CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Banner Baywood Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $58
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Banner Baywood Medical Center is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.61x the Medicare baseline. Located in 6644 East Baywood Avenue, Mesa, AZ.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $187 (196%)
Insurance Median: $58 (61%)
Cash: $187 (196% of Medicare)
Ins. Median: $58 (61% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $16 - $169 17%
Health Choice Arizona, Inc. $24 - $160 25%
Hospice Of The Valley $28 - $112 29%
Arizona Priority Care $32 - $128 34%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $36 - $144 38%
Plotkin Health $36 - $144 38%
UnitedHealthcare $39 - $171 41%
Oscar Health Plan $40 - $160 42%
Quiktrip Corporation $43 - $173 45%
Cigna $53 - $220 56%
Arizona Physicians Ipa $55 58%
Banner University Health Plan $55 58%
Mercy Care $55 58%
Arizona Medical Network $56 - $224 59%
Provider Network Of America $60 - $240 63%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6644 East Baywood Avenue, Mesa, AZ 85206
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals