CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Jeff Davis Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $261
Cash Discount Price: $131
vs. Medicare Baseline: 2.74x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Jeff Davis Hospital is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.74x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

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: $131 (138%)

Insurance Median: $261 (274%)

Cash: $131 (138% of Medicare)

Ins. Median: $261 (274% 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 274% of the Medicare baseline (a markup of 174%). 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	$41 - $182	43%
Humana	$68 - $289	71%
Peach_State	$68	71%
Wellcare	$68	71%
Pen_Network	$98	103%
Medicare (plans)	$105 - $106	110%
Blue Cross Blue Shield	$107 - $255	112%
Care_Improvement_Plus	$107	112%
Coventry_Hmo	$238	250%
Coventry_Pos	$238	250%
Coventry_Ppo	$261	274%
Beech_Street	$272	286%
Care_Source	$272	286%
Cigna	$272	286%
One_Health_Ppo	$272	286%
Choicecare	$289	304%
Community_Care_Network	$289	304%
Georgia_Hospital_Network	$289	304%
Industry_Buying_Group	$289	304%
Novanet	$289	304%
Principal_Health_Care_Of_Georgia	$289	304%
Three_Rivers_Provider_Network	$289	304%
Usa_Managed_Care	$289	304%
Memorial_Health_Partners	$306	321%
Tricare	$316	332%
Multiplan	$323	339%

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 $131.
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 Jeff Davis 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.