CMS Price Transparency Data

Review of medical records for care

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 90889 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90889
Insurance Median: $152
Cash Discount Price: Unavailable
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Review of medical records for care at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$70 - $189	N/A
Coventry	$135	N/A
Aetna	$152	N/A
United Options Nexus	$189	N/A
Cigna	$208	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90889.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UT of Texas Southwestern University Hospital - William P. Clements Jr. is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90889.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.