CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Banner - University Medical Center Tucson Campus

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $295
Cash Discount Price: $545
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Banner - University Medical Center Tucson Campus is $295. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $545. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 3.10x the Medicare baseline. Located in 1625 North Campbell Avenue, Tucson, AZ.

Cash / Self-Pay

$545

Average discount available for prompt cash payment at this facility.

Insurance Median

$295

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: $545 (573%)

Insurance Median: $295 (310%)

Cash: $545 (573% of Medicare)

Ins. Median: $295 (310% 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 310% of the Medicare baseline (a markup of 210%). 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
Aetna	$42 - $777	44%
Arizona Physicians Ipa	$55	58%
Banner University Health Plan	$55	58%
Health Choice Arizona, Inc.	$55 - $738	58%
Health Net	$55 - $796	58%
Mercy Care	$55	58%
University Of Arizona (Kasser Medical Treatment Center)	$74 - $516	78%
Arizona Priority Care	$84 - $590	88%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$94 - $664	99%
Plotkin Health	$94 - $664	99%
Oscar Health Plan	$105 - $738	110%
Quiktrip Corporation	$113 - $796	119%
UnitedHealthcare	$121 - $817	127%
Cigna	$129 - $907	136%
Provider Network Of America	$158 - $1,106	166%
Arizona Medical Network	$168 - $1,180	176%

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 $545.
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 Banner - University Medical Center Tucson Campus 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.