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Initial hospital care, low complexity

CPT 99221 · negotiated-rate distribution across hospitals in TX

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Hospitals
23
Min
$47.5
Median
$135.5
Max
$7,584
Range multiplier
159.7×

By payer (39 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield1545$45$245.4$8,427187.3×
Aetna1127$50$155$3346.7×
UnitedHealthcare1026$15.87$113.35$23014.5×
Anthem BCBS222$71.02$97.63$97.631.4×
Humana712$65$92.56$235.463.6×
Medicaid512$71.02$71.02$175.812.5×
Cigna911$40.4$100$3147.8×
patoka valley tier 124$97.63$97.63$97.631.0×
patoka valley tier 224$97.63$97.63$97.631.0×
mhs care connect24$71.02$71.02$71.021.0×
galaxy health network23$80$80$3544.4×
Medicare Advantage12$89.83$90.44$91.051.0×
encore exclusive22$97.63$97.63$97.631.0×
health partners open network22$167.73$167.73$167.731.0×
Multiplan22$175$284$3932.2×
pphp12$91.62$92.25$92.871.0×
superior health plan12$278$333.5$3891.4×
wellmed22$65$79.54$94.071.4×
healthcare highways11$150$150$1501.0×
firstcare11$354$354$3541.0×
First Health11$150$150$1501.0×
three rivers provider network11$334$334$3341.0×
muti-plan11$40$40$401.0×
oklahoma complete health11$71.36$71.36$71.361.0×
choicecare11$314$314$3141.0×
capstar11$389$389$3891.0×
amerivantage11$74.73$74.73$74.731.0×
prime health11$225$225$2251.0×
private health care systems (phcs)11$354$354$3541.0×
provider select11$213$213$2131.0×
scott and white11$96.47$96.47$96.471.0×
scott and white health plan11$354$354$3541.0×
scott and whte11$59$59$591.0×
superior health11$100$100$1001.0×
wellpoint11$259$259$2591.0×
healthsmart11$40$40$401.0×
healthsmart preferred network11$354$354$3541.0×
healthchoice11$120.4$120.4$120.41.0×
iowa health11$78.47$78.47$78.471.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ASCENSION SETON SHOAL CREEKAUSTINTX7$15.87$97.63$113.35
ASCENSION SETON BASTROPBASTROPTX7$15.87$97.63$113.35
FALLS COMMUNITY HOSPITAL AND CLINICMARLINTX6$202$161.6$40.4$96.47$463.82
BAYLOR COUNTY HOSPITAL DISTRICTSEYMOURTX9$240$168$65$80$100
SAN ANTONIO-AMG SPECIALTY HOSPITALSAN ANTONIOTX1$77.17$77.17$77.17
BAYLOR ORTHOPEDIC AND SPINE HOSPITALARLINGTONTX1$3,986$7,584$8,427
CHILDRENS MEDICAL CENTER OF PLANOPLANOTX4$71.36$71.36$71.36
CLAY COUNTY MEMORIAL HOSPITALHENRIETTATX5$198$139$40$50$63
EASTLAND MEMORIAL HOSPITALEASTLANDTX3$66$33$41$47.5$59
BIG SPRING STATE HOSPITALBIG SPRINGSTX1$344.25$361.78$361.78
RIVER CREST HOSPITALSAN ANGELOTX1$344.25$361.78$361.78
SAN ANGELO COMMUNITY MEDICAL CENTERSAN ANGELOTX1$344.25$361.78$361.78
SHANNON MEDICAL CENTERSAN ANGELOTX1$344.25$361.78$361.78
MCCAMEY COUNTY HOSPITAL DISTRICTMCCAMEYTX14$393$393$236$346$393
GOLDEN PLAINS COMMUNITY HOSPITALBORGERTX6$409$286.3$75.26$207.17$278.12
LIMESTONE MEDICAL CENTERGROESBECKTX8$313.95$188.37$89.83$191.43$251.16
NORTH TEXAS MEDICAL CENTERGAINSVILLETX9$250$63$100$150$230
WILSON N JONES REGIONAL MEDICAL CTRSHERMANTX8$227$181.6$74.73$135.5$226.16
TRINITY REGIONAL HOSPITAL SACHSESACHSETX6$227$181.6$74.73$135.5$226.16
HERITAGE PARK SURGICAL HOSPITALSHERMANTX1$120.4$120.4$120.4
HASKELL MEMORIAL HOSPITALHASKELLTX0$326.61$326.61
YOAKUM COUNTY HOSPITALDENVER CITYTX0$255.78$255.78
KINGWOOD EMERGENCY HOSPITALKINGWOODTX0$410$205

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.