Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes 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.
$15.61 with Superior Health Plan vs $337.87 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 | CHIP | $15.61 | — |
| Superior Health Plan | STARHealth | $15.61 | — |
| Superior Health Plan | MCDSTAR | $15.61 | — |
| Superior Health Plan | STARPLUS | $15.61 | — |
| Superior Health Plan | STARKids | $15.61 | — |
| Cigna | IFP | $30.11 | — |
| Cigna | QHP | $31.23 | — |
| WellMed | MGMCR | $42.34 | — |
| BCBS | MGMCRHMO | $42.44 | — |
| BCBS | MCRPPO | $42.44 | — |
| Mutual of Omaha | MGMCR | $42.55 | — |
| Devoted Health | SNP | $42.55 | — |
| Devoted Health | HMO | $42.55 | — |
| Devoted Health | POS | $42.55 | — |
| Devoted Health | MCR | $42.55 | — |
| Devoted Health | MME | $42.55 | — |
| Humana | MGMCR | $42.55 | — |
| Devoted Health | PPO | $42.55 | — |
| Amerigroup | DualEligible | $42.55 | — |
| TriWest Health Alliance | FEDERAL | $42.55 | — |
| United | MGMCR | $42.76 | — |
| Aetna | MCR | $42.91 | — |
| Care N Care | MGMCR | $42.97 | — |
| Cigna Healthspring | MGMCR | $43.40 | — |
| WellCare | MGMCR | $43.82 | — |
| Integranet | MGMCR | $43.82 | — |
| United | OptionsPPO | $44.38 | — |
| ProCare Advantge | MCR | $44.68 | — |
| American Health Plan of Texas, Inc. | MGMCR | $44.68 | — |
| Superior Health Plan | MGMCRHMO | $44.68 | — |
| Superior Health Plan | MGMCRPPO | $44.68 | — |
| Superior Health Plan | MGMCRDualEligible | $44.68 | — |
| Superior Health Plan | MGMCRPFFS | $44.68 | — |
| Superior Health Plan | MGMCRPOS | $44.68 | — |
| Superior Health Plan | MGMCRSNP | $44.68 | — |
| Provider Partners Health Plan | MCR | $45.10 | — |
| Texas Independent Health Plan | MGMCR | $45.10 | — |
| Molina | MMP | $46.38 | — |
| Molina | MCR | $46.38 | — |
| Molina | MME | $46.38 | — |
| Oscar | HIX | $46.39 | — |
| Humana | Tricare | $46.78 | — |
| Imperial Insurance Company | MCR | $46.80 | — |
| Universal Healthcare Group | MCR | $51.06 | — |
| Unicare | CHIP | $53.53 | — |
| Verda Health Plan | MGMCR | $55.31 | — |
| Bravo Health | MCRHMO | $63.82 | — |
| Bravo Health | MCRPFFS | $63.82 | — |
| Bravo Health | MCRSNP | $63.82 | — |
| Bravo Health | MCRPOS | $63.82 | — |
| Bravo Health | MCRPPO | $63.82 | — |
| Healthcare Highways | CityofPlano | $75.39 | — |
| Superior | ValueHMO | $76.16 | — |
| USA Managed Care | WORKERSCOMP | $80.84 | — |
| Corvel Corporation | WORKERSCOMP | $84.25 | — |
| Superior | EPO | $95.31 | — |
| Superior | HMO | $95.31 | — |
| BCBS | Traditional | $99.03 | — |
| City of McKinney | COMM | $100.37 | — |
| Fidelis SecureCare | MGMCR | $100.37 | — |
| Aetna | QHPHIX | $106.00 | — |
| Molina Healthcare | HIX | $111.48 | — |
| National ChoiceCare | WCOMP | $111.52 | — |
| Aetna | ASA | $117.54 | — |
| BCBS | BluePremier | $121.63 | — |
| Aetna | WCOMP | $122.67 | — |
| Rockport Health Group | WORKERSCOMP | $122.67 | — |
| Physicians Coop of TX | MGMCR | $122.67 | — |
| PC Texas Partners | WCOMP | $122.67 | — |
| Averde Health, Inc | PPO | $129.36 | — |
| USC Health Services | COMM | $133.82 | — |
| BCBS | BlueAdvantageHMO | $141.73 | — |
| BCBS | MyBlueHealth | $141.73 | — |
| Aetna | NewBusiness | $143.00 | — |
| Aetna | COMM | $155.00 | — |
| Aetna | Meritain | $155.00 | — |
| Multiplan PHCS | PrimaryNetwork | $156.13 | — |
| Jostens | WCOMP | $156.13 | — |
| Mega Life | MGMCRPPO | $156.13 | — |
| Coastal Comp Health Networks | WCOMP | $156.13 | — |
| Aetna Coventry First Health | COMM | $162.15 | — |
| HealthSmart Preferred Care | PPO | $167.28 | — |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $167.28 | — |
| USA Managed Care | COMM | $178.43 | — |
| Aetna | OON | $179.00 | — |
| Galaxy Health Network | PPO | $189.58 | — |
| Unicare | MCD | $223.04 | — |
| Independent Medical Systems | COMM | $223.04 | — |
| National Healthcare Solutions | COMM | $223.04 | — |
| BCBS | BlueEssentialsAccess | $251.00 | — |
| BCBS | BlueEssentials | $251.00 | — |
| BCBS | EPOSOA | $263.37 | — |
| BCBS | PPO | $275.74 | — |
| Humana | COMM | $337.87 | — |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $124.35 | $35.23 – $176.16 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $135.00 | $27.79 – $202.50 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $118.67 | $23.73 – $155.65 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $124.35 | $33.16 – $176.16 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $135.00 | $43.34 – $202.50 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $135.00 | $69.75 – $253.00 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $118.67 | $39.56 – $178.01 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $124.35 | $33.16 – $176.16 |