Egd/remov tum/polyp/hot bx forcep 43250 at Covenant Medical Center
3615 19th St, Lubbock, TX · Providence · · NPI 1972517365
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.
$1,277.84 with Scott And White vs $6,330.82 with Capstar — 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 |
|---|---|---|---|
| Scott And White | Individual Bsw Premier Exchange | $1,277.84 | — |
| Scott And White | Group Bsw Premier/Covenant Preferred Other Commercial Plan | $1,545.75 | — |
| Aetna | Medicare Managed Care Plan | $1,927.65 | — |
| Superior Healthplan | Wellcare Medicare Managed Care Plan | $2,024.03 | — |
| Unitedhealthcare | Medicare Managed Care Plan | $2,033.67 | — |
| Scott And White | Group Bsw Plus All Commercial Plans | $2,116.85 | — |
| Phcs | All Commercial Plans | $2,150.00 | — |
| Bcbs | Blue Essentials Hmo | $2,382.82 | — |
| Aetna | Preferred Other Commercial Plan | $2,560.53 | — |
| Bcbs | Par Traditional | $2,756.60 | — |
| Aetna | New Business Tier 1 Other Commercial Plan | $2,875.00 | — |
| Bcbs | Ers Blue Essentials For Healthselect Members Hmo | $3,161.52 | — |
| Covenant Preferred | All Commercial Plans | $3,218.00 | — |
| Bcbs | Ppo | $3,301.69 | — |
| Unitedhealthcare | All Commercial Plans | $4,554.00 | — |
| Aetna | All Commercial Plans | $4,566.00 | — |
| Cigna | New Buisness Other Commercial Plan | $4,574.00 | — |
| Cigna | Oap | $4,711.00 | — |
| Capstar | All Commercial Plans | $6,330.82 | — |
Visitor-reported prices
Comments
Egd/remov tum/polyp/hot bx forcep 43250 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Children's Hospital | Lubbock | not published | $1,256.62 – $7,034.24 |
| St. Luke's Health - Patients Medical Center | Pasadena | $688.59 | $1,180.44 – $1,475.55 |
| Adventhealth Rollins Brook | Lampasas | not published | $1,946.75 – $3,432.54 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | not published | $564.97 – $4,713.77 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | not published | $564.97 – $4,713.77 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - MCKINNEY | McKinney | not published | $564.97 – $4,713.77 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PLANO | Plano | not published | $564.97 – $4,713.77 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - WAXAHACHIE | Waxahachie | not published | $564.97 – $4,713.77 |