CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Texas Health Presbyterian Hospital Kaufman

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $264
  • Cash Discount Price: $539
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Texas Health Presbyterian Hospital Kaufman is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $539. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.95x the Medicare baseline. Located in 850 Ed Hall, Kaufman, TX.
Cash / Self-Pay
$539

Average discount available for prompt cash payment at this facility.

Insurance Median
$264

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: $539 (397%)
Insurance Median: $264 (195%)
Cash: $539 (397% of Medicare)
Ins. Median: $264 (195% 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
Amerigroup $32 - $138 24%
Blue Cross Blue Shield $32 - $657 24%
Parkland $32 - $136 24%
UnitedHealthcare $32 - $797 24%
Superior Wellcare $34 - $145 25%
Molina $35 - $147 26%
American Health $132 97%
Healthspring $134 99%
Humana $137 101%
Aetna $140 - $1,020 103%
Fort Worth Firefighters $150 - $888 111%
City Of Fort Worth $161 - $684 119%
Cigna $189 - $1,369 139%
Quick Trip $243 - $1,033 179%
Phcs $286 - $1,216 211%
Healthsmart $298 - $1,397 220%
Multiplan $298 - $1,266 220%
Galaxy $301 - $1,280 222%
Usa $301 - $1,280 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 850 Ed Hall, Kaufman, TX 75142
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals