $88.85 | ↓ -90% |
| Integranet | MGMCR | $88.85 | ↓ -90% |
| Superior Health Plan | MGMCRSNP | $90.57 | ↓ -90% |
| Superior Health Plan | MGMCRPFFS | $90.57 | ↓ -90% |
| Superior Health Plan | MGMCRHMO | $90.57 | ↓ -90% |
| Superior Health Plan | MGMCRPPO | $90.57 | ↓ -90% |
| American Health Plan of Texas, Inc. | MGMCR | $90.57 | ↓ -90% |
| Superior Health Plan | MGMCRDualEligible | $90.57 | ↓ -90% |
| Superior Health Plan | MGMCRPOS | $90.57 | ↓ -90% |
| ProCare Advantge | MCR | $90.57 | ↓ -90% |
| Provider Partners Health Plan | MCR | $91.43 | ↓ -89% |
| Texas Independent Health Plan | MGMCR | $91.43 | ↓ -89% |
| Molina | MMP | $94.02 | ↓ -89% |
| Molina | MME | $94.02 | ↓ -89% |
| Molina | MCR | $94.02 | ↓ -89% |
| Humana | Tricare | $94.86 | ↓ -89% |
| Imperial Insurance Company | MCR | $94.88 | ↓ -89% |
| Universal Healthcare Group | MCR | $103.51 | ↓ -88% |
| Aetna | QHPHIX | $106.00 | ↓ -88% |
| Verda Health Plan | MGMCR | $112.14 | ↓ -87% |
| Cigna | IFP | $117.17 | ↓ -87% |
| Cigna | QHP | $121.51 | ↓ -86% |
| Bravo Health | MCRPPO | $129.39 | ↓ -85% |
| Bravo Health | MCRHMO | $129.39 | ↓ -85% |
| Bravo Health | MCRPOS | $129.39 | ↓ -85% |
| Bravo Health | MCRPFFS | $129.39 | ↓ -85% |
| Bravo Health | MCRSNP | $129.39 | ↓ -85% |
| Aetna | NewBusiness | $143.00 | ↓ -84% |
| Superior | ValueHMO | $154.40 | ↓ -82% |
| Aetna | COMM | $155.00 | ↓ -82% |
| Aetna | Meritain | $155.00 | ↓ -82% |
| USA Managed Care | WORKERSCOMP | $163.89 | ↓ -81% |
| Corvel Corporation | WORKERSCOMP | $170.79 | ↓ -80% |
| United | OptionsPPO | $172.72 | ↓ -80% |
| Aetna | OON | $179.00 | ↓ -79% |
| Oscar | HIX | $180.53 | ↓ -79% |
| Superior | EPO | $193.22 | ↓ -78% |
| Superior | HMO | $193.22 | ↓ -78% |
| Unicare | CHIP | $208.31 | ↓ -76% |
| BCBS | BluePremier | $219.43 | ↓ -75% |
| Molina Healthcare | HIX | $226.00 | ↓ -74% |
| BCBS | BlueAdvantageHMO | $255.70 | ↓ -71% |
| BCBS | MyBlueHealth | $255.70 | ↓ -71% |
| Healthcare Highways | CityofPlano | $293.36 | ↓ -66% |
| BCBS | Traditional | $385.37 | ↓ -56% |
| City of McKinney | COMM | $390.57 | ↓ -55% |
| Fidelis SecureCare | MGMCR | $390.57 | ↓ -55% |
| National ChoiceCare | WCOMP | $433.97 | ↓ -50% |
| BCBS | BlueEssentialsAccess | $452.81 | ↓ -48% |
| BCBS | BlueEssentials | $452.81 | ↓ -48% |
| Aetna | ASA | $457.40 | ↓ -47% |
| BCBS | EPOSOA | $475.13 | ↓ -45% |
| Physicians Coop of TX | MGMCR | $477.37 | ↓ -45% |
| PC Texas Partners | WCOMP | $477.37 | ↓ -45% |
| Rockport Health Group | WORKERSCOMP | $477.37 | ↓ -45% |
| Aetna | WCOMP | $477.37 | ↓ -45% |
| BCBS | PPO | $497.44 | ↓ -43% |
| Averde Health, Inc | PPO | $503.41 | ↓ -42% |
| USC Health Services | COMM | $520.76 | ↓ -40% |
| Coastal Comp Health Networks | WCOMP | $607.56 | ↓ -30% |
| Jostens | WCOMP | $607.56 | ↓ -30% |
| Mega Life | MGMCRPPO | $607.56 | ↓ -30% |
| Multiplan PHCS | PrimaryNetwork | $607.56 | ↓ -30% |
| Aetna Coventry First Health | COMM | $630.99 | ↓ -27% |
| Humana | COMM | $638.18 | ↓ -26% |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $650.96 | ↓ -25% |
| HealthSmart Preferred Care | PPO | $650.96 | ↓ -25% |
| USA Managed Care | COMM | $694.35 | ↓ -20% |
| Galaxy Health Network | PPO | $737.75 | ↓ -15% |
| Unicare | MCD | $867.94 | ↑ +0% |
| Independent Medical Systems | COMM | $867.94 | ↑ +0% |
| National Healthcare Solutions | COMM | $867.94 | ↑ +0% |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $333.87 | $357.97 – $357.97 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $374.12 | $106.00 – $530.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $419.98 | $86.45 – $629.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $405.44 | $81.09 – $506.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $374.12 | $99.76 – $530.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $419.98 | $108.00 – $629.97 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $419.98 | $155.00 – $629.97 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $405.44 | $108.00 – $608.17 |