CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Blake Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $86
Cash Discount Price: $467
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Blake Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.90x the Medicare baseline. Located in 2020 59Th St W, Bradenton, FL.

Cash / Self-Pay

$467

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $467 (491%)

Insurance Median: $86 (90%)

Cash: $467 (491% of Medicare)

Ins. Median: $86 (90% 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	$10 - $58	11%
Freedom Health Care	$10 - $96	11%
Optimum Healthcare	$10 - $96	11%
Aetna	$14 - $370	15%
Truli	$14 - $169	15%
Access 2 Healthcare Physicians Freedom Health	$15 - $89	16%
Access 2 Healthcare Physicians Optimum	$15 - $89	16%
Blue Cross Blue Shield	$15 - $260	16%
United	$21 - $555	22%
Simply Healthcare	$22 - $210	23%
Cigna	$23 - $215	24%
Molina	$25 - $333	26%
Sunshine State Health Plan	$33 - $314	35%
Humana	$37 - $345	39%
Behealthy America	$51 - $481	54%
Corvel Corporation	$55 - $136	58%
Rockport Healthcare Group	$55 - $136	58%
Prime Health	$56 - $139	59%
Healthcare Sarasota	$65 - $617	68%
Plotkin Health	$65 - $617	68%
Prime Health Sheriff	$65 - $617	68%
Evolutions Healthcare Systems	$78 - $1,135	82%
Multiplan	$98 - $1,048	103%

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 $467.
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 Blake 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.