Office visit, established patient (20-29 min)
Facility: John Muir Medical Center - Walnut Creek Campus
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $188
- Cash Discount Price: $297
- vs. Medicare Baseline: 1.97x 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 |
|---|---|---|
| Contra Costa County Jail [1012104] | $24 | 25% |
| Aetna | $75 - $188 | 79% |
| Alignment Health [1177113] | $75 - $188 | 79% |
| Blue Cross Blue Shield | $75 - $590 | 79% |
| Care 1St Health Plan [1094113] | $75 - $188 | 79% |
| Caremore [1171113] | $75 - $188 | 79% |
| Essence Healthcare [1049028] | $75 - $188 | 79% |
| Essence Healthcare [1049128] | $75 - $188 | 79% |
| Humana | $75 - $547 | 79% |
| Medicare (plans) | $75 - $527 | 79% |
| Generic Commercial/Indemnity [1017001] | $80 - $264 | 84% |
| Generic Hmo [1018103] | $80 | 84% |
| Generic Ppo [1021104] | $80 | 84% |
| Golden State-Network Mcare [1023127] | $169 | 178% |
| Tricare | $179 | 188% |
| Health Net-Network Mcare [1028127] | $184 | 193% |
| Blue Shield-Network Mcare [1006127] | $188 | 197% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $188 | 197% |
| Easy Choice Health Plan [1083113] | $188 | 197% |
| Scan-Network Mcare [1043127] | $188 | 197% |
| UnitedHealthcare | $188 - $758 | 197% |
| Veterans Administration [1051113] | $188 | 197% |
| Carecentrix [1011001] | $264 | 277% |
| Aps Healthcare [1003103] | $297 | 312% |
| Canopy Hn Hmo [1166103] | $344 | 361% |
| Carelon Behavioral Health [1050104] | $362 | 380% |
| Fortified Provider Network [1063104] | $362 | 380% |
| Medigap [1036001] | $362 | 380% |
| Three Rivers Provider Network [1073104] | $362 | 380% |
| Contra Costa Health Plan Hmo [1013103] | $395 | 415% |
| Health Net Ppo [1028104] | $479 | 503% |
| Federal Correction Institute [1062104] | $527 | 554% |
| First Health [1016104] | $527 - $560 | 554% |
| Healthsmart - Pka Interplan [1031104] | $527 | 554% |
| National Provider Network/Plancare America [1069104] | $527 | 554% |
| Networks By Design [1084104] | $527 | 554% |
| Pponext [1072104] | $527 | 554% |
| Sutter Preferred Health Plan [1044104] | $527 | 554% |
| Health Management Network [1066104] | $560 | 588% |
| Healthcomp [1089104] | $560 | 588% |
| Galaxy Health Network [1064104] | $593 | 623% |
| Integrated Health Plan [1075104] | $593 | 623% |
| Jmpn Canopy Hn [1640000011] | $758 | 796% |
| Donor Network West [1008103] | $4,000 - $12,000 | 4202% |