Revasc intra lithotrip-stent at Methodist Southlake Medical Center

421 E State Hwy 114, Souhtlake, TX · Methodisthealthsystem · · NPI 1568818417

Source: hospital's published price file ↗ · Published Mar 23, 2026 · Ingested Sep 17, 2026

$10,862.50

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$21,725.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$6,074.31 with UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] vs $49,802.88 with HEALTHSCOPE BENEFITS [2052] — 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 →

Payer
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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
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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
UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] MHS HB UNITED MEDICAID STAR PLUS MSMC $6,074.31 ↓ -44%
AETNA COMMERCIAL [2042] MHS HB AETNA TX PREF PLUS II MSMC $11,232.00 ↑ +3%
AETNA COMMERCIAL [2042] MHS HB AETNA TEXAS ADVANTAGE MSMC $11,232.00 ↑ +3%
AETNA MANAGED CARE [2068] MHS HB AETNA TEXAS ADVANTAGE MSMC $11,232.00 ↑ +3%
WEB TPA [3049] MHS HB AETNA WHOLE HEALTH MSMC $11,232.00 ↑ +3%
AETNA MANAGED CARE [2068] MHS HB AETNA WHOLE HEALTH MSMC $11,232.00 ↑ +3%
AETNA MANAGED CARE [2068] MHS HB AETNA TX PREF PLUS II MSMC $11,232.00 ↑ +3%
UNITED HEALTHCARE-COMMERCIAL [2026] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
UHC - MHS EMPLOYEE HEALTH PLAN [9000] MHS HB UHC EMPLOYEE HEALTH MSMC $11,840.13 ↑ +9%
UNITED HEALTHCARE MANAGED CARE [3021] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
TML INTERGOVERNMENTAL EMPLOYEE BENEFITS [3050] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
GEHA FEDERAL [3066] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
FREEDOM LIFE INSURANCE COMPANY [2029] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
DEFINITY HEALTH [3006] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
BIND BENEFITS INC [1004] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
UNITED HEALTHCARE-MANAGED CARE [2067] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
UNITED HEALTHCARE GLOBAL [3075] MHS HB UNITED HEALTHCARE MSMC $11,840.13 ↑ +9%
AETNA [3000] MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC $12,166.00 ↑ +12%
SCOTT & WHITE HEALTH PLAN TRS [3062] MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC $12,166.00 ↑ +12%
HEALTHEZ AETNA SIGNATURE ADMINISTRATORS [3074] MHS HB AETNA HMO PPO MSMC $12,480.00 ↑ +15%
AETNA [3000] MHS HB AETNA HMO PPO MSMC $12,480.00 ↑ +15%
WEB TPA [3049] MHS HB AETNA HMO PPO MSMC $12,480.00 ↑ +15%
BCBS [3001] MHS HB BCBS MY BLUE HEALTH MSMC $12,682.85 ↑ +17%
TRIWEST WPS [8010] MHS HB TRICARE MSMC $17,155.13 ↑ +58%
TRICARE [1001] MHS HB TRICARE MSMC $17,155.13 ↑ +58%
VETERANS ADMINISTRATION [9001] MHS HB TRICARE MSMC $17,155.13 ↑ +58%
CHAMPVA [1000] MHS HB TRICARE MSMC $17,155.13 ↑ +58%
UHC AARP SECURE HORIZONS [7023] MHS HB MANAGED MEDICARE PART A & B MSMC $18,445.51 ↑ +70%
SUPERIOR MEDICARE MANAGED CARE [7008] MHS HB MANAGED MEDICARE PART A & B MSMC $18,445.51 ↑ +70%
BCBS MEDICARE MANAGED CARE [7002] MHS HB BCBS MEDICARE ADVANTAGE MSMC $18,445.51 ↑ +70%
AETNA MEDICARE MANAGED CARE [7000] MHS HB AETNA GOLDEN MSMC $18,445.51 ↑ +70%
GENERIC MEDICARE MANAGED CARE [7004] MHS HB MANAGED MEDICARE PART A & B MSMC $18,445.51 ↑ +70%
WELLCARE [7016] MHS HB MANAGED MEDICARE PART A & B MSMC $18,445.51 ↑ +70%
UST HEALTH PROOF [1005] MHS HB UHC MEDICARE COMPLETE MSMC $18,445.51 ↑ +70%
UNITED HEALTHCARE MEDICARE MANAGED CARE [7010] MHS HB UHC MEDICARE DIRECT MSMC $18,445.51 ↑ +70%
UNITED HEALTHCARE MEDICARE MANAGED CARE [7010] MHS HB UHC MEDICARE COMPLETE MSMC $18,445.51 ↑ +70%
UNITED HEALTHCARE MEDICARE MANAGED CARE [3044] MHS HB UHC MEDICARE COMPLETE MSMC $18,445.51 ↑ +70%
TEXAN PLUS HMO MEDICARE MANAGED CARE [7009] MHS HB MANAGED MEDICARE PART A & B MSMC $18,445.51 ↑ +70%
MUTUAL OF OMAHA MEDICARE MANAGED CARE [7019] MHS HB MUTUAL OF OMAHA MSMC $18,814.42 ↑ +73%
SCOTT AND WHITE MEDICARE [9911] MHS HB SCOTT AND WHITE MEDICARE MSMC $19,367.79 ↑ +78%
GLOBALHEALTH [1003] MHS HB GLOBAL HEALTH MSMC $19,367.79 ↑ +78%
CIGNA MEDICARE [7011] MHS HB 105% MEDICARE MSMC $19,367.79 ↑ +78%
MOLINA MEDICARE MANAGED CARE [7007] MHS HB MOLINA MEDICARE MSMC $19,367.79 ↑ +78%
PROCARE ADVANTAGE [7018] MHS HB SCOTT AND WHITE MEDICARE MSMC $19,367.79 ↑ +78%
AMERICAN HEALTH ADVANTAGE OF TEXAS [7099] MHS HB 105% MEDICARE MSMC $19,367.79 ↑ +78%
CARE N CARE MEDICARE MANAGED CARE [7003] MHS HB SCOTT AND WHITE MEDICARE MSMC $19,367.79 ↑ +78%
CIGNA MEDICARE [7011] MHS HB UHC WELLMED MSMC $19,552.24 ↑ +80%
BCBS MEDICARE MANAGED CARE [7002] MHS HB MANAGED MEDICARE 106% MSMC $19,552.24 ↑ +80%
HUMANA COMMERCIAL [2051] MHS HB HUMANA MEDICARE MSMC $19,552.24 ↑ +80%
HUMANA MEDICARE MANAGED CARE [7005] MHS HB HUMANA MEDICARE MSMC $19,552.24 ↑ +80%
HUMANA MEDICARE TRANSPLANT [7013] MHS HB HUMANA MEDICARE MSMC $19,552.24 ↑ +80%
OPTUM TRANSPLANT NETWORK MEDICARE [7012] MHS HB MANAGED MEDICARE 106% MSMC $19,552.24 ↑ +80%
SOUTHWESTERN HEALTH RESOURCES SWHR [7015] MHS HB MANAGED MEDICARE 106% MSMC $19,552.24 ↑ +80%
UNITED HEALTHCARE MEDICARE MANAGED CARE [7010] MHS HB UHC WELLMED MSMC $19,552.24 ↑ +80%
WELLPOINT MEDICARE MANAGED CARE [7001] MHS HB MANAGED MEDICARE 106% MSMC $19,552.24 ↑ +80%
MULTIPLAN MEDICARE MANAGED CARE [7022] MHS HB MULTIPLAN ADVANTAGE MSMC $19,736.70 ↑ +82%
UNITED HEALTHCARE MANAGED CARE [3021] MHS HB UHC EXCHANGE MSMC $19,736.70 ↑ +82%
PROVIDER PARTNERS HEALTH PLAN [7025] MHS HB PROVIDERS PARTNER HEALTH MSMC $19,921.15 ↑ +83%
BCBS [3001] MHS HB BCBS HMO MSMC $22,393.16 ↑ +106%
BCBS [3001] MHS HB BCBS PREMIER MSMC $22,492.25 ↑ +107%
BCBS [3001] MHS HB BCBS HIGH PERFORMANCE NETWORK MSMC $22,492.25 ↑ +107%
MOLINA MEDICAID MANAGED CARE [5005] MHS HB MEDICAID 110% STAR PLUS MSMC $22,502.76 ↑ +107%
ALTERNATIVE SERVICE CONCEPTS [8005] MHS HB CITY OF PLANO MSMC $23,056.89 ↑ +112%
BCBS [3001] MHS HB BCBS CITY OF DALLAS MSMC $23,384.01 ↑ +115%
OSCAR INSURANCE COMPANY [2057] MHS HB OSCAR HMO MSMC $23,979.17 ↑ +121%
BRIGHT HEALTHCARE [2222] MHS HB BRIGHT HEALTH MSMC $25,823.72 ↑ +138%
BCBS [3001] MHS HB BCBS TRADITIONAL MSMC $25,960.22 ↑ +139%
BCBS [3001] MHS HB BCBS PPO MSMC $25,960.22 ↑ +139%
MOLINA [3017] MHS HB MOLINA MARKETPLACE MSMC $26,745.99 ↑ +146%
WELLPOINT MEDICAID MANAGED CARE [5001] MHS HB WELLPOINT MEDICAID STAR MSMC $27,321.36 ↑ +152%
WELLPOINT MARKETPLACE EXCHANGE [3071] MHS HB WELLPOINT TEXAS ESSENTIALS MSMC $28,590.54 ↑ +163%
KEMPTON GROUP ADMINISTRATORS, TOWER EXTRUSIONS [3061] MHS HB TOWER EXTRUSIONS MSMC $29,512.82 ↑ +172%
AETNA [3000] MHS HB AETNA EXCHANGE MSMC $29,881.73 ↑ +175%
AETNA [3000] MHS HB AETNA CVS MSMC $29,881.73 ↑ +175%
ALLIED NATIONAL [2031] MHS HB 90 DEGREE MSMC $30,435.10 ↑ +180%
ENTRUST/90 DEGREE [2058] MHS HB 90 DEGREE MSMC $30,435.10 ↑ +180%
90 DEGREE BENEFIT [3057] MHS HB 90 DEGREE MSMC $30,435.10 ↑ +180%
FRIDAY HEALTH PLAN [2061] MHS HB FRIDAY HEALTH MSMC $31,357.37 ↑ +189%
AMBETTER SUPERIOR [3051] MHS HB AMBETTER SUPERIOR MSMC $31,541.83 ↑ +190%
IMPERIAL INSURANCE COMPANIES [3073] MHS HB IMPERIAL MANAGED CARE MSMC $33,201.92 ↑ +206%
CIGNA [3004] MHS HB CUSTOM INK MSMC $34,124.20 ↑ +214%
WEB TPA [3049] MHS HB CUSTOM INK MSMC $34,124.20 ↑ +214%
GENERIC WORKERS COMP TX PAR [9011] MHS HB WORKERS COMP MSMC $36,891.02 ↑ +240%
TRISTAR RISK MANAGEMENT [8006] MHS HB WORKERS COMP MSMC $36,891.02 ↑ +240%
GENERIC WORKERS COMP TX NON PAR [9010] MHS HB WORKERS COMP MSMC $36,891.02 ↑ +240%
GENERIC WORKERS COMP TX PAR [8002] MHS HB WORKERS COMP MSMC $36,891.02 ↑ +240%
DEPARTMENT OF LABOR [8004] MHS HB WORKERS COMP MSMC $36,891.02 ↑ +240%
VELOCITY [3070] MHS HB VELOCITY MSMC $36,891.02 ↑ +240%
SANA BENEFITS [3069] MHS HB SANA MSMC $36,891.02 ↑ +240%
EVRY HEALTH [1013] MHS HB EVRY MSMC $36,891.02 ↑ +240%
MEDICAL COST CONTAINMENT PROFESSIONALS [3059] MHS HB MEDICAL COST CONTAINMENT MSMC $46,113.78 ↑ +325%
HEALTH PLANS INC [5017] MHS HB EMPLOYERS HEALTH NETWORK MSMC $46,113.78 ↑ +325%
HEALTHSCOPE BENEFITS [3063] MHS HB DART MEMBER CARE MSMC $49,802.88 ↑ +358%
DART MEMBER CARE [3039] MHS HB DART MEMBER CARE MSMC $49,802.88 ↑ +358%
HEALTHSCOPE BENEFITS [2052] MHS HB DART MEMBER CARE MSMC $49,802.88 ↑ +358%

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Revasc intra lithotrip-stent at other Texas hospitals

Hospital City Cash price Negotiated range
BAYLOR UNIVERSITY MEDICAL CENTER Dallas $26,279.32 $6,299.00 – $43,439.01
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham $21,758.84 $4,478.69 – $43,439.01
BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA Suite 110 $25,523.12 $5,104.62 – $43,439.01
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL Frisco $26,279.32 $7,007.82 – $43,439.01
BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION College Station $21,758.84 $5,388.00 – $43,439.01
BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL Temple $21,758.84 $11,242.07 – $43,439.01
BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK Cedar Park $25,523.12 $5,388.00 – $43,439.01
BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH Fort Worth $26,279.32 $7,007.82 – $43,439.01

All Texas hospitals for this procedure →