CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Perry County Memorial Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $140
  • Cash Discount Price: $158
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Perry County Memorial Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.47x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.
Cash / Self-Pay
$158

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

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: $158 (166%)
Insurance Median: $140 (147%)
Cash: $158 (166% of Medicare)
Ins. Median: $140 (147% 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 $52 - $226 55%
Veterans Administration $56 - $226 59%
Bc 130 $59 - $181 62%
Group Insurance $59 - $226 62%
Medicare (plans) $59 62%
Workers Compensation $113 119%
Nsa $133 - $140 140%
Guarantor Liable $158 - $226 166%
Pcmh Insurnace $176 - $226 185%
Secondary Insurance $181 190%
UnitedHealthcare $181 190%
Operating Engineers $192 202%
Boilermakers Healthcare $197 207%
Cigna $197 207%
Great West $197 - $226 207%
Sagxxxx $197 207%
Champus $226 237%
Ngs American, Inc $226 237%
Patoka Valley $226 237%
Southwire $226 237%
Tricare $226 237%
Wausau Benefits $226 237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8885 Sr 237, Tell City, IN 47586
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals