Established Patient Office Visit (level 4) at MEDICAL CITY MCKINNEY HOSPITAL
4500 Medical Center Drive, McKinney, TX · Medicalcityhealthcare · · NPI 1437102639
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.
$11.39 with Superior Health Plan vs $428.05 with BCBS — 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 |
|---|---|---|---|
| Superior Health Plan | CHIP | $11.39 | — |
| Superior Health Plan | STARHealth | $11.39 | — |
| Superior Health Plan | MCDSTAR | $11.39 | — |
| Superior Health Plan | STARPLUS | $11.39 | — |
| Superior Health Plan | STARKids | $11.39 | — |
| Cigna | IFP | $21.96 | — |
| Aetna | QHPHIX | $21.96 | — |
| Cigna | QHP | $22.77 | — |
| United | OptionsPPO | $30.42 | — |
| Imperial Insurance Company | MCR | $30.90 | — |
| Aetna | NewBusiness | $32.37 | — |
| Aetna | Meritain | $34.64 | — |
| Aetna | COMM | $34.64 | — |
| Healthcare Highways | NarrowNetwork | $39.85 | — |
| Aetna | OON | $40.83 | — |
| Evry Health | COMM | $41.96 | — |
| Unicare | CHIP | $42.29 | — |
| Healthcare Highways | CityofPlano | $54.98 | — |
| City of McKinney | COMM | $56.93 | — |
| Curative Administrators | COMM | $65.06 | — |
| BCBS | Traditional | $72.22 | — |
| Fidelis SecureCare | MGMCR | $73.19 | — |
| National ChoiceCare | WCOMP | $81.33 | — |
| Aetna | ASA | $85.72 | — |
| Physicians Coop of TX | MGMCR | $89.46 | — |
| Aetna | WCOMP | $89.46 | — |
| Rockport Health Group | WORKERSCOMP | $89.46 | — |
| PC Texas Partners | WCOMP | $89.46 | — |
| Averde Health, Inc | PPO | $94.34 | — |
| Value Options Behavioral Health | COMM | $97.59 | — |
| Magellan BH | Pinnacle | $97.59 | — |
| Magellan BH | Summit | $97.59 | — |
| Cigna | LocalPlus | $98.62 | — |
| Cigna | NewBusiness | $98.62 | — |
| Humana | BHCOMM | $105.72 | — |
| Cigna | HMO | $110.20 | — |
| Cigna | NetworkBenefit | $110.20 | — |
| Cigna | OpenAccessPlus | $110.20 | — |
| Multiplan PHCS | PrimaryNetwork | $113.86 | — |
| Mega Life | MGMCRPPO | $113.86 | — |
| Coastal Comp Health Networks | WCOMP | $113.86 | — |
| Aetna Coventry First Health | COMM | $118.25 | — |
| LEWISVILLE ISD/DLS CONSULTING | COMMPPO | $121.99 | — |
| Cigna Behavioral Health | COMM | $130.12 | — |
| HealthSmart Preferred Care | PPO | $130.12 | — |
| ComPsych Corporation | COMM | $130.12 | — |
| USA Managed Care | COMM | $130.12 | — |
| Galaxy Health Network | PPO | $138.25 | — |
| Cigna | AllOther | $139.34 | — |
| Independent Medical Systems | COMM | $162.65 | — |
| National Healthcare Solutions | COMM | $162.65 | — |
| Unicare | MCD | $162.65 | — |
| Humana | COMM | $198.09 | — |
| BCBS | BlueAdvantageHMO | $220.03 | — |
| BCBS | MyBlueHealth | $220.03 | — |
| BCBS | BlueEssentialsAccess | $389.65 | — |
| BCBS | BlueEssentials | $389.65 | — |
| BCBS | EPOSOA | $408.85 | — |
| BCBS | PPO | $428.05 | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $439.04 | $308.04 – $308.04 |
| Baylor St Luke's Medical Center | Houston | $168.70 | $82.00 – $482.00 |
| St. Joseph Health Madison Hospital | Madisonville | $148.58 | $22.68 – $160.20 |
| St. Luke's Health Memorial Lufkin | Lufkin | $83.39 | $73.75 – $442.48 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $168.70 | $74.00 – $482.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $168.70 | $74.00 – $482.00 |
| St. Joseph Health College Station Hospital | College Station | $148.58 | $77.00 – $245.98 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $168.70 | $74.00 – $482.00 |