CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Buena Vista Regional Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $69
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 0.72x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Buena Vista Regional Medical Center is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.72x the Medicare baseline. Located in 1525 West 5Th Street, Storm Lake, IA.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $159 (167%)
Insurance Median: $69 (72%)
Cash: $159 (167% of Medicare)
Ins. Median: $69 (72% 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 $16 - $108 17%
Ambetter / Centene $16 - $108 17%
Blue Cross Blue Shield $16 - $108 17%
Champus $16 - $108 17%
Champva $16 - $108 17%
Health Partners $16 - $134 17%
Humana $16 - $108 17%
Iowa Health Advantage $16 - $108 17%
Medicare (plans) $16 - $108 17%
UnitedHealthcare $16 - $189 17%
Wellcare $16 - $108 17%
Wellpoint $16 - $108 17%
American Postal Workers $25 - $162 26%
Avera $26 - $173 27%
Cigna $28 - $183 29%
First Administrators $30 - $197 32%
Golden Rule $30 - $197 32%
Great West $30 - $197 32%
Healthscope $30 - $197 32%
Medical Associates $30 - $197 32%
Meritain $30 - $197 32%
Midlands Choice $30 - $197 32%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1525 West 5Th Street, Storm Lake, IA 50588
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals