CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: St Francis Hospital & Medical Center
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $98
- Cash Discount Price: $237
- vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at St Francis Hospital & Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.03x the Medicare baseline. Located in 114 Woodland Street & 500 Blue Hills Avenue, Hartford, CT.
Cash / Self-Pay
$237
Average discount available for prompt cash payment at this facility.
Insurance Median
$98
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: $237 (249%)
Insurance Median: $98 (103%)
Cash: $237 (249% of Medicare)
Ins. Median: $98 (103% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $43 - $156 | 45% |
| Albany County Correctional Facility | $43 | 45% |
| Ambetter / Centene | $43 | 45% |
| Amish Mennonite | $43 | 45% |
| Ascension St. Vincent Public Safety Medical | $43 | 45% |
| Bcccp-Michigan | $43 | 45% |
| Bccp | $43 | 45% |
| Blue Cross Blue Shield | $43 - $111 | 45% |
| Bmc Healthnet | $43 | 45% |
| Breast Grant-Connecticut | $43 | 45% |
| Broward County Dept of Health | $43 | 45% |
| California Health and Wellness | $43 | 45% |
| Can Community Health Inc | $43 | 45% |
| Cardinal Innovations Lme | $43 | 45% |
| Care Connections of Northern Iowa | $43 | 45% |
| Care Oregon Ohp | $43 | 45% |
| Cencal Health Plan | $43 | 45% |
| Cenpatico | $43 | 45% |
| Chhuny | $43 | 45% |
| Childrens Comm Health Plan | $43 | 45% |
| Childrens Medical Services Title 19 | $43 | 45% |
| Cigna | $43 - $161 | 45% |
| City of Philadelphia | $43 | 45% |
| Cmh Allegan County | $43 | 45% |
| Cmh Ausable Valley | $43 | 45% |
| Cmh Barry County | $43 | 45% |
| Cmh Bay-Arenac County | $43 | 45% |
| Cmh Berrien County | $43 | 45% |
| Cmh Cass County | $43 | 45% |
| Cmh Central Mi County | $43 | 45% |
| Cmh Clinton-Eaton-Ingham County | $43 | 45% |
| Cmh Detroit Wayne Integrated Health Network | $43 | 45% |
| Cmh Genesee County | $43 | 45% |
| Cmh Ionia County | $43 | 45% |
| Cmh Jackson County/Lifeways | $43 | 45% |
| Cmh Kalamazoo | $43 | 45% |
| Cmh Kent County | $43 | 45% |
| Cmh Lenawee County | $43 | 45% |
| Cmh Livingston County | $43 | 45% |
| Cmh Macomb | $43 | 45% |
| Cmh Misc | $43 | 45% |
| Cmh Monroe County | $43 | 45% |
| Cmh Montcalm County | $43 | 45% |
| Cmh Muskegon County | $43 | 45% |
| Cmh Newaygo County | $43 | 45% |
| Cmh North Country | $43 | 45% |
| Cmh Northern Lakes County | $43 | 45% |
| Cmh Oakland County | $43 | 45% |
| Cmh Ottawa County | $43 | 45% |
| Cmh Van Buren County | $43 | 45% |
| Cmh Washtenaw County | $43 | 45% |
| Cmh Wayne County/Carelink | $43 | 45% |
| Cmh Wayne Cty/Com Liv Svcs | $43 | 45% |
| Cmh West Mi County | $43 | 45% |
| Community Benefit Health | $43 | 45% |
| Community Care Behavorial Health | $43 | 45% |
| Community Care Partners | $43 | 45% |
| Community Health Choice | $43 | 45% |
| Connections Csp | $43 | 45% |
| County Coroner | $43 | 45% |
| County Funding Generic | $43 | 45% |
| Covid19 Hrsa Uninsured Testing and Treatment Fund | $43 | 45% |
| Dean Wi Badgercare | $43 | 45% |
| Delaware County Department of Health | $43 | 45% |
| Delaware First Health | $43 | 45% |
| Dph Tb Program | $43 | 45% |
| Dscc | $43 | 45% |
| Eastpointe Lme | $43 | 45% |
| Family Health Network | $43 | 45% |
| Freedom First Healthcare | $43 | 45% |
| Fresno County Ccs | $43 | 45% |
| Ghc Scw Wi Badgercare | $43 | 45% |
| Harbor Health | $43 | 45% |
| Health Safety Net | $43 | 45% |
| Healthy Blue Ne | $43 | 45% |
| Hennepin Health | $43 | 45% |
| Humana | $43 - $98 | 45% |
| Id County Ada | $43 | 45% |
| Id County Canyon | $43 | 45% |
| Id County Cat Fund | $43 | 45% |
| Id County Other | $43 | 45% |
| Id County Payette | $43 | 45% |
| Idaho Dept Health and Wellfare | $43 | 45% |
| Idaho Womens Health Check | $43 | 45% |
| Indiana Breast Cervical Cancer | $43 | 45% |
| Inland Empire Health Plan | $43 | 45% |
| Intercommunity Health Ohp | $43 | 45% |
| Iowa Total Care | $43 | 45% |
| Jai Medical System | $43 | 45% |
| Kern Family Health Plan | $43 | 45% |
| Keystone First | $43 | 45% |
| Keystone First Chip | $43 | 45% |
| La Care Health Plan | $43 | 45% |
| Lakeland Care Inc | $43 | 45% |
| Managed Health Services - Indiana | $43 | 45% |
| Maryland Breast & Cervical Program | $43 | 45% |
| Maryland Healthy Smiles - Scion Dental | $43 | 45% |
| Maryland Physicians Care | $43 | 45% |
| Massachusetts Behavioral Health Partnership | $43 | 45% |
| Mdwise | $43 | 45% |
| Medi-Cal | $43 | 45% |
| Medi-Cal Healthnet | $43 | 45% |
| Medicaid / KanCare | $43 - $179 | 45% |
| Medstar Dc Healthy Family | $43 | 45% |
| Medstar Md Health Choice | $43 | 45% |
| Mo Home State Health Plan | $43 | 45% |
| Molina Centennial Care | $43 | 45% |
| Nascentia Health Options | $43 | 45% |
| Nebraska Total Care | $43 | 45% |
| New York Cancer Services Program | $43 | 45% |
| Nextlevel Health | $43 | 45% |
| Oregon Screenwise | $43 | 45% |
| Pace of Southwest Michigan | $43 - $98 | 45% |
| Paramount Advantage | $43 | 45% |
| Parkland Community Health Plan | $43 | 45% |
| Partners Behavioral Lme | $43 | 45% |
| Peach State Healthplan | $43 | 45% |
| Philadelphia County Funding | $43 | 45% |
| Presbyterian Centennial Care | $43 | 45% |
| Prestige Health Choice | $43 | 45% |
| Priority Partners | $43 | 45% |
| Robert F Sing Program | $43 | 45% |
| Rx 340B Pass Along | $43 | 45% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $43 | 45% |
| Rx Medi-Cal | $43 | 45% |
| Rx Meridian Rx | $43 | 45% |
| Ryan White Florida Mssrp | $43 | 45% |
| Sandhills Center Lme | $43 | 45% |
| Screening for Life | $43 | 45% |
| St Joseph County Hlth Dpt | $43 | 45% |
| Stephenson Cty Health | $43 | 45% |
| Sunshine State Health Plan | $43 | 45% |
| Superior Health | $43 | 45% |
| Tenncare | $43 | 45% |
| Texas Children's Health Plan | $43 | 45% |
| Trillium Community Ohp | $43 | 45% |
| Tufts Health Public Plans | $43 | 45% |
| UnitedHealthcare | $43 - $161 | 45% |
| Vaya Health Lme | $43 | 45% |
| Washtenaw Health Plan | $43 | 45% |
| Wellsense Health Plan | $43 | 45% |
| Wi Womens Wellness | $43 | 45% |
| Medicare (plans) | $59 - $160 | 62% |
| Fallon Health | $78 - $213 | 82% |
| Health New England | $85 - $198 | 89% |
| Champva | $91 | 96% |
| Tricare | $91 | 96% |
| Triwest Health Alliance | $91 | 96% |
| Veterans Eval Services | $91 | 96% |
| Align Senior Care | $98 | 103% |
| Ally Align Care Adv | $98 | 103% |
| American Health Advantage of Idaho | $98 | 103% |
| American Health Plan | $98 | 103% |
| Aurora Special Needs | $98 | 103% |
| Blue Care Network Advantage | $98 | 103% |
| Blue Shield - De (Highmark) Medciare Advantage | $98 | 103% |
| Care Dimensions | $98 | 103% |
| Care Improvement Plus | $98 | 103% |
| Care Resources Pace | $98 | 103% |
| Careplus Health Plans | $98 | 103% |
| Cca - Zing Health | $98 | 103% |
| Central Valley Medical Services Corp Pace | $98 | 103% |
| Champion Health Plan McR Advantage | $98 | 103% |
| Clear Spring Health | $98 | 103% |
| Clover Health | $98 | 103% |
| Commonwealth Care Alliance | $98 - $107 | 103% |
| Community Pace at Home | $98 | 103% |
| Eddy Senior Care-Pace | $98 | 103% |
| Eddy Seniorcare Pace | $98 | 103% |
| Elementcare | $98 | 103% |
| Evercare | $98 | 103% |
| Everence | $98 | 103% |
| Gateway Health Plan | $98 | 103% |
| Genesys Pace of Genesee County | $98 | 103% |
| Georgia Health Advantage | $98 | 103% |
| Gold Advantage | $98 | 103% |
| Gpa Croell Redi Mix | $98 | 103% |
| Health America Advantra | $98 | 103% |
| Highmark Health Options Dual Plan | $98 | 103% |
| Hope Select Pace | $98 | 103% |
| Horizon Nj Total Care | $98 | 103% |
| Hudson Headwaters Pace | $98 | 103% |
| Huron Valley Pace | $98 | 103% |
| Innovative Integrated Health Community Plans | $98 | 103% |
| Iowa Health Advantage | $98 | 103% |
| Johns Hopkins Advantage Md | $98 | 103% |
| Lasso Healthcare Msa | $98 | 103% |
| Life St Marys Pace | $98 | 103% |
| Lifecircles Pace | $98 | 103% |
| Longevity Health Plan | $98 | 103% |
| Longevity IPA of Michigan LLC Health Plan Isnp | $98 | 103% |
| Martins Point Generations Advantage | $98 | 103% |
| Mass General Brigham McR Adv | $98 | 103% |
| Medipak Advantage | $98 | 103% |
| Mercy Life | $98 | 103% |
| Mercyone Cedar Valley | $98 | 103% |
| Meridian Complete | $98 | 103% |
| Michigan Complete Health | $98 | 103% |
| Nascentia Health Plus | $98 | 103% |
| New Centry Health Careplus | $98 | 103% |
| Osu Prime Care Advantage | $98 | 103% |
| Pace Cny | $98 | 103% |
| Pace Iowa Immanuel Pathways | $98 | 103% |
| Pace Southeast | $98 | 103% |
| Pace-Trinity Health | $98 | 103% |
| Peak Pace Solutions | $98 | 103% |
| Perennial Advantage | $98 | 103% |
| Preferred Care Partners | $98 | 103% |
| Presbyterian Senior Plan | $98 | 103% |
| Provider Partners Health Plan of Illinois | $98 | 103% |
| Provider Partners Health Plan of Indiana | $98 | 103% |
| Pruitthealth Premier | $98 | 103% |
| Reliance Community Care Partners Care Resources Pace | $98 | 103% |
| Rx Allwin | $98 | 103% |
| Rx Grane Grnmedd | $98 | 103% |
| Rx Retiree Rx Care | $98 | 103% |
| Scan Health Plan McR IPA Meritage Oon | $98 | 103% |
| Secure Horizons Ma Pffs | $98 | 103% |
| Serenity Pace | $98 | 103% |
| Siouxland Pace | $98 | 103% |
| Solis Health Plans | $98 | 103% |
| Sunnyview-Pace Finance Dept | $98 | 103% |
| Texan Plus | $98 | 103% |
| The Health Plan | $98 | 103% |
| Thome Pace | $98 | 103% |
| Todays Options | $98 | 103% |
| Tribute Health Plans | $98 | 103% |
| Um Health Advantage | $98 | 103% |
| Union Health Service | $98 | 103% |
| Welbe Health | $98 | 103% |
| Wellmed | $98 | 103% |
| Veterans Administration | $100 | 105% |
| Us Family Health Plan | $104 - $199 | 109% |
| Cca Senior Care Options | $105 - $160 | 110% |
| Bcn Domestic | $111 | 117% |
| Blue Benefit Administrators of Massachusetts | $111 | 117% |
| Blue Care Network | $111 | 117% |
| Blue Distinction Transplant | $111 | 117% |
| Blue Shield - Ca | $111 | 117% |
| Blue Shield - Id (Regence) | $111 | 117% |
| Blue Shield - Ny Highmark Northeastern | $111 | 117% |
| Blue Shield - Ny Highmark Western | $111 | 117% |
| Blue Shield - PA (Highmark) | $111 | 117% |
| Blue Shield - Wa (Regence) | $111 | 117% |
| Health Choices | $111 | 117% |
| Kaiser Domestic | $111 | 117% |
| Pre-Employment | $111 | 117% |
| Wc Domestic | $111 | 117% |
| Centivo | $120 - $186 | 126% |
| Innovative Health Plan II | $126 - $176 | 132% |
| Connecticare | $129 - $167 | 136% |
| Allegiance | $133 | 140% |
| Andrie Inc | $134 | 141% |
| East Greenbush Central School District | $134 | 141% |
| Genex Wc | $134 | 141% |
| Healthsmart Workers Comp | $134 | 141% |
| Jag Source | $134 | 141% |
| New York State Insurance Fund | $134 | 141% |
| Njm Insurance Group | $134 | 141% |
| Rx Heatlhcomp | $134 | 141% |
| Rx Restat | $134 | 141% |
| Rx Saif Opdp Wc | $134 | 141% |
| Rx Worker's Comp | $134 | 141% |
| Wc Accident Fund | $134 | 141% |
| Wc Ace | $134 | 141% |
| Wc Acs Federal Employees | $134 | 141% |
| Wc Acuity | $134 | 141% |
| Wc Advantage | $134 | 141% |
| Wc Aegis | $134 | 141% |
| Wc Aig | $134 | 141% |
| Wc Aims | $134 | 141% |
| Wc Alaska National Ins | $134 | 141% |
| Wc Align Network | $134 | 141% |
| Wc Allied | $134 | 141% |
| Wc Am Trust N America | $134 | 141% |
| Wc American Claims Mgmt | $134 | 141% |
| Wc Amerisure | $134 | 141% |
| Wc Amtrust | $134 | 141% |
| Wc Asu Risk Mgt | $134 | 141% |
| Wc Benetech | $134 | 141% |
| Wc Berkley Admin | $134 | 141% |
| Wc Broadspire | $134 | 141% |
| Wc Broward County | $134 | 141% |
| Wc Bunch & Associates | $134 | 141% |
| Wc California State Comp Ins | $134 | 141% |
| Wc California State Ins Fund | $134 | 141% |
| Wc Capitol Area Health Consortium | $134 | 141% |
| Wc Ccmsi | $134 | 141% |
| Wc Chartis | $134 | 141% |
| Wc Chubb | $134 | 141% |
| Wc Cirma | $134 | 141% |
| Wc City of Albany | $134 | 141% |
| Wc City of Sioux City | $134 | 141% |
| Wc Claims Mgmt Inc | $134 | 141% |
| Wc Cna | $134 | 141% |
| Wc Comp One Admin C/O Manageability | $134 | 141% |
| Wc Compone Admin | $134 | 141% |
| Wc Ct Healthcare Trust | $134 | 141% |
| Wc Donegal Insurance Group | $134 | 141% |
| Wc Emc Insurance Company | $134 | 141% |
| Wc Employee Mutual | $134 | 141% |
| Wc Enablecomp | $134 | 141% |
| Wc Encore Health Network | $134 | 141% |
| Wc Erie | $134 | 141% |
| Wc Esis | $134 | 141% |
| Wc Evolutions | $134 | 141% |
| Wc Fcci | $134 | 141% |
| Wc Fed Ex | $134 | 141% |
| Wc Federal Black Lung | $134 | 141% |
| Wc Federated | $134 | 141% |
| Wc Finley Occupational Health | $134 | 141% |
| Wc First Agency/Occunet | $134 | 141% |
| Wc Ford Motor | $134 | 141% |
| Wc Fresno Unified Emp | $134 | 141% |
| Wc Gallagher Bassett | $134 | 141% |
| Wc General Motors | $134 | 141% |
| Wc Generic | $134 | 141% |
| Wc Genex Care for Ohio | $134 | 141% |
| Wc Great West Casualty | $134 | 141% |
| Wc Guarantee Insurance | $134 | 141% |
| Wc Guard Insurance Company | $134 | 141% |
| Wc Hab | $134 | 141% |
| Wc Hartford | $134 | 141% |
| Wc Hastings | $134 | 141% |
| Wc Health Management | $134 | 141% |
| Wc Heritage Summit | $134 | 141% |
| Wc Hireright | $134 | 141% |
| Wc Horizon | $134 | 141% |
| Wc Icw Group | $134 | 141% |
| Wc Idaho State Ins Fund | $134 | 141% |
| Wc Intercare Insurance | $134 | 141% |
| Wc Intermountain | $134 | 141% |
| Wc Johns Eastern | $134 | 141% |
| Wc Kemberton | $134 | 141% |
| Wc Key Ins & Benefit Solutions | $134 | 141% |
| Wc Liberty Mutual | $134 | 141% |
| Wc Mac Risk Management | $134 | 141% |
| Wc Massachusetts | $134 | 141% |
| Wc Mdia | $134 | 141% |
| Wc Meadowbrook Claim | $134 | 141% |
| Wc Medical Administrators | $134 | 141% |
| Wc Meijers | $134 | 141% |
| Wc Memic | $134 | 141% |
| Wc Mercy Workcare | $134 | 141% |
| Wc Michigan | $134 | 141% |
| Wc Michigan Millers Mutual | $134 | 141% |
| Wc Mitchell Frankenmuth | $134 | 141% |
| Wc Mra | $134 | 141% |
| Wc Nationwide | $134 | 141% |
| Wc Nca Comp | $134 | 141% |
| Wc New York | $134 | 141% |
| Wc New York Special Funds | $134 | 141% |
| Wc North American Rishces | $134 | 141% |
| Wc Northeast Health | $134 | 141% |
| Wc Notre Dame | $134 | 141% |
| Wc Novanet | $134 | 141% |
| Wc O'Hara Corp | $134 | 141% |
| Wc Occ Health Allen | $134 | 141% |
| Wc Ohio Bureau | $134 | 141% |
| Wc One Call Medical | $134 | 141% |
| Wc Paradigm | $134 | 141% |
| Wc Peerless | $134 | 141% |
| Wc Pma | $134 | 141% |
| Wc Praxis Health Network | $134 | 141% |
| Wc Price Chopper | $134 | 141% |
| Wc Procura Management | $134 | 141% |
| Wc Qualcare | $134 | 141% |
| Wc Quiktrip | $134 | 141% |
| Wc Reny Company | $134 | 141% |
| Wc Rev Claims | $134 | 141% |
| Wc Risico | $134 | 141% |
| Wc Rural Mutual | $134 | 141% |
| Wc Saif Oregon | $134 | 141% |
| Wc Secura | $134 | 141% |
| Wc Sedgwick | $134 | 141% |
| Wc Sentry | $134 | 141% |
| Wc Sheakley Unicomp | $134 | 141% |
| Wc Smile Lodge | $134 | 141% |
| Wc Society | $134 | 141% |
| Wc Srs | $134 | 141% |
| Wc Taconic (Mro) | $134 | 141% |
| Wc Taconic Farms | $134 | 141% |
| Wc Travelers | $134 | 141% |
| Wc Triad Group | $134 | 141% |
| Wc Tristar | $134 | 141% |
| Wc Troy Ny | $134 | 141% |
| Wc Tyson | $134 | 141% |
| Wc Unified Health Services | $134 | 141% |
| Wc United Heartland | $134 | 141% |
| Wc Us Dept of Labor | $134 | 141% |
| Wc Velocity | $134 | 141% |
| Wc Walmart | $134 | 141% |
| Wc West Bend | $134 | 141% |
| Wc West Bend Mutual/Argent | $134 | 141% |
| Wc Winnebago Industries | $134 | 141% |
| Wc Yankee Trails | $134 | 141% |
| Wc York Risk | $134 | 141% |
| Wc Zenith | $134 | 141% |
| Wc Zurich | $134 | 141% |
| Coventry | $139 | 146% |
| First Health | $139 | 146% |
| Guardian | $139 | 146% |
| Mass General Brigham Health Plan | $139 - $210 | 146% |
| Meritain | $139 | 146% |
| Multiplan | $148 | 155% |
| Healthscope | $155 | 163% |
| Unicare | $163 - $179 | 171% |
| Wellpoint | $163 - $179 | 171% |
| Claimdoc | $176 | 185% |
| Tufts Health Plan | $199 | 209% |
| Health Smart | $201 | 211% |
| Wc Corvel | $201 | 211% |
| Harvard Pilgrim Healthcare | $205 | 215% |
| Delta Dental Ga | $237 | 249% |
| Delta Dental Mi | $237 | 249% |
| Delta Dental Mo | $237 | 249% |
| Delta Dental Nj | $237 | 249% |
| Delta Dental Ny | $237 | 249% |
| Delta Dental Oh | $237 | 249% |
| Delta Dental Or | $237 | 249% |
| Delta Dental PA | $237 | 249% |
| Delta Dental VA | $237 | 249% |
| Delta Dental Wa | $237 | 249% |
| Liberty Dental | $237 | 249% |
| Prime Health Services | $237 | 249% |