CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Banner-University Medical Center South Campus

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $95
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Banner-University Medical Center South Campus is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.00x the Medicare baseline. Located in 2800 East Ajo Way, Tucson, AZ.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $71 (75%)
Insurance Median: $95 (100%)
Cash: $71 (75% of Medicare)
Ins. Median: $95 (100% 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 $42 - $111 44%
Arizona Physicians Ipa $55 58%
Banner University Health Plan $55 58%
Health Choice Arizona, Inc. $55 - $105 58%
Health Net $55 - $113 58%
Mercy Care $55 58%
University Of Arizona (Kasser Medical Treatment Center) $74 78%
Arizona Priority Care $84 88%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $94 99%
Plotkin Health $94 99%
Oscar Health Plan $105 110%
Quiktrip Corporation $113 119%
UnitedHealthcare $121 127%
Cigna $129 136%
Provider Network Of America $158 166%
Arizona Medical Network $168 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2800 East Ajo Way, Tucson, AZ 85713
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals