CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Saint Alphonsus Regional Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $75
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Saint Alphonsus Regional Medical Center is $75. 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 0.79x the Medicare baseline. Located in 1055 North Curtis Road, Boise, ID.
Cash / Self-Pay
$178

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%)
Cash / Self-Pay: $178 (187%)
Insurance Median: $75 (79%)
Cash: $178 (187% of Medicare)
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
Medicaid / KanCare $45 - $84 47%
Aetna $46 - $191 48%
Align Senior Care $46 - $75 48%
Ally Align Care Adv $46 - $75 48%
American Health Plan $46 - $75 48%
Aurora Special Needs $46 - $75 48%
Blue Care Network Advantage $46 - $75 48%
Blue Cross Blue Shield $46 - $185 48%
Blue Shield - De (Highmark) Medciare Advantage $46 - $75 48%
Care Dimensions $46 - $75 48%
Care Improvement Plus $46 - $75 48%
Care Resources Pace $46 - $75 48%
Careplus Health Plans $46 - $75 48%
Cca - Zing Health $46 - $75 48%
Cca Senior Care Options $46 - $75 48%
Central Valley Medical Services Corp Pace $46 - $75 48%
Champion Health Plan Mcr Advantage $46 - $75 48%
Cigna $46 - $153 48%
Clear Spring Health $46 - $75 48%
Clover Health $46 - $75 48%
Commonwealth Care Alliance $46 - $75 48%
Community Pace At Home $46 - $75 48%
Eddy Senior Care-Pace $46 - $75 48%
Eddy Seniorcare Pace $46 - $75 48%
Elementcare $46 - $75 48%
Evercare $46 - $75 48%
Everence $46 - $75 48%
Gateway Health Plan $46 - $75 48%
Genesys Pace Of Genesee County $46 - $75 48%
Georgia Health Advantage $46 - $75 48%
Gold Advantage $46 - $75 48%
Gpa Croell Redi Mix $46 - $75 48%
Health America Advantra $46 - $75 48%
Highmark Health Options Dual Plan $46 - $75 48%
Hope Select Pace $46 - $75 48%
Horizon Nj Total Care $46 - $75 48%
Hudson Headwaters Pace $46 - $75 48%
Humana $46 - $104 48%
Huron Valley Pace $46 - $75 48%
Innovative Integrated Health Community Plans $46 - $75 48%
Iowa Health Advantage $46 - $75 48%
Johns Hopkins Advantage Md $46 - $75 48%
Lasso Healthcare Msa $46 - $75 48%
Life St Marys Pace $46 - $75 48%
Lifecircles Pace $46 - $75 48%
Longevity Health Plan $46 - $75 48%
Longevity Ipa Of Michigan Llc Health Plan Isnp $46 - $75 48%
Martins Point Generations Advantage $46 - $75 48%
Mass General Brigham Mcr Adv $46 - $75 48%
Medicare (plans) $46 - $83 48%
Medipak Advantage $46 - $75 48%
Mercy Life $46 - $75 48%
Mercyone Cedar Valley $46 - $75 48%
Meridian Complete $46 - $75 48%
Michigan Complete Health $46 - $75 48%
Nascentia Health Plus $46 - $75 48%
New Centry Health Careplus $46 - $75 48%
Osu Prime Care Advantage $46 - $75 48%
Pace Cny $46 - $75 48%
Pace Iowa Immanuel Pathways $46 - $75 48%
Pace Of Southwest Michigan $46 - $75 48%
Pace Southeast $46 - $75 48%
Pace-Trinity Health $46 - $75 48%
Peak Pace Solutions $46 - $75 48%
Perennial Advantage $46 - $75 48%
Preferred Care Partners $46 - $75 48%
Presbyterian Senior Plan $46 - $75 48%
Provider Partners Health Plan Of Illinois $46 - $75 48%
Provider Partners Health Plan Of Indiana $46 - $75 48%
Pruitthealth Premier $46 - $75 48%
Reliance Community Care Partners Care Resources Pace $46 - $75 48%
Rx Allwin $46 - $75 48%
Rx Grane Grnmedd $46 - $75 48%
Rx Retiree Rx Care $46 - $75 48%
Scan Health Plan Mcr Ipa Meritage Oon $46 - $75 48%
Secure Horizons Ma Pffs $46 - $75 48%
Serenity Pace $46 - $75 48%
Siouxland Pace $46 - $75 48%
Solis Health Plans $46 - $75 48%
Sunnyview-Pace Finance Dept $46 - $75 48%
Texan Plus $46 - $75 48%
The Health Plan $46 - $75 48%
Thome Pace $46 - $75 48%
Todays Options $46 - $75 48%
Tribute Health Plans $46 - $75 48%
Um Health Advantage $46 - $75 48%
Union Health Service $46 - $75 48%
UnitedHealthcare $46 - $143 48%
Welbe Health $46 - $75 48%
Wellmed $46 - $75 48%
Veterans Administration $47 - $76 49%
Albany County Correctional Facility $48 - $68 50%
Ambetter / Centene $48 - $68 50%
American Health Advantage Of Idaho $48 - $79 50%
Amish Mennonite $48 - $68 50%
Ascension St. Vincent Public Safety Medical $48 - $68 50%
Bcccp-Michigan $48 - $68 50%
Bccp $48 - $68 50%
Bmc Healthnet $48 - $68 50%
Breast Grant-Connecticut $48 - $68 50%
Broward County Dept Of Health $48 - $68 50%
California Health And Wellness $48 - $68 50%
Can Community Health Inc $48 - $68 50%
Cardinal Innovations Lme $48 - $68 50%
Care Connections Of Northern Iowa $48 - $68 50%
Care Oregon Ohp $48 - $68 50%
Cencal Health Plan $48 - $68 50%
Cenpatico $48 - $68 50%
Centurion Of Idaho $48 - $68 50%
Chhuny $48 - $68 50%
Childrens Comm Health Plan $48 - $68 50%
Childrens Medical Services Title 19 $48 - $68 50%
City Of Philadelphia $48 - $68 50%
Cmh Allegan County $48 - $68 50%
Cmh Ausable Valley $48 - $68 50%
Cmh Barry County $48 - $68 50%
Cmh Bay-Arenac County $48 - $68 50%
Cmh Berrien County $48 - $68 50%
Cmh Cass County $48 - $68 50%
Cmh Central Mi County $48 - $68 50%
Cmh Clinton-Eaton-Ingham County $48 - $68 50%
Cmh Detroit Wayne Integrated Health Network $48 - $68 50%
Cmh Genesee County $48 - $68 50%
Cmh Ionia County $48 - $68 50%
Cmh Jackson County/Lifeways $48 - $68 50%
Cmh Kalamazoo $48 - $68 50%
Cmh Kent County $48 - $68 50%
Cmh Lenawee County $48 - $68 50%
Cmh Livingston County $48 - $68 50%
Cmh Macomb $48 - $68 50%
Cmh Misc $48 - $68 50%
Cmh Monroe County $48 - $68 50%
Cmh Montcalm County $48 - $68 50%
Cmh Muskegon County $48 - $68 50%
Cmh Newaygo County $48 - $68 50%
Cmh North Country $48 - $68 50%
Cmh Northern Lakes County $48 - $68 50%
Cmh Oakland County $48 - $68 50%
Cmh Ottawa County $48 - $68 50%
Cmh Van Buren County $48 - $68 50%
Cmh Washtenaw County $48 - $68 50%
Cmh Wayne County/Carelink $48 - $68 50%
Cmh Wayne Cty/Com Liv Svcs $48 - $68 50%
Cmh West Mi County $48 - $68 50%
Community Benefit Health $48 - $68 50%
Community Care Behavorial Health $48 - $68 50%
Community Care Partners $48 - $68 50%
Community Health Choice $48 - $68 50%
Connections Csp $48 - $68 50%
County Coroner $48 - $68 50%
County Funding Generic $48 - $68 50%
Covid19 Hrsa Uninsured Testing And Treatment Fund $48 - $68 50%
Dean Wi Badgercare $48 - $68 50%
Delaware County Department Of Health $48 - $68 50%
Delaware First Health $48 - $68 50%
Delta Dental Nj $48 - $68 50%
Dph Tb Program $48 - $68 50%
Dscc $48 - $68 50%
Eastpointe Lme $48 - $68 50%
Family Health Network $48 - $68 50%
Freedom First Healthcare $48 - $68 50%
Fresno County Ccs $48 - $68 50%
Ghc Scw Wi Badgercare $48 - $68 50%
Harbor Health $48 - $68 50%
Health Safety Net $48 - $68 50%
Healthy Blue Ne $48 - $68 50%
Hennepin Health $48 - $68 50%
Id County Ada $48 - $68 50%
Id County Canyon $48 - $68 50%
Id County Cat Fund $48 - $68 50%
Id County Other $48 - $68 50%
Id County Payette $48 - $68 50%
Idaho Dept Health And Wellfare $48 - $68 50%
Idaho Womens Health Check $48 - $68 50%
Indiana Breast Cervical Cancer $48 - $68 50%
Inland Empire Health Plan $48 - $68 50%
Intercommunity Health Ohp $48 - $68 50%
Iowa Total Care $48 - $68 50%
Jai Medical System $48 - $68 50%
Kern Family Health Plan $48 - $68 50%
Keystone First $48 - $68 50%
Keystone First Chip $48 - $68 50%
La Care Health Plan $48 - $68 50%
Lakeland Care Inc $48 - $68 50%
Managed Health Services - Indiana $48 - $68 50%
Maryland Breast & Cervical Program $48 - $68 50%
Maryland Healthy Smiles - Scion Dental $48 - $68 50%
Maryland Physicians Care $48 - $68 50%
Massachusetts Behavioral Health Partnership $48 - $68 50%
Mdwise $48 - $68 50%
Medi-Cal $48 - $68 50%
Medi-Cal Healthnet $48 - $68 50%
Medstar Dc Healthy Family $48 - $68 50%
Medstar Md Health Choice $48 - $68 50%
Mo Home State Health Plan $48 - $68 50%
Molina Centennial Care $48 - $68 50%
Nascentia Health Options $48 - $68 50%
Nebraska Total Care $48 - $68 50%
New York Cancer Services Program $48 - $68 50%
Nextlevel Health $48 - $68 50%
Paramount Advantage $48 - $68 50%
Parkland Community Health Plan $48 - $68 50%
Partners Behavioral Lme $48 - $68 50%
Peach State Healthplan $48 - $68 50%
Philadelphia County Funding $48 - $68 50%
Presbyterian Centennial Care $48 - $68 50%
Prestige Health Choice $48 - $68 50%
Priority Partners $48 - $68 50%
Robert F Sing Program $48 - $68 50%
Rx 340B Pass Along $48 - $68 50%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $48 - $68 50%
Rx Medi-Cal $48 - $68 50%
Rx Meridian Rx $48 - $68 50%
Ryan White Florida Mssrp $48 - $68 50%
Sandhills Center Lme $48 - $68 50%
Screening For Life $48 - $68 50%
St Joseph County Hlth Dpt $48 - $68 50%
Stephenson Cty Health $48 - $68 50%
Sunshine State Health Plan $48 - $68 50%
Superior Health $48 - $68 50%
Tenncare $48 - $68 50%
Texas Children'S Health Plan $48 - $68 50%
Trillium Community Ohp $48 - $68 50%
Tufts Health Public Plans $48 - $68 50%
Vaya Health Lme $48 - $68 50%
Washtenaw Health Plan $48 - $68 50%
Wellsense Health Plan $48 - $68 50%
Wi Womens Wellness $48 - $68 50%
Champva $51 - $71 54%
Tricare $51 - $71 54%
Triwest Health Alliance $51 - $71 54%
Us Family Health Plan $51 - $71 54%
Veterans Eval Services $51 - $71 54%
Oregon Screenwise $69 - $73 72%
Healthnet $75 79%
Pacificsource Health Plans $79 - $149 83%
Webtpa $84 - $137 88%
First Choice Health $86 - $120 90%
Providence $86 - $153 90%
Molina Marketplace $91 - $149 96%
Geha $99 - $143 104%
Allied Benefit Systems $100 - $134 105%
Asr Health Benefits $100 - $134 105%
Boon Chapman $100 - $134 105%
Christian Brother Services $100 - $134 105%
Healthscope $100 - $134 105%
Luminare Health (Detroit) $100 - $134 105%
Meritain $100 - $134 105%
Rural Carrier Health Benefit Plan $100 - $134 105%
Allegiance $102 - $143 107%
Asuris Northwest Health $107 - $147 112%
Blue Shield - Id (Regence) $107 - $159 112%
Healthcare Management Admin $107 - $147 112%
Moda Health $118 - $188 124%
Mountain Health Co-Op $118 - $159 124%
Selecthealth $118 - $198 124%
Andrie Inc $119 - $191 125%
East Greenbush Central School District $119 - $191 125%
Genex Wc $119 - $191 125%
Healthsmart Workers Comp $119 - $191 125%
Jag Source $119 - $191 125%
New York State Insurance Fund $119 - $191 125%
Njm Insurance Group $119 - $191 125%
Rx Heatlhcomp $119 - $191 125%
Rx Restat $119 - $191 125%
Rx Saif Opdp Wc $119 - $191 125%
Rx Worker'S Comp $119 - $191 125%
Wc Accident Fund $119 - $191 125%
Wc Ace $119 - $191 125%
Wc Acs Federal Employees $119 - $191 125%
Wc Acuity $119 - $191 125%
Wc Advantage $119 - $191 125%
Wc Aegis $119 - $191 125%
Wc Aig $119 - $191 125%
Wc Aims $119 - $191 125%
Wc Alaska National Ins $119 - $191 125%
Wc Align Network $119 - $191 125%
Wc Allied $119 - $191 125%
Wc Am Trust N America $119 - $191 125%
Wc American Claims Mgmt $119 - $191 125%
Wc Amerisure $119 - $191 125%
Wc Amtrust $119 - $191 125%
Wc Asu Risk Mgt $119 - $191 125%
Wc Benetech $119 - $191 125%
Wc Berkley Admin $119 - $191 125%
Wc Broadspire $119 - $191 125%
Wc Broward County $119 - $191 125%
Wc Bunch & Associates $119 - $191 125%
Wc California State Comp Ins $119 - $191 125%
Wc California State Ins Fund $119 - $191 125%
Wc Capitol Area Health Consortium $119 - $191 125%
Wc Ccmsi $119 - $191 125%
Wc Chartis $119 - $191 125%
Wc Chubb $119 - $191 125%
Wc Cirma $119 - $191 125%
Wc City Of Albany $119 - $191 125%
Wc City Of Sioux City $119 - $191 125%
Wc Claims Mgmt Inc $119 - $191 125%
Wc Cna $119 - $191 125%
Wc Comp One Admin C/O Manageability $119 - $191 125%
Wc Compone Admin $119 - $191 125%
Wc Corvel $119 - $191 125%
Wc Ct Healthcare Trust $119 - $191 125%
Wc Donegal Insurance Group $119 - $191 125%
Wc Emc Insurance Company $119 - $191 125%
Wc Employee Mutual $119 - $191 125%
Wc Enablecomp $119 - $191 125%
Wc Encore Health Network $119 - $191 125%
Wc Erie $119 - $191 125%
Wc Esis $119 - $191 125%
Wc Evolutions $119 - $191 125%
Wc Fcci $119 - $191 125%
Wc Fed Ex $119 - $191 125%
Wc Federal Black Lung $119 - $191 125%
Wc Federated $119 - $191 125%
Wc Finley Occupational Health $119 - $191 125%
Wc First Agency/Occunet $119 - $191 125%
Wc Ford Motor $119 - $191 125%
Wc Fresno Unified Emp $119 - $191 125%
Wc Gallagher Bassett $119 - $191 125%
Wc General Motors $119 - $191 125%
Wc Generic $119 - $191 125%
Wc Genex Care For Ohio $119 - $191 125%
Wc Great West Casualty $119 - $191 125%
Wc Guarantee Insurance $119 - $191 125%
Wc Guard Insurance Company $119 - $191 125%
Wc Hab $119 - $191 125%
Wc Hartford $119 - $191 125%
Wc Hastings $119 - $191 125%
Wc Health Management $119 - $191 125%
Wc Heritage Summit $119 - $191 125%
Wc Hireright $119 - $191 125%
Wc Horizon $119 - $191 125%
Wc Icw Group $119 - $191 125%
Wc Idaho State Ins Fund $119 - $191 125%
Wc Intercare Insurance $119 - $191 125%
Wc Intermountain $119 - $191 125%
Wc Johns Eastern $119 - $191 125%
Wc Kemberton $119 - $191 125%
Wc Key Ins & Benefit Solutions $119 - $191 125%
Wc Liberty Mutual $119 - $191 125%
Wc Mac Risk Management $119 - $191 125%
Wc Massachusetts $119 - $191 125%
Wc Mdia $119 - $191 125%
Wc Meadowbrook Claim $119 - $191 125%
Wc Medical Administrators $119 - $191 125%
Wc Meijers $119 - $191 125%
Wc Memic $119 - $191 125%
Wc Mercy Workcare $119 - $191 125%
Wc Michigan $119 - $191 125%
Wc Michigan Millers Mutual $119 - $191 125%
Wc Mitchell Frankenmuth $119 - $191 125%
Wc Mra $119 - $191 125%
Wc Nationwide $119 - $191 125%
Wc Nca Comp $119 - $191 125%
Wc New York $119 - $191 125%
Wc New York Special Funds $119 - $191 125%
Wc North American Rishces $119 - $191 125%
Wc Northeast Health $119 - $191 125%
Wc Notre Dame $119 - $191 125%
Wc Novanet $119 - $191 125%
Wc O'Hara Corp $119 - $191 125%
Wc Occ Health Allen $119 - $191 125%
Wc Ohio Bureau $119 - $191 125%
Wc One Call Medical $119 - $191 125%
Wc Paradigm $119 - $191 125%
Wc Peerless $119 - $191 125%
Wc Pma $119 - $191 125%
Wc Praxis Health Network $119 - $191 125%
Wc Price Chopper $119 - $191 125%
Wc Procura Management $119 - $191 125%
Wc Qualcare $119 - $191 125%
Wc Quiktrip $119 - $191 125%
Wc Reny Company $119 - $191 125%
Wc Rev Claims $119 - $191 125%
Wc Risico $119 - $191 125%
Wc Rural Mutual $119 - $191 125%
Wc Saif Oregon $119 - $191 125%
Wc Secura $119 - $191 125%
Wc Sedgwick $119 - $191 125%
Wc Sentry $119 - $191 125%
Wc Sheakley Unicomp $119 - $191 125%
Wc Smile Lodge $119 - $191 125%
Wc Society $119 - $191 125%
Wc Srs $119 - $191 125%
Wc Taconic (Mro) $119 - $191 125%
Wc Taconic Farms $119 - $191 125%
Wc Travelers $119 - $191 125%
Wc Triad Group $119 - $191 125%
Wc Tristar $119 - $191 125%
Wc Troy Ny $119 - $191 125%
Wc Tyson $119 - $191 125%
Wc Unified Health Services $119 - $191 125%
Wc United Heartland $119 - $191 125%
Wc Us Dept Of Labor $119 - $191 125%
Wc Velocity $119 - $191 125%
Wc Walmart $119 - $191 125%
Wc West Bend $119 - $191 125%
Wc West Bend Mutual/Argent $119 - $191 125%
Wc Winnebago Industries $119 - $191 125%
Wc Yankee Trails $119 - $191 125%
Wc York Risk $119 - $191 125%
Wc Zenith $119 - $191 125%
Wc Zurich $119 - $191 125%
Allied National Global Care $120 - $172 126%
Asrm - Reliance Standard Life Insurance $120 - $172 126%
Christian Care Ministry $120 - $172 126%
Dean Health $120 - $172 126%
Fallon Health $120 - $172 126%
Family Life Insurance Company $120 - $172 126%
Ghc Scw $120 - $172 126%
International Benefit Administrators $120 - $172 126%
Lifetime Benefit Solutions $120 - $172 126%
Manhattan Life $120 - $172 126%
Medi Share $120 - $172 126%
Multiplan $120 - $172 126%
Pai $120 - $172 126%
Pan-American Life $120 - $172 126%
Paramount Hmo $120 - $172 126%
Phcs $120 - $172 126%
Trinity Health Share $120 - $172 126%
Health Plans Inc $126 - $168 132%
Ms Administrative Services $126 - $168 132%
St Lukes Health Plan $131 - $188 138%
Bcn Domestic $134 - $185 141%
Blue Benefit Administrators Of Massachusetts $134 - $185 141%
Blue Care Network $134 - $185 141%
Blue Distinction Transplant $134 - $185 141%
Blue Shield - Ca $134 - $185 141%
Blue Shield - Ny Highmark Northeastern $134 - $185 141%
Blue Shield - Ny Highmark Western $134 - $185 141%
Blue Shield - Pa (Highmark) $134 - $185 141%
Blue Shield - Wa (Regence) $134 - $185 141%
Health Choices $134 - $185 141%
Kaiser Domestic $134 - $185 141%
Pre-Employment $134 - $185 141%
Wc Domestic $134 - $185 141%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1055 North Curtis Road, Boise, ID 83706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals