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Office visit, established patient, 10-19 min

CPT 99212 · negotiated-rate distribution across hospitals in TX

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Hospitals
46
Min
$28.18
Median
$97.00
Max
$7,584.00
Range multiplier
269.1×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield38182$15.23$60.11$8,427.00553.3×
UnitedHealthcare3079$4.09$109.00$269.0065.8×
Aetna2377$13.23$94.00$394.4229.8×
Humana1641$15.23$211.64$295.8119.4×
Cigna1837$6.26$80.00$1,090.00174.1×
Medicaid1124$1.00$74.72$547.80547.8×
Anthem BCBS222$29.97$43.00$43.001.4×
Multiplan1721$77.00$228.75$315.004.1×
First Health1217$66.00$224.25$247.203.7×
healthsmart716$20.00$264.38$266.1113.3×
commercial | galaxy | all plans912$259.25$270.93$319.501.2×
assurant health48$197.34$197.34$197.341.0×
web tpa48$134.55$134.55$134.551.0×
commercial | phcs | all plans58$211.95$239.63$297.501.4×
scott & white56$89.70$89.70$219.392.4×
wellmed26$13.23$48.49$248.4818.8×
superior health plan36$44.00$68.33$109.002.5×
commercial | nppn | all plans55$244.00$244.00$244.001.0×
Medicare15$33.14$137.35$138.664.2×
galaxy health network35$80.00$83.16$493.026.2×
commercial | usa health network | all plans55$259.25$259.25$259.251.0×
patoka valley tier 124$43.00$43.00$43.001.0×
commercial | healthsmart | ppo44$213.50$213.50$213.501.0×
patoka valley tier 224$43.00$43.00$43.001.0×
city of san angelo44$41.56$41.56$41.561.0×
Medicare Advantage14$15.23$43.09$111.757.3×
mhs care connect24$29.97$29.97$29.971.0×
pphp14$15.53$43.95$113.997.3×
txp optum health (transplant)14$163.77$191.58$231.751.4×
oscar12$45.00$131.50$218.004.8×
muti-plan12$20.00$50.50$81.004.0×
commercial | healthsmart | all plans22$213.50$213.50$213.501.0×
commercial | health first | all plans12$144.00$146.75$149.501.0×
commercial | firstcare | all plans22$210.00$210.00$210.001.0×
health partners open network22$42.19$42.19$42.191.0×
health industry trust and welfare plan12$83.16$288.09$493.025.9×
accountable health plans of america12$78.54$272.09$465.635.9×
phcs12$231.75$231.75$231.751.0×
galaxy health12$299.73$299.73$299.731.0×
methodist12$175.98$175.98$175.981.0×
choicecare network ppo, pos, med adv12$73.92$256.08$438.245.9×
friday health insurance company12$290.00$853.50$1,417.004.9×
medcorp southwest12$78.54$272.09$465.635.9×
alliance regional12$71.00$109.50$148.002.1×
choice one inc ppo12$73.92$256.08$438.245.9×
great west healthcare of texas12$81.31$281.69$482.065.9×
equifax healthcare12$262.65$262.65$262.651.0×
choice one inc epo/pos12$66.53$230.48$394.425.9×
90 degrees12$79.00$121.50$164.002.1×
imagine health12$216.30$216.30$216.301.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Mccamey County Hospital DistrictMccameyTX14$110.00$110.00$66.00$97.00$110.00
Hansford County Hospital DistrictSpearmanTX5$156.00$117.00$53.00$94.00$164.00
Falls Community Hospital And ClinicMarlinTX6$252.00$201.60$17.40$93.19$201.60
Rice Medical CenterEagle LakeTX19$547.80$383.46$1.00$92.40$547.80
Heritage Park Surgical HospitalShermanTX1$63.00$37.80$80.09$80.09$80.09
Baylor County Hospital DistrictSeymourTX9$209.00$146.30$65.00$80.00$263.08
Baylor Orthopedic And Spine HospitalArlingtonTX1$3,986.00$7,584.00$8,427.00
Brazosport Regional Health SystemLake JacksonTX2$299.00$104.65$53.75$72.35$149.50
Limestone Medical CenterGroesbeckTX8$385.35$231.21$15.23$67.12$308.28
North Texas Medical CenterGainsvilleTX9$110.00$28.00$26.00$66.00$101.00
Golden Plains Community HospitalBorgerTX6$298.00$208.60$6.26$63.93$248.48
Muleshoe Area Medical CenterMuleshoeTX4$75.00$45.00$29.00$60.00$75.00
Driscoll Childrens HospitalCorpus ChristiTX2$581.90$116.38$165.82$582.91$1,000.00
Eastland Memorial HospitalEastlandTX3$80.00$40.00$50.00$57.00$72.00
St. Joseph Regional Health CenterBryanTX2$350.00$122.50$45.00$56.50$297.50
College Station Medical CenterCollege StationTX2$350.00$122.50$45.00$56.50$297.50
Grimes St. Joseph Health CenterNavasotaTX2$350.00$122.50$45.00$56.50$297.50
Crane County Hospital DistrictCraneTX2$91.00$64.00$56.00$56.50$82.00
Clay County Memorial HospitalHenriettaTX5$403.00$282.00$20.00$56.50$129.00
Trinity Regional Hospital SachseSachseTX6$104.00$83.20$32.24$49.59$66.60
Wilson N Jones Regional Medical CtrShermanTX8$104.00$83.20$32.24$49.59$66.60
Ascension Seton BastropBastropTX7$418.00$250.80$4.09$36.49$43.00
Ascension Seton Shoal CreekAustinTX7$418.00$250.80$4.09$36.49$43.00
Acuity Hospital Of South TexasSan AntonioTX1$28.18$28.18$28.18
Crescent Medical Center LancasterLancasterTX5$1,090.00$709.00$45.00$256.50$1,417.00
St Lukes Health Memorial San AugustSan AugustineTX7$355.00$124.25$47.00$224.75$319.50
Burleson St. Joseph Health CenterCaldwellTX6$350.00$122.50$45.00$217.00$315.00
Childrens Medical Center Of PlanoPlanoTX31$309.00$231.75$48.07$216.30$299.73
Shannon Medical CenterSan AngeloTX11$299.00$149.50$41.56$215.28$266.11
San Angelo Community Medical CenterSan AngeloTX11$299.00$149.50$41.56$215.28$266.11
Big Spring State HospitalBig SpringsTX11$299.00$149.50$41.56$215.28$266.11
River Crest HospitalSan AngeloTX11$299.00$149.50$41.56$215.28$266.11
Chi St Lukes Health Mem LivingstonLivingstonTX6$355.00$124.25$47.00$211.80$319.50
Chi St Lukes Health Memorial LufkinLufkinTX7$355.00$124.25$47.00$211.80$319.50
Madison St. Joseph Health CenterMadisonvilleTX5$350.00$122.50$45.00$210.00$315.00
St. Lukes Patients Medical CenterPasadenaTX6$305.00$106.75$36.59$205.88$269.00
St Lukes Hospital At The VintageHoustonTX9$305.00$106.75$36.36$138.38$259.25
St. Lukes Lakeside HospitalThe WoodlandsTX9$305.00$106.75$36.36$138.38$259.25
St. Lukes Sugar Land HospitalSugar LandTX9$305.00$106.75$36.36$138.38$259.25
St. Lukes The Woodlands HospitalThe WoodlandsTX9$305.00$106.75$36.36$138.38$259.25
Chi St Lukes Health Baylor Med CtrHoustonTX10$305.00$106.75$23.00$137.25$259.25
Methodist Hospital For SurgeryAddisonTX32$390.00$234.00$33.14$130.81$141.28
Dimmit Regional Hospital DistrictCarrizo SpringsTX3$215.00$129.00$46.00$115.00$206.00
St Joseph Medical CenterHoustonTX0$495.59$495.59
Yoakum County HospitalDenver CityTX0$68.82$68.82
The Medical Ctr Of Southeast TexasPort ArthurTX0$444.09$444.09

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.