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Office visit, established patient, 40-54 min

CPT 99215 · negotiated-rate distribution across hospitals in TX

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Hospitals
45
Min
$56.50
Median
$256.54
Max
$7,584.00
Range multiplier
134.2×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield38174$37.20$210.58$8,427.00226.5×
UnitedHealthcare3081$17.49$242.00$1,011.2757.8×
Aetna2375$36.83$232.00$1,203.5132.7×
Humana1642$36.83$390.21$1,250.4034.0×
Cigna1833$36.49$213.63$1,300.0035.6×
Multiplan1727$261.00$434.35$1,094.104.2×
Medicaid1123$1.00$155.27$704.00704.0×
Anthem BCBS222$100.08$141.38$141.381.4×
commercial | galaxy | all plans918$428.40$544.95$1,406.703.3×
First Health1217$224.00$439.50$694.403.1×
healthsmart715$56.00$521.54$737.8013.2×
commercial | phcs | all plans514$346.28$471.15$1,055.033.0×
web tpa48$263.70$263.70$263.701.0×
assurant health48$386.76$386.76$386.761.0×
galaxy health network37$61.38$80.00$633.6010.3×
wellmed26$65.00$71.48$248.483.8×
scott & white56$175.80$175.80$616.283.5×
superior health plan36$133.00$183.09$270.002.0×
Medicare15$130.81$137.35$138.661.1×
commercial | nppn | all plans55$403.20$403.20$403.201.0×
commercial | usa health network | all plans55$428.40$428.40$428.401.0×
commercial | healthsmart | ppo44$352.80$352.80$352.801.0×
patoka valley tier 224$141.38$141.38$141.381.0×
patoka valley tier 124$141.38$141.38$141.381.0×
accountable health plans of america14$57.97$198.69$598.4010.3×
private healthcare systems14$54.56$188.71$563.2010.3×
great west healthcare of texas14$60.02$205.70$619.5210.3×
city of san angelo44$81.45$81.45$81.451.0×
mhs care connect24$100.08$100.08$100.081.0×
choicecare network ppo, pos, med adv14$54.56$187.00$563.2010.3×
choice one inc ppo14$54.56$187.00$563.2010.3×
choice one inc epo/pos14$49.10$168.30$506.8810.3×
medavant healthcare solutions14$54.56$187.00$563.2010.3×
health industry trust and welfare plan14$61.38$210.38$633.6010.3×
proamerica ppo14$57.97$198.69$598.4010.3×
medcorp southwest14$57.97$200.40$598.4010.3×
txp optum health (transplant)14$460.04$538.16$651.001.4×
Medicare Advantage23$36.83$130.02$150.734.1×
tml intergovernmental employee benefits13$57.97$339.41$598.4010.3×
superior13$68.20$399.30$704.0010.3×
phcs12$651.00$651.00$651.001.0×
pphp12$132.62$143.18$153.741.2×
prime health services12$709.00$777.00$845.001.2×
commercial | healthsmart | all plans22$352.80$352.80$352.801.0×
commercial | firstcare | all plans22$306.60$306.60$306.601.0×
health partners open network22$183.88$183.88$183.881.0×
oscar12$218.00$239.00$260.001.2×
galaxy health12$841.96$841.96$841.961.0×
Molina22$181.73$242.77$303.801.7×
friday health insurance company12$1,417.00$1,553.50$1,690.001.2×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Baylor County Hospital DistrictSeymourTX9$464.00$324.80$65.00$80.00$263.08
Baylor Orthopedic And Spine HospitalArlingtonTX1$3,986.00$7,584.00$8,427.00
Clay County Memorial HospitalHenriettaTX5$292.00$204.00$56.00$71.50$93.00
Crescent Medical Center LancasterLancasterTX5$1,300.00$845.00$218.00$617.50$1,690.00
Childrens Medical Center Of PlanoPlanoTX31$868.00$651.00$50.00$607.60$841.96
Driscoll Childrens HospitalCorpus ChristiTX2$1,233.10$246.62$165.82$582.91$1,000.00
Grimes St. Joseph Health CenterNavasotaTX2$511.00$178.85$45.00$56.50$434.35
College Station Medical CenterCollege StationTX2$511.00$178.85$45.00$56.50$434.35
St. Joseph Regional Health CenterBryanTX2$511.00$178.85$45.00$56.50$434.35
St Lukes Health Memorial San AugustSan AugustineTX7$1,563.00$547.05$47.00$523.50$1,406.70
Chi St Lukes Health Memorial LufkinLufkinTX7$1,563.00$547.05$47.00$479.88$1,406.70
Chi St Lukes Health Mem LivingstonLivingstonTX6$1,563.00$547.05$47.00$479.88$1,406.70
Big Spring State HospitalBig SpringsTX11$586.00$293.00$81.45$421.92$521.54
San Angelo Community Medical CenterSan AngeloTX11$586.00$293.00$81.45$421.92$521.54
Shannon Medical CenterSan AngeloTX11$586.00$293.00$81.45$421.92$521.54
River Crest HospitalSan AngeloTX11$586.00$293.00$81.45$421.92$521.54
Dimmit Regional Hospital DistrictCarrizo SpringsTX3$684.00$410.00$152.00$384.00$657.00
Burleson St. Joseph Health CenterCaldwellTX6$511.00$178.85$45.00$316.82$459.90
Madison St. Joseph Health CenterMadisonvilleTX5$511.00$178.85$45.00$306.60$459.90
St. Lukes Patients Medical CenterPasadenaTX6$504.00$176.40$159.05$285.65$428.40
Limestone Medical CenterGroesbeckTX8$519.75$311.85$130.02$284.07$415.80
St. Lukes The Woodlands HospitalThe WoodlandsTX9$504.00$176.40$98.00$269.89$428.40
St. Lukes Lakeside HospitalThe WoodlandsTX9$504.00$176.40$98.00$269.89$428.40
St Lukes Hospital At The VintageHoustonTX9$504.00$176.40$98.00$269.89$428.40
St. Lukes Sugar Land HospitalSugar LandTX9$504.00$176.40$98.00$269.89$428.40
Brazosport Regional Health SystemLake JacksonTX2$504.00$176.40$234.40$269.26$315.53
Heritage Park Surgical HospitalShermanTX1$189.00$113.40$256.54$256.54$256.54
Chi St Lukes Health Baylor Med CtrHoustonTX10$504.00$176.40$99.00$242.28$428.40
Mccamey County Hospital DistrictMccameyTX14$273.00$273.00$164.00$240.50$273.00
North Texas Medical CenterGainsvilleTX9$373.00$93.00$113.00$224.00$343.00
Rice Medical CenterEagle LakeTX23$704.00$492.80$1.00$215.62$704.00
Trinity Regional Hospital SachseSachseTX6$332.00$265.60$131.48$203.00$272.53
Wilson N Jones Regional Medical CtrShermanTX8$332.00$265.60$131.48$203.00$272.53
Golden Plains Community HospitalBorgerTX6$645.00$451.50$54.83$194.35$438.60
Falls Community Hospital And ClinicMarlinTX6$436.00$348.80$70.00$189.00$507.60
Eastland Memorial HospitalEastlandTX3$256.00$128.00$159.00$183.00$230.00
Muleshoe Area Medical CenterMuleshoeTX4$225.00$135.00$88.00$180.00$225.00
Crane County Hospital DistrictCraneTX2$254.00$178.00$155.00$157.50$229.00
Methodist Hospital For SurgeryAddisonTX32$735.00$441.00$123.94$137.35$250.66
Hansford County Hospital DistrictSpearmanTX5$150.00$113.00$105.00$135.00$158.00
Ascension Seton Shoal CreekAustinTX7$17.49$133.17$141.38
Ascension Seton BastropBastropTX7$17.49$133.17$141.38
Acuity Hospital Of South TexasSan AntonioTX1$113.70$113.70$113.70
St Joseph Medical CenterHoustonTX0$1,435.30$1,435.30
The Medical Ctr Of Southeast TexasPort ArthurTX0$894.90$894.90

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.