CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Medical City Fort Worth

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $70
Cash Discount Price: $127
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Medical City Fort Worth is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.74x the Medicare baseline. Located in 900 Eighth Avenue, Fort Worth, TX.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $127 (133%)

Insurance Median: $70 (74%)

Cash: $127 (133% of Medicare)

Ins. Median: $70 (74% 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.

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
Cigna	$17 - $67	18%
Aetna	$21 - $75	22%
Imperial Insurance Company	$24	25%
United	$24	25%
Unicare	$28 - $127	29%
Healthcare Highways	$31 - $43	33%
Evry Health	$33	35%
Curative Administrators	$51	54%
Blue Cross Blue Shield	$56 - $278	59%
City Of Mckinney	$57	60%
Fidelis Securecare	$57	60%
Emerging Therapy Solutions	$63 - $91	66%
National Choicecare	$63	66%
Pc Texas Partners	$70	74%
Physicians Coop Of Tx	$70	74%
Rockport Health Group	$70	74%
Averde Health, Inc	$73	77%
Coastal Comp Health Networks	$89	93%
Mega Life	$89	93%
Multiplan Phcs	$89	93%
Healthsmart Preferred Care	$90	95%
Lewisville Isd/Dls Consulting	$95	100%
Tcu Athletics	$101	106%
Usa Managed Care	$101	106%
Usc Health Services	$101	106%
Galaxy Health Network	$108	113%
UnitedHealthcare	$109	115%
Independent Medical Systems	$127	133%
National Healthcare Solutions	$127	133%
Humana	$147	154%

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 $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Fort Worth is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
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.