CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Texas Health Presbyterian Hospital Flower Mound

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $136
  • Cash Discount Price: $155
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Texas Health Presbyterian Hospital Flower Mound is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.16x the Medicare baseline. Located in 4400 Long Prairie Road, Flower Mound, TX.
Cash / Self-Pay
$155

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $155 (132%)
Insurance Median: $136 (116%)
Cash: $155 (132% of Medicare)
Ins. Median: $136 (116% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $24 - $120 20%
Blue Cross Blue Shield $24 - $636 20%
Cook Childrens $24 - $99 20%
UnitedHealthcare $24 - $362 20%
Molina $25 - $120 21%
Superior Wellcare $25 - $125 21%
Aetna $26 - $463 22%
Fort Worth Firefighters $69 - $403 59%
City Of Fort Worth $74 - $310 63%
Cigna $87 - $622 74%
Quick Trip $94 - $416 80%
Phcs $109 - $492 93%
American Health $114 97%
Healthspring $116 99%
Healthsmart $117 - $555 100%
Humana $119 101%
Multiplan $136 - $575 116%
Galaxy $138 - $581 117%
Usa $138 - $581 117%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4400 Long Prairie Road, Flower Mound, TX 75028
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals