How much does preventive visit, established, 40-64 cost in Texas?

CPT 99396 — the fair price, every hospital's price, and the Medicare benchmark for Texas.

Estimates only. Educational estimates from public Medicare benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
99396 Preventive visit, established, 40-64
Ask to pay
$150
This is the local cash / self-pay price — usually the best rate you can ask for.
What Medicare paysⓘ
$121
Typical price near you
$242
Cash / self-pay price
$150
Prices near you — 59 facilities, lowest first
FacilityTypePricevs MedicareQuality
University Medical Center of El Paso lowest Hospital $43cash 0.4× ★★★★★
University Hospital - University Health (San Antonio) Hospital $75cash 0.6× —
Parkland Health (Dallas) Hospital $82cash 0.7× ★★★★★
Harris Health Lyndon B. Johnson Hospital (Houston) Hospital $103cash 0.9× —
Harris Health Ben Taub Hospital (Houston) Hospital $103cash 0.9× —
Texas Health Harris Methodist Hospital Cleburne Hospital $124negotiated 1.0× —
JPS Health Network – John Peter Smith Hospital (Fort Worth) Hospital $128cash 1.1× ★★★★★
Texas Health Presbyterian Hospital Flower Mound Hospital $132negotiated 1.1× —
Texas Health Hospital Rockwall Hospital $132negotiated 1.1× —
Texas Health Presbyterian Hospital Allen Hospital $132negotiated 1.1× —
Texas Health Harris Methodist Hospital Stephenville Hospital $132negotiated 1.1× —
Texas Health Hospital Frisco Hospital $132negotiated 1.1× —
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges. 1 unusually low/high price excluded from the typical price as likely data errors.
💬 What to say — negotiation scripts
  • For 99396 (Preventive visit, established, 40-64), Medicare's benchmark rate is $120.98. A fair self-pay target for this line is $149.78. If I was charged more than that, please reduce it toward this benchmark.
  • Your own published cash / self-pay price for 99396 is $149.78, and negotiated rates at nearby facilities run $131.67–$308.10. Please apply a rate in that range to my bill rather than the gross charge.
  • Please send a fully itemized bill listing every CPT/HCPCS/DRG code and its individual charge, so I can review each line against published rates.
  • Separately, what is your financial assistance / charity care policy, and am I eligible? Please send me the application and the income thresholds.
See preventive visit, established, 40-64 prices in another area
Houston MetroDallas–Fort WorthAustin MetroSan Antonio MetroEl Paso, Lubbock & the rest of TexasAll ArizonaAll CaliforniaAll UtahAll New MexicoAll Colorado

What should 99396 cost in Texas?

For preventive visit, established, 40-64 (CPT 99396) in Texas, a fair self-pay price is around $242, with hospitals ranging from $132 to $308 across 59 facilities. Medicare's benchmark rate is $121, the floor to negotiate toward. The card above lists each hospital's price, cheapest first, with CMS quality stars.

Frequently asked questions

How much does preventive visit, established, 40-64 cost in Texas?

A fair self-pay price for preventive visit, established, 40-64 (CPT 99396) in Texas is around $242, with hospital prices ranging from $132 to $308 across 59 facilities. These are estimates from hospital-published prices, not a guarantee.

What is the Medicare rate for CPT 99396?

Medicare pays about $121 for preventive visit, established, 40-64 (CPT 99396). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.

Can I negotiate the price of preventive visit, established, 40-64?

Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.

Got a bill for this?

If you were charged more than the fair price, you can usually negotiate it down. Paste your itemized bill to get a personalized appeal letter, the exact numbers to cite, an AI negotiation coach, and a charity-care eligibility check — free.

Compare other procedures in Texas

Screening mammogram, bilateralDiagnostic mammogram, unilateralDiagnostic mammogram, bilateralDEXA bone density scanColonoscopy, diagnosticScreening colonoscopy (average risk)Chest X-ray, 2 viewsChest X-ray, 1 view

Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.