Aco annual medicare visit (awv), initial g0438aco at Houston Methodist Clear Lake Hospital
18300 St John Drive, Nassau Bay, TX · Houstonmethodist · · NPI 1952723967
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.
$173.06 with Bcbs vs $346.12 with Molina Healthcare — 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 |
|---|---|---|---|
| Bcbs | Medicare Managed Care - Hmo | $173.06 | — |
| Aetna | Medicare Managed Care - Hmo/Ppo | $175.66 | — |
| Unitedhealthcare | Medicare Managed Care - Hmo | $176.52 | — |
| Cigna | Texas Healthspring Medicare Managed Care - Hmo/Ppo | $178.25 | — |
| Molina Healthcare | Advantage Medicare Managed Care Plan | $181.71 | — |
| Community Health Choice | D-Snp Medicare Managed Care - Hmo | $185.17 | — |
| Procare Advantage | Medicare Managed Care - Hmo | $190.37 | — |
| Community Health Choice | Silver & Gold Exchange | $282.09 | — |
| Optum Health | Transplant Medicare Managed Care Plan | $337.47 | — |
| Molina Healthcare | Exchange | $346.12 | — |
Visitor-reported prices
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Aco annual medicare visit (awv), initial g0438aco at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. Joseph Health Madison Hospital | Madisonville | $41.30 | $30.07 – $236.00 |
| St. Joseph Health College Station Hospital | College Station | $41.30 | $77.00 – $507.58 |
| St. Joseph Health Grimes Hospital | Navasota | $41.30 | $77.00 – $261.96 |
| St. Joseph Health Burleson Hospital | Caldwell | $41.30 | $51.92 – $236.00 |
| Covenant Hospital Plainview | Plainview | $141.12 | $167.87 – $182.58 |
| Covenant Hospital Levelland | Levelland | $141.12 | $167.87 – $182.58 |
| MEDICAL CITY NORTH HILLS HOSPITAL | North Richland Hills | $152.00 | $132.51 – $453.94 |
| CHRISTUS Children's Hospital | San Antonio | not published | $452.33 – $452.33 |