Pt evaluation moderate complexity patient/family at MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
$459.02
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.
?
What you pay up front if you don't use insurance.
$459.02
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.
?
The hospital's undiscounted list price — almost no one pays this.
$32.13 with Superior Health Plan vs $592.25 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $32.13 | ↓ -93% |
| Superior Health Plan | STARPLUS | $32.13 | ↓ -93% |
| Superior Health Plan | MCDSTAR | $32.13 | ↓ -93% |
| Superior Health Plan | CHIP | $32.13 | ↓ -93% |
| Superior Health Plan | STARHealth | $32.13 | ↓ -93% |
| Cigna | IFP | $61.97 | ↓ -86% |
| Cigna | QHP | $64.26 | ↓ -86% |
| WellMed | MGMCR | $83.60 | ↓ -82% |
| BCBS | MCRPPO | $83.90 | ↓ -82% |
| BCBS | MGMCRHMO | $83.90 | ↓ -82% |
| Mutual of Omaha | MGMCR | $84.02 | ↓ -82% |
| Devoted Health | SNP | $84.02 | ↓ -82% |
| Devoted Health | HMO | $84.02 | ↓ -82% |
| Devoted Health | POS | $84.02 | ↓ -82% |
| Devoted Health | MCR | $84.02 | ↓ -82% |
| Devoted Health | MME | $84.02 | ↓ -82% |
| Devoted Health | PPO | $84.02 | ↓ -82% |
| Humana | MGMCR | $84.02 | ↓ -82% |
| TriWest Health Alliance | FEDERAL | $84.02 | ↓ -82% |
| Amerigroup | DualEligible | $84.02 | ↓ -82% |
| United | MGMCR | $84.44 | ↓ -82% |
| Aetna | MCR | $84.74 | ↓ -82% |
| Care N Care | MGMCR | $84.86 | ↓ -82% |
| Cigna Healthspring | MGMCR | $85.70 | ↓ -81% |
| Integranet | MGMCR | $86.54 | ↓ -81% |
| WellCare | MGMCR | $86.54 | ↓ -81% |
| Superior Health Plan | MGMCRPFFS | $88.22 | ↓ -81% |
| Superior Health Plan | MGMCRPOS | $88.22 | ↓ -81% |
| Superior Health Plan | MGMCRSNP | $88.22 | ↓ -81% |
| American Health Plan of Texas, Inc. | MGMCR | $88.22 | ↓ -81% |
| ProCare Advantge | MCR | $88.22 | ↓ -81% |
| Superior Health Plan | MGMCRHMO | $88.22 | ↓ -81% |
| Superior Health Plan | MGMCRPPO | $88.22 | ↓ -81% |
| Superior Health Plan | MGMCRDualEligible | $88.22 | ↓ -81% |
| Provider Partners Health Plan | MCR | $89.06 | ↓ -81% |
| Texas Independent Health Plan | MGMCR | $89.06 | ↓ -81% |
| United | OptionsPPO | $91.34 | ↓ -80% |
| Molina | MME | $91.58 | ↓ -80% |
| Molina | MMP | $91.58 | ↓ -80% |
| Molina | MCR | $91.58 | ↓ -80% |
| Imperial Insurance Company | MCR | $92.42 | ↓ -80% |
| Humana | Tricare | $92.48 | ↓ -80% |
| Oscar | HIX | $95.48 | ↓ -79% |
| Universal Healthcare Group | MCR | $100.83 | ↓ -78% |
| Aetna | QHPHIX | $106.00 | ↓ -77% |
| Verda Health Plan | MGMCR | $109.23 | ↓ -76% |
| Unicare | CHIP | $110.16 | ↓ -76% |
| Bravo Health | MCRHMO | $126.03 | ↓ -73% |
| Bravo Health | MCRPPO | $126.03 | ↓ -73% |
| Bravo Health | MCRPOS | $126.03 | ↓ -73% |
| Bravo Health | MCRSNP | $126.03 | ↓ -73% |
| Bravo Health | MCRPFFS | $126.03 | ↓ -73% |
| Aetna | NewBusiness | $143.00 | ↓ -69% |
| Superior | ValueHMO | $150.40 | ↓ -67% |
| Aetna | COMM | $155.00 | ↓ -66% |
| Aetna | Meritain | $155.00 | ↓ -66% |
| Healthcare Highways | CityofPlano | $155.15 | ↓ -66% |
| USA Managed Care | WORKERSCOMP | $159.64 | ↓ -65% |
| Corvel Corporation | WORKERSCOMP | $166.36 | ↓ -64% |
| Aetna | OON | $179.00 | ↓ -61% |
| Superior | EPO | $188.21 | ↓ -59% |
| Superior | HMO | $188.21 | ↓ -59% |
| BCBS | Traditional | $203.80 | ↓ -56% |
| BCBS | BluePremier | $204.12 | ↓ -56% |
| Fidelis SecureCare | MGMCR | $206.56 | ↓ -55% |
| City of McKinney | COMM | $206.56 | ↓ -55% |
| Molina Healthcare | HIX | $220.14 | ↓ -52% |
| National ChoiceCare | WCOMP | $229.51 | ↓ -50% |
| BCBS | BlueAdvantageHMO | $237.85 | ↓ -48% |
| BCBS | MyBlueHealth | $237.85 | ↓ -48% |
| Aetna | ASA | $241.90 | ↓ -47% |
| Physicians Coop of TX | MGMCR | $252.46 | ↓ -45% |
| Rockport Health Group | WORKERSCOMP | $252.46 | ↓ -45% |
| Aetna | WCOMP | $252.46 | ↓ -45% |
| PC Texas Partners | WCOMP | $252.46 | ↓ -45% |
| Averde Health, Inc | PPO | $266.23 | ↓ -42% |
| USC Health Services | COMM | $275.41 | ↓ -40% |
| Multiplan PHCS | PrimaryNetwork | $321.31 | ↓ -30% |
| Coastal Comp Health Networks | WCOMP | $321.31 | ↓ -30% |
| Jostens | WCOMP | $321.31 | ↓ -30% |
| Mega Life | MGMCRPPO | $321.31 | ↓ -30% |
| Aetna Coventry First Health | COMM | $333.71 | ↓ -27% |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $344.26 | ↓ -25% |
| HealthSmart Preferred Care | PPO | $344.26 | ↓ -25% |
| USA Managed Care | COMM | $367.22 | ↓ -20% |
| Galaxy Health Network | PPO | $390.17 | ↓ -15% |
| BCBS | BlueEssentialsAccess | $421.21 | ↓ -8% |
| BCBS | BlueEssentials | $421.21 | ↓ -8% |
| BCBS | EPOSOA | $441.96 | ↓ -4% |
| National Healthcare Solutions | COMM | $459.02 | ↑ +0% |
| Independent Medical Systems | COMM | $459.02 | ↑ +0% |
| Unicare | MCD | $459.02 | ↑ +0% |
| BCBS | PPO | $462.72 | ↑ +1% |
| Humana | COMM | $592.25 | ↑ +29% |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $554.20 | $332.99 – $332.99 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $285.10 | $80.78 – $403.89 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $332.36 | $68.41 – $498.55 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $352.31 | $70.46 – $440.38 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $285.10 | $76.03 – $403.89 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $332.36 | $106.69 – $498.55 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $332.36 | $155.00 – $498.55 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $352.31 | $108.00 – $528.46 |