CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Mat-Su Regional Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $3,260
Cash Discount Price: $1,287
vs. Medicare Baseline: 34.25x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mat-Su Regional Medical Center is $3,260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,287. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 34.25x the Medicare baseline. Located in 2500 South Woodworth Loop, Palmer, AK.

Cash / Self-Pay

$1,287

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,260

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)

Cash / Self-Pay: $1,287 (1352%)

Insurance Median: $3,260 (3425%)

Cash: $1,287 (1352% of Medicare)

Ins. Median: $3,260 (3425% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 3425% of the Medicare baseline (a markup of 3325%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Veterans Eval Services	$112	118%
Ak Ladies First Breast And Cervical	$115	121%
Node Us Dept Of Labor	$136	143%
Medicaid / KanCare	$460	483%
Self Pay	$1,287	1352%
Blue Cross Blue Shield	$2,406 - $2,616	2528%
Hccmca	$2,573	2703%
Aetna	$2,745	2884%
Multiplan Phcs	$3,260	3425%
Moda Assurance	$3,388	3559%
Cigna	$3,397	3569%
Carlie Trans Grp	$3,646	3830%
UnitedHealthcare	$3,646	3830%
First Choice Health	$3,860	4055%
Multiplan Mpi	$3,903	4100%
Plan Vista Solutions	$3,989	4191%
Multiplan Wc	$4,075	4281%
One Health	$4,075	4281%
First Health Group	$4,117	4325%
Medical Control Network Solutions	$4,117	4325%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,287.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mat-Su Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.