Outpatient new patient office visit, high complexity at Medical City Plano

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 5 NP

Plano, TX

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Pricing by billing methodology

Price type

How this price compares nationally

Medical City Plano’s median price of $465 is 81% above the median hospital's median price ($257), higher than 80% of the 1,937 hospitals reporting CPT 99205. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99205 at Medical City Plano

Negotiated rates from the hospital’s own file: 8 payers, 28 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	$84	$94	$49	52%	—	$40 – $159
2	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$84	$94	$49	52%	—	$40 – $159
3	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$84	$94	$49	52%	—	$40 – $159
4	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$84	$94	$49	52%	—	$40 – $159
5	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$84	$94	$49	52%	—	$40 – $159
6	Cigna ifp percent of total billed charges · outpatientfrom % of charges	$162	$182	$94	52%	—	$78 – $306
7	Cigna qhp percent of total billed charges · outpatientfrom % of charges	$168	$189	$98	52%	—	$80 – $317
8	Aetna qhphix percent of total billed charges · outpatientfrom % of charges	$196	$220	$114	52%	—	$94 – $369
9	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$209	$234	$121	52%	—	$100 – $394
10	Humana comm fee schedule · outpatient	$258	$258	—	—	—	$258 – $258
11	Aetna newbusiness percent of total billed charges · outpatientfrom % of charges	$286	$321	$166	52%	—	$137 – $539
12	Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges	$295	$330	$171	52%	—	$141 – $555
13	Aetna comm percent of total billed charges · outpatientfrom % of charges	$308	$345	$179	52%	—	$147 – $580
14	Aetna meritain percent of total billed charges · outpatientfrom % of charges	$308	$345	$179	52%	—	$147 – $580
15	Aetna oon percent of total billed charges · outpatientfrom % of charges	$361	$404	$209	52%	—	$172 – $680
16	Healthcare Highways cityofplano percent of total billed charges · outpatientfrom % of charges	$407	$455	$236	52%	—	$194 – $766
17	Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient	$471	$471	—	—	—	$471 – $471
18	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$471	$471	—	—	—	$471 – $471
19	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$534	$598	$310	52%	—	$255 – $1.0k
20	Aetna asa percent of total billed charges · outpatientfrom % of charges	$634	$710	$368	52%	—	$303 – $1.2k
21	Aetna wcomp percent of total billed charges · outpatientfrom % of charges	$661	$741	$384	52%	—	$316 – $1.2k
22	Aetna exclusive percent of total billed charges · outpatientfrom % of charges	$728	$815	$422	52%	—	$347 – $1.4k
23	Aetna nonexclusive percent of total billed charges · outpatientfrom % of charges	$728	$815	$422	52%	—	$347 – $1.4k
24	Blue Cross Blue Shield blueessentials fee schedule · outpatient	$834	$834	—	—	—	$834 – $834
25	Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient	$834	$834	—	—	—	$834 – $834

Page 1 of 2 · 28 rates

Last updated: Mar 1, 2026

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