CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: University of Texas M. D. Anderson Cancer Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $155
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at University of Texas M. D. Anderson Cancer Center is $155. 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 $95.19, this hospital’s rate is 1.63x the Medicare baseline. Located in 1515 Holcombe Blvd, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$155

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Insurance Median: $155 (163%)
Ins. Median: $155 (163% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Texaschildrens $19 - $125 20%
UnitedHealthcare $34 - $214 36%
Tricare $56 - $214 59%
Vacare $56 - $125 59%
Medicare (plans) $79 - $125 83%
Cigna $100 - $155 105%
Humana $109 - $151 115%
Aetna $119 - $214 125%
Blue Cross Blue Shield $124 - $138 130%
Ontarioministriesofhealth $135 - $211 142%
Beijingst.Lucia $136 - $214 143%
Embassyofqatar $136 - $214 143%
Memorialhermannhealth $136 - $214 143%
Emergingtherapysolutions_Cancercare $146 - $228 153%
Interlink_Cancercare $146 - $228 153%
Saudiarmedforces $146 - $228 153%
Uae_Medical $146 - $228 153%
Uaepoliceattache $146 - $228 153%
Healthsmart $155 - $242 163%
Vantage $155 - $242 163%
Multiplan $187 - $245 196%
Phcs $187 - $245 196%
Emergingtherapysolutions $214 - $228 225%
Interlink $214 - $242 225%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 Holcombe Blvd, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL