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.
Original text from hospital filings
OP VISIT LEVEL 4 EST
FT WORTH, TX
See all hospitals reporting CPT 99214 →Price type
Medical City Fort Worth’s median price of $101 is 36% below the median hospital's median price ($159), higher than 20% of the 2,010 hospitals reporting CPT 99214. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 30 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 | $12.87 | $12.87 | $12.87 – $12.87 |
| 2 | Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges | $12.87 | $12.87 | $12.87 – $12.87 |
| 3 | Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges | $12.87 | $12.87 | $12.87 – $12.87 |
| 4 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $12.87 | $12.87 | $12.87 – $12.87 |
| 5 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $12.87 | $12.87 | $12.87 – $12.87 |
| 6 | Cigna ifp percent of total billed charges · outpatientfrom % of charges | $24.82 | $24.82 | $24.82 – $24.82 |
| 7 | Cigna qhp percent of total billed charges · outpatientfrom % of charges | $25.74 | $25.74 | $25.74 – $25.74 |
| 8 | Aetna qhphix percent of total billed charges · outpatientfrom % of charges | $29.97 | $29.97 | $29.97 – $29.97 |
| 9 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $34.56 | $34.56 | $34.56 – $34.56 |
| 10 | Aetna newbusiness percent of total billed charges · outpatientfrom % of charges | $43.76 | $43.76 | $43.76 – $43.76 |
| 11 | Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges | $45.04 | $45.04 | $45.04 – $45.04 |
| 12 | Aetna comm percent of total billed charges · outpatientfrom % of charges | $47.07 | $47.07 | $47.07 – $47.07 |
| 13 | Aetna meritain percent of total billed charges · outpatientfrom % of charges | $47.07 | $47.07 | $47.07 – $47.07 |
| 14 | Aetna oon percent of total billed charges · outpatientfrom % of charges | $55.16 | $55.16 | $55.16 – $55.16 |
| 15 | Healthcare Highways cityofplano percent of total billed charges · outpatientfrom % of charges | $62.14 | $62.14 | $62.14 – $62.14 |
| 16 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $81.63 | $81.63 | $81.63 – $81.63 |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $96.89 | $96.89 | $96.89 – $96.89 |
| 18 | Cigna comm percent of total billed charges · outpatientfrom % of charges | $97.44 | $97.44 | $97.44 – $97.44 |
| 19 | Aetna wcomp percent of total billed charges · outpatientfrom % of charges | $101.12 | $101.12 | $101.12 – $101.12 |
| 20 | Aetna exclusive percent of total billed charges · outpatientfrom % of charges | $108.29 | $108.29 | $108.29 – $108.29 |
| 21 | Aetna nonexclusive percent of total billed charges · outpatientfrom % of charges | $108.29 | $108.29 | $108.29 – $108.29 |
| 22 | MultiPlan primarynetwork percent of total billed charges · outpatientfrom % of charges | $128.69 | $128.69 | $128.69 – $128.69 |
| 23 | Optum comm percent of total billed charges · outpatientfrom % of charges | $158.11 | $158.11 | $158.11 – $158.11 |
| 24 | Humana comm fee schedule · outpatient | $198.09 | $198.09 | $198.09 – $198.09 |
| 25 | Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient | $220.03 | $220.03 | $220.03 – $220.03 |
Last updated: Mar 1, 2026
See Outpatient office visit, established patient, level 4 pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.