Office visit, established patient (20-29 min)
Facility: St Francis Hospital & Medical Center
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $98 compared to the $88 fair price benchmark.
2-Star CMS clinical quality rating paired with 1.11× fair market pricing.
On the higher side — 7 of 8 other CT hospitals charge less.
Black dot = this hospital, among the 9 CT hospitals with a price for this procedure. Full list below.
A fair price for a Office visit, established patient (20-29 min) is about $88 (about 0.9× the $95 Medicare rate). St Francis Hospital & Medical Center charges insurers about $98, or about $237 in cash — about the fair price. Located in Hartford, CT.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
6 of 6 major insurers have a published price at this hospital
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 | $43 - $161 | 45% |
| Blue Cross Blue Shieldmajor | $43 - $179 | 45% |
| Aetnamajor | $43 - $156 | 45% |
| Cignamajor | $43 - $161 | 45% |
| Humanamajor | $43 - $98 | 45% |
| Kaiser Permanentemajor | $111 | 117% |
| Ambetter (Centene) | $43 | 45% |
| Clover Health | $98 | 103% |
| Harvard Pilgrim | $205 | 215% |
| Health Net | $43 - $134 | 45% |
| HealthPartners | $43 | 45% |
| Meridian | $43 - $98 | 45% |
| Molina | $43 | 45% |
| Paramount | $43 | 45% |
| Presbyterian | $43 - $98 | 45% |
| Tufts Health Plan | $43 - $199 | 45% |
| UniCare | $163 - $179 | 171% |
| WellMed | $98 | 103% |
| WellSense | $43 | 45% |
| + 355 smaller / regional plans | $43 - $237 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at St Francis Hospital & Medical Center
Compare: Office visit, established patient (20-29 min) at other CT hospitals
- Johnson Memorial Hospital · Stafford Springs $31
- Saint Mary's Hospital · Waterbury $43
- Hartford Hospital · Hartford $60
- The Hospital of Central Connecticut · New Britain $60
- Bristol Hospital · Bristol $70
- Greenwich Hospital Association - · Greenwich $75
- Natchaug Hospital · Mansfield Center $83
- Gaylord Hospital · Wallingford $100
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at St Francis Hospital & Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $86
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $86).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
St Francis Hospital & Medical Center's published 45 CFR § 180 self-pay cash rate is $237 (vs. $98 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $88 Fair BaseRate ($95 Medicare)
Your bill ($237) is $149 above the denoised Fair BaseRate ($88) and 2.5× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.