Office visit, established patient (20-29 min)
Facility: Casa Colina Hospital
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $60
- Cash Discount Price: $78
- vs. Medicare Baseline: 0.63x 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 |
|---|---|---|
| Heritage Prvdr Ntwrk Comm - All Other Plans | $26 | 27% |
| Heritage Prvdr Ntwrk Mcr | $26 | 27% |
| Healthnet Comm - All Other Plans | $27 | 28% |
| Corvel - All Plans | $32 | 34% |
| Humana | $32 - $60 | 34% |
| Multiplan - All Plans | $32 | 34% |
| Three Rivers - All Plans | $32 | 34% |
| UnitedHealthcare | $32 - $60 | 34% |
| Medi-Cal | $34 | 36% |
| Cigna | $36 | 38% |
| Blue Cross Blue Shield | $38 - $60 | 40% |
| Kaiser Mcal | $38 | 40% |
| Brand New Day Mcr Adv - All Plans | $39 | 41% |
| Galaxy Provdr Ntwrk - All Plans | $45 | 47% |
| Blue Shield Comm - All Other Plans | $48 | 50% |
| Heritage Prvdr Ntwrk Mcal | $48 | 50% |
| Healthcare Partners - All Other Plans | $52 | 55% |
| Healthcare Partners Mcr | $52 | 55% |
| Primecare Comm - All Other Plans | $52 | 55% |
| Primecare Mcr Adv | $52 | 55% |
| Prospect Hp Mcal | $54 | 57% |
| Prospect Med Grp Alta - All Plans | $55 | 58% |
| Promed Hlth Ntwrk Op Only - All Plans | $57 | 60% |
| Aetna | $60 - $181 | 63% |
| Blue Shield Mcr Adv | $60 | 63% |
| Caremore Mcr Adv - All Plans | $60 | 63% |
| Central Hlth Plan - All Plans | $60 | 63% |
| Doctors Managed Op Only - All Plans | $60 | 63% |
| Empire Healthcare Op Only - All Plans | $60 | 63% |
| Epic Comm - All Other Plans | $60 | 63% |
| Epic Mcr Adv | $60 | 63% |
| Focus Healthcare Wc - All Plans | $60 | 63% |
| Healthnet Mcr Adv | $60 | 63% |
| Iehp - All Other Plans | $60 | 63% |
| Iehp Mcr Adv | $60 | 63% |
| Kaiser Comm - All Other Plans | $60 | 63% |
| Kaiser Mcr Adv | $60 | 63% |
| Premiercare Op Only - All Plans | $60 | 63% |
| Prospect Hp Mcr Adv | $60 | 63% |
| Triwest - All Plans | $60 | 63% |
| Wellcare Mcr Adv - All Plans | $60 | 63% |
| Iehp Mcal | $65 | 68% |
| Prospect Hp Comm - All Other Plans | $66 | 69% |
| Affiliated Hlth Funds - All Plans | $75 | 79% |
| Coventry - All Plans | $181 | 190% |