CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Medical City Plano

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $218
  • Cash Discount Price: $486
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Medical City Plano is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $486. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.85x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$486

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $486 (413%)
Insurance Median: $218 (185%)
Cash: $486 (413% of Medicare)
Ins. Median: $218 (185% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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 $21 - $113 18%
Cigna $41 - $227 35%
Aetna $50 - $979 43%
United $53 - $282 45%
Imperial Insurance Company $58 - $307 49%
Healthcare Highways $75 - $547 64%
Evry Health $79 - $417 67%
Lifecare Hospitals $92 - $485 78%
Curative Administrators $122 - $647 104%
Prominence Health Plan $122 - $647 104%
Blue Cross Blue Shield $136 - $718 116%
City Of Mckinney $138 - $728 117%
Fidelis Securecare $138 - $728 117%
National Choicecare $153 - $809 130%
Pc Texas Partners $168 - $890 143%
Physicians Coop Of Tx $168 - $890 143%
Rockport Health Group $168 - $890 143%
Averde Health, Inc $177 - $938 151%
Texas Healthcare Foundation Wc $199 - $1,052 169%
Humana $213 181%
Coastal Comp Health Networks $214 - $1,133 182%
Mega Life $214 - $1,133 182%
Multiplan Phcs $214 - $1,133 182%
Healthsmart Preferred Care $229 - $1,214 195%
Lewisville Isd/Dls Consulting $229 - $1,214 195%
Usa Managed Care $244 - $1,294 208%
Usc Health Services $244 - $1,294 208%
Galaxy Health Network $260 - $1,375 221%
Independent Medical Systems $306 - $1,618 260%
National Healthcare Solutions $306 - $1,618 260%
Unicare $306 - $1,618 260%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals