CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Healthone Rose

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $175
  • Cash Discount Price: $285
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Healthone Rose is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.84x the Medicare baseline. Located in 4567 E 9Th Ave, Denver, CO.
Cash / Self-Pay
$285

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $285 (299%)
Insurance Median: $175 (184%)
Cash: $285 (299% of Medicare)
Ins. Median: $175 (184% 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
Vail Health $41 - $46 43%
Kaiser $54 - $78 57%
United $55 - $135 58%
Aetna $80 - $158 84%
Bright Health $80 - $90 84%
Colorado Program For Children With Special Needs $121 - $135 127%
Cigna $172 - $192 181%
Western Plains Community Health $174 - $195 183%
Multiplan $188 - $270 197%
Northcare $188 - $210 197%
Physician Health Partners $188 - $210 197%
Blue Cross Blue Shield $198 - $222 208%
Pinnacol Workers Comp $201 - $225 211%
Medical Development International $214 - $240 225%
Triwest Health Alliance $214 - $240 225%
Rocky Mtn Planned Parenthood $228 - $255 240%
Prime Health $241 - $270 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4567 E 9Th Ave, Denver, CO 80220
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals