CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Medical City North Hills

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $130
  • Cash Discount Price: $345
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Medical City North Hills is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.37x the Medicare baseline. Located in 4401 Booth Calloway Road, North Richland Hills, TX.
Cash / Self-Pay
$345

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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%)
Cash / Self-Pay: $345 (362%)
Insurance Median: $130 (137%)
Cash: $345 (362% of Medicare)
Ins. Median: $130 (137% 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
Superior Health Plan $11 - $24 12%
Aetna $22 - $353 23%
Cigna $22 - $388 23%
Imperial Insurance Company $31 - $92 33%
Unicare $34 - $485 36%
United $35 - $104 37%
Healthcare Highways $40 - $164 42%
Evry Health $42 - $125 44%
Curative Administrators $65 - $194 68%
Blue Cross Blue Shield $72 - $278 76%
City Of Mckinney $73 - $218 77%
Fidelis Securecare $73 - $155 77%
National Choicecare $81 - $243 85%
Pc Texas Partners $89 - $267 93%
Physicians Coop Of Tx $89 - $267 93%
Rockport Health Group $89 - $267 93%
Averde Health, Inc $94 - $282 99%
Magellan Behavior Health $97 - $291 102%
Coastal Comp Health Networks $113 - $340 119%
Mega Life $113 - $340 119%
Multiplan Phcs $113 - $340 119%
Healthsmart Preferred Care $122 - $364 128%
Lewisville Isd/Dls Consulting $122 - $364 128%
Usa Managed Care $130 - $388 137%
Usc Health Services $130 - $388 137%
Galaxy Health Network $138 - $413 145%
Humana $147 154%
Independent Medical Systems $162 - $485 170%
National Healthcare Solutions $162 - $485 170%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4401 Booth Calloway Road, North Richland Hills, TX 76180
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals