Ot evaluation high complexity patient/family at MEDICAL CITY ALLIANCE HOSPITAL
727 W BAILEY BOSWELL RD, SAGINAW, TX · Medicalcityhealthcare · · NPI 1871911016
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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$63.16 with Superior Health Plan vs $902.33 with National Healthcare Solutions — 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 |
|---|---|---|---|
| Superior Health Plan | STARPLUS | $63.16 | — |
| Superior Health Plan | STARKids | $63.16 | — |
| Superior Health Plan | STARHealth | $63.16 | — |
| Superior Health Plan | MCDSTAR | $63.16 | — |
| Superior Health Plan | CHIP | $63.16 | — |
| WellMed | MGMCR | $87.80 | — |
| Devoted Health | PPO | $88.24 | — |
| Devoted Health | HMO | $88.24 | — |
| Devoted Health | POS | $88.24 | — |
| Devoted Health | MCR | $88.24 | — |
| Devoted Health | MME | $88.24 | — |
| TriWest Veterans | FEDERAL | $88.24 | — |
| Humana | MGMCR | $88.24 | — |
| Mutual of Omaha | MGMCR | $88.24 | — |
| Amerigroup | DualEligible | $88.24 | — |
| Devoted Health | SNP | $88.24 | — |
| United | MGMCR | $88.68 | — |
| BCBS | MGMCRHMO | $88.81 | — |
| BCBS | MCRPPO | $88.81 | — |
| Aetna | MCR | $88.99 | — |
| Care N Care | MGMCR | $89.12 | — |
| Cigna Healthspring | MGMCR | $90.00 | — |
| WellCare | MGMCR | $90.89 | — |
| Integranet | MGMCR | $90.89 | — |
| American Health Plan of Texas, Inc. | MGMCR | $92.65 | — |
| Superior Health Plan | MGMCRHMO | $92.65 | — |
| Superior Health Plan | MGMCRPPO | $92.65 | — |
| Superior Health Plan | MGMCRDualEligible | $92.65 | — |
| Superior Health Plan | MGMCRPFFS | $92.65 | — |
| Superior Health Plan | MGMCRPOS | $92.65 | — |
| Superior Health Plan | MGMCRSNP | $92.65 | — |
| ProCare Advantge | MCR | $92.65 | — |
| Texas Independent Health Plan | MGMCR | $93.53 | — |
| Provider Partners Health Plan | MCR | $93.53 | — |
| Molina | MME | $96.18 | — |
| Molina | MCR | $96.18 | — |
| Molina | MMP | $96.18 | — |
| Imperial Insurance Company | MCR | $97.06 | — |
| Humana | Tricare | $97.89 | — |
| TriWest Health Alliance | TRCR | $100.92 | — |
| Aetna | QHPHIX | $106.00 | — |
| Verda Health Plan | MGMCR | $114.71 | — |
| Cigna | IFP | $121.81 | — |
| Cigna | QHP | $126.33 | — |
| Aetna | NewBusiness | $143.00 | — |
| Aetna | Meritain | $155.00 | — |
| Aetna | COMM | $155.00 | — |
| Superior | ValueHMO | $157.95 | — |
| Aetna | OON | $179.00 | — |
| Oscar | HIX | $187.68 | — |
| Superior | HMO | $197.65 | — |
| Superior | EPO | $197.65 | — |
| United | OptionsPPO | $204.83 | — |
| BCBS | BluePremier | $219.43 | — |
| Molina Healthcare | HIX | $231.18 | — |
| BCBS | BlueAdvantageHMO | $255.70 | — |
| BCBS | MyBlueHealth | $255.70 | — |
| Healthcare Highways | CityofPlano | $304.99 | — |
| BCBS | Traditional | $400.63 | — |
| BCBS | BlueEssentialsAccess | $452.81 | — |
| BCBS | BlueEssentials | $452.81 | — |
| BCBS | EPOSOA | $475.13 | — |
| Aetna | ASA | $475.53 | — |
| BCBS | PPO | $497.44 | — |
| Multiplan PHCS | PrimaryNetwork | $631.63 | — |
| Humana | COMM | $638.18 | — |
| Aetna Coventry First Health | COMM | $655.99 | — |
| HealthSmart Preferred Care | PPO | $676.75 | — |
| Independent Medical Systems | COMM | $902.33 | — |
| National Healthcare Solutions | COMM | $902.33 | — |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $333.87 | $357.97 – $357.97 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $374.12 | $106.00 – $530.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $419.98 | $86.45 – $629.97 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $405.44 | $81.09 – $506.81 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $374.12 | $99.76 – $530.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $419.98 | $108.00 – $629.97 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $419.98 | $155.00 – $629.97 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $405.44 | $108.00 – $608.17 |