CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Methodist Celina Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $136
Cash Discount Price: $211
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Methodist Celina Medical Center is $136. 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 1.16x the Medicare baseline. Located in 1500 S Dallas Parkway, Celina, TX.

Cash / Self-Pay

$211

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: $211 (179%)

Insurance Median: $136 (116%)

Cash: $211 (179% 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.

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
Medicare (plans)	$76 - $142	65%
Blue Cross Blue Shield	$81 - $154	69%
Oscar Insurance Company [2057]	$92	78%
Molina [3017]	$103	88%
Wellpoint Marketplace Exchange [3071]	$110	94%
Aetna	$115 - $134	98%
90 Degree Benefit [3057]	$117	100%
Allied National [2031]	$117	100%
Entrust/90 Degree [2058]	$117	100%
Champva [1000]	$124	105%
Tricare	$124	105%
Triwest Wps [8010]	$124	105%
Veterans Administration [9001]	$124	105%
Mcs Advantage, Inc Classicare [7021]	$134	114%
UnitedHealthcare	$134 - $142	114%
Ust Health Proof [1005]	$134	114%
Wellcare [7016]	$134	114%
American Health Advantage Of Texas [7099]	$140	119%
Cigna	$140 - $142	119%
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%
Velocity [3070]	$142	121%
Health Plans Inc [5017]	$178	151%
Medical Cost Containment Professionals [3059]	$178	151%
Kempton Group Administrators, Tower Extrusions [3061]	$214	182%
Medicaid / KanCare	$318	270%

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 $211.
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 Methodist Celina Medical Center 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.