CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Childrens Medical Center Plano

Billing Code: 99203 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$91

about 0.8× the $118 Medicare rate · typically $71–$243

modeled estimate · not a bill or quote

What this hospital charges insurers

$96

About the fair price

about $5 over the fair price · 0.8× Medicare

Medicare pays $118 Fair price $91 This hospital $96 Cash price $536 Hospital's list price $715

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $54 Priciest $96

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a New patient office visit (30-44 min) is about $91 (about 0.8× the $118 Medicare rate). Childrens Medical Center Plano charges insurers about $96, or about $536 in cash — about the fair price. Located in Plano, TX.

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	$379 - $536	322%
Blue Cross Blue Shieldmajor	$272 - $486	231%
Aetnamajor	$96 - $572	82%
Cignamajor	$472 - $493	401%
Humanamajor	$96 - $536	82%
Health Net	$500	425%
Molina	$250	213%
+ 13 smaller / regional plans	$96 - $608

Government programs also on file: Medicaid.

Excludes 6 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 536), 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: 99203.

Insurance Before you use insurance

Call your insurance company to confirm Childrens Medical Center Plano is in-network.
Ask your insurer whether prior approval is required for CPT code 99203.
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 Childrens Medical Center Plano

Compare: New patient office visit (30-44 min) at other TX hospitals

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