Ph1 assmt&mgmt nqhp 11-20 at HCA HOUSTON NORTHWEST
621 RAYFORD RD, SPRING, TX · HCA Houston Healthcare · · NPI 1740450121
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.
$13.15 with Humana vs $83.82 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 |
|---|---|---|---|
| Humana | PPO | $13.15 | — |
| Humana | HMO | $13.15 | — |
| Christus (USFHP) | TRICARE | $19.13 | — |
| TriWest Health Alliance | TRCR | $19.13 | — |
| Oscar | MGMCR | $24.87 | — |
| TriWest Healthcare Alliance | VeteransPCCC | $24.87 | — |
| BCBS | MedicareAdvantageHMO | $25.38 | — |
| BCBS | MCRPPO | $25.38 | — |
| Devoted Health | MGMCR | $25.38 | — |
| Humana | MedicareAdvantageHMO | $25.38 | — |
| Humana | MedicareAdvantagePPOPFFS | $25.38 | — |
| Cigna HealthSpring | MCRHMO | $25.38 | — |
| Cigna HealthSpring | MCRPPO | $25.38 | — |
| Cigna HealthSpring | MCRSNP | $25.38 | — |
| Cigna HealthSpring | PFFS | $25.38 | — |
| Cigna HealthSpring | MMP | $25.38 | — |
| WellMed | MGMCR | $25.51 | — |
| Van Lang IPA | MCR | $25.63 | — |
| United | MCR | $25.89 | — |
| WellCare | POS | $26.14 | — |
| WellCare | PFFS | $26.14 | — |
| Integranet Amerigroup IPA | MCR | $26.14 | — |
| WellCare | PPO | $26.14 | — |
| WellCare | SNP | $26.14 | — |
| WellCare | MCRHMO | $26.14 | — |
| Superior Health Plan | MCRPOS | $26.65 | — |
| Superior Health Plan | MCRHMO | $26.65 | — |
| ProCare Advantage | MGMCR | $26.65 | — |
| Superior Health Plan | DualEligible | $26.65 | — |
| American Health Plan | MGMCR | $26.65 | — |
| Superior Health Plan | MCRPPO | $26.65 | — |
| Superior Health Plan | MCRSNP | $26.65 | — |
| Superior Health Plan | PFFS | $26.65 | — |
| Shared Health | MGMCR | $26.65 | — |
| Provider Partners Health Plan of Texas | MCRHMO | $26.90 | — |
| Provider Partners Health Plan of Texas | PPO | $26.90 | — |
| Provider Partners Health Plan of Texas | SNP | $26.90 | — |
| Provider Partners Health Plan of Texas | POS | $26.90 | — |
| Provider Partners Health Plan of Texas | PFFS | $26.90 | — |
| Molina | MGMCR | $27.66 | — |
| Verda Health Plan | MCR | $32.99 | — |
| Community Health Choice | HIX | $36.80 | — |
| Superior | ValueHMO | $36.80 | — |
| Superior | EPO | $39.34 | — |
| Superior | HMO | $39.34 | — |
| Molina Healthcare | HIX | $54.57 | — |
| BCBS | MyBlueHealth | $60.72 | — |
| BCBS | BAV | $66.95 | — |
| TriWest Healthcare Alliance | Veterans | $76.14 | — |
| BCBS | EPOSOA | $83.82 | — |
| BCBS | PPO | $83.82 | — |
| BCBS | HMO | $83.82 | — |
Visitor-reported prices
Comments
Ph1 assmt&mgmt nqhp 11-20 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $53.40 | $15.13 – $79.67 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $54.47 | $11.21 – $81.70 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $53.40 | $10.68 – $78.37 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $53.40 | $14.24 – $75.65 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $54.47 | $17.48 – $95.76 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $54.47 | $28.14 – $81.70 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $53.40 | $17.80 – $80.10 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $53.40 | $14.24 – $79.67 |