CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Tug Valley Arh Regional Medical Center

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$59

about 0.6× the $95 Medicare rate · typically $49–$85

modeled estimate · not a bill or quote

What this hospital charges insurers

$56

About the fair price

about $3 under the fair price · 0.6× Medicare

Medicare pays $95 Fair price $59 This hospital $56 Cash price $136 Hospital's list price $227

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

One of the lower prices — 0 of 8 other KY hospitals charge more for the same procedure.

Cheapest $42 Priciest $56

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $59 (about 0.6× the $95 Medicare rate). Tug Valley Arh Regional Medical Center charges insurers about $56, or about $136 in cash — about the fair price. Located in South Williamson, KY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

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	$53 - $373	56%
Blue Cross Blue Shieldmajor	$35 - $455	37%
Aetnamajor	$11 - $468	12%
Humanamajor	$11 - $80	12%
Molina	$35 - $80	37%
WellCare	$17 - $120	18%
+ 2 smaller / regional plans	$44 - $312

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 136), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Tug Valley Arh Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Tug Valley Arh Regional Medical Center

Compare: Office visit, established patient (20-29 min) at other KY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.