CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Fawcett Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $157
  • Cash Discount Price: $1,207
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Fawcett Hospital is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,207. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.65x the Medicare baseline. Located in 21298 Olean Blvd, Port Charlotte, FL.
Cash / Self-Pay
$1,207

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $1,207 (1268%)
Insurance Median: $157 (165%)
Cash: $1,207 (1268% of Medicare)
Ins. Median: $157 (165% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members $18 - $91 19%
Blue Cross Blue Shield $19 - $395 20%
Aetna $27 - $583 28%
Access 2 Healthcare Physicians Freedom Health $28 - $140 29%
Access 2 Healthcare Physicians Optimum $28 - $140 29%
Freedom Health Care $30 - $152 32%
Optimum Healthcare $30 - $152 32%
Truli $33 - $165 35%
Corvel Corporation $55 - $132 58%
Rockport Healthcare Group $55 - $132 58%
Prime Health $56 - $135 59%
Simply Healthcare $60 - $299 63%
United $64 - $875 67%
Cigna $68 - $338 71%
Molina $74 - $525 78%
Sunshine State Health Plan $99 - $496 104%
Humana $109 - $544 115%
Behealthy America $151 - $758 159%
Evolutions Healthcare Systems $194 - $1,789 204%
Healthcare Sarasota $194 - $972 204%
Plotkin Health $194 - $972 204%
Prime Health Sheriff $194 - $972 204%
Multiplan $291 - $1,653 306%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 21298 Olean Blvd, Port Charlotte, FL 33952
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals