Ot evaluation moderate complexity patient/family at MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
$402.44
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.
$402.44
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.
$28.17 with Superior Health Plan vs $638.18 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 |
|---|---|---|---|
| Superior Health Plan | STARKids | $28.17 | ↓ -93% |
| Superior Health Plan | STARHealth | $28.17 | ↓ -93% |
| Superior Health Plan | STARPLUS | $28.17 | ↓ -93% |
| Superior Health Plan | MCDSTAR | $28.17 | ↓ -93% |
| Superior Health Plan | CHIP | $28.17 | ↓ -93% |
| Cigna | IFP | $54.33 | ↓ -86% |
| Cigna | QHP | $56.34 | ↓ -86% |
| United | OptionsPPO | $80.09 | ↓ -80% |
| Oscar | HIX | $83.71 | ↓ -79% |
| WellMed | MGMCR | $85.83 | ↓ -79% |
| BCBS | MCRPPO | $86.06 | ↓ -79% |
| BCBS | MGMCRHMO | $86.06 | ↓ -79% |
| Devoted Health | MME | $86.26 | ↓ -79% |
| Devoted Health | PPO | $86.26 | ↓ -79% |
| Humana | MGMCR | $86.26 | ↓ -79% |
| TriWest Health Alliance | FEDERAL | $86.26 | ↓ -79% |
| Mutual of Omaha | MGMCR | $86.26 | ↓ -79% |
| Amerigroup | DualEligible | $86.26 | ↓ -79% |
| Devoted Health | SNP | $86.26 | ↓ -79% |
| Devoted Health | HMO | $86.26 | ↓ -79% |
| Devoted Health | POS | $86.26 | ↓ -79% |
| Devoted Health | MCR | $86.26 | ↓ -79% |
| United | MGMCR | $86.69 | ↓ -78% |
| Aetna | MCR | $86.99 | ↓ -78% |
| Care N Care | MGMCR | $87.12 | ↓ -78% |
| Cigna Healthspring | MGMCR | $87.98 | ↓ -78% |
| WellCare | MGMCR | $88.85 | ↓ -78% |
| Integranet | MGMCR | $88.85 | ↓ -78% |
| American Health Plan of Texas, Inc. | MGMCR | $90.57 | ↓ -77% |
| Superior Health Plan | MGMCRHMO | $90.57 | ↓ -77% |
| Superior Health Plan | MGMCRPPO | $90.57 | ↓ -77% |
| Superior Health Plan | MGMCRDualEligible | $90.57 | ↓ -77% |
| Superior Health Plan | MGMCRPFFS | $90.57 | ↓ -77% |
| Superior Health Plan | MGMCRPOS | $90.57 | ↓ -77% |
| Superior Health Plan | MGMCRSNP | $90.57 | ↓ -77% |
| ProCare Advantge | MCR | $90.57 | ↓ -77% |
| Texas Independent Health Plan | MGMCR | $91.43 | ↓ -77% |
| Provider Partners Health Plan | MCR | $91.43 | ↓ -77% |
| Molina | MME | $94.02 | ↓ -77% |
| Molina | MCR | $94.02 | ↓ -77% |
| Molina | MMP | $94.02 | ↓ -77% |
| Humana | Tricare | $94.86 | ↓ -76% |
| Imperial Insurance Company | MCR | $94.88 | ↓ -76% |
| Unicare | CHIP | $96.59 | ↓ -76% |
| Universal Healthcare Group | MCR | $103.51 | ↓ -74% |
| Aetna | QHPHIX | $106.00 | ↓ -74% |
| Verda Health Plan | MGMCR | $112.14 | ↓ -72% |
| Bravo Health | MCRPOS | $129.39 | ↓ -68% |
| Bravo Health | MCRSNP | $129.39 | ↓ -68% |
| Bravo Health | MCRPPO | $129.39 | ↓ -68% |
| Bravo Health | MCRHMO | $129.39 | ↓ -68% |
| Bravo Health | MCRPFFS | $129.39 | ↓ -68% |
| Healthcare Highways | CityofPlano | $136.02 | ↓ -66% |
| Aetna | NewBusiness | $143.00 | ↓ -64% |
| Superior | ValueHMO | $154.40 | ↓ -62% |
| Aetna | COMM | $155.00 | ↓ -61% |
| Aetna | Meritain | $155.00 | ↓ -61% |
| USA Managed Care | WORKERSCOMP | $163.89 | ↓ -59% |
| Corvel Corporation | WORKERSCOMP | $170.79 | ↓ -58% |
| BCBS | Traditional | $178.68 | ↓ -56% |
| Aetna | OON | $179.00 | ↓ -56% |
| City of McKinney | COMM | $181.10 | ↓ -55% |
| Fidelis SecureCare | MGMCR | $181.10 | ↓ -55% |
| Superior | HMO | $193.22 | ↓ -52% |
| Superior | EPO | $193.22 | ↓ -52% |
| National ChoiceCare | WCOMP | $201.22 | ↓ -50% |
| Aetna | ASA | $212.09 | ↓ -47% |
| BCBS | BluePremier | $219.43 | ↓ -45% |
| Physicians Coop of TX | MGMCR | $221.34 | ↓ -45% |
| Aetna | WCOMP | $221.34 | ↓ -45% |
| PC Texas Partners | WCOMP | $221.34 | ↓ -45% |
| Rockport Health Group | WORKERSCOMP | $221.34 | ↓ -45% |
| Molina Healthcare | HIX | $226.00 | ↓ -44% |
| Averde Health, Inc | PPO | $233.42 | ↓ -42% |
| USC Health Services | COMM | $241.46 | ↓ -40% |
| BCBS | BlueAdvantageHMO | $255.70 | ↓ -36% |
| BCBS | MyBlueHealth | $255.70 | ↓ -36% |
| Coastal Comp Health Networks | WCOMP | $281.71 | ↓ -30% |
| Mega Life | MGMCRPPO | $281.71 | ↓ -30% |
| Jostens | WCOMP | $281.71 | ↓ -30% |
| Multiplan PHCS | PrimaryNetwork | $281.71 | ↓ -30% |
| Aetna Coventry First Health | COMM | $292.57 | ↓ -27% |
| HealthSmart Preferred Care | PPO | $301.83 | ↓ -25% |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $301.83 | ↓ -25% |
| USA Managed Care | COMM | $321.95 | ↓ -20% |
| Galaxy Health Network | PPO | $342.07 | ↓ -15% |
| Unicare | MCD | $402.44 | ↑ +0% |
| National Healthcare Solutions | COMM | $402.44 | ↑ +0% |
| Independent Medical Systems | COMM | $402.44 | ↑ +0% |
| BCBS | BlueEssentialsAccess | $452.81 | ↑ +13% |
| BCBS | BlueEssentials | $452.81 | ↑ +13% |
| BCBS | EPOSOA | $475.13 | ↑ +18% |
| BCBS | PPO | $497.44 | ↑ +24% |
| Humana | COMM | $638.18 | ↑ +59% |
Visitor-reported prices
Comments
Ot evaluation moderate 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 | $352.05 | $99.75 – $498.74 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $378.80 | $77.97 – $568.21 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $359.41 | $71.88 – $449.26 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $352.05 | $93.88 – $498.74 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $378.80 | $108.00 – $568.21 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $378.80 | $155.00 – $568.21 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $359.41 | $108.00 – $539.12 |