CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Halifax Health Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $117
  • Cash Discount Price: $166
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Halifax Health Medical Center is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.23x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
$166

Average discount available for prompt cash payment at this facility.

Insurance Median
$117

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: $166 (174%)
Insurance Median: $117 (123%)
Cash: $166 (174% of Medicare)
Ins. Median: $117 (123% 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
Embs $47 - $188 49%
Aetna $54 - $232 57%
Florida Healthcare - Hecn $58 - $76 61%
Sunshine State Health Plan $59 - $77 62%
Blue Cross Blue Shield $66 - $97 69%
Avmed $78 - $110 82%
Coventry $79 - $140 83%
UnitedHealthcare $79 - $133 83%
Centivo $84 - $110 88%
County Of Volusia Corrections $84 - $110 88%
Independent Living Systems $84 - $232 88%
Division Of The Blind $85 89%
A&G Admin $86 - $113 90%
Volusia County Employee $86 - $113 90%
Claimdoc $101 - $133 106%
Devoted Health $101 - $133 106%
Employers Health Network $101 - $133 106%
Oscar $101 - $133 106%
Prime Health Services $101 - $133 106%
Volusia $101 - $155 106%
Sim Plan Pay $110 - $144 116%
Hrgi $118 - $155 124%
Plotkin Consulting $118 - $155 124%
Evolutions International $127 - $166 133%
Summit America $135 - $177 142%
Americas Choice Provider Network $152 - $221 160%
Integrated Health Plan $152 - $199 160%
Multiplan $152 - $199 160%
Three Rivers $161 - $210 169%
Simply Healthcare Plans $177 - $232 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals