Surgical pathology level 5 gross & microscopic examination at MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
$6,238.39
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.
$6,238.39
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.
$271.04 with Aetna vs $6,238.39 with Unicare — 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 |
|---|---|---|---|
| Aetna | QHPHIX | $271.04 | ↓ -96% |
| United | NarrowNetworkIndivExchange | $291.26 | ↓ -95% |
| United | SmallGroup | $291.26 | ↓ -95% |
| United | AllPayerAppendix | $291.26 | ↓ -95% |
| Aetna | NewBusiness | $373.32 | ↓ -94% |
| Aetna | Meritain | $397.61 | ↓ -94% |
| Aetna | COMM | $397.61 | ↓ -94% |
| Superior Health Plan | STARKids | $436.69 | ↓ -93% |
| Superior Health Plan | MCDSTAR | $436.69 | ↓ -93% |
| Superior Health Plan | STARHealth | $436.69 | ↓ -93% |
| Superior Health Plan | CHIP | $436.69 | ↓ -93% |
| Superior Health Plan | STARPLUS | $436.69 | ↓ -93% |
| Aetna | OON | $467.93 | ↓ -92% |
| BCBS | BluePremier | $481.80 | ↓ -92% |
| BCBS | MyBlueHealth | $495.97 | ↓ -92% |
| BCBS | BlueAdvantageHMO | $495.97 | ↓ -92% |
| BCBS | BlueEssentials | $700.02 | ↓ -89% |
| BCBS | BlueEssentialsAccess | $700.02 | ↓ -89% |
| BCBS | EPOSOA | $734.03 | ↓ -88% |
| BCBS | PPO | $768.04 | ↓ -88% |
| Cigna | LocalPlus | $806.01 | ↓ -87% |
| Cigna | NewBusiness | $806.81 | ↓ -87% |
| Cigna | IFP | $842.18 | ↓ -87% |
| Cigna | QHP | $873.37 | ↓ -86% |
| Cigna | NetworkBenefit | $900.26 | ↓ -86% |
| Cigna | OpenAccessPlus | $900.26 | ↓ -86% |
| Cigna | HMO | $900.26 | ↓ -86% |
| Cigna | AllOther | $1,139.39 | ↓ -82% |
| United | OptionsPPO | $1,241.44 | ↓ -80% |
| Oscar | HIX | $1,297.59 | ↓ -79% |
| Unicare | CHIP | $1,497.21 | ↓ -76% |
| Healthcare Highways | NarrowNetwork | $1,528.41 | ↓ -75% |
| Humana | COMM | $1,536.55 | ↓ -75% |
| Evry Health | COMM | $1,609.50 | ↓ -74% |
| Healthcare Highways | CityofPlano | $2,108.58 | ↓ -66% |
| BCBS | Traditional | $2,769.85 | ↓ -56% |
| Fidelis SecureCare | MGMCR | $2,807.28 | ↓ -55% |
| City of McKinney | COMM | $2,807.28 | ↓ -55% |
| National ChoiceCare | WCOMP | $3,119.20 | ↓ -50% |
| Aetna | ASA | $3,287.63 | ↓ -47% |
| Rockport Health Group | WORKERSCOMP | $3,431.11 | ↓ -45% |
| Physicians Coop of TX | MGMCR | $3,431.11 | ↓ -45% |
| PC Texas Partners | WCOMP | $3,431.11 | ↓ -45% |
| Aetna | WCOMP | $3,431.11 | ↓ -45% |
| Averde Health, Inc | PPO | $3,618.27 | ↓ -42% |
| USC Health Services | COMM | $3,743.03 | ↓ -40% |
| Mega Life | MGMCRPPO | $4,366.87 | ↓ -30% |
| Coastal Comp Health Networks | WCOMP | $4,366.87 | ↓ -30% |
| Multiplan PHCS | PrimaryNetwork | $4,366.87 | ↓ -30% |
| Jostens | WCOMP | $4,366.87 | ↓ -30% |
| Aetna Coventry First Health | COMM | $4,535.31 | ↓ -27% |
| HealthSmart Preferred Care | PPO | $4,678.79 | ↓ -25% |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $4,678.79 | ↓ -25% |
| USA Managed Care | COMM | $4,990.71 | ↓ -20% |
| Galaxy Health Network | PPO | $5,302.63 | ↓ -15% |
| Independent Medical Systems | COMM | $6,238.39 | ↑ +0% |
| National Healthcare Solutions | COMM | $6,238.39 | ↑ +0% |
| Unicare | MCD | $6,238.39 | ↑ +0% |
| Curative Administrators | COMM | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $1,114.69 | $1,091.13 – $1,091.13 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $476.75 | $35.00 – $890.45 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $519.16 | $36.00 – $890.45 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $491.47 | $36.00 – $890.45 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $476.75 | $35.00 – $890.45 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $519.16 | $36.00 – $890.45 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $519.16 | $26.00 – $890.45 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $491.47 | $36.00 – $890.45 |