Office visit, established patient (20-29 min)
Facility: Oak Valley Hospital District
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $80
- Cash Discount Price: $108
- vs. Medicare Baseline: 0.84x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $34 - $156 | 36% |
| Healthnet Medi-Cal Ip/Op Only | $34 | 36% |
| Kaiser Medi-Cal Ip/Op Only | $34 | 36% |
| Medi-Cal Ip/Op Only | $34 | 36% |
| Hp Of San Joaquin Ip/Op Only-All Plans | $41 | 43% |
| Alignment Op Only Ip/Op Only-All Plans | $58 | 61% |
| Humana | $58 | 61% |
| Kaiser Mcr Adv Ip/Op Only | $58 | 61% |
| Scan Health Plan Ip/Op Only-All Plans | $59 | 62% |
| Imperial Health Ip/Op Only-All Plans | $64 | 67% |
| Healthnet Comm Op Only Ip/Op Only-All Other Plans | $67 - $102 | 70% |
| UnitedHealthcare | $68 - $104 | 71% |
| Kaiser Comm Ip/Op Only-All Other Plans | $71 - $107 | 75% |
| Cigna | $76 - $116 | 80% |
| Blue Shield Epn Ip/Op Only | $88 | 92% |
| Aetna | $97 - $147 | 102% |
| Blue Shield/Bcout Ip/Op Only-All Other Plans | $103 - $156 | 108% |