Welcome

Welcome

As a consumer, it can be hard to know how much different health care services and procedures usually cost. Even if you get an estimate from your doctor and insurance company, what can you compare it to?

That's why the Texas Department of Insurance has put together a Health Insurance Reimbursement Rates Consumer Information Guide. Using the billing codes for many common medical procedures, you can compare both in-network and out-of-network claims data. You can also see the average costs for different regions in Texas.

You could use this guide to:

  • Estimate costs before you have a procedure.
  • Understand cost variations across regions.
  • Help you make informed decisions when you are able to plan for medical services.

To use this tool, you will need to know the city or county where your medical procedure takes place. You will also need the medical code for the procedure. No personal data will be collected.


Terms & Conditions

Additional AMA Notice

The five character codes and lay descriptions included in the Health Insurance Reimbursement Rate Consumer Information are obtained from Current Procedural Terminology (CPT), copyright 2008 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures.

The responsibility for the content of Health Insurance Reimbursement Rate Consumer Information is with TDI and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Health Insurance Reimbursement Rate Consumer Information. The AMA assumes no liability for data contained or not contained herein. Any use of CPT outside of Health Insurance Reimbursement Rate Consumer Information should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply.

CPT is a registered trademark of the American Medical Association.

User Agreement

This guide uses Current Procedural Technology (CPT™) codes and Medicare Severity Diagnosis Related Groups (MS-DRG) codes. Because CPT is a registered trademark of the American Medical Association (AMA), you must agree to the terms of the AMA's user agreement before you can view the data in this guide.

AMA End User Agreement

CPT only copyright 2008 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

You, your employees and agents are authorized to use CPT only as contained in Health Insurance Reimbursement Rate Consumer Information solely for your own personal use and in connection with consumer healthcare education programs administered by TDI. You acknowledge that the American Medical Association (AMA) holds all copyright, trademark and other rights in CPT.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this Agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60654. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt.

U.S. Government Rights

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with TDI, and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.

This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "Search Rates."

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