CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Medical City Lewisville

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $274
Cash Discount Price: $609
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Medical City Lewisville is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $609. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.02x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.

Cash / Self-Pay

$609

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $609 (449%)

Insurance Median: $274 (202%)

Cash: $609 (449% of Medicare)

Ins. Median: $274 (202% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 202% of the Medicare baseline (a markup of 102%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$43	32%
Aetna	$82 - $442	60%
Cigna	$82 - $85	60%
Imperial Insurance Company	$116	86%
United	$121	89%
Unicare	$146 - $609	108%
Healthcare Highways	$149 - $206	110%
Evry Health	$157	116%
Humana	$198	146%
Blue Cross Blue Shield	$220 - $428	162%
Curative Administrators	$243	179%
City Of Mckinney	$274	202%
Fidelis Securecare	$274	202%
National Choicecare	$304	224%
Pc Texas Partners	$335	247%
Physicians Coop Of Tx	$335	247%
Rockport Health Group	$335	247%
Averde Health, Inc	$353	260%
Usc Health Services	$365	269%
Coastal Comp Health Networks	$426	314%
Jostens	$426	314%
Mega Life	$426	314%
Multiplan Phcs	$426	314%
Healthsmart Preferred Care	$456	336%
Lewisville Isd/Dls Consulting	$456	336%
Usa Managed Care	$487	359%
Galaxy Health Network	$517	381%
Independent Medical Systems	$609	449%
National Healthcare Solutions	$609	449%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $609.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Lewisville is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.