CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Johnson Memorial Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $39
  • Cash Discount Price: $85
  • vs. Medicare Baseline: 0.41x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Johnson Memorial Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.41x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$85

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $85 (89%)
Insurance Median: $39 (41%)
Cash: $85 (89% of Medicare)
Ins. Median: $39 (41% 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
Blue Cross Blue Shield $10 - $78 11%
Cca Senior Care Options $10 - $62 11%
Champva $10 - $64 11%
Commonwealth Care Alliance $10 - $63 11%
Humana $10 - $64 11%
Medicaid / KanCare $10 - $103 11%
Medicare (plans) $10 - $66 11%
Tricare $10 - $64 11%
Triwest Health Alliance $10 - $64 11%
UnitedHealthcare $10 - $116 11%
Veterans Administration $10 - $60 11%
Veterans Eval Services $10 - $64 11%
Bcn Domestic $11 - $78 12%
Blue Benefit Administrators Of Massachusetts $11 - $78 12%
Blue Care Network $11 - $78 12%
Blue Distinction Transplant $11 - $78 12%
Blue Shield - Ca $11 - $78 12%
Blue Shield - Id (Regence) $11 - $78 12%
Blue Shield - Ny Highmark Northeastern $11 - $78 12%
Blue Shield - Ny Highmark Western $11 - $78 12%
Blue Shield - Pa (Highmark) $11 - $78 12%
Blue Shield - Wa (Regence) $11 - $78 12%
Health Choices $11 - $78 12%
Kaiser Domestic $11 - $78 12%
Pre-Employment $11 - $78 12%
Wc Domestic $11 - $78 12%
Fallon Health $12 - $127 13%
Us Family Health Plan $12 - $116 13%
Aetna $15 - $96 16%
Andrie Inc $15 - $96 16%
Connecticare $15 - $121 16%
Coventry $15 - $94 16%
East Greenbush Central School District $15 - $96 16%
First Health $15 - $94 16%
Genex Wc $15 - $96 16%
Guardian $15 - $94 16%
Healthscope $15 - $92 16%
Healthsmart Workers Comp $15 - $96 16%
Jag Source $15 - $96 16%
Meritain $15 - $94 16%
New York State Insurance Fund $15 - $96 16%
Njm Insurance Group $15 - $96 16%
Rx Heatlhcomp $15 - $96 16%
Rx Restat $15 - $96 16%
Rx Saif Opdp Wc $15 - $96 16%
Rx Worker'S Comp $15 - $96 16%
Wc Accident Fund $15 - $96 16%
Wc Ace $15 - $96 16%
Wc Acs Federal Employees $15 - $96 16%
Wc Acuity $15 - $96 16%
Wc Advantage $15 - $96 16%
Wc Aegis $15 - $96 16%
Wc Aig $15 - $96 16%
Wc Aims $15 - $96 16%
Wc Alaska National Ins $15 - $96 16%
Wc Align Network $15 - $96 16%
Wc Allied $15 - $96 16%
Wc Am Trust N America $15 - $96 16%
Wc American Claims Mgmt $15 - $96 16%
Wc Amerisure $15 - $96 16%
Wc Amtrust $15 - $96 16%
Wc Asu Risk Mgt $15 - $96 16%
Wc Benetech $15 - $96 16%
Wc Berkley Admin $15 - $96 16%
Wc Broadspire $15 - $96 16%
Wc Broward County $15 - $96 16%
Wc Bunch & Associates $15 - $96 16%
Wc California State Comp Ins $15 - $96 16%
Wc California State Ins Fund $15 - $96 16%
Wc Capitol Area Health Consortium $15 - $96 16%
Wc Ccmsi $15 - $96 16%
Wc Chartis $15 - $96 16%
Wc Chubb $15 - $96 16%
Wc Cirma $15 - $96 16%
Wc City Of Albany $15 - $96 16%
Wc City Of Sioux City $15 - $96 16%
Wc Claims Mgmt Inc $15 - $96 16%
Wc Cna $15 - $96 16%
Wc Comp One Admin C/O Manageability $15 - $96 16%
Wc Compone Admin $15 - $96 16%
Wc Ct Healthcare Trust $15 - $96 16%
Wc Donegal Insurance Group $15 - $96 16%
Wc Emc Insurance Company $15 - $96 16%
Wc Employee Mutual $15 - $96 16%
Wc Enablecomp $15 - $96 16%
Wc Encore Health Network $15 - $96 16%
Wc Erie $15 - $96 16%
Wc Esis $15 - $96 16%
Wc Evolutions $15 - $96 16%
Wc Fcci $15 - $96 16%
Wc Fed Ex $15 - $96 16%
Wc Federal Black Lung $15 - $96 16%
Wc Federated $15 - $96 16%
Wc Finley Occupational Health $15 - $96 16%
Wc First Agency/Occunet $15 - $96 16%
Wc Ford Motor $15 - $96 16%
Wc Fresno Unified Emp $15 - $96 16%
Wc Gallagher Bassett $15 - $96 16%
Wc General Motors $15 - $96 16%
Wc Generic $15 - $96 16%
Wc Genex Care For Ohio $15 - $96 16%
Wc Great West Casualty $15 - $96 16%
Wc Guarantee Insurance $15 - $96 16%
Wc Guard Insurance Company $15 - $96 16%
Wc Hab $15 - $96 16%
Wc Hartford $15 - $96 16%
Wc Hastings $15 - $96 16%
Wc Health Management $15 - $96 16%
Wc Heritage Summit $15 - $96 16%
Wc Hireright $15 - $96 16%
Wc Horizon $15 - $96 16%
Wc Icw Group $15 - $96 16%
Wc Idaho State Ins Fund $15 - $96 16%
Wc Intercare Insurance $15 - $96 16%
Wc Intermountain $15 - $96 16%
Wc Johns Eastern $15 - $96 16%
Wc Kemberton $15 - $96 16%
Wc Key Ins & Benefit Solutions $15 - $96 16%
Wc Liberty Mutual $15 - $96 16%
Wc Mac Risk Management $15 - $96 16%
Wc Massachusetts $15 - $96 16%
Wc Mdia $15 - $96 16%
Wc Meadowbrook Claim $15 - $96 16%
Wc Medical Administrators $15 - $96 16%
Wc Meijers $15 - $96 16%
Wc Memic $15 - $96 16%
Wc Mercy Workcare $15 - $96 16%
Wc Michigan $15 - $96 16%
Wc Michigan Millers Mutual $15 - $96 16%
Wc Mitchell Frankenmuth $15 - $96 16%
Wc Mra $15 - $96 16%
Wc Nationwide $15 - $96 16%
Wc Nca Comp $15 - $96 16%
Wc New York $15 - $96 16%
Wc New York Special Funds $15 - $96 16%
Wc North American Rishces $15 - $96 16%
Wc Northeast Health $15 - $96 16%
Wc Notre Dame $15 - $96 16%
Wc Novanet $15 - $96 16%
Wc O'Hara Corp $15 - $96 16%
Wc Occ Health Allen $15 - $96 16%
Wc Ohio Bureau $15 - $96 16%
Wc One Call Medical $15 - $96 16%
Wc Paradigm $15 - $96 16%
Wc Peerless $15 - $96 16%
Wc Pma $15 - $96 16%
Wc Praxis Health Network $15 - $96 16%
Wc Price Chopper $15 - $96 16%
Wc Procura Management $15 - $96 16%
Wc Qualcare $15 - $96 16%
Wc Quiktrip $15 - $96 16%
Wc Reny Company $15 - $96 16%
Wc Rev Claims $15 - $96 16%
Wc Risico $15 - $96 16%
Wc Rural Mutual $15 - $96 16%
Wc Saif Oregon $15 - $96 16%
Wc Secura $15 - $96 16%
Wc Sedgwick $15 - $96 16%
Wc Sentry $15 - $96 16%
Wc Sheakley Unicomp $15 - $96 16%
Wc Smile Lodge $15 - $96 16%
Wc Society $15 - $96 16%
Wc Srs $15 - $96 16%
Wc Taconic (Mro) $15 - $96 16%
Wc Taconic Farms $15 - $96 16%
Wc Travelers $15 - $96 16%
Wc Triad Group $15 - $96 16%
Wc Tristar $15 - $96 16%
Wc Troy Ny $15 - $96 16%
Wc Tyson $15 - $96 16%
Wc Unified Health Services $15 - $96 16%
Wc United Heartland $15 - $96 16%
Wc Us Dept Of Labor $15 - $96 16%
Wc Velocity $15 - $96 16%
Wc Walmart $15 - $96 16%
Wc West Bend $15 - $96 16%
Wc West Bend Mutual/Argent $15 - $96 16%
Wc Winnebago Industries $15 - $96 16%
Wc Yankee Trails $15 - $96 16%
Wc York Risk $15 - $96 16%
Wc Zenith $15 - $96 16%
Wc Zurich $15 - $96 16%
Mass General Brigham Health Plan $16 - $142 17%
Multiplan $16 - $100 17%
Claimdoc $17 - $105 18%
Innovative Health Plan Ii $17 - $105 18%
Unicare $17 - $103 18%
Wellpoint $17 - $103 18%
Centivo $18 - $111 19%
Health New England $18 - $131 19%
Health Smart $19 - $201 20%
Wc Corvel $19 - $201 20%
Delta Dental Ga $22 - $237 23%
Delta Dental Mi $22 - $237 23%
Delta Dental Mo $22 - $237 23%
Delta Dental Nj $22 - $237 23%
Delta Dental Ny $22 - $237 23%
Delta Dental Oh $22 - $237 23%
Delta Dental Or $22 - $237 23%
Delta Dental Pa $22 - $237 23%
Delta Dental Va $22 - $237 23%
Delta Dental Wa $22 - $237 23%
Harvard Pilgrim Healthcare $22 - $131 23%
Liberty Dental $22 - $237 23%
Prime Health Services $22 - $131 23%
Tufts Health Plan $22 - $131 23%
Albany County Correctional Facility $39 - $43 41%
Ambetter / Centene $39 - $43 41%
Amish Mennonite $39 - $43 41%
Ascension St. Vincent Public Safety Medical $39 - $43 41%
Bcccp-Michigan $39 - $43 41%
Bccp $39 - $43 41%
Bmc Healthnet $39 - $43 41%
Breast Grant-Connecticut $39 - $43 41%
Broward County Dept Of Health $39 - $43 41%
California Health And Wellness $39 - $43 41%
Can Community Health Inc $39 - $43 41%
Cardinal Innovations Lme $39 - $43 41%
Care Connections Of Northern Iowa $39 - $43 41%
Care Oregon Ohp $39 - $43 41%
Cencal Health Plan $39 - $43 41%
Cenpatico $39 - $43 41%
Chhuny $39 - $43 41%
Childrens Comm Health Plan $39 - $43 41%
Childrens Medical Services Title 19 $39 - $43 41%
Cigna $39 - $59 41%
City Of Philadelphia $39 - $43 41%
Cmh Allegan County $39 - $43 41%
Cmh Ausable Valley $39 - $43 41%
Cmh Barry County $39 - $43 41%
Cmh Bay-Arenac County $39 - $43 41%
Cmh Berrien County $39 - $43 41%
Cmh Cass County $39 - $43 41%
Cmh Central Mi County $39 - $43 41%
Cmh Clinton-Eaton-Ingham County $39 - $43 41%
Cmh Detroit Wayne Integrated Health Network $39 - $43 41%
Cmh Genesee County $39 - $43 41%
Cmh Ionia County $39 - $43 41%
Cmh Jackson County/Lifeways $39 - $43 41%
Cmh Kalamazoo $39 - $43 41%
Cmh Kent County $39 - $43 41%
Cmh Lenawee County $39 - $43 41%
Cmh Livingston County $39 - $43 41%
Cmh Macomb $39 - $43 41%
Cmh Misc $39 - $43 41%
Cmh Monroe County $39 - $43 41%
Cmh Montcalm County $39 - $43 41%
Cmh Muskegon County $39 - $43 41%
Cmh Newaygo County $39 - $43 41%
Cmh North Country $39 - $43 41%
Cmh Northern Lakes County $39 - $43 41%
Cmh Oakland County $39 - $43 41%
Cmh Ottawa County $39 - $43 41%
Cmh Van Buren County $39 - $43 41%
Cmh Washtenaw County $39 - $43 41%
Cmh Wayne County/Carelink $39 - $43 41%
Cmh Wayne Cty/Com Liv Svcs $39 - $43 41%
Cmh West Mi County $39 - $43 41%
Community Benefit Health $39 - $43 41%
Community Care Behavorial Health $39 - $43 41%
Community Care Partners $39 - $43 41%
Community Health Choice $39 - $43 41%
Connections Csp $39 - $43 41%
County Coroner $39 - $43 41%
County Funding Generic $39 - $43 41%
Covid19 Hrsa Uninsured Testing And Treatment Fund $39 - $43 41%
Dean Wi Badgercare $39 - $43 41%
Delaware County Department Of Health $39 - $43 41%
Delaware First Health $39 - $43 41%
Dph Tb Program $39 - $43 41%
Dscc $39 - $43 41%
Eastpointe Lme $39 - $43 41%
Family Health Network $39 - $43 41%
Freedom First Healthcare $39 - $43 41%
Fresno County Ccs $39 - $43 41%
Ghc Scw Wi Badgercare $39 - $43 41%
Harbor Health $39 - $43 41%
Health Safety Net $39 - $43 41%
Healthy Blue Ne $39 - $43 41%
Hennepin Health $39 - $43 41%
Id County Ada $39 - $43 41%
Id County Canyon $39 - $43 41%
Id County Cat Fund $39 - $43 41%
Id County Other $39 - $43 41%
Id County Payette $39 - $43 41%
Idaho Dept Health And Wellfare $39 - $43 41%
Idaho Womens Health Check $39 - $43 41%
Indiana Breast Cervical Cancer $39 - $43 41%
Inland Empire Health Plan $39 - $43 41%
Intercommunity Health Ohp $39 - $43 41%
Iowa Total Care $39 - $43 41%
Jai Medical System $39 - $43 41%
Kern Family Health Plan $39 - $43 41%
Keystone First $39 - $43 41%
Keystone First Chip $39 - $43 41%
La Care Health Plan $39 - $43 41%
Lakeland Care Inc $39 - $43 41%
Managed Health Services - Indiana $39 - $43 41%
Maryland Breast & Cervical Program $39 - $43 41%
Maryland Healthy Smiles - Scion Dental $39 - $43 41%
Maryland Physicians Care $39 - $43 41%
Massachusetts Behavioral Health Partnership $39 - $43 41%
Mdwise $39 - $43 41%
Medi-Cal $39 - $43 41%
Medi-Cal Healthnet $39 - $43 41%
Medstar Dc Healthy Family $39 - $43 41%
Medstar Md Health Choice $39 - $43 41%
Mo Home State Health Plan $39 - $43 41%
Molina Centennial Care $39 - $43 41%
Nascentia Health Options $39 - $43 41%
Nebraska Total Care $39 - $43 41%
New York Cancer Services Program $39 - $43 41%
Nextlevel Health $39 - $43 41%
Oregon Screenwise $39 - $43 41%
Pace Of Southwest Michigan $39 - $59 41%
Paramount Advantage $39 - $43 41%
Parkland Community Health Plan $39 - $43 41%
Partners Behavioral Lme $39 - $43 41%
Peach State Healthplan $39 - $43 41%
Philadelphia County Funding $39 - $43 41%
Presbyterian Centennial Care $39 - $43 41%
Prestige Health Choice $39 - $43 41%
Priority Partners $39 - $43 41%
Robert F Sing Program $39 - $43 41%
Rx 340B Pass Along $39 - $43 41%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $39 - $43 41%
Rx Medi-Cal $39 - $43 41%
Rx Meridian Rx $39 - $43 41%
Ryan White Florida Mssrp $39 - $43 41%
Sandhills Center Lme $39 - $43 41%
Screening For Life $39 - $43 41%
St Joseph County Hlth Dpt $39 - $43 41%
Stephenson Cty Health $39 - $43 41%
Sunshine State Health Plan $39 - $43 41%
Superior Health $39 - $43 41%
Tenncare $39 - $43 41%
Texas Children'S Health Plan $39 - $43 41%
Trillium Community Ohp $39 - $43 41%
Tufts Health Public Plans $39 - $43 41%
Vaya Health Lme $39 - $43 41%
Washtenaw Health Plan $39 - $43 41%
Wellsense Health Plan $39 - $43 41%
Wi Womens Wellness $39 - $43 41%
Align Senior Care $50 - $59 53%
Ally Align Care Adv $50 - $59 53%
American Health Advantage Of Idaho $50 - $59 53%
American Health Plan $50 - $59 53%
Aurora Special Needs $50 - $59 53%
Blue Care Network Advantage $50 - $59 53%
Blue Shield - De (Highmark) Medciare Advantage $50 - $59 53%
Care Dimensions $50 - $59 53%
Care Improvement Plus $50 - $59 53%
Care Resources Pace $50 - $59 53%
Careplus Health Plans $50 - $59 53%
Cca - Zing Health $50 - $59 53%
Central Valley Medical Services Corp Pace $50 - $59 53%
Champion Health Plan Mcr Advantage $50 - $59 53%
Clear Spring Health $50 - $59 53%
Clover Health $50 - $59 53%
Community Pace At Home $50 - $59 53%
Eddy Senior Care-Pace $50 - $59 53%
Eddy Seniorcare Pace $50 - $59 53%
Elementcare $50 - $59 53%
Evercare $50 - $59 53%
Everence $50 - $59 53%
Gateway Health Plan $50 - $59 53%
Genesys Pace Of Genesee County $50 - $59 53%
Georgia Health Advantage $50 - $59 53%
Gold Advantage $50 - $59 53%
Gpa Croell Redi Mix $50 - $59 53%
Health America Advantra $50 - $59 53%
Highmark Health Options Dual Plan $50 - $59 53%
Hope Select Pace $50 - $59 53%
Horizon Nj Total Care $50 - $59 53%
Hudson Headwaters Pace $50 - $59 53%
Huron Valley Pace $50 - $59 53%
Innovative Integrated Health Community Plans $50 - $59 53%
Iowa Health Advantage $50 - $59 53%
Johns Hopkins Advantage Md $50 - $59 53%
Lasso Healthcare Msa $50 - $59 53%
Life St Marys Pace $50 - $59 53%
Lifecircles Pace $50 - $59 53%
Longevity Health Plan $50 - $59 53%
Longevity Ipa Of Michigan Llc Health Plan Isnp $50 - $59 53%
Martins Point Generations Advantage $50 - $59 53%
Mass General Brigham Mcr Adv $50 - $59 53%
Medipak Advantage $50 - $59 53%
Mercy Life $50 - $59 53%
Mercyone Cedar Valley $50 - $59 53%
Meridian Complete $50 - $59 53%
Michigan Complete Health $50 - $59 53%
Nascentia Health Plus $50 - $59 53%
New Centry Health Careplus $50 - $59 53%
Osu Prime Care Advantage $50 - $59 53%
Pace Cny $50 - $59 53%
Pace Iowa Immanuel Pathways $50 - $59 53%
Pace Southeast $50 - $59 53%
Pace-Trinity Health $50 - $59 53%
Peak Pace Solutions $50 - $59 53%
Perennial Advantage $50 - $59 53%
Preferred Care Partners $50 - $59 53%
Presbyterian Senior Plan $50 - $59 53%
Provider Partners Health Plan Of Illinois $50 - $59 53%
Provider Partners Health Plan Of Indiana $50 - $59 53%
Pruitthealth Premier $50 - $59 53%
Reliance Community Care Partners Care Resources Pace $50 - $59 53%
Rx Allwin $50 - $59 53%
Rx Grane Grnmedd $50 - $59 53%
Rx Retiree Rx Care $50 - $59 53%
Scan Health Plan Mcr Ipa Meritage Oon $50 - $59 53%
Secure Horizons Ma Pffs $50 - $59 53%
Serenity Pace $50 - $59 53%
Siouxland Pace $50 - $59 53%
Solis Health Plans $50 - $59 53%
Sunnyview-Pace Finance Dept $50 - $59 53%
Texan Plus $50 - $59 53%
The Health Plan $50 - $59 53%
Thome Pace $50 - $59 53%
Todays Options $50 - $59 53%
Tribute Health Plans $50 - $59 53%
Um Health Advantage $50 - $59 53%
Union Health Service $50 - $59 53%
Welbe Health $50 - $59 53%
Wellmed $50 - $59 53%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals