Office visit, established patient (20-29 min)
Facility: Bluffton Regional Medical Center
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $80
- Cash Discount Price: $55
- vs. Medicare Baseline: 0.84x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Lutheran Preferred Network | $10 - $212 | 11% |
| Cigna | $11 - $94 | 12% |
| Php | $11 - $84 | 12% |
| Php Freedom Network | $11 - $83 | 12% |
| Aetna | $13 - $118 | 14% |
| Lutheran Trma | $14 - $119 | 15% |
| Php Management Systems | $14 - $103 | 15% |
| UnitedHealthcare | $16 - $124 | 17% |
| Encore Ppo | $17 - $130 | 18% |
| Sagamore Sebt | $18 - $135 | 19% |
| Sagamore Health Newtork Inc | $19 - $142 | 20% |
| Self Pay | $19 - $146 | 20% |
| Consumer Life | $22 - $164 | 23% |
| Ahg Dana Employees | $23 - $172 | 24% |
| Align Networks | $24 - $186 | 25% |
| Amish Aid | $24 - $64 | 25% |
| Physicians Health Plan | $24 - $64 | 25% |
| Prime Health Services | $26 - $199 | 27% |
| Private Healthcare Systems Inc | $26 - $199 | 27% |
| Multiplan | $28 - $212 | 29% |
| Advantage 360 | $29 - $220 | 30% |
| Encore Health Network | $29 - $238 | 30% |
| Community Health Alliance | $30 - $225 | 32% |
| First Health | $30 - $228 | 32% |
| Allied Benefit Systems | $32 - $238 | 34% |
| Cardinal Health Alliance | $32 - $238 | 34% |
| Ppom | $32 - $238 | 34% |
| Veterans Eval Services | $35 - $84 | 37% |
| Bccp | $71 | 75% |