Shldr disar prosth tiss shap 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.
$4,528.31 with Humana vs $26,374.26 with Humana — 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 |
|---|---|---|---|
| Humana | Tricare | $4,528.31 | — |
| BCBS | MGMCRHMO | $4,576.82 | — |
| BCBS | MCRPPO | $4,576.82 | — |
| WellMed | MGMCR | $4,645.02 | — |
| Devoted Health | PPO | $4,668.36 | — |
| Amerigroup | DualEligible | $4,668.36 | — |
| Mutual of Omaha | MGMCR | $4,668.36 | — |
| Devoted Health | SNP | $4,668.36 | — |
| Devoted Health | HMO | $4,668.36 | — |
| Devoted Health | POS | $4,668.36 | — |
| Devoted Health | MCR | $4,668.36 | — |
| Devoted Health | MME | $4,668.36 | — |
| TriWest Veterans | FEDERAL | $4,668.36 | — |
| Humana | MGMCR | $4,668.36 | — |
| United | MGMCR | $4,691.70 | — |
| Aetna | MCR | $4,708.04 | — |
| Care N Care | MGMCR | $4,715.04 | — |
| Cigna Healthspring | MGMCR | $4,761.73 | — |
| Integranet | MGMCR | $4,808.41 | — |
| WellCare | MGMCR | $4,808.41 | — |
| American Health Plan of Texas, Inc. | MGMCR | $4,901.78 | — |
| Superior Health Plan | MGMCRHMO | $4,901.78 | — |
| Superior Health Plan | MGMCRPPO | $4,901.78 | — |
| Superior Health Plan | MGMCRDualEligible | $4,901.78 | — |
| Superior Health Plan | MGMCRPFFS | $4,901.78 | — |
| Superior Health Plan | MGMCRPOS | $4,901.78 | — |
| Superior Health Plan | MGMCRSNP | $4,901.78 | — |
| ProCare Advantge | MCR | $4,901.78 | — |
| Texas Independent Health Plan | MGMCR | $4,948.46 | — |
| Provider Partners Health Plan | MCR | $4,948.46 | — |
| Molina | MME | $5,088.51 | — |
| Molina | MCR | $5,088.51 | — |
| Cenpatico | BHMGMCR | $5,088.51 | — |
| Molina | MMP | $5,088.51 | — |
| Imperial Insurance Company | MCR | $5,135.20 | — |
| Universal Healthcare Group | MCR | $5,602.03 | — |
| Verda Health Plan | MGMCR | $6,068.87 | — |
| Bravo Health | MCRPOS | $7,002.54 | — |
| Bravo Health | MCRSNP | $7,002.54 | — |
| Bravo Health | MCRHMO | $7,002.54 | — |
| Bravo Health | MCRPPO | $7,002.54 | — |
| Bravo Health | MCRPFFS | $7,002.54 | — |
| Superior | ValueHMO | $8,356.36 | — |
| USA Managed Care | WORKERSCOMP | $8,869.88 | — |
| Corvel Corporation | WORKERSCOMP | $9,243.35 | — |
| Superior | EPO | $10,457.13 | — |
| Superior | HMO | $10,457.13 | — |
| Molina Healthcare | HIX | $12,231.10 | — |
| Humana | COMM | $26,374.26 | — |
Visitor-reported prices
Comments
Shldr disar prosth tiss shap at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON CONROE | CONROE | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON KINGWOOD | HUMBLE | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON NORTHWEST | SPRING | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON PEARLAND | Pearland | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON SOUTHEAST | PASADENA | not published | $4,574.99 – $10,036.97 |
| HCA HOUSTON WEST | HOUSTON | not published | $4,574.99 – $10,036.97 |