Office visit, established patient (20-29 min)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $54 compared to the $62 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.87× fair market pricing.
A typical price — 2 charge more and 5 charge less, among the 9 KS hospitals compared.
Black dot = this hospital, among the 9 KS hospitals with a price for this procedure. Full list below.
A fair price for a Office visit, established patient (20-29 min) is about $62 (about 0.7× the $95 Medicare rate). Mercy Hospital Pittsburg, Inc charges insurers about $54, or about $127 in cash — below the fair price — a good deal. Located in Pittsburg, KS.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 of 6 major insurers have a published price at this hospital
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 | $56 - $166 | 59% |
| Blue Cross Blue Shieldmajor | $54 - $157 | 57% |
| Aetnamajor | $54 - $210 | 57% |
| Cignamajor | $85 - $190 | 89% |
| Humanamajor | $54 - $80 | 57% |
| Ambetter (Centene) | $94 | 99% |
| HealthLink | $98 - $198 | 103% |
| Medica | $45 - $90 | 47% |
| + 23 smaller / regional plans | $54 - $198 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Mercy Hospital Pittsburg, Inc
Compare: Office visit, established patient (20-29 min) at other KS hospitals
- Hamilton County Hospital · Syracuse $38
- Stevens County Hospital · Hugoton $38
- Holton Community Hospital · Holton $47
- Kansas Heart Hospital · Wichita $50
- Smith County Memorial Hospital · Smith Center $53
- Wesley Medical Center · Wichita $54
- Kansas Spine & Specialty Hospital, LLC · Wichita $55
- Mercy Specialty Hospital Southeast Kansas · Galena $55
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Mercy Hospital Pittsburg, Inc (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $71
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $71).
Self-Pay Cash Rate ($127) Beats Your Bill
Mercy Hospital Pittsburg, Inc's published 45 CFR § 180 self-pay cash rate is $127 (vs. $54 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $62 Fair BaseRate ($95 Medicare)
Your bill ($195) is $133 above the denoised Fair BaseRate ($62) and 2.1× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.