Office visit, established patient (20-29 min)
Facility: The Women's Hospital
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $70
- Cash Discount Price: $60
- vs. Medicare Baseline: 0.74x 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 |
|---|---|---|
| Aetna | $40 - $103 | 42% |
| Humana | $40 - $61 | 42% |
| Passport Molina Ky | $40 | 42% |
| UnitedHealthcare | $40 - $84 | 42% |
| Wellcare Ky | $40 - $61 | 42% |
| Blue Cross Blue Shield | $45 - $91 | 47% |
| Meridian Health Il | $45 - $61 | 47% |
| Molina Il | $45 - $61 | 47% |
| Amish | $60 | 63% |
| Self Pay | $60 | 63% |
| Caresource | $61 | 64% |
| Iu Health | $61 | 64% |
| Mhs | $61 | 64% |
| Molina Ky | $61 | 64% |
| Molina Ky Dual | $61 | 64% |
| One Care | $64 | 67% |
| Ambetter / Centene | $70 | 74% |
| Chamber Care | $70 | 74% |
| Immergrun | $73 | 77% |
| Patoka Valley Health Care (80/20 Plan) | $73 | 77% |
| Patoka Valley Health Care (90/10 Plan) | $73 | 77% |
| Caresource Marketplace (Just4Me) | $79 | 83% |
| Hst | $82 | 86% |
| Alliance Coal | $84 | 88% |
| Caresource Hip | $84 | 88% |
| Caresource In | $84 | 88% |
| Mdwise Hip | $84 | 88% |
| Mhs Behavioral | $84 | 88% |
| Allied National/Zelis - Freedom Plan | $85 | 89% |
| Claimdoc | $88 | 92% |
| Hope Trust | $97 | 102% |
| Noncontracted | $97 | 102% |
| Encorecombined | $99 | 104% |
| Encoreprime | $99 | 104% |
| Center Care | $102 | 107% |
| Cigna | $103 | 108% |
| Claritev (Formerly Phcs/Mulitplan) | $103 | 108% |
| First Health/Coventry | $103 | 108% |
| Healthlink | $103 | 108% |
| Sagamore | $103 | 108% |