Outpatient office visit, established patient at Medical City Decatur

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

OP VISIT LEVEL 3 EST

DECATUR, TX

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Pricing by billing methodology

Price type

How this price compares nationally

Medical City Decatur’s median price of $48 is 61% below the median hospital's median price ($124), higher than 4% of the 2,009 hospitals reporting CPT 99213. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99213 at Medical City Decatur

Negotiated rates from the hospital’s own file: 8 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$11.35	$11.35	$11.35 – $11.35
2	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$11.35	$11.35	$11.35 – $11.35
3	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$11.35	$11.35	$11.35 – $11.35
4	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$11.35	$11.35	$11.35 – $11.35
5	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$11.35	$11.35	$11.35 – $11.35
6	Aetna qhphix percent of total billed charges · outpatientfrom % of charges	$21.89	$21.89	$21.89 – $21.89
7	Cigna ifp percent of total billed charges · outpatientfrom % of charges	$21.89	$21.89	$21.89 – $21.89
8	Cigna qhp percent of total billed charges · outpatientfrom % of charges	$22.70	$22.70	$22.70 – $22.70
9	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$28.53	$28.53	$28.53 – $28.53
10	Aetna newbusiness percent of total billed charges · outpatientfrom % of charges	$32.26	$32.26	$32.26 – $32.26
11	Aetna meritain percent of total billed charges · outpatientfrom % of charges	$34.53	$34.53	$34.53 – $34.53
12	Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges	$39.72	$39.72	$39.72 – $39.72
13	Aetna oon percent of total billed charges · outpatientfrom % of charges	$40.69	$40.69	$40.69 – $40.69
14	Healthcare Highways cityofplano percent of total billed charges · outpatientfrom % of charges	$54.80	$54.80	$54.80 – $54.80
15	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$71.99	$71.99	$71.99 – $71.99
16	Aetna comm percent of total billed charges · outpatientfrom % of charges	$76.44	$76.44	$34.53 – $118.35
17	Aetna asa percent of total billed charges · outpatientfrom % of charges	$85.44	$85.44	$85.44 – $85.44
18	MultiPlan primarynetwork percent of total billed charges · outpatientfrom % of charges	$113.49	$113.49	$113.49 – $113.49
19	Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient	$142.72	$142.72	$142.72 – $142.72
20	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$142.72	$142.72	$142.72 – $142.72
21	Humana comm fee schedule · outpatient	$147.37	$147.37	$147.37 – $147.37
22	Blue Cross Blue Shield blueessentials fee schedule · outpatient	$252.75	$252.75	$252.75 – $252.75
23	Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient	$252.75	$252.75	$252.75 – $252.75
24	Blue Cross Blue Shield eposoa fee schedule · outpatient	$265.21	$265.21	$265.21 – $265.21
25	Blue Cross Blue Shield ppo fee schedule · outpatient	$277.66	$277.66	$277.66 – $277.66

Last updated: Mar 1, 2026

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