CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Methodist Southlake Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $139
  • Cash Discount Price: $211
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Methodist Southlake Medical Center is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.18x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$211

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

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: $211 (179%)
Insurance Median: $139 (118%)
Cash: $211 (179% of Medicare)
Ins. Median: $139 (118% 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
Blue Cross Blue Shield $34 - $142 29%
Medicare (plans) $76 - $142 65%
UnitedHealthcare $76 - $240 65%
Alternative Service Concepts [8005] $89 76%
Oscar Insurance Company [2057] $92 78%
Bright Healthcare [2222] $100 85%
Molina [3017] $103 88%
Wellpoint Marketplace Exchange [3071] $110 94%
Aetna $115 - $274 98%
90 Degree Benefit [3057] $117 100%
Allied National [2031] $117 100%
Entrust/90 Degree [2058] $117 100%
Friday Health Plan [2061] $121 103%
Ambetter / Centene $122 104%
Champva [1000] $123 105%
Tricare $123 105%
Triwest Wps [8010] $123 105%
Veterans Administration [9001] $123 105%
Imperial Insurance Companies [3073] $128 109%
Cigna $132 - $142 112%
Web Tpa [3049] $132 - $274 112%
Bind Benefits Inc [1004] $133 - $240 113%
Definity Health [3006] $133 - $240 113%
Freedom Life Insurance Company [2029] $133 - $240 113%
Geha Federal [3066] $133 - $240 113%
Tml Intergovernmental Employee Benefits [3050] $133 - $240 113%
Ust Health Proof [1005] $134 114%
Wellcare [7016] $134 114%
American Health Advantage Of Texas [7099] $141 120%
Globalhealth [1003] $141 120%
Procare Advantage [7018] $141 120%
Department Of Labor [8004] $142 121%
Evry Health [1013] $142 121%
Generic Workers Comp Tx Non Par [9010] $142 121%
Generic Workers Comp Tx Par [8002] $142 121%
Generic Workers Comp Tx Par [9011] $142 121%
Humana $142 121%
Sana Benefits [3069] $142 121%
Southwestern Health Resources Swhr [7015] $142 121%
Tristar Risk Management [8006] $142 121%
Velocity [3070] $142 121%
Provider Partners Health Plan [7025] $145 123%
Health Plans Inc [5017] $178 151%
Medical Cost Containment Professionals [3059] $178 151%
Dart Member Care [3039] $192 163%
Healthscope Benefits [2052] $192 163%
Healthscope Benefits [3063] $192 163%
Kempton Group Administrators, Tower Extrusions [3061] $214 182%
Scott & White Health Plan Trs [3062] $236 201%
Medicaid / KanCare $437 - $531 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 421 E State Highway 114, Southlake, TX 76092
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals