Ot evaluation moderate complexity patient/family at Covenant Medical Center
3615 19th St, Lubbock, TX · Providence · · NPI 1972517365
$175.00
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.
$1,621.00
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.
$98.02 with Aetna vs $484.43 with Bcbs — 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 |
|---|---|---|---|
| Aetna | Medicare Managed Care Plan | $98.02 | ↓ -44% |
| Superior Healthplan | Wellcare Medicare Managed Care Plan | $102.92 | ↓ -41% |
| Unitedhealthcare | Medicare Managed Care Plan | $103.41 | ↓ -41% |
| Bcbs | Blue Essentials Hmo | $317.06 | ↑ +81% |
| Bcbs | Par Traditional | $369.13 | ↑ +111% |
| Bcbs | Ers Blue Essentials For Healthselect Members Hmo | $456.53 | ↑ +161% |
| Bcbs | Ppo | $484.43 | ↑ +177% |
Visitor-reported prices
Comments
Ot evaluation moderate complexity patient/family at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Children's Hospital | Lubbock | $175.00 | $317.06 – $317.06 |
| Covenant Specialty Hospital | Lubbock | $680.82 | not published |
| Adventhealth Rollins Brook | Lampasas | $333.87 | $357.97 – $357.97 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $352.05 | $99.75 – $498.74 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $378.80 | $77.97 – $568.21 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $359.41 | $71.88 – $449.26 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $352.05 | $93.88 – $498.74 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $378.80 | $108.00 – $568.21 |