CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Fairview Park Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $294
Cash Discount Price: $893
vs. Medicare Baseline: 3.09x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Fairview Park Hospital is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $893. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 3.09x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

$893

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

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: $893 (938%)

Insurance Median: $294 (309%)

Cash: $893 (938% of Medicare)

Ins. Median: $294 (309% 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 309% of the Medicare baseline (a markup of 209%). 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
Amerigroup	$109 - $131	115%
Ambetter / Centene	$118 - $142	124%
Aetna	$122 - $538	128%
Friday Health	$122 - $146	128%
Nhc Advantage	$154 - $185	162%
Pruitt Health	$154 - $185	162%
Peach State	$162 - $195	170%
Wellcare	$162 - $195	170%
Memorial Health Plan	$178 - $439	187%
United	$200 - $439	210%
Cigna	$220 - $354	231%
Centurion	$224 - $270	235%
Leavitt Risk Partners	$243 - $292	255%
Dodge County Hospital	$405 - $488	425%
American Steel Products	$688 - $829	723%
City Of Eastman	$688 - $829	723%
Dodge Co Board Of Commissioners	$688 - $829	723%
Graham Brothers Construction	$688 - $829	723%
Multiplan	$729 - $878	766%
Novanet	$729 - $878	766%

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 $893.
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 Fairview Park 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.