CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Medical City North Hills

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $149
  • Cash Discount Price: $398
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Medical City North Hills is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $398. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.10x the Medicare baseline. Located in 4401 Booth Calloway Road, North Richland Hills, TX.
Cash / Self-Pay
$398

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $398 (294%)
Insurance Median: $149 (110%)
Cash: $398 (294% of Medicare)
Ins. Median: $149 (110% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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
Aetna $21 - $432 15%
Cigna $21 - $475 15%
Superior Health Plan $28 21%
Imperial Insurance Company $29 - $113 21%
Unicare $32 - $594 24%
United $33 - $128 24%
Healthcare Highways $37 - $201 27%
Evry Health $39 - $153 29%
Curative Administrators $61 - $238 45%
Blue Cross Blue Shield $67 - $428 49%
City Of Mckinney $68 - $267 50%
Fidelis Securecare $68 - $179 50%
National Choicecare $76 - $297 56%
Pc Texas Partners $84 - $327 62%
Physicians Coop Of Tx $84 - $327 62%
Rockport Health Group $84 - $327 62%
Averde Health, Inc $88 - $344 65%
Magellan Behavior Health $91 - $356 67%
Coastal Comp Health Networks $106 - $416 78%
Mega Life $106 - $416 78%
Multiplan Phcs $106 - $416 78%
Healthsmart Preferred Care $114 - $445 84%
Lewisville Isd/Dls Consulting $114 - $445 84%
Usa Managed Care $122 - $475 90%
Usc Health Services $122 - $475 90%
Galaxy Health Network $129 - $505 95%
Independent Medical Systems $152 - $594 112%
National Healthcare Solutions $152 - $594 112%
Humana $198 146%

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