CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Shands Jacksonville

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $171
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Shands Jacksonville is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.80x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$171

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: $130 (137%)
Insurance Median: $171 (180%)
Cash: $130 (137% of Medicare)
Ins. Median: $171 (180% 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
UnitedHealthcare $45 - $407 47%
Aetna $48 - $389 50%
Wellcare Of Florida $60 - $142 63%
Florida Health Care Plan $77 - $236 81%
Devoted Health Plan $81 - $189 85%
Molina $81 - $330 85%
Simply Healthcare $81 - $189 85%
Volusia Health Network $85 - $198 89%
Northeast Florida State Hospital $89 - $208 93%
Amerihealth Caritas Florida $91 - $212 96%
Beacon Health Strategies $91 - $212 96%
Careplus Health Plan $91 - $212 96%
Positive Healthcare Partners $91 - $212 96%
Humana $95 - $401 100%
North Florida Evaluation & Treatment Center $95 - $222 100%
Capital Health Plan $101 - $236 106%
Community Care Plan $101 - $236 106%
Florida Complete Care $101 - $236 106%
Wellpath $101 - $236 106%
Blue Cross Blue Shield $102 - $412 107%
Centivo $111 - $260 117%
Disney Cruise Line $121 - $283 127%
Cigna $125 - $292 131%
Health First Health Plan $131 - $354 138%
Mental Health Associates $131 - $307 138%
Prime Health Services $141 - $354 148%
Florida Health Alliance $145 - $340 152%
Archbold Medical Center $151 - $354 159%
Genex $151 - $354 159%
Rockport Provider $151 - $354 159%
Corvel Corp $171 - $401 180%
First Health $171 - $401 180%
Florida Hospital Healthcare System $171 - $401 180%
Medsave Usa Tpa $171 - $401 180%
Fringe Benefits Coordinators $181 - $448 190%
Multiplan $181 - $425 190%
Novanet $181 - $425 190%
Ambetter / Centene $375 394%
Truli For Health $375 394%
Avmed $390 410%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals