CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Methodist Midlothian Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $140
  • Cash Discount Price: $321
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Methodist Midlothian Medical Center is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.03x the Medicare baseline. Located in 1201 E Highway 287, Midlothian, TX.
Cash / Self-Pay
$321

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $321 (237%)
Insurance Median: $140 (103%)
Cash: $321 (237% of Medicare)
Ins. Median: $140 (103% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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
Medicare (plans) $90 - $142 66%
UnitedHealthcare $90 - $142 66%
Alternative Service Concepts [8005] $105 77%
Oscar Insurance Company [2057] $110 81%
Bright Healthcare [2222] $118 87%
Molina [3017] $122 90%
Wellpoint Marketplace Exchange [3071] $131 97%
Aetna $134 - $137 99%
Blue Cross Blue Shield $134 - $142 99%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $134 99%
Ust Health Proof [1005] $134 99%
Wellcare [7016] $134 99%
90 Degree Benefit [3057] $139 103%
Allied National [2031] $139 103%
Entrust/90 Degree [2058] $139 103%
American Health Advantage Of Texas [7099] $140 103%
Cigna $140 - $156 103%
Globalhealth [1003] $140 103%
Procare Advantage [7018] $140 103%
Humana $142 105%
Southwestern Health Resources Swhr [7015] $142 105%
Friday Health Plan [2061] $143 105%
Ambetter / Centene $144 106%
Provider Partners Health Plan [7025] $144 106%
Imperial Insurance Companies [3073] $152 112%
Web Tpa [3049] $156 115%
Department Of Labor [8004] $169 125%
Evry Health [1013] $169 125%
Generic Workers Comp Tx Non Par [9010] $169 125%
Generic Workers Comp Tx Par [8002] $169 125%
Generic Workers Comp Tx Par [9011] $169 125%
Sana Benefits [3069] $169 125%
Tristar Risk Management [8006] $169 125%
Velocity [3070] $169 125%
Health Plans Inc [5017] $211 156%
Medical Cost Containment Professionals [3059] $211 156%
Kempton Group Administrators, Tower Extrusions [3061] $214 158%
Dart Member Care [3039] $228 168%
Healthscope Benefits [2052] $228 168%
Healthscope Benefits [3063] $228 168%
Medicaid / KanCare $467 344%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 E Highway 287, Midlothian, TX 76065
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals