CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Medstar Health Physical Therapy
Billing Code: 99213 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$99
about 1.0× the $95 Medicare rate · typically $64–$128
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $99 Cash price $98 Hospital's list price $151
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana
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 | $102 - $121 | 107% |
| Blue Cross Blue Shieldmajor | $74 - $96 | 78% |
| Aetnamajor | $106 - $126 | 111% |
| Cignamajor | $128 | 134% |
| Kaiser Permanentemajor | $106 - $347 | 111% |
| + 1 smaller / regional plan | $107 - $154 |
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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