Amazing Stats On Office Visits

The Texas Department of Insurance offers a link to consumer information on health care pricing. So we checked what the average cost allowed by insurance companies for a routine office visit in the Lower Rio Grande Valley of Texas.

Below you will find the pricing information. Does not seem right but if it is, and a plan has an office co-pay of $25, guess who is really paying for the office visit? Hint: It’s not the plan paying.

Medical Specialty: Office Visits – Rates
Procedure Description: Office or Outpatient Visit, Established Patient, Level 1, 5 minutes
GeoZIP: 78520
Region: Rio Grande Valley

Average Rates For Selected Region

NetworkTotal BilledTotal Allowed

Average Rates Statewide

NetworkTotal BilledTotal Allowed


Billing Definitions

Total Billed Definition

Total Billed
The dollar amount physicians or hospitals bill to health plans for medical care.

Total Allowed Definition

Table – Texas Healthcare Costs