CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: HCA Florida Palms West Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $74
  • Cash Discount Price: $343
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at HCA Florida Palms West Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.78x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$343

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $343 (360%)
Insurance Median: $74 (78%)
Cash: $343 (360% of Medicare)
Ins. Median: $74 (78% 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 $24 - $103 25%
Blue Cross Blue Shield $25 - $78 26%
Freedom Health $30 - $55 32%
Optimum $30 32%
Simply Healthcare Plans $45 47%
Corvel Corporation $57 - $141 60%
Careworks (Rockport) $58 - $144 61%
Prime Health $58 - $144 61%
Molina $65 - $93 68%
Cigna $72 76%
Humana $72 - $117 76%
Health Sun Health Plan $73 77%
Aids Healthcare $75 - $412 79%
Mmm Of Fl (Health Advantage Plan) $79 83%
United Ppo $81 85%
Sunshine State Health Plan $89 93%
United $154 162%
Health Care District $172 181%
Palm Beach Juvenile Correction $172 181%
Plotkin Health $172 181%
Prime Health Sherriff $172 181%
Medica Healthcare $199 209%
Multiplan $257 - $292 270%
Healthy Palm Beaches $550 578%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13001 Southern Blvd, Loxahatchee, FL 33470
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals