CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Medical City Plano

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$168

about 1.2× the $136 Medicare rate · typically $100–$401

modeled estimate · not a bill or quote

Medicare pays $136 Fair price $168 Cash price $345 Hospital's list price $345

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$49 - $302	36%
Blue Cross Blue Shieldmajor	$136 - $770	100%
Aetnamajor	$46 - $1,049	34%
Cignamajor	$38 - $243	28%
Humanamajor	$198	146%
Fidelis Care	$138 - $781	102%
Health Net	$214 - $1,214	158%
Healthcare Highways	$69 - $586	51%
UniCare	$306 - $1,735	226%
+ 16 smaller / regional plans	$54 - $1,735

Government programs also on file: Medicaid.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 345), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm Medical City Plano is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Medical City Plano

Compare: Office visit, established patient (30-39 min) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.