CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Kossuth Regional Health Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $142
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Kossuth Regional Health Center is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.49x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$142

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: $178 (187%)
Insurance Median: $142 (149%)
Cash: $178 (187% of Medicare)
Ins. Median: $142 (149% 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
Va Ccn - All Plans $55 - $84 58%
Mercy One - All Plans $57 - $84 60%
Humana $85 - $166 89%
Amerigroup Mcr Adv - All Other Plans $86 90%
UnitedHealthcare $87 - $168 91%
Medical Associates - All Plans $90 - $189 95%
Preferred Health - All Plans $90 - $189 95%
Blue Cross Blue Shield $93 98%
Midlands Choice - All Plans $98 - $155 103%
Health Partners New Bus - All Other Plans $123 - $155 129%
Aetna $135 - $215 142%
Health Partners Exisiting Bus $135 - $215 142%
Multiplan - All Plans $211 222%
Molina Mcaid/Chip - All Plans $228 - $229 240%
Amerigroup Mcaid $229 - $231 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 South Phillips Street, Algona, IA 50511
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals