CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Bayou Bend Health System

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $106
Cash Discount Price: $109
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Bayou Bend Health System is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.11x the Medicare baseline. Located in 1097 Northwest Blvd, Franklin, LA.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $109 (115%)

Insurance Median: $106 (111%)

Cash: $109 (115% of Medicare)

Ins. Median: $106 (111% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$32 - $110	34%
Tricare	$70	74%
UnitedHealthcare	$73 - $78	77%
Aetna	$78 - $106	82%
Dignity Mcr Adv Ip/Op Only-All Plans	$78	82%
Humana	$78 - $101	82%
Sterling Hp Mcr Adv Ip/Op Only-All Plans	$78	82%
Verity Healthnet Mcr Adv Ip/Op Only	$78	82%
Wellcare Mcr Allwell Ip/Op Only-All Plans	$78	82%
Ambetter / Centene	$90	95%
Amerihealth Caritas Mcaid Ip/Op Only-All Plans	$110	116%
La Health Mcaid Ip/Op Only	$110	116%
Verity Healthnet Mcaid Ip/Op Only	$110	116%
Diocese Of Lafaytte Ip/Op Only-All Plans	$117	123%
Gilsbar 360 Ip/Op Only-All Plans	$117	123%
Verity Healthnet Ip/Op Only-All Other Plans	$117	123%
Ccn/First Health Ip/Op Only-All Plans	$125	131%
Integrated Hp Multiplan Ip/Op Only-All Plans	$125	131%
Ppo Plus / Zelis Ip/Op Only-All Plans	$125	131%
Geha Ppo Ip/Op Only-All Plans	$133	140%
Usa Mco Ip/Op Only-All Plans	$133	140%
Galaxy Ip/Op Only-All Plans	$140	147%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $109.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Bayou Bend Health System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.