CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Banner Del E. Webb Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $256
Cash Discount Price: $588
vs. Medicare Baseline: 2.69x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Banner Del E. Webb Medical Center is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $588. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.69x the Medicare baseline. Located in 14502 West Meeker Boulevard, Sun City West, AZ.

Cash / Self-Pay

$588

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

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: $588 (618%)

Insurance Median: $256 (269%)

Cash: $588 (618% of Medicare)

Ins. Median: $256 (269% 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 269% of the Medicare baseline (a markup of 169%). 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
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%
Aetna	$64 - $851	67%
Hospice Of The Valley	$112 - $516	118%
Arizona Priority Care	$128 - $590	134%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$144 - $664	151%
Plotkin Health	$144 - $664	151%
UnitedHealthcare	$155 - $1,236	163%
Oscar Health Plan	$160 - $738	168%
Quiktrip Corporation	$173 - $796	182%
Cigna	$210 - $1,013	221%
Provider Network Of America	$240 - $1,106	252%
Arizona Medical Network	$256 - $1,180	269%

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 $588.
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 Del E. Webb 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.