CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: West Carroll Memorial Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $74
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at West Carroll Memorial Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.78x the Medicare baseline. Located in 706 Ross Street, Oak Grove, LA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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%)
Insurance Median: $74 (78%)
Ins. Median: $74 (78% 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
Boon Chapman-Icl 1136 $11 12%
Ambetter / Centene $37 39%
Aetna $38 - $55 40%
Louisiana Healthcare Connections $38 40%
Medicaid / KanCare $38 - $53 40%
Amerihealth Caritas Louisiana $42 44%
International Benefits Administrators $51 54%
Bankers Life And Casualty Company $53 56%
Omaha Insurance Company $55 58%
United Of Omaha Life Insurance Company $55 58%
Cno (Key Bank) $62 65%
United World Life Insurance Company $62 65%
Golden Rule Insurance Company $65 68%
UnitedHealthcare $65 - $263 68%
Auxiant $73 77%
Physicians Mutual Insurance Company $74 78%
Mutual Of Omaha Companies Claims Department $78 82%
Cigna $79 83%
Blue Cross Blue Shield $84 88%
Fep $84 88%
Fep Postal $84 88%
Hmo Of Louisiana $84 88%
Humana $177 186%
Christian Care Medi-Share $189 199%
Healthy Blue $200 210%
Administrative Concepts Inc $224 235%
Ameriben Solutions $224 235%
Insurance Systems Inc $224 235%
Allied Benefit - Aso $263 276%
Blue Advantage $263 276%
Medicare (plans) $263 276%
Novitas Solutions $263 276%
Tricare $263 276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 706 Ross Street, Oak Grove, LA 71263
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals