CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Sarah Bush Lincoln Health Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $109
  • Cash Discount Price: $139
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Sarah Bush Lincoln Health Center is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.15x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$139

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $139 (146%)
Insurance Median: $109 (115%)
Cash: $139 (146% of Medicare)
Ins. Median: $109 (115% 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
Plain Church Mg-All Plans $51 - $60 54%
Aetna $58 - $135 61%
Bc Comm Mmai $58 61%
Beacon Health Options Behav-All Plans $58 61%
Hlth Alliance Mcr Adv $58 61%
Humana $58 - $59 61%
Mennonite-All Plans $58 - $68 61%
Meridian Mmai-All Other Plans $58 61%
Molina Mmai-All Other Plans $58 61%
Tricare $58 61%
UnitedHealthcare $58 - $124 61%
Va Ccn-All Plans $58 61%
Wellcare Med Adv-All Plans $58 61%
Bc Med Adv Ppo/Hmo $60 63%
Eiu Athlete-All Other Plans $90 - $105 95%
Healthscope-All Plans $95 - $111 100%
Rural King-All Plans $95 - $111 100%
Blue Cross Blue Shield $101 - $120 106%
Consociate-All Plans $102 - $120 107%
Hope Trust-All Plans $102 - $120 107%
Eiu Student $105 - $123 110%
Allied National-All Plans $108 - $126 113%
Companion Life-All Plans $108 - $126 113%
Hlth Alliance-All Other Plans $108 - $126 113%
First Health-All Plans $109 - $128 115%
Innovative Hlthware-All Plans $109 - $128 115%
Healthlink Hmo $110 - $129 116%
Healthlink Ppo - All Other Plans $110 - $129 116%
Multiplan-All Plans $110 - $129 116%
Cigna $115 - $135 121%
Cphp-All Plans $115 - $135 121%
Beech Street-All Plans $118 - $138 124%
Hfn-All Plans $118 - $138 124%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals