CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Atrium Health Navicent Peach

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $75
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Atrium Health Navicent Peach is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.79x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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%)
Insurance Median: $75 (79%)
Ins. Median: $75 (79% 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 $71 - $77 75%
Blue Cross Blue Shield $71 75%
Georgia Health Advantage $71 75%
Humana $71 - $87 75%
UnitedHealthcare $71 - $82 75%
Care Source $73 77%
Clover $73 77%
Eon Health $73 77%
Alliant $74 78%
Pruitt Health $75 79%
Ambetter / Centene $81 85%
Cigna $94 99%
Securehealth $105 110%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1960 Highway 247 Connector, Byron, GA 31008
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals