CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Piedmont Columbus Regional Midtown

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $257
Cash Discount Price: $119
vs. Medicare Baseline: 2.70x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Piedmont Columbus Regional Midtown is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.70x the Medicare baseline. Located in 710 Center Street, Columbus, GA.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $119 (125%)

Insurance Median: $257 (270%)

Cash: $119 (125% of Medicare)

Ins. Median: $257 (270% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 270% of the Medicare baseline (a markup of 170%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$58 - $59	61%
UnitedHealthcare	$164 - $252	172%
Cigna	$173 - $257	182%
Alliant Health Plans Of Georgia [10952]	$271	285%
Phcs [10601]	$279	293%
Kaiser [10500]	$286	300%
Novanet [10819]	$298	313%
First Health [10303]	$318	334%
Aetna	$330	347%
Multiplan [10600]	$338	355%

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 $119.
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 Piedmont Columbus Regional Midtown 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.