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ED visit level 5

CPT 99285 · negotiated-rate distribution across hospitals in TX

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Hospitals
60
Min
$80.00
Median
$1,325.60
Max
$6,854.00
Range multiplier
85.7×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield45230$21.88$2,255.16$10,230467.6×
UnitedHealthcare41124$22.55$1,166.59$6,389.00283.3×
Aetna39122$22.00$1,133.69$6,582.00299.2×
Humana2970$22.55$1,325.60$3,663.20162.4×
Cigna3067$35.20$1,193.04$4,925.00139.9×
Medicaid1843$1.00$386.42$2,567.942567.9×
Medicare1037$468.93$538.46$627.341.3×
Multiplan1830$350.00$2,976.58$4,136.4011.8×
First Health1327$300.00$2,531.10$3,434.2511.4×
Anthem BCBS324$121.94$252.81$1,846.0015.1×
healthsmart723$249.00$2,852.84$4,075.3116.4×
assurant health416$1,093.62$2,057.88$3,022.142.8×
web tpa416$745.65$1,403.10$2,060.552.8×
healthcare highways [2210]515$686.25$847.25$2,567.943.7×
web tpa [2115]59$686.25$1,715.97$2,738.254.0×
commercial | galaxy | all plans99$3,104.10$3,309.90$3,347.301.1×
commercial | phcs | all plans59$2,328.08$2,892.55$3,906.601.7×
Ambetter88$752.90$1,119.16$1,237.731.6×
city of san angelo48$230.32$433.40$636.482.8×
wellmed88$65.00$575.69$612.009.4×
commercial | entrust | all plans88$1,038.48$1,233.39$1,374.071.3×
health partners open network27$19.97$296.09$970.7848.6×
TRICARE27$171.78$171.78$589.633.4×
commercial | community health choice | exchange77$530.41$783.69$784.171.5×
healthscope benefits [2290]56$686.25$915.36$1,715.972.5×
medica exchange inspire26$43.56$484.25$989.2422.7×
scott & white56$925.00$925.00$2,774.683.0×
wellpoint66$612.00$777.18$1,524.122.5×
commercial | firstcare | all plans26$2,041.80$2,117.40$2,757.601.4×
commercial | renaissance | all plans55$376.17$376.40$376.401.0×
commercial | superior health plan | all plans55$783.69$784.17$784.171.0×
commercial | nxhealth | all plans55$1,687.53$1,698.00$1,699.041.0×
commercial | usa health network | all plans55$3,309.90$3,309.90$3,309.901.0×
commercial | kelseycare | all plans55$1,240.20$1,240.20$1,240.201.0×
commercial | harris health | ers55$783.69$784.17$784.171.0×
commercial | nppn | all plans55$3,115.20$3,115.20$3,115.201.0×
phcs [1780]45$1,839.15$2,168.96$2,555.701.4×
commercial | kelseycare | exchange55$705.32$705.75$705.751.0×
90 degree benefits55$612.00$1,439.22$1,439.222.4×
superior health plan35$595.00$668.00$1,133.001.9×
black lung [6055]44$686.25$785.38$1,715.972.5×
medica exchange insure24$25.47$293.82$1,032.3040.5×
group pension admin [1450]44$1,825.50$1,889.07$2,168.961.2×
mhs care connect24$121.94$121.94$121.941.0×
patoka valley tier 124$252.81$252.81$252.811.0×
insurance services of lubbock44$938.37$938.37$938.371.0×
kempton group44$1,151.38$1,151.38$1,151.381.0×
patoka valley tier 224$252.81$252.81$252.811.0×
amerigroup commercial [5055]44$686.25$785.38$1,715.972.5×
lucent health [6000]44$686.25$785.38$1,715.972.5×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Muleshoe Area Medical CenterMuleshoeTX4$1,133.00$680.00$442.00$906.00$1,133.00
Golden Plains Community HospitalBorgerTX6$2,416.00$1,691.20$444.54$814.79$1,642.88
Baylor County Hospital DistrictSeymourTX11$854.00$597.80$55.00$80.00$1,125.00
Lifecare Spec Hosp Of North TexasDallasTX9$2,894.00$289.40$723.50$723.50$1,938.98
Baylor Scott And White Mc At SunnyvaSunnyvaleTX2$6,574.00$3,944.40$585.19$6,854.00$10,230
Heritage Park Surgical HospitalShermanTX2$1,715.00$1,029.00$585.19$6,854.00$10,230
Brazosport Regional Health SystemLake JacksonTX11$1,808.00$632.80$286.57$647.85$3,520.00
Clay County Memorial HospitalHenriettaTX5$4,335.00$3,035.00$249.00$632.50$1,387.00
Methodist Hospital For SurgeryAddisonTX32$3,549.00$2,129.40$585.14$623.18$5,800.00
North Texas Medical CenterGainsvilleTX17$1,329.00$332.00$200.00$612.00$1,223.00
Baylor Orthopedic And Spine HospitalArlingtonTX3$7,303.00$4,381.80$2,457.00$5,646.00$8,427.00
Falls Community Hospital And ClinicMarlinTX6$3,862.00$3,089.60$301.00$548.11$3,089.60
Limestone Medical CenterGroesbeckTX8$1,890.25$1,134.15$163.82$486.39$1,512.20
Crosbyton Clinic HospitalCrosbytonTX4$677.00$677.00$128.00$467.50$542.00
Trinity Regional Hospital SachseSachseTX10$1,163.81$931.05$25.47$386.61$1,608.91
Grimes St. Joseph Health CenterNavasotaTX3$4,596.00$1,608.60$2,560.00$3,040.00$4,200.00
Madison St. Joseph Health CenterMadisonvilleTX6$4,596.00$1,608.60$2,041.80$2,970.55$4,200.00
Burleson St. Joseph Health CenterCaldwellTX5$4,596.00$1,608.60$2,041.80$2,941.44$4,136.40
St Lukes Health Memorial San AugustSan AugustineTX8$3,449.00$1,207.15$2,231.51$2,880.00$4,368.00
Wilson N Jones Regional Medical CtrShermanTX12$1,163.81$931.05$19.97$287.60$1,163.81
Dimmit Regional Hospital DistrictCarrizo SpringsTX3$3,066.00$1,840.00$1,165.00$2,805.00$2,943.00
Childrens Medical Center Of PlanoPlanoTX31$3,908.00$2,931.00$153.05$2,735.60$3,790.76
Seton Medical Center Harker HeightsHarker HeightsTX13$5,463.70$546.37$949.59$2,567.94$4,731.56
Baptist Saint Anthonys HospitalAmarilloTX84$3,651.00$365.10$341.73$2,555.70$3,103.35
Ascension Seton BastropBastropTX7$30.50$235.33$252.81
Ascension Seton Shoal CreekAustinTX7$30.50$235.33$252.81
Chi St Lukes Health Memorial LufkinLufkinTX9$3,449.00$1,207.15$445.48$2,326.36$4,368.00
Pam Squared At Corpus ChristiCorpus ChrstiTX7$2,818.09$2,818.09$1,972.66$2,113.57$2,395.38
Chi St Lukes Health Mem LivingstonLivingstonTX11$3,449.00$1,207.15$272.95$2,069.41$4,368.00
St. Lukes Patients Medical CenterPasadenaTX12$3,938.00$1,378.30$282.08$1,800.00$6,582.00
St. Lukes Sugar Land HospitalSugar LandTX19$3,894.00$1,362.90$376.40$1,760.00$6,582.00
Chi St Lukes Health Baylor Med CtrHoustonTX21$3,894.00$1,362.90$376.17$1,752.30$6,582.00
Driscoll Childrens HospitalCorpus ChristiTX4$2,931.65$586.33$171.78$171.78$1,000.00
St Lukes Hospital At The VintageHoustonTX21$3,894.00$1,362.90$376.40$1,699.04$6,582.00
St. Lukes The Woodlands HospitalThe WoodlandsTX20$3,894.00$1,362.90$376.17$1,698.00$6,582.00
St. Joseph Regional Health CenterBryanTX9$4,596.00$1,608.60$519.24$1,687.53$4,200.00
College Station Medical CenterCollege StationTX9$4,596.00$1,608.60$519.24$1,687.53$4,200.00
Glen Rose Medical CenterGlen RoseTX8$2,307.00$2,307.00$907.00$1,500.00$2,192.00
Crescent Medical Center LancasterLancasterTX12$4,925.00$3,201.00$583.00$1,477.50$83,343
Hansford County Hospital DistrictSpearmanTX5$1,600.00$1,200.00$1,120.00$1,440.00$1,680.00
Acuity Hospital Of South TexasSan AntonioTX1$137.36$137.36$137.36
San Angelo Community Medical CenterSan AngeloTX21$4,579.00$2,289.50$230.32$1,325.60$4,075.31
Shannon Medical CenterSan AngeloTX21$4,579.00$2,289.50$230.32$1,325.60$4,075.31
Big Spring State HospitalBig SpringsTX21$4,579.00$2,289.50$230.32$1,325.60$4,075.31
River Crest HospitalSan AngeloTX21$4,579.00$2,289.50$230.32$1,325.60$4,075.31
St. Lukes Lakeside HospitalThe WoodlandsTX20$3,894.00$1,362.90$376.40$1,240.20$6,582.00
Rice Medical CenterEagle LakeTX19$1,642.30$1,149.61$1.00$1,182.46$1,642.30
Texas Rehabilitation Hospital Of KelKellerTX17$2,745.00$274.50$686.25$1,133.69$1,839.15
Crane County Hospital DistrictCraneTX2$1,726.00$1,208.00$1,046.00$1,128.00$1,553.00
Eastland Memorial HospitalEastlandTX3$1,576.00$788.00$977.00$1,127.00$1,418.00
Ut Health East Texas Specialty HospiTylerTX17$3,389.00$338.90$292.81$1,030.69$2,168.96
Haskell Memorial HospitalHaskellTX0$1,113.95$1,113.95
Navarro Regional HospitalCorsicanaTX0$4,118.00$1,441.30
Longview Regional Medical CenterLongviewTX0$5,035.67$1,359.63
Yoakum County HospitalDenver CityTX0$1,244.25$1,244.25
St Joseph Medical CenterHoustonTX0$3,261.73$3,261.73
Kingwood Emergency HospitalKingwoodTX0$4,079.96$2,039.98
Laredo Medical CenterLaredoTX0$8,622.55$3,017.89
The Medical Ctr Of Southeast TexasPort ArthurTX0$2,207.32$2,207.32
Nocona General HospitalNoconaTX0$1,589.00$175.86

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.