CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Methodist Celina Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $137
Cash Discount Price: $321
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Methodist Celina Medical Center is $137. 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 1.01x the Medicare baseline. Located in 1500 S Dallas Parkway, Celina, TX.

Cash / Self-Pay

$321

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $137 (101%)

Cash: $321 (237% of Medicare)

Ins. Median: $137 (101% 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.

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
Blue Cross Blue Shield	$62 - $142	46%
Medicare (plans)	$90 - $142	66%
Oscar Insurance Company [2057]	$110	81%
Molina [3017]	$122	90%
Champva [1000]	$124	91%
Tricare	$124	91%
Triwest Wps [8010]	$124	91%
Veterans Administration [9001]	$124	91%
Wellpoint Marketplace Exchange [3071]	$131	97%
Aetna	$134 - $137	99%
Mcs Advantage, Inc Classicare [7021]	$134	99%
UnitedHealthcare	$134 - $142	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 - $142	103%
Humana	$142	105%
Southwestern Health Resources Swhr [7015]	$142	105%
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%
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%
Medicaid / KanCare	$483	356%

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 $321.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

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 99214.
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.