CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $157
  • Cash Discount Price: $188
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at University of Iowa Health Care Medical Center Down is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.65x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.
Cash / Self-Pay
$188

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $188 (197%)
Insurance Median: $157 (165%)
Cash: $188 (197% of Medicare)
Ins. Median: $157 (165% 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
Iowa Total Care $35 - $63 37%
Molina Healthcare $35 37%
Aetna $60 - $146 63%
Medical Associates $60 - $147 63%
UnitedHealthcare $60 - $220 63%
Blue Cross Blue Shield $61 - $93 64%
Healthpartners $62 - $229 65%
Wellpoint (Amerigroup) $63 66%
Immergrun $67 70%
Midlands Choice $137 - $161 144%
Quad City Community Healthcare $147 - $202 154%
Oscar Health $169 178%
Great River Health Systems $188 197%
Aplos Health Plan $192 202%
Sedgwick $215 226%
Global Excel $229 241%
Sanford Health Plan $229 241%
Employee Benefit Systems $237 249%
Sisco $237 249%
Healthsmart $242 254%
Hfn $247 259%
Multiplan $247 259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 E Market Street, Iowa City, IA 52245
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals