CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Northside Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $60
  • Cash Discount Price: $352
  • vs. Medicare Baseline: 0.63x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Northside Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $352. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.63x the Medicare baseline. Located in 6000 49Th St N, Saint Petersburg, FL.
Cash / Self-Pay
$352

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $352 (370%)
Insurance Median: $60 (63%)
Cash: $352 (370% of Medicare)
Ins. Median: $60 (63% 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 $15 - $18 16%
Blue Cross Blue Shield $17 - $81 18%
Aetna $22 - $116 23%
Access 2 Healthcare Physicians Freedom Health $23 - $28 24%
Access 2 Healthcare Physicians Optimum $23 - $28 24%
Freedom Health Care $25 - $30 26%
Optimum Healthcare $25 - $30 26%
Truli $27 - $48 28%
Simply Healthcare $49 - $60 51%
United $52 - $174 55%
Corvel Corporation $55 - $136 58%
Rockport Healthcare Group $55 - $136 58%
Prime Health $56 - $139 59%
Cigna $57 - $70 60%
Molina $60 - $105 63%
Sunshine State Health Plan $81 - $99 85%
Humana $88 - $109 92%
Plotkin Health $158 - $194 166%
Prime Health Sheriff $158 - $194 166%
Evolutions Healthcare Systems $174 - $357 183%
Multiplan $237 - $329 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6000 49Th St N, Saint Petersburg, FL 33709
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals