CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Clay County Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$82
about 0.9× the $95 Medicare rate · typically $52–$188
modeled estimate · not a bill or quote
What this hospital charges insurers
$70
Below the fair price — a good deal
about $12 under the fair price · 0.7× Medicare
Medicare pays $95 Fair price $82 This hospital $70 Cash price $157 Hospital's list price $157

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $48 Priciest $70

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $82 (about 0.9× the $95 Medicare rate). Clay County Hospital charges insurers about $70, or about $157 in cash — below the fair price — a good deal. Located in Flora, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $42 - $126 44%
Blue Cross Blue Shieldmajor $70 - $115 74%
Aetnamajor $42 - $124 44%
Cignamajor $126 132%
Ambetter (Centene) $42 44%
HealthLink $102 - $126 107%
Medica $42 - $97 44%
Meridian $42 44%
WellCare $42 44%
+ 1 smaller / regional plan $149

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 911 Stacy Burk Dr, Flora, IL 62839
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals