CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Saint Agnes Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $57
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 0.60x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Saint Agnes Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.60x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$22

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $22 (23%)
Insurance Median: $57 (60%)
Cash: $22 (23% of Medicare)
Ins. Median: $57 (60% 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
Champva $10 - $65 11%
Humana $10 - $66 11%
Medicare (plans) $10 - $61 11%
Tricare $10 - $65 11%
Triwest Health Alliance $10 - $65 11%
Us Family Health Plan $10 - $65 11%
Veterans Eval Services $10 - $65 11%
Welbe Health $10 - $60 11%
Align Senior Care $11 - $67 12%
Coventry $11 - $69 12%
First Health $11 - $69 12%
Medicaid / KanCare $11 - $66 12%
Aetna $12 - $72 13%
Blue Cross Blue Shield $12 - $94 13%
Blue Shield - Ca $12 - $94 13%
Cba Network By Design $12 - $75 13%
Cigna $12 - $82 13%
Healthnet $12 - $72 13%
UnitedHealthcare $12 - $72 13%
Bcn Domestic $15 - $94 16%
Blue Benefit Administrators Of Massachusetts $15 - $94 16%
Blue Care Network $15 - $94 16%
Blue Distinction Transplant $15 - $94 16%
Blue Shield - Id (Regence) $15 - $94 16%
Blue Shield - Ny Highmark Northeastern $15 - $94 16%
Blue Shield - Ny Highmark Western $15 - $94 16%
Blue Shield - Pa (Highmark) $15 - $94 16%
Blue Shield - Wa (Regence) $15 - $94 16%
Health Choices $15 - $94 16%
Kaiser Domestic $15 - $94 16%
Pre-Employment $15 - $94 16%
Wc Domestic $15 - $94 16%
Kaiser Permanente $18 - $113 19%
Albany County Correctional Facility $19 - $66 20%
Ambetter / Centene $19 - $66 20%
Amish Mennonite $19 - $66 20%
Andrie Inc $19 - $66 20%
Ascension St. Vincent Public Safety Medical $19 - $66 20%
Bcccp-Michigan $19 - $66 20%
Bccp $19 - $66 20%
Bmc Healthnet $19 - $66 20%
Breast Grant-Connecticut $19 - $66 20%
Broward County Dept Of Health $19 - $66 20%
California Health And Wellness $19 - $66 20%
Can Community Health Inc $19 - $66 20%
Cardinal Innovations Lme $19 - $66 20%
Care Connections Of Northern Iowa $19 - $66 20%
Care Oregon Ohp $19 - $66 20%
Cencal Health Plan $19 - $66 20%
Cenpatico $19 - $66 20%
Chhuny $19 - $66 20%
Childrens Comm Health Plan $19 - $66 20%
Childrens Medical Services Title 19 $19 - $66 20%
City Of Philadelphia $19 - $66 20%
Cmh Allegan County $19 - $66 20%
Cmh Ausable Valley $19 - $66 20%
Cmh Barry County $19 - $66 20%
Cmh Bay-Arenac County $19 - $66 20%
Cmh Berrien County $19 - $66 20%
Cmh Cass County $19 - $66 20%
Cmh Central Mi County $19 - $66 20%
Cmh Clinton-Eaton-Ingham County $19 - $66 20%
Cmh Detroit Wayne Integrated Health Network $19 - $66 20%
Cmh Genesee County $19 - $66 20%
Cmh Ionia County $19 - $66 20%
Cmh Jackson County/Lifeways $19 - $66 20%
Cmh Kalamazoo $19 - $66 20%
Cmh Kent County $19 - $66 20%
Cmh Lenawee County $19 - $66 20%
Cmh Livingston County $19 - $66 20%
Cmh Macomb $19 - $66 20%
Cmh Misc $19 - $66 20%
Cmh Monroe County $19 - $66 20%
Cmh Montcalm County $19 - $66 20%
Cmh Muskegon County $19 - $66 20%
Cmh Newaygo County $19 - $66 20%
Cmh North Country $19 - $66 20%
Cmh Northern Lakes County $19 - $66 20%
Cmh Oakland County $19 - $66 20%
Cmh Ottawa County $19 - $66 20%
Cmh Van Buren County $19 - $66 20%
Cmh Washtenaw County $19 - $66 20%
Cmh Wayne County/Carelink $19 - $66 20%
Cmh Wayne Cty/Com Liv Svcs $19 - $66 20%
Cmh West Mi County $19 - $66 20%
Community Benefit Health $19 - $66 20%
Community Care Behavorial Health $19 - $66 20%
Community Care Partners $19 - $66 20%
Community Health Choice $19 - $66 20%
Connections Csp $19 - $66 20%
County Coroner $19 - $66 20%
County Funding Generic $19 - $66 20%
Covid19 Hrsa Uninsured Testing And Treatment Fund $19 - $66 20%
Dean Wi Badgercare $19 - $66 20%
Delaware County Department Of Health $19 - $66 20%
Delaware First Health $19 - $66 20%
Delta Dental Nj $19 - $66 20%
Dph Tb Program $19 - $66 20%
Dscc $19 - $66 20%
East Greenbush Central School District $19 - $66 20%
Eastpointe Lme $19 - $66 20%
Family Health Network $19 - $66 20%
Freedom First Healthcare $19 - $66 20%
Fresno County Ccs $19 - $66 20%
Genex Wc $19 - $66 20%
Ghc Scw Wi Badgercare $19 - $66 20%
Harbor Health $19 - $66 20%
Health Safety Net $19 - $66 20%
Healthsmart Workers Comp $19 - $66 20%
Healthy Blue Ne $19 - $66 20%
Hennepin Health $19 - $66 20%
Id County Ada $19 - $66 20%
Id County Canyon $19 - $66 20%
Id County Cat Fund $19 - $66 20%
Id County Other $19 - $66 20%
Id County Payette $19 - $66 20%
Idaho Dept Health And Wellfare $19 - $66 20%
Idaho Womens Health Check $19 - $66 20%
Indiana Breast Cervical Cancer $19 - $66 20%
Inland Empire Health Plan $19 - $66 20%
Intercommunity Health Ohp $19 - $66 20%
Iowa Total Care $19 - $66 20%
Jag Source $19 - $66 20%
Jai Medical System $19 - $66 20%
Kern Family Health Plan $19 - $66 20%
Keystone First $19 - $66 20%
Keystone First Chip $19 - $66 20%
La Care Health Plan $19 - $66 20%
Lakeland Care Inc $19 - $66 20%
Managed Health Services - Indiana $19 - $66 20%
Maryland Breast & Cervical Program $19 - $66 20%
Maryland Healthy Smiles - Scion Dental $19 - $66 20%
Maryland Physicians Care $19 - $66 20%
Massachusetts Behavioral Health Partnership $19 - $66 20%
Mdwise $19 - $66 20%
Medi-Cal $19 - $66 20%
Medi-Cal Healthnet $19 - $82 20%
Medstar Dc Healthy Family $19 - $66 20%
Medstar Md Health Choice $19 - $66 20%
Mo Home State Health Plan $19 - $66 20%
Molina Centennial Care $19 - $66 20%
Nascentia Health Options $19 - $66 20%
Nebraska Total Care $19 - $66 20%
New York Cancer Services Program $19 - $66 20%
New York State Insurance Fund $19 - $66 20%
Nextlevel Health $19 - $66 20%
Njm Insurance Group $19 - $66 20%
Oregon Screenwise $19 - $66 20%
Pace Of Southwest Michigan $19 - $66 20%
Paramount Advantage $19 - $66 20%
Parkland Community Health Plan $19 - $66 20%
Partners Behavioral Lme $19 - $66 20%
Peach State Healthplan $19 - $66 20%
Philadelphia County Funding $19 - $66 20%
Presbyterian Centennial Care $19 - $66 20%
Prestige Health Choice $19 - $66 20%
Priority Partners $19 - $66 20%
Robert F Sing Program $19 - $66 20%
Rx 340B Pass Along $19 - $66 20%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $19 - $66 20%
Rx Heatlhcomp $19 - $66 20%
Rx Medi-Cal $19 - $66 20%
Rx Meridian Rx $19 - $66 20%
Rx Restat $19 - $66 20%
Rx Saif Opdp Wc $19 - $66 20%
Rx Worker'S Comp $19 - $66 20%
Ryan White Florida Mssrp $19 - $66 20%
Sandhills Center Lme $19 - $66 20%
Screening For Life $19 - $66 20%
St Joseph County Hlth Dpt $19 - $66 20%
Stephenson Cty Health $19 - $66 20%
Sunshine State Health Plan $19 - $66 20%
Superior Health $19 - $66 20%
Tenncare $19 - $66 20%
Texas Children'S Health Plan $19 - $66 20%
Trillium Community Ohp $19 - $66 20%
Tufts Health Public Plans $19 - $66 20%
Vaya Health Lme $19 - $66 20%
Washtenaw Health Plan $19 - $66 20%
Wc Accident Fund $19 - $66 20%
Wc Ace $19 - $66 20%
Wc Acs Federal Employees $19 - $66 20%
Wc Acuity $19 - $66 20%
Wc Advantage $19 - $66 20%
Wc Aegis $19 - $66 20%
Wc Aig $19 - $66 20%
Wc Aims $19 - $66 20%
Wc Alaska National Ins $19 - $66 20%
Wc Align Network $19 - $66 20%
Wc Allied $19 - $66 20%
Wc Am Trust N America $19 - $66 20%
Wc American Claims Mgmt $19 - $66 20%
Wc Amerisure $19 - $66 20%
Wc Amtrust $19 - $66 20%
Wc Asu Risk Mgt $19 - $66 20%
Wc Benetech $19 - $66 20%
Wc Berkley Admin $19 - $66 20%
Wc Broadspire $19 - $66 20%
Wc Broward County $19 - $66 20%
Wc Bunch & Associates $19 - $66 20%
Wc California State Comp Ins $19 - $66 20%
Wc California State Ins Fund $19 - $66 20%
Wc Capitol Area Health Consortium $19 - $66 20%
Wc Ccmsi $19 - $66 20%
Wc Chartis $19 - $66 20%
Wc Chubb $19 - $66 20%
Wc Cirma $19 - $66 20%
Wc City Of Albany $19 - $66 20%
Wc City Of Sioux City $19 - $66 20%
Wc Claims Mgmt Inc $19 - $66 20%
Wc Cna $19 - $66 20%
Wc Comp One Admin C/O Manageability $19 - $66 20%
Wc Compone Admin $19 - $66 20%
Wc Ct Healthcare Trust $19 - $66 20%
Wc Donegal Insurance Group $19 - $66 20%
Wc Emc Insurance Company $19 - $66 20%
Wc Employee Mutual $19 - $66 20%
Wc Enablecomp $19 - $66 20%
Wc Encore Health Network $19 - $66 20%
Wc Erie $19 - $66 20%
Wc Esis $19 - $66 20%
Wc Evolutions $19 - $66 20%
Wc Fcci $19 - $66 20%
Wc Fed Ex $19 - $66 20%
Wc Federal Black Lung $19 - $66 20%
Wc Federated $19 - $66 20%
Wc Finley Occupational Health $19 - $66 20%
Wc First Agency/Occunet $19 - $66 20%
Wc Ford Motor $19 - $66 20%
Wc Fresno Unified Emp $19 - $66 20%
Wc Gallagher Bassett $19 - $66 20%
Wc General Motors $19 - $66 20%
Wc Generic $19 - $66 20%
Wc Genex Care For Ohio $19 - $66 20%
Wc Great West Casualty $19 - $66 20%
Wc Guarantee Insurance $19 - $66 20%
Wc Guard Insurance Company $19 - $66 20%
Wc Hab $19 - $66 20%
Wc Hartford $19 - $66 20%
Wc Hastings $19 - $66 20%
Wc Health Management $19 - $66 20%
Wc Heritage Summit $19 - $66 20%
Wc Hireright $19 - $66 20%
Wc Horizon $19 - $66 20%
Wc Icw Group $19 - $66 20%
Wc Idaho State Ins Fund $19 - $66 20%
Wc Intercare Insurance $19 - $66 20%
Wc Intermountain $19 - $66 20%
Wc Johns Eastern $19 - $66 20%
Wc Kemberton $19 - $66 20%
Wc Key Ins & Benefit Solutions $19 - $66 20%
Wc Liberty Mutual $19 - $66 20%
Wc Mac Risk Management $19 - $66 20%
Wc Massachusetts $19 - $66 20%
Wc Mdia $19 - $66 20%
Wc Meadowbrook Claim $19 - $66 20%
Wc Medical Administrators $19 - $66 20%
Wc Meijers $19 - $66 20%
Wc Memic $19 - $66 20%
Wc Mercy Workcare $19 - $66 20%
Wc Michigan $19 - $66 20%
Wc Michigan Millers Mutual $19 - $66 20%
Wc Mitchell Frankenmuth $19 - $66 20%
Wc Mra $19 - $66 20%
Wc Nationwide $19 - $66 20%
Wc Nca Comp $19 - $66 20%
Wc New York $19 - $66 20%
Wc New York Special Funds $19 - $66 20%
Wc North American Rishces $19 - $66 20%
Wc Northeast Health $19 - $66 20%
Wc Notre Dame $19 - $66 20%
Wc Novanet $19 - $66 20%
Wc O'Hara Corp $19 - $66 20%
Wc Occ Health Allen $19 - $66 20%
Wc Ohio Bureau $19 - $66 20%
Wc One Call Medical $19 - $66 20%
Wc Paradigm $19 - $66 20%
Wc Peerless $19 - $66 20%
Wc Pma $19 - $66 20%
Wc Praxis Health Network $19 - $66 20%
Wc Price Chopper $19 - $66 20%
Wc Procura Management $19 - $66 20%
Wc Qualcare $19 - $66 20%
Wc Quiktrip $19 - $66 20%
Wc Reny Company $19 - $66 20%
Wc Rev Claims $19 - $66 20%
Wc Risico $19 - $66 20%
Wc Rural Mutual $19 - $66 20%
Wc Saif Oregon $19 - $66 20%
Wc Secura $19 - $66 20%
Wc Sedgwick $19 - $66 20%
Wc Sentry $19 - $66 20%
Wc Sheakley Unicomp $19 - $66 20%
Wc Smile Lodge $19 - $66 20%
Wc Society $19 - $66 20%
Wc Srs $19 - $66 20%
Wc Taconic (Mro) $19 - $66 20%
Wc Taconic Farms $19 - $66 20%
Wc Travelers $19 - $66 20%
Wc Triad Group $19 - $66 20%
Wc Tristar $19 - $66 20%
Wc Troy Ny $19 - $66 20%
Wc Tyson $19 - $66 20%
Wc Unified Health Services $19 - $66 20%
Wc United Heartland $19 - $66 20%
Wc Us Dept Of Labor $19 - $66 20%
Wc Velocity $19 - $66 20%
Wc Walmart $19 - $66 20%
Wc West Bend $19 - $66 20%
Wc West Bend Mutual/Argent $19 - $66 20%
Wc Winnebago Industries $19 - $66 20%
Wc Yankee Trails $19 - $66 20%
Wc York Risk $19 - $66 20%
Wc Zenith $19 - $66 20%
Wc Zurich $19 - $66 20%
Wellsense Health Plan $19 - $66 20%
Wi Womens Wellness $19 - $66 20%
Wc Corvel $20 - $170 21%
Advantek Central Usd $55 58%
Ally Align Care Adv $57 60%
American Health Advantage Of Idaho $57 60%
American Health Plan $57 60%
Aurora Special Needs $57 60%
Blue Care Network Advantage $57 60%
Blue Shield - De (Highmark) Medciare Advantage $57 60%
Care Dimensions $57 60%
Care Improvement Plus $57 60%
Care Resources Pace $57 60%
Careplus Health Plans $57 60%
Cca - Zing Health $57 60%
Cca Senior Care Options $57 60%
Central Valley Medical Services Corp Pace $57 60%
Champion Health Plan Mcr Advantage $57 60%
Clear Spring Health $57 60%
Clover Health $57 60%
Commonwealth Care Alliance $57 60%
Community Pace At Home $57 60%
Eddy Senior Care-Pace $57 60%
Eddy Seniorcare Pace $57 60%
Elementcare $57 60%
Evercare $57 60%
Everence $57 60%
Gateway Health Plan $57 60%
Genesys Pace Of Genesee County $57 60%
Georgia Health Advantage $57 60%
Gold Advantage $57 60%
Gpa Croell Redi Mix $57 60%
Health America Advantra $57 60%
Highmark Health Options Dual Plan $57 60%
Hope Select Pace $57 60%
Horizon Nj Total Care $57 60%
Hudson Headwaters Pace $57 60%
Huron Valley Pace $57 60%
Innovative Integrated Health Community Plans $57 60%
Iowa Health Advantage $57 60%
Johns Hopkins Advantage Md $57 60%
Lasso Healthcare Msa $57 60%
Life St Marys Pace $57 60%
Lifecircles Pace $57 60%
Longevity Health Plan $57 60%
Longevity Ipa Of Michigan Llc Health Plan Isnp $57 60%
Martins Point Generations Advantage $57 60%
Mass General Brigham Mcr Adv $57 60%
Medipak Advantage $57 60%
Mercy Life $57 60%
Mercyone Cedar Valley $57 60%
Meridian Complete $57 60%
Michigan Complete Health $57 60%
Nascentia Health Plus $57 60%
New Centry Health Careplus $57 60%
Osu Prime Care Advantage $57 60%
Pace Cny $57 60%
Pace Iowa Immanuel Pathways $57 60%
Pace Southeast $57 60%
Pace-Trinity Health $57 60%
Peak Pace Solutions $57 60%
Perennial Advantage $57 60%
Preferred Care Partners $57 60%
Presbyterian Senior Plan $57 60%
Provider Partners Health Plan Of Illinois $57 60%
Provider Partners Health Plan Of Indiana $57 60%
Pruitthealth Premier $57 60%
Reliance Community Care Partners Care Resources Pace $57 60%
Rx Allwin $57 60%
Rx Grane Grnmedd $57 60%
Rx Retiree Rx Care $57 60%
Scan Health Plan Mcr Ipa Meritage Oon $57 60%
Secure Horizons Ma Pffs $57 60%
Serenity Pace $57 60%
Siouxland Pace $57 60%
Solis Health Plans $57 60%
Sunnyview-Pace Finance Dept $57 60%
Texan Plus $57 60%
The Health Plan $57 60%
Thome Pace $57 60%
Todays Options $57 60%
Tribute Health Plans $57 60%
Um Health Advantage $57 60%
Union Health Service $57 60%
Wellmed $57 60%
Geha $58 61%
Meritain $58 61%
Multiplan $58 61%
Phcs $58 61%
Veterans Administration $58 61%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals