What insurers pay Dallas hospitals, beside what Wellness pays

Baylor University Medical Center, in Dallas, dates its file June 29, 2026. Among its payers is one named "Mark Cuban", plan "Commercial". For the 17 codes on this page, those rates match the Wellness contract with Baylor Scott & White (C010) within $1. So one federal file shows the Wellness price beside the prices of Baylor's commercial insurers, for the same code at the same hospital.

• Scans. For the MRI and CT scans, Wellness pays 0.31 to 0.48 times the commercial median, and every one of the 11 plans pays more. Both sides are fee schedule rates for the same code, so this comparison is like for like. The echocardiogram is the exception: Wellness pays 1.49 times the median.
• Endoscopy. Wellness pays 0.79 to 0.91 times the median. Most plans pay more.
• Outpatient surgery, on a different basis. Baylor lists its commercial surgery rates as case rates and the Wellness rates as fee schedule rates. The file does not say what a case rate includes. If implants are paid on top of a case rate, the commercial figures understate what those plans pay, and this comparison does not hold. One sign that they may be: Cigna's case rate for a knee replacement, $7,038, is below Medicare's $12,897, which includes the implant. With that caveat, the Wellness rates sit at 1.05 to 1.75 times the commercial median. For a knee replacement, Wellness pays $32,604; 3 of Baylor's 10 commercial plans pay more and 7 pay less. For a rotator cuff repair, Wellness pays $17,723, and 3 of 10 pay more.

The Wellness table gives one rate per code for every Baylor site (see Wellness 004). For scans, it is below every one of Baylor's own insurers: a plan that sends a member to Baylor for an MRI pays less than any of them. For surgery, the files do not let us say the same with confidence; the rows are shown for completeness.

Medicare: CY2026 OPPS Addendum B, October 2026, Dallas. When a plan lists more than one line for a code (for example, a case rate and a percent-of-charges line), the table uses one, by the rule in the last section. Whole dollars.

Across the 8 adult hospitals, in 7 adult health systems, insurers pay a median $1,452 for the facility fee of a knee MRI, 6.1 times Medicare. Medicare pays a Dallas hospital $239.69. The Wellness network has two prices for the same scan in Dallas: $607 in the Baylor table, and $285.25 at Memorial MRI & Diagnostic's Dallas site on Hillcrest Road (contract C042, 140% of Medicare's physician fee schedule). Memorial's price is the global rate, which includes the radiologist's reading. The hospital figures are the facility fee alone; the radiologist bills separately.

Insurers' median: for each health system and insurer, the median rate over that insurer's commercial plans at the system's hospitals; then the median over every system and insurer pair. Range across systems: the lowest and highest system median. The two children's hospitals are left out of these figures, because adults do not use them for these services; their rates are in the downloads. Some plans have only a percent-of-charges line for a code, with the hospital's own dollar estimate; 165 of the 1,049 rates are of that kind. Without them, the knee MRI median is $1,410 (5.9 times Medicare). Medicare: CY2026 OPPS Addendum B, October 2026, Dallas. Memorial MRI: 2026 Medicare Physician Fee Schedule, Dallas, non-facility, global, at 140%. Whole dollars.

Legent Health (contract C060) has three Wellness sites in Dallas-Fort Worth: Legent Orthopedic Hospital in Carrollton, Legent Surgical Hospital Plano and Legent Outpatient Surgery Frisco. It prices surgery as one bundle, a "Bundled episode rate (facility + professional)". The bundle pays the surgeon and the anesthesia as well as the facility. The hospital figures below are the facility fee alone. For 6 of the 8 surgeries in this table that Legent's contract prices, its whole bundle is below the hospitals' median facility rate. The two that are not: trigger finger release, $4,100 against a median $3,571; and rotator cuff repair, arthroscopic, $15,333 against a median $15,254. Without the percent-of-charges estimates, the count is 5 of the 8.

Each surgery median rests on 11 to 18 system and insurer pairs, so one system's contracts can move it. The knee and hip replacement medians each equal the Baylor Wellness rate ($32,604) by coincidence: the middle value is Medical City's UnitedHealthcare plan "SmallGroup", at $32,604. Legent lists hip replacement twice, at $32,000 and $33,500, with the same description; the table shows the lower. Legent pays durable medical equipment at cost, and its bundles are paid at the lesser of billed charges or the bundle (contract C060, pages 12, 16 to 21). Most hospitals list surgery as case rates; the files do not say what each case rate includes, for example implants. Medicare: CY2026 OPPS, the comprehensive rate for the procedure, Dallas. Whole dollars.

Each hospital names its file in a text file at its own web address (cms-hpt.txt), as the rule requires. We downloaded the 10 files on October 22, 2026 and kept the commercial plans of the four insurers for the 17 codes on this page: 1,049 rates from 101 plans, one rate per plan and code. We dropped 628 rates under the same kind of rule we used for insurer price files in our Utah pilot, where many listed rates were for services the plan had not paid for:

• No dollar (14): the line gives only a percentage or a formula.
• Zero volume (581): the hospital's own file says that plan made no payments for this service in the lookback period, or the line's claim count is 0. The files say it in different words: "No services performed during 15-month lookback period" (Texas Health, UT Southwestern and Children's); "Zero final payments for the item or service in the 15 months prior to posting the file" (Parkland); "0 remits to support allowed amounts" (Cook Children's); and a count of 0 (Methodist). The test reaches only lines that carry such a note or a count: 931 of the kept rates have no count, mostly fixed case and fee schedule rates (Medical City 301, Texas Health 236, Baylor 176 and UT Southwestern 93), so they are not tested.
• Not a price for the service (7): the line is a per diem (Methodist lists some scans this way).
• No Medicare volume reported (18): CMS reports no 2024 Medicare volume for the hospital in the procedure's payment group. CMS suppresses counts under 11, so this can mean a small volume, not none. CMS publishes this file only for comprehensive payment groups, which here are the surgeries, so scans and endoscopy are not tested. The two children's hospitals are not tested.
• Implausible (8): the dollar is below a quarter of the hospital's Medicare rate or above 50 times it. Contracts that pay a percent of billed charges run near 20 times Medicare for some scans; they are real terms, so they stay.

When a plan lists more than one dollar for the same code, the table keeps one: a fixed rate for the service (a case rate or a fee schedule rate) before a percent-of-charges estimate, and within that the lowest line. The higher lines are multiples, such as a second side or a second unit, or other chargemaster lines for the same code that a percent-of-charges plan prices from a higher gross charge. That set aside 88 extra lines. In 13 cases the fixed rate kept is above a percent-of-charges line for the same plan and code, so those figures are not the lowest posted. Baylor's hernia repair is one: with fixed rates first, Baylor's commercial median is $7,219 and 3 of 11 plans pay more than Wellness; with the lowest line, $6,437 and 0 of 11. The build checks that each hospital, plan and code has one rate.

The two Texas Health Resources hospitals list the same rates, so the market figures count Texas Health Resources once. Children's Health posts its file in its own layout, not the CMS template, and gives no file date. Plans left out: Medicare Advantage, Medicaid and CHIP, out-of-network, workers' compensation, behavioral health and transplant plans, and lines for both sides of the body (modifier 50). Medical City lists one UnitedHealthcare plan as "AllPayerAppendix"; it is kept as a plan, as filed.

The 1,049 commercial rates kept, one per plan and code. Search by code, procedure, hospital, insurer or plan.

• Hospital files: the machine-readable standard charge file each hospital posts under 45 CFR 180, found through its cms-hpt.txt: Baylor Scott & White, Texas Health Resources, Methodist Health System, Parkland, UT Southwestern, Medical City, JPS Health Network, Children's Health and Cook Children's. The JSON download gives each file's address.
• Rates used: outpatient facility lines with a negotiated dollar amount for the commercial plans of Blue Cross Blue Shield, UnitedHealthcare, Aetna and Cigna. Commercial includes employer plans and individual-market (exchange) plans. A hospital's rate for an insurer is the median over that insurer's plans; a system's rate for an insurer pools its hospitals' plans.
• Medicare volume for the volume test: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024.
• Medicare rates: CY2026 OPPS Addendum B, October 2026: national rate x (0.60 x 0.9721 + 0.40). 0.9721 is the FY2026 wage index of every adult hospital in IPPS Table 2, the Fort Worth hospitals included. Texas Health Fort Worth and JPS also get an out-migration adjustment of 0.0027; the plausibility test applies it, and the Medicare column shows the Dallas rate. Memorial MRI: 2026 Medicare Physician Fee Schedule, Dallas locality, non-facility.
• Wellness contracts, as published on costpluswellness.com and read for Wellness 003: Baylor Scott & White (C010, MCC UB-04 Rates Table, outpatient lines), Memorial MRI & Diagnostic (C042, MRI and CT at 140%, page 11) and Legent Health (C060, bundled rates, pages 16 to 20).
• The build checks that Baylor's file and contract C010 agree within $1 for every code, that each hospital, plan and code has one rate, that no kept line carries a zero-volume note or count, and that every table row on this page matches its data. Any mismatch stops the build.

What this can and cannot say. These are posted rates, not payments: the files do not say how often each plan uses each rate. Rates differ by plan, so a median hides the spread; the downloads show every plan. The hospital figures are facility fees, and the physician bills separately at a hospital, except where a bundle says otherwise. The page says nothing about the quality of care at any hospital or Wellness provider.

Each figure group on this page, with its source, a link to the public original and a link to a copy kept next to this page. The hospital links are the file addresses that each hospital's cms-hpt.txt names. The copies are extracts of the hospital file rows we used, with what we did with each row; the block of each cms-hpt.txt that names the file; images of the contract pages we cite; and dated screenshots of the web pages. We do not host the hospital files or the contract PDFs. Some hospital files are over 1 GB. The build makes these rows from the data and stops if a figure on this page has no receipt or a copy differs from its source.