Office visit, established patient (20-29 min)
Facility: Mitchell County Hospital Health Systems
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $96
- Cash Discount Price: $104
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| First Health-All Plans | $28 - $137 | 29% |
| Aetna | $28 - $137 | 29% |
| Triwest Well Mark All Plans | $28 - $138 | 29% |
| UnitedHealthcare | $31 - $154 | 33% |
| Blue Cross Blue Shield | $38 | 40% |
| Auxiant-All Plans | $80 - $96 | 84% |
| Pref Hlth Care Sytms Comm - All Plans | $91 | 96% |
| Health Partners Ks-All Plans | $93 - $100 | 98% |
| Multiplan Ppo - All Plans | $96 | 101% |
| Phc Leased Ntwrk Access - All Plans | $96 | 101% |
| Cigna | $100 | 105% |
Consumer Guidance & Cost Commentary
This CPT code represents an office visit for an established patient lasting between 20 and 29 minutes at Mitchell County Hospital Health Systems in Beloit, Kansas. The facility's cash median rate is $104.00, while the median negotiated rate paid by insurance plans is $96.00. For patients with high-deductible plans, paying the cash price of $104.00 upfront may be more cost-effective than using insurance, as the negotiated rate of $96.00 often exceeds the cash price due to administrative overhead. It is important to note that the cash rate is slightly lower than the gross charge of $115.00, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially reduce this amount further.
The facility is a Critical Access Hospital with government-local ownership, and its pricing is benchmarked against Medicare, which sets the standard for fair cost. The Medicare amount for this service is $95.19, and the facility's cash rate of $104.00 is very close to this benchmark, indicating a transparent pricing structure. While the data does not provide specific state or county average comparisons for this exact procedure, the facility's rates are consistent with the national standard for Critical Access Hospitals. To ensure you receive the most accurate pricing, always request an itemized bill before paying, as summary bills can obscure individual charges, and consider asking for a prompt-pay discount if you are paying in full.