CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Pasadena Hospital A Part of HCA Florid

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $179
Cash Discount Price: $1,037
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Pasadena Hospital A Part of HCA Florid is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,037. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.88x the Medicare baseline. Located in 1501 Pasadena Ave S, Saint Petersburg, FL.

Cash / Self-Pay

$1,037

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $1,037 (1089%)

Insurance Median: $179 (188%)

Cash: $1,037 (1089% of Medicare)

Ins. Median: $179 (188% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$48 - $53	50%
Blue Cross Blue Shield	$49 - $236	51%
Corvel Corporation	$55 - $136	58%
Rockport Healthcare Group	$55 - $136	58%
Prime Health	$56 - $139	59%
Aetna	$71 - $338	75%
Access 2 Healthcare Physicians Freedom Health	$74 - $81	78%
Access 2 Healthcare Physicians Optimum	$74 - $81	78%
Freedom Health Care	$80 - $88	84%
Optimum Healthcare	$80 - $88	84%
Truli	$84 - $93	88%
Simply Healthcare	$158 - $174	166%
United	$169 - $508	178%
Cigna	$185 - $203	194%
Molina	$195 - $305	205%
Sunshine State Health Plan	$262 - $288	275%
Humana	$288 - $316	303%
Evolutions Healthcare Systems	$514 - $1,038	540%
Plotkin Health	$514 - $564	540%
Prime Health Sheriff	$514 - $564	540%
Multiplan	$771 - $959	810%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,037.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Pasadena Hospital A Part of HCA Florid is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.