CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Trinity Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $167
Cash Discount Price: $1,174
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Trinity Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,174. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.75x the Medicare baseline. Located in 9330 Sr 54, Trinity, FL.

Cash / Self-Pay

$1,174

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $1,174 (1233%)

Insurance Median: $167 (175%)

Cash: $1,174 (1233% of Medicare)

Ins. Median: $167 (175% 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	$55	58%
Corvel Corporation	$55 - $136	58%
Rockport Healthcare Group	$55 - $136	58%
Prime Health	$56 - $139	59%
Blue Cross Blue Shield	$59 - $236	62%
Aetna	$81 - $352	85%
Truli	$83 - $143	87%
Access 2 Healthcare Physicians Freedom Health	$85	89%
Access 2 Healthcare Physicians Optimum	$85	89%
Freedom Health Care	$92	97%
Optimum Healthcare	$92	97%
Simply Healthcare	$181	190%
United	$193 - $528	203%
Cigna	$211	222%
Molina	$223 - $317	234%
Sunshine State Health Plan	$299	314%
Humana	$329	346%
Beacon Health Options	$587	617%
Plotkin Health	$587	617%
Prime Health Sheriff	$587	617%
Evolutions Healthcare Systems	$704 - $1,080	740%
Multiplan	$880 - $998	924%
Evernorth	$939	986%

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 $1,174.
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 Trinity Hospital 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.