CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Medical Center of McKinney

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $75
  • Cash Discount Price: $131
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Medical Center of McKinney is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.79x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$131

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $131 (138%)
Insurance Median: $75 (79%)
Cash: $131 (138% of Medicare)
Ins. Median: $75 (79% 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
Aetna $17 - $213 18%
Cigna $17 - $234 18%
Imperial Insurance Company $24 - $56 25%
United $24 - $55 25%
Healthcare Highways $31 - $99 33%
Evry Health $33 - $76 35%
Unicare $33 - $293 35%
City Of Mckinney $44 - $103 46%
Curative Administrators $51 - $117 54%
Blue Cross Blue Shield $56 - $278 59%
Fidelis Securecare $57 - $60 60%
National Choicecare $63 - $147 66%
Pc Texas Partners $70 - $161 74%
Physicians Coop Of Tx $70 - $161 74%
Rockport Health Group $70 - $161 74%
Averde Health, Inc $74 - $170 78%
Magellan Bh $76 - $176 80%
Value Options Behavioral Health $76 - $176 80%
Humana $83 - $191 87%
Coastal Comp Health Networks $89 - $205 93%
Mega Life $89 - $205 93%
Multiplan Phcs $89 - $205 93%
Lewisville Isd/Dls Consulting $95 - $220 100%
Compsych Corporation $102 - $234 107%
Healthsmart Preferred Care $102 - $234 107%
Usa Managed Care $102 - $234 107%
Galaxy Health Network $108 - $249 113%
Independent Medical Systems $127 - $293 133%
National Healthcare Solutions $127 - $293 133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals