CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Texas Health Hospital Frisco

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $128
Cash Discount Price: $245
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Texas Health Hospital Frisco is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.09x the Medicare baseline. Located in 12400 N Dallas Parkway, Frisco, TX.

Cash / Self-Pay

$245

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $245 (208%)

Insurance Median: $128 (109%)

Cash: $245 (208% of Medicare)

Ins. Median: $128 (109% 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.

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	$28 - $120	24%
Blue Cross Blue Shield	$28 - $636	24%
Parkland	$28 - $118	24%
UnitedHealthcare	$28 - $362	24%
Superior Wellcare	$29 - $125	25%
Molina	$30 - $127	26%
Aetna	$64 - $463	54%
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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $245.
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 Hospital Frisco 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.