CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Grossmont Hospital
Billing Code: 99213 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$78
about 0.8× the $95 Medicare rate · typically $38–$163
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $78 Cash price $304 Hospital's list price $405
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
6 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $120 - $217 | 126% |
| Blue Cross Blue Shieldmajor | $117 - $320 | 123% |
| Aetnamajor | $22 - $407 | 23% |
| Cignamajor | $62 - $282 | 65% |
| Humanamajor | $253 - $296 | 266% |
| Kaiser Permanentemajor | $234 - $316 | 246% |
| Health Net | $59 - $320 | 62% |
| Molina | $141 - $280 | 148% |
| + 6 smaller / regional plans | $26 - $407 |
Government programs also on file: Medicare, Medicaid.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Grossmont Hospital
Compare: Office visit, established patient (20-29 min) at other CA hospitals
- Children's Hosp of Los Angeles · Los Angeles $18
- Tri-City Medical Center · Oceanside $24
- Mountains Community Hospital · Lake Arrowhead $24
- Riverside Community Hospital · Riverside $29
- Good Samaritan Hospital · San Jose $29
- Los Robles Hospital & Medical Center · Thousand Oaks $30
- Plumas District Hospital · Quincy $30
- Paradise Valley Hospital · National City $34
Insurance negotiated median for the same procedure, sorted lowest first.