CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Spanish Peaks Regional Health Center

Billing Code: 99213 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$75

about 0.8× the $95 Medicare rate · typically $48–$174

modeled estimate · not a bill or quote

What this hospital charges insurers

$81

About the fair price

about $6 over the fair price · 0.9× Medicare

Medicare pays $95 Fair price $75 This hospital $81 Cash price $146 Hospital's list price $162

How we calculate the fair BaseRate →

How this hospital compares to other CO hospitals

Highest price of the 9 CO hospitals we have prices for — worth calling around.

Cheapest $58 Priciest $81

Black dot = this hospital, among the 9 CO hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $75 (about 0.8× the $95 Medicare rate). Spanish Peaks Regional Health Center charges insurers about $81, or about $146 in cash — about the fair price. Located in Walsenburg, CO.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$60 - $142	63%
Blue Cross Blue Shieldmajor	$75 - $138	79%
Cignamajor	$138 - $154	145%
Humanamajor	$300	315%
Devoted Health	$51 - $315	54%
+ 6 smaller / regional plans	$75 - $171

Government programs also on file: Medicare.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 146), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Spanish Peaks Regional Health Center is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Spanish Peaks Regional Health Center

Compare: Office visit, established patient (20-29 min) at other CO hospitals

Insurance negotiated median for the same procedure, sorted lowest first.