CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Texas Health Presbyterian Hospital Denton

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $302
Cash Discount Price: $326
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Texas Health Presbyterian Hospital Denton is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.57x the Medicare baseline. Located in 3000 N I-35, Denton, TX.

Cash / Self-Pay

$326

Average discount available for prompt cash payment at this facility.

Insurance Median

$302

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: $326 (277%)

Insurance Median: $302 (257%)

Cash: $326 (277% of Medicare)

Ins. Median: $302 (257% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 257% of the Medicare baseline (a markup of 157%). 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
Amerigroup	$38 - $150	32%
Blue Cross Blue Shield	$38 - $636	32%
Cook Childrens	$38 - $150	32%
UnitedHealthcare	$38 - $880	32%
Superior Wellcare	$40 - $158	34%
Molina	$41 - $162	35%
Aetna	$42 - $1,126	36%
American Health	$114	97%
Healthspring	$116	99%
Humana	$119	101%
Fort Worth Firefighters	$180 - $980	153%
City Of Fort Worth	$193 - $755	164%
Cigna	$227 - $1,511	193%
Quick Trip	$246 - $1,012	209%
Phcs	$285 - $1,196	242%
Healthsmart	$308 - $1,349	262%
Multiplan	$357 - $1,397	304%
Galaxy	$361 - $1,413	307%
Usa	$361 - $1,413	307%

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 $326.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Texas Health Presbyterian Hospital Denton is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
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.