CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Capital Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $184
  • Cash Discount Price: $728
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Capital Hospital is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $728. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.93x the Medicare baseline. Located in 2626 Capital Medical Blvd, Tallahassee, FL.
Cash / Self-Pay
$728

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $728 (765%)
Insurance Median: $184 (193%)
Cash: $728 (765% of Medicare)
Ins. Median: $184 (193% 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
Aetna $31 - $294 33%
Blue Cross Blue Shield $31 - $248 33%
Corvel Corporation $55 - $125 58%
Prime Health $56 - $128 59%
Careworks (Rockport Community) $58 - $132 61%
Oscar $58 61%
Simply $69 - $151 72%
Simply Healthcare $75 79%
United $91 - $440 96%
Sunshine State Health Plan $114 - $250 120%
Cigna $127 - $406 133%
Molina Healthcare $138 - $313 145%
Humana $146 - $196 153%
Avmed $224 - $489 235%
Plotkin Health $224 - $489 235%
Prime Health Sheriff $224 - $489 235%
Multiplan $349 - $832 367%
Evernorth $358 - $783 376%
Evolutions Healthcare $380 - $832 399%
Ppo Next $380 - $832 399%
Novanet $402 - $881 422%
Beacon Health Options $728 - $979 765%
American Health Plan $15,000 15758%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2626 Capital Medical Blvd, Tallahassee, FL 32308
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals