Office visit, established patient (20-29 min) cost in TX
What a office visit, established patient (20-29 min) costs at TX hospitals — and the fair price to aim for.
Typical commercial prices here are +46% above the fair benchmark (1.46×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Aligned Regional Benchmark Peer
Coryell Memorial Hospital prices shoppable and inpatient services (1.4× to 1.8× Medicare, divergence 1.29×) in alignment with regional hospital peers (0.98× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 2% below peer Fair BaseRate (0.98×)
- Self-pay cash beats commercial insurance on 61% of shoppable procedures (99/100 Cash Honesty)
- 5-Star CMS clinical rating with 85% patient recommendation (81/100 safety score)
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.46× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Captive ER (0.9×) & laboratory (2.7×) services average 1.29× higher multiples than routine shoppable care (1.4×)
- Upper-quartile procedures (Q75 1.33×) jump +46% above the median procedure ratio (Q50 0.91×)
- Consolidated metro market (HHI 5,012) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, TX hospitals charge above the fair price — worth shopping around here. how we calculate the BaseRate →
Compared with the rest of the country, TX’s fair BaseRate ($105) is above the national fair price of $87.
Cheapest TX hospitals for a office visit, established patient (20-29 min)
- Coryell Memorial Hospital · Gatesville $27
- Muenster Memorial Hospital · Muenster $38
- Ward Memorial Hospital · Monahans $46
- Frio Regional Hospital · Pearsall $47
- PAM Specialty Hospital of Texarkana North · Texarkana $47
- Riceland Medical Center · Winnie $48
- Cook Childrens Medical Center Prosper · Prosper $51
- Cook Childrens Medical Center · Fort Worth $51
- North Texas Medical Center · Gainesville $52
- PAM Specialty Hospital of San Antonio Medical Center · San Antonio $52
- PAM Health Rehabilitation Hospital of El Paso · El Paso $56
- South Texas Spine and Surgical Hospital · San Antonio $57
- Parkland Health & Hospital System · Dallas $57
- Shriners Hospitals for Children · Galveston $59
- El Paso Children's Hospital · El Paso $63
Audit a Bill or Quote at TX Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $111
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $111).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask TX Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $105 Fair BaseRate ($61 Medicare)
Your bill ($305) is $200 above the denoised Fair BaseRate ($105) and 5.0× the $61 Medicare rate.