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
LEWISVILLE, TX
See all hospitals reporting CPT 99214 →Price type
Medical City Lewisville’s median price of $274 is 72% above the median hospital's median price ($159), higher than 78% 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: 8 payers, 26 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 | $42.60 | $42.60 | $42.60 – $42.60 |
| 2 | Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges | $42.60 | $42.60 | $42.60 – $42.60 |
| 3 | Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges | $42.60 | $42.60 | $42.60 – $42.60 |
| 4 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $42.60 | $42.60 | $42.60 – $42.60 |
| 5 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $42.60 | $42.60 | $42.60 – $42.60 |
| 6 | Aetna qhphix percent of total billed charges · outpatientfrom % of charges | $82.15 | $82.15 | $82.15 – $82.15 |
| 7 | Cigna ifp percent of total billed charges · outpatientfrom % of charges | $82.15 | $82.15 | $82.15 – $82.15 |
| 8 | Cigna qhp percent of total billed charges · outpatientfrom % of charges | $85.20 | $85.20 | $85.20 – $85.20 |
| 9 | Aetna newbusiness percent of total billed charges · outpatientfrom % of charges | $121.10 | $121.10 | $121.10 – $121.10 |
| 10 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $121.10 | $121.10 | $121.10 – $121.10 |
| 11 | Aetna meritain percent of total billed charges · outpatientfrom % of charges | $129.62 | $129.62 | $129.62 – $129.62 |
| 12 | Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges | $149.09 | $149.09 | $149.09 – $149.09 |
| 13 | Aetna oon percent of total billed charges · outpatientfrom % of charges | $152.75 | $152.75 | $152.75 – $152.75 |
| 14 | Humana comm fee schedule · outpatient | $198.09 | $198.09 | $198.09 – $198.09 |
| 15 | Healthcare Highways cityofplano percent of total billed charges · outpatientfrom % of charges | $205.69 | $205.69 | $205.69 – $205.69 |
| 16 | Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient | $220.03 | $220.03 | $220.03 – $220.03 |
| 17 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $220.03 | $220.03 | $220.03 – $220.03 |
| 18 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $270.20 | $270.20 | $270.20 – $270.20 |
| 19 | Aetna comm percent of total billed charges · outpatientfrom % of charges | $286.02 | $286.02 | $129.62 – $442.42 |
| 20 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $320.71 | $320.71 | $320.71 – $320.71 |
| 21 | Aetna wcomp percent of total billed charges · outpatientfrom % of charges | $334.70 | $334.70 | $334.70 – $334.70 |
| 22 | Blue Cross Blue Shield blueessentials fee schedule · outpatient | $389.65 | $389.65 | $389.65 – $389.65 |
| 23 | Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient | $389.65 | $389.65 | $389.65 – $389.65 |
| 24 | Blue Cross Blue Shield eposoa fee schedule · outpatient | $408.85 | $408.85 | $408.85 – $408.85 |
| 25 | MultiPlan primarynetwork percent of total billed charges · outpatientfrom % of charges | $425.99 | $425.99 | $425.99 – $425.99 |
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.