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Hospital Profile Children's Hospital Voluntary non-profit - Private 905 Beds · urban Updated: 2026-03-05

Texas Childrens Hospital

6621 Fannin Street, Houston, TX 77030 · 82 Priced Procedures

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Above Fair Market · Negotiate
1.23×vs. Fair Market Price
Position vs. 1.00× Fair Price+23% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are +23% above the fair benchmark (1.23×) even after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).82/100 · Corroborated
82/100Self-Pay Cash Beats Insurance 35% of the Time
File Completeness66Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic87Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment71Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing89Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.High-Markup Tier
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Texas Childrens Hospital maintains elevated commercial insurance contracts (1.23× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 35% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#175 of 307 in TX · 56th State Percentile#2,091 of 3,385 in U.S. · 61st National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.67× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 35% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (54/100 safety score) with 72% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (57.6% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (1.23× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
  • Captive ER (1.2×) & laboratory (2.7×) services average 1.38× higher multiples than routine shoppable care (0.8×)
  • Upper-quartile procedures (Q75 1.05×) jump +22% above the median procedure ratio (Q50 0.86×)
  • Unnegotiated chargemaster list prices average 14.7× Medicare (21¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
0.8× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.38× Divergence
1.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+22% Upper Tail
Q25 0.67× · Q50 0.86× · Q75 1.05×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
0.8× MedicareGood
Outpatient Surgery & ORBack-Door Captive
1.0× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.6× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
1.2× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
2.7× MedicareFair
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.9× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
35% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated

Procedure Prices at Texas Childrens Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 82 published procedures.

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Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Sleep study (overnight, in lab)
CPT Code: 95810
 $4,114 4.0×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $2,743 4.7×
Rabies immune globulin
HCPCS Code: 90375
 $2,348 7.3×
Blood transfusion
CPT Code: 36430
 $889 1.8×
Office visit, established patient (30-39 min)
CPT Code: 99214
 $674 unverified
Orthotic fitting and training
CPT Code: 97760
 $586 11.5×
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $436 6.8×
Office visit, established patient (20-29 min)
CPT Code: 99213
 $418 unverified
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $335 0.7×
MRI, brain (with and without contrast)
CPT Code: 70553
 $353 0.7×
Speech therapy (language evaluation)
CPT Code: 92507
 $296 3.4×
Breathing treatment (nebulizer)
CPT Code: 94640
 $258 1.3×
Speech therapy (group session)
CPT Code: 92508
 $213 7.9×
Physical therapy (therapeutic exercise)
CPT Code: 97110
 $203 5.8×
Physical therapy (neuromuscular re-education)
CPT Code: 97112
 $219 5.8×
Physical therapy (manual therapy)
CPT Code: 97140
 $190 5.6×
Occupational therapy (therapeutic activities)
CPT Code: 97530
 $198 5.0×
New patient office visit (30-44 min)
CPT Code: 99203
 $204 1.9×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $199 0.7×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $202 0.7×
MRI, brain (no contrast)
CPT Code: 70551
 $217 0.6×
CT scan, head (with and without contrast)
CPT Code: 70470
 $188 0.7×
MRI, lower back (no contrast)
CPT Code: 72148
 $212 0.6×
MRI, knee or other leg joint
CPT Code: 73721
 $225 0.6×
CT scan, head (with contrast)
CPT Code: 70460
 $164 0.7×
Showing top 25 high-impact procedures of 82 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 57.6%

Audit a Bill or Quote at Texas Childrens Hospital (Zero PHI Required)

CMS CCN: 453304
CPT 95810
Fair BaseRate™ $1,021
Medicare Rate $877
Self-Pay Cash $4,114
Insurer Median $4,114
Pre-filled with Texas Childrens Hospital’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $3,540 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,540

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (57.6% of gross = $3,540).

Step 2 · Cash vs. Insurance Arbitrage Save $2,027 Paying Cash

Self-Pay Cash Rate ($4,114) Beats Your Bill

Texas Childrens Hospital's published 45 CFR § 180 self-pay cash rate is $4,114 (vs. $4,114 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$5,120 Above Fair BaseRate

Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)

Your bill ($6,141) is $5,120 above the denoised Fair BaseRate ($1,021) and 7.0× the $877 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold
Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier
Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported
26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (57.6% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Texas Childrens Hospital.

Price Index: 2.25× regional baseline
Quality: 54/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Kelseycare
+77.4%
Median Household Income$73,104U.S. Census ACS
Local Uninsured Share21.2%Regional ACS estimate
200% FPL (1 Person)$31,920Common free-care ceiling
400% FPL (Family of 4)$128,600Common AGB cap ceiling
45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 82/100 · Corroborated CMS CCN 453304

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 453304) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2026-03-05
Validated Rate Rows7,616 (CMS v3.0.0)
File Integrity DigestVerified · CCN 453304

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy