Prcrd drg 0-5yr or w/anomly 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.
$361.53 with BCBS vs $24,339.00 with Cigna — 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 |
|---|---|---|---|
| BCBS | BluePremier | $361.53 | — |
| Superior Health Plan | CHIP | $607.42 | — |
| Superior Health Plan | STARHealth | $607.42 | — |
| Superior Health Plan | MCDSTAR | $607.42 | — |
| Superior Health Plan | STARPLUS | $607.42 | — |
| Superior Health Plan | STARKids | $607.42 | — |
| Cigna | IFP | $1,171.44 | — |
| Cigna | QHP | $1,214.83 | — |
| Imperial Insurance Company | MCR | $1,648.70 | — |
| United | OptionsPPO | $1,726.79 | — |
| Fidelis SecureCare | MGMCR | $1,995.00 | — |
| Healthcare Highways | NarrowNetwork | $2,069.00 | — |
| Unicare | CHIP | $2,082.57 | — |
| Evry Health | COMM | $2,287.00 | — |
| Aetna | QHPHIX | $2,513.00 | — |
| Humana | COMM | $2,689.11 | — |
| Healthcare Highways | CityofPlano | $2,932.95 | — |
| Aetna | NewBusiness | $3,445.00 | — |
| Aetna | Meritain | $3,682.00 | — |
| Aetna | COMM | $3,682.00 | — |
| BCBS | BlueEssentialsAccess | $3,740.71 | — |
| BCBS | BlueEssentials | $3,740.71 | — |
| BCBS | Traditional | $3,852.75 | — |
| City of McKinney | COMM | $3,904.81 | — |
| BCBS | EPOSOA | $3,927.31 | — |
| BCBS | BlueAdvantageHMO | $4,032.27 | — |
| BCBS | MyBlueHealth | $4,032.27 | — |
| BCBS | PPO | $4,111.00 | — |
| Aetna | OON | $4,332.00 | — |
| National ChoiceCare | WCOMP | $4,338.68 | — |
| Aetna | ASA | $4,572.97 | — |
| PC Texas Partners | WCOMP | $4,772.55 | — |
| Physicians Coop of TX | MGMCR | $4,772.55 | — |
| Rockport Health Group | WORKERSCOMP | $4,772.55 | — |
| Aetna | WCOMP | $4,772.55 | — |
| Averde Health, Inc | PPO | $5,032.87 | — |
| USC Health Services | COMM | $5,206.42 | — |
| Jostens | WCOMP | $6,074.15 | — |
| Mega Life | MGMCRPPO | $6,074.15 | — |
| Multiplan PHCS | PrimaryNetwork | $6,074.15 | — |
| Coastal Comp Health Networks | WCOMP | $6,074.15 | — |
| Aetna Coventry First Health | COMM | $6,308.44 | — |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $6,508.02 | — |
| HealthSmart Preferred Care | PPO | $6,508.02 | — |
| Oscar | HIX | $6,587.00 | — |
| USA Managed Care | COMM | $6,941.89 | — |
| Galaxy Health Network | PPO | $7,375.76 | — |
| United | SmallGroup | $7,977.00 | — |
| National Healthcare Solutions | COMM | $8,677.36 | — |
| Independent Medical Systems | COMM | $8,677.36 | — |
| Unicare | MCD | $8,677.36 | — |
| United | NarrowNetworkIndivExchange | $9,360.00 | — |
| United | AllPayerAppendix | $10,868.00 | — |
| Curative Administrators | COMM | $12,018.00 | — |
| Cigna | LocalPlus | $17,220.00 | — |
| Cigna | NewBusiness | $17,238.00 | — |
| Cigna | OpenAccessPlus | $19,240.00 | — |
| Cigna | NetworkBenefit | $19,240.00 | — |
| Cigna | HMO | $19,240.00 | — |
| Cigna | AllOther | $24,339.00 | — |
| WellMed | MGMCR | not published by hospital | — |
Visitor-reported prices
Comments
Prcrd drg 0-5yr or w/anomly at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,769.84 | $501.46 – $2,507.28 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $1,609.03 | $71.00 – $17,181.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,943.97 | $71.00 – $17,181.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,769.84 | $471.96 – $17,181.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $1,609.03 | $85.00 – $17,181.00 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $1,609.03 | $831.33 – $2,413.55 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,943.97 | $71.00 – $2,915.95 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $1,769.84 | $471.96 – $2,507.28 |