CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Medstar Washington Hospital Center
Billing Code: 99213 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$147
about 1.5× the $95 Medicare rate · typically $74–$225
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $147 Cash price $183 Hospital's list price $281
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✓ Aetna✓ Kaiser Permanente CignaHumana
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 | $82 | 86% |
| Blue Cross Blue Shieldmajor | $99 | 104% |
| Aetnamajor | $128 | 134% |
| Kaiser Permanentemajor | $94 - $347 | 99% |
| Amerigroup | $395 | 415% |
| AmeriHealth | $395 | 415% |
| + 1 smaller / regional plan | $135 - $395 |
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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