CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Oak Hill Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $112
Cash Discount Price: $493
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Oak Hill Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $493. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.18x the Medicare baseline. Located in 11375 Cortez Blvd, Brooksville, FL.

Cash / Self-Pay

$493

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $493 (518%)

Insurance Median: $112 (118%)

Cash: $493 (518% of Medicare)

Ins. Median: $112 (118% 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
Blue Cross Blue Shield	$14 - $586	15%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$20 - $23	21%
Aetna	$29 - $874	30%
Access 2 Healthcare Physicians Freedom Health	$30 - $35	32%
Access 2 Healthcare Physicians Optimum	$30 - $35	32%
Freedom Health Care	$33 - $38	35%
Optimum Healthcare	$33 - $38	35%
Truli	$34 - $355	36%
Corvel Corporation	$55 - $136	58%
Rockport Healthcare Group	$55 - $136	58%
Prime Health	$56 - $139	59%
Simply Healthcare	$65 - $370	68%
United	$69 - $1,311	72%
Cigna	$73 - $86	77%
Molina	$80 - $133	84%
Sunshine State Health Plan	$107 - $743	112%
Humana	$117 - $138	123%
Plotkin Health	$210 - $1,457	221%
Prime Health Sheriff	$210 - $1,457	221%
Evolutions Healthcare Systems	$251 - $2,680	264%
Multiplan	$314 - $2,476	330%
Oscar	$437	459%

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 $493.
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 Oak Hill 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.